Accepted for/Published in: JMIR Research Protocols
Date Submitted: Oct 20, 2025
Date Accepted: Mar 18, 2026
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Factors associated with the evolution in the use of Medical Assistance in Dying: a scoping review protocol
ABSTRACT
Background:
As of June 2025, Medical Assistance in Dying (MAiD) is allowed in over 25 jurisdictions across 12 countries, with varying rates of requests and provisions. Hypotheses have been suggested to explain these variations, but they are rarely backed up by empirical evidence. As more jurisdictions consider legalizing MAiD, it is important to better understand what factors may explain the evolution in the use of MAiD around the world with a systematic approach.
Objective:
This scoping review aims to map the available evidence regarding the factors associated with the evolution in the use of MAiD in jurisdictions where such practices are allowed.
Methods:
The scoping review will follow the Joanna Briggs Institute (JBI) methodology and the PRISMA-ScR guidelines. Ten electronic databases (including MEDLINE, Embase, CINAHL Complete, and APA PsycInfo) and additional grey literature sources will be searched from inception to present. This scoping review will consider multiple types of publications (eg, primary studies, research syntheses, government reports) reporting factors associated with the use of MAiD for people who have requested or died by MAiD in jurisdictions that have allowed it for at least 5 years. Publications in English, French, Spanish, German, or Dutch will be included. Screening for assessment against the inclusion criteria and data extraction will be carried out independently by pairs of reviewers. Findings will be presented in a narrative format, mapped into tables and graphs, and thematically synthetized to address the review aims.
Results:
The database search for scientific publications was completed on March 2025. A total of 8570 publications were identified after removing duplicates. As of October 2025, title and abstract screening is complete, with 216 articles retained for the next stage. The full-text review is underway, and results are expected to be submitted for publication in 2026.
Conclusions:
MAiD is gaining legal and policy attention globally, with wide variation in rates of request and provision over time across jurisdictions. This scoping review will contribute to mapping and synthesizing evidence on the factors that may explain these variations. Clinical Trial: OSF Registries osf.io/tknam ; https://osf.io/tknam
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