Review of Writing On The Wind’s Wall: Dialogues About ‘Medical Assistance In Dying’ by Kevin Andrew Heslop (ed) (2026)

Denise Koster

koster [at] istar [dot] ca

The Writing on the Wind's Wall: Dialogues about ‘Medical Assistance in Dying,’ written by theatre-trained poet Kevin Andrew Heslop, is an assembly of seventeen dialogues questioning the ethical, social, political, and personal components of Medical Assistance in Dying (MAiD). Through bringing together voices from disability studies, medicine, advocacy, and higher education, Heslop approaches MAiD not merely as a legal or medical issue but as an examination into human dignity and justice in a democratic society. Through informal conversations, he creates a comfortable space where diverse perspectives contest one another, producing a compelling portrait of Canadians with lived experience of MAiD grappling with one of the country's most significant public controversies.

The interviewees fall into several thematic groupings that illuminate debates surrounding assisted dying. Scholars and public intellectuals examine disability, higher education, technology, and public policy while emphasizing that disability is shaped as much by institutional structures and public attitudes as by medical conditions. Jeff Preston, an Associate Professor of Disability Studies who lives with neuromuscular myopathy, argues that accessibility begins by consulting disabled people about their lived experiences rather than imposing assumptions about independence or accommodation. His reflections exemplify the disability studies critique that inclusion depends on dialogue rather than paternalism.

Throughout Heslop's interviews, rather than reducing MAiD to constitutional or legislative questions, these discussions situate it within broader debates about disability, vulnerability, caregiving, and collective responsibility. Alex Schadenberg, Director of the Euthanasia Prevention Coalition, argues that contemporary concerns about eugenics emerge less through overt coercion than through cultural discomfort with dependency and frailty, suggesting that attitudes toward disability shape perceptions of whose lives are valued. In contrast, René D., whose father chose a medically assisted death, argues that compassion includes respecting requests to relieve intolerable suffering. Ron Posno, a retired educator living with dementia, argues that disability often reflects social perception more than objective reality, illustrating how language shapes understandings of human worth and capability. Together, these opposing perspectives shift attention from abstract debates about autonomy to the social conditions within which end-of-life choices are made.

Spirituality, and resilience emerge in conversations with Indigenous dual-spirited tarot reader Nyxx Noir, in collaboration with retired educator Sheri Knott, and the represented reflections of her late husband, Roger Knott. Rather than sentimentalizing illness or grief, Heslop allows participants to describe caregiving, identity, and loss in their own terms. Roger Knott's posthumous reflections on choosing MAiD emphasize preserving dignity, memory, and relationships amid progressive suffering, deepening the collection's exploration of the existential dimensions of dying.

Heslop's work is particularly timely as Canada continues to debate expanding MAiD eligibility to individuals whose sole underlying condition is ‘mental illness.’ Echoing disability scholarship, several participants argue that suffering often arises from inaccessible environments, inadequate healthcare, poverty, and social isolation as much as from illness itself. Mohamad Elfakhani, Chief of Psychiatry at London Health Sciences Centre, explains that psychiatric MAiD requests present uniquely difficult clinical and ethical challenges because mental illnesses often involve fluctuating symptoms, impaired judgment, and uncertain prognoses. Reverend Matt Arguin similarly argues that although MAiD legislation emerged from compassionate intentions, its implementation has produced injustices that are difficult to reverse. Together, these perspectives ask whether Canadian society has made life genuinely livable before expanding access to medically assisted death.

One of the volume's greatest strengths lies in Heslop's methodology as an interviewer. Despite his lived experience of MAiD twice in his lifetime, he is committed to what he describes as taking "no position" because he is "here to listen," whereby privileging attentive listening over authorial intervention. Moreover, Heslop allows participants' perspectives to unfold on their own terms, permitting uncertainty, disagreement, and complexity to remain visible, enhancing the collection's credibility by resisting artificial consensus.

The collection's principal limitation lies in the composition of its contributors. Although it brings together diverse professions and viewpoints, it offers comparatively limited religious and ethnocultural diversity. Greater engagement with Indigenous epistemologies alongside Muslim, Jewish, Hindu, Sikh, Buddhist, and other religious traditions would have enriched discussions of disability, suffering, autonomy, compassion, and moral responsibility by introducing alternative understandings of personhood and community.

Nevertheless, this limitation does not diminish the collection's considerable achievements. The Writing on the Wind's Wall succeeds because it refuses to reduce MAiD to a binary conflict between supporters and opponents. Instead, Heslop engages in thoughtful conversations that illuminate ethical tensions, lived experience, and structural inequalities. By foregrounding personal experience without sacrificing intellectual rigour, the collection exemplifies how public discourse benefits when difficult questions are approached through sustained dialogue rather than ideological certainty.

Ultimately, Heslop’s work poses a profound question, without explicitly stating it: what kind of society emerges when its legal capacity to end suffering advances more rapidly than its collective capacity to alleviate it? Most importantly, Heslop wisely avoids imposing a definitive conclusion, allowing the interviews to return to the enduring ethical question invoked by interviewee Death Doula Jayne Dill through the words of Sue Rodriguez: "Whose life is it?"