Medical assistance in dying for mental illness as a sole underlying medical condition (MAiD MI-SUMC) is a controversial and complex policy in terms of psychosocial and ethical medical practice implications. We discuss the status of MAiD MI-SUMC in Canada and argue for the use of the UK Medical Research Council's framework on complex interventions in programme evaluations of MAiD MI-SUMC. It is imperative to carefully and rigorously evaluate the implementation of MAiD MI-SUMC to ensure an understanding of the multiple facets of implementation in contexts permeated by unique social, economic, cultural and historical influences, with a correspondingly diverse array of outcomes. This requires a complexity-informed programme evaluation focused on context-dependent mechanisms and stakeholder experiences, including patients, service providers and other people affected by the policy. It is also important to consider the economic impact on health and social welfare systems. Such evaluations can provide the data needed to guide evidence-informed decision-making that can contribute to safer implementation and refinement of MAiD MI-SUMC.

就心理社会和道德医疗实践影响而言，因精神疾病死亡作为唯一基础疾病的医疗援助（MAiD MI-SUMC）是一项有争议且复杂的政策。我们讨论了 MAiD MI-SUMC 在加拿大的地位，并主张在 MAiD MI-SUMC 项目评估中使用英国医学研究委员会的复杂干预框架。必须仔细、严格地评估 MAiD MI-SUMC 的实施情况，以确保了解在独特的社会、经济、文化和历史影响的背景下实施的多个方面，并产生相应不同的结果。这需要进行基于复杂性的项目评估，重点关注上下文相关的机制和利益相关者的经验，包括患者、服务提供者和其他受政策影响的人。考虑对健康和社会福利系统的经济影响也很重要。此类评估可以提供指导循证决策所需的数据，从而有助于更安全地实施和完善 MAiD MI-SUMC。