Health Equity and Access

Legalisation does not automatically produce patient access. The health equity domain of the framework assesses explicit access and inclusion policies, disparity monitoring, and mitigation mechanisms. The central implementation challenge is the gap between statutory rights and clinical enactment. Questionnaires will be written in plain English with a short glossary, and readability will be checked using the Flesch Reading Ease score. Because the Delphi process is fully online, participation may be biased toward settings and stakeholders with greater digital maturity and capacity. Rural communities and communities served by objecting institutions faced disproportionate access barriers for MAiD and abortion. Health inequity is described as an observed unintended consequence of implementation. Lack of universal coverage was cited in 32% of studies. Patient advocates are included as one of the six Delphi stakeholder groups and will help refine domains, maturity descriptors, and dissemination outputs.