As the first day of my visit to Canada starts, the view from my window shows the sun lighting up the Toronto skyline. I last visited Toronto around Christmas 2019 which seems a lifetime ago - mostly because of the COVID pandemic which hit shortly afterwards. Many of the sights and landmarks in Toronto seem familiar - but also  different (they were also covered in snow last time I saw them) and I am looking forward to exploring them again over the next week.

I also have my first meetings with researchers based in and around Toronto and am very much looking forward to discussing issues around ethics, consent, inclusion of under-served groups, and how best to ensure that research actually benefits the populations who are most in need of evidence-based care. I am looking forward to understanding more about research governance in Canada and whether issues that arise around capacity and consent in the UK are experienced (or not) in the provinces and territories here. This all offers an opportunity to explore whether advance research planning may help bridge the gap between arrangements for people to make their wishes known about their future care and treatment, and people being able to express their wishes about future research participation.

I am also looking forward to a visit to Kingston in the coming days, and seeing the place where "history and innovation thrive". It will also be an opportunity to see a snowier skyline!

As January approaches its end, and after what feels like a year of waiting, I have arrived in Canada for the first leg of my Churchill Fellowship research visits. One of my first sights on arrival in a chilly Toronto was the Great Hall at the heart of Union Station. It is currently part way through restoration works, but its Beaux-Arts architectural features show how it was intended to be an important part of the 'new vision' for Toronto when it was built after the Great Fire in 1904. The vaulted ceiling is particularly striking, with the provincial flags of Canada lining the wall below. The flags reminded me about one of the reasons for visiting Canada as part of my Churchill Fellowship exploring advance research planning - which is that Canada's legal system  with a combination of common law and civil law provides an interesting perspective on health law, alongside its universal health care system, and the differences between provinces and territories in both health and law. 

My visit to Canada will include two neighbouring provinces - Ontario and Quebec - and I am fortunate to have the opportunity to talk to experts in health law, bioethics, clinical trials, advance care planning, clinical care and social work in both. I am looking forward to hearing more about the wider context in which Canadian healthcare and research is organised and delivered, as well as from researchers who have explored advance research planning, in order to understand more about how advance research planning might (or might not) be successfully implemented in the UK.

​I am immensely grateful for their warm welcome - even if the weather is fairly chilly!