Understanding How Canadian Physicians and Public Stakeholders Rationalize MAiD Amid Bill C-7: A Critical Analysis
DOI:
https://doi.org/10.7202/1124208arKeywords:
palliative care, qualitative methods, medical assistance in dying, MAiD, Bill C-7, Canada, physician perspectives, public opinionLanguage(s):
EnglishAbstract
Despite its legalization, the ethics of medical assistance in dying (MAiD) remain contentious due to an evolving eligibility criteria goalpost and the subsequent implications for individuals suffering from non-terminal conditions, namely mental illness. Given the expanding availability of MAiD, comparing societal narratives with those of physicians is important to inform the development of health policies and laws that reflect a variety of stakeholder values and concerns. This paper presents a critical qualitative analysis of two types of data: 1) interview responses from Canadian physicians regarding the practice of MAiD, and 2) Canadian digital news media, with the goal of determining areas of convergence and divergence in the narratives of both source types. This analysis captured four overarching themes: 1) autonomy and choice, 2) “dying with dignity” and harm reduction, 3) paternalism and vulnerability, and 4) the medicalization of suffering. In general, while both physicians and other stakeholders express a commitment to the principle of patient autonomy, all parties raised concerns about systemic inequities and the risk of MAiD being used as a proxy for addressing broader social determinants of health.
References
1. Government of Canada. Legislative background: medical assistance in dying (Bill C-14). 2016.
2. Government of Canada. Bill C-7: An Act to amend the Criminal Code (medical assistance in dying). 2020.
3. Coelho R, Maher J, Gaind KS, Lemmens T. The realities of medical assistance in dying in Canada. Palliat Support Care. 2023;21(5):871-8.
4. Wiebe K, Mullin A. Choosing death in unjust conditions: hope, autonomy, and harm reduction. J Med Ethics. 2024;50(6):407-12.
5. Kaiser A, Grant I, Lemmens T, Sheehy E. Opinion: MAiD bill is an affront to equality. Toronto Star. 11 Mar 2021.
6. Quinn G, De Schutter O, Mahler C. Disability is not a reason to sanction medically assisted dying — UN experts. UN Office of the High Commissioner; 2021.
7. Levitz S. Assisted dying bill sends wrong message to young Indigenous people, advocates argue. The Canadian Press. 24 Nov2020.
8. Government of Canada. Canada’s medical assistance in Dying (MAiD) law. 2024.
9. Favaro A, St. Philip E, Jones AM. Senate amendment raises debate over medically assisted death for those with mental illness. CTV News. 11 Feb 2021.
10. Ayed N. MAID law on the right to die should respect individual choice: ethicist. CBC News. 16 May 2024.
11. Gilmore M. ‘Catastrophic Pandora’s box’: Disabled Ontarians speak out against proposed MAiD law. TV Ontario. 3 Mar 2021.
12. Khalatbari M. Surge in medically assisted deaths under Canada’s MAID program outpaces every other country. Toronto Star. 27 Jan 2024.
13. Gilmour M. Spina bifida patient says Montreal hospital staff twice offered MAiD unprompted. CTV News. 5 Jul 2024.
14. Watts R. Quadriplegic Quebec man chooses assisted dying after 4-day ER stay leaves horrific bedsore. CBC News. 12 Apr 2024.
15. Gupta M. Canadians with mental disorders shouldn’t be excluded from requesting MAID. Maclean’s. 4 May 2023.
16. Zafar A. Misunderstanding of mental illness clouds MAID expansion, patient and psychiatrist say. CBC News. 1 Feb 2024.
17. Lemmens T, Shariff MJ, Herx L. How Bill C-7 will sacrifice the medical profession’s Standard of Care. Policy Options. 11 Feb 2021.
18. Beaudry JS. Bill C-7, assisted dying and “lives not worth living.” Policy Options. 14 Dec 2020.
19. Mulligan C, Bond M. Ontario man not considering medically-assisted death anymore after outpouring of support. CityNews.16 Nov 2022.
20. Mahboob T. As Bill C-7 reaches Senate, UN watchdog raises concerns about MAiD for persons with disabilities. CBC News. 2 Feb 2021.
21. Dosani N. Opinion: If medically assisted death becomes more accessible for Canadians, we have a moral obligation to make living well - through housing, mental health supports - accessible too. Toronto Star. 11 Feb 2021.
22. Stradiotto N. Loneliness big factor in people choosing medically assisted death: Doctor. The Sudbury Star. 3 May 2024.
23. Anderssen E. Doctors, disability advocates condemn parliamentary committee’s recommendation to expand MAiD law. The Globe and Mail. 6 Mar 2023.
24. Boothby L. Q and A with Heidi Janz: COVID-19 exposed ableism, assisted death Bill C-7 endangers those with disabilities. Edmonton Journal. 25 Oct 2020.
25. Richler N. Opinion: I’ve seen what a good death looks like. I hope MAiD’s future looks the same. The Globe and Mail. 1 Mar 2024.
26. Brassolotto J, Manduca-Barone A, Zurbrigg P. Medical assistance in dying: a review of related Canadian news media texts. J Med Humanit. 2023;44(2):167-186.
27. Durant KL, Kortes-Miller K. Physician snapshot: the forming landscape of MAiD in northwestern Ontario. Palliat Care Soc Pract. 2020;14:2632352420932927.
28. Mackenzie C, Stoljar N, editors. Relational Autonomy: Feminist Perspectives on Autonomy, Agency, and the Social Self. New York: Oxford University Press; 2000.
29. Veltman A, Piper M, editors. Autonomy, Oppression, and Gender. New York, Oxford University Press; 2014.
30. Grant I, Benedet J, Sheehy E, Frazee C. A conversation on feminism, ableism, and medical assistance in dying. Can J Women Law. 2024;35(1):31-72.
31. CBC Radio. ‘Cold comfort to be offered the choice to die’ when not offered support to live, says disability advocate. The Current. 19 Nov 2020.
32. Mackenzie C. Three dimensions of autonomy: A relational analysis. In: Veltman A, Piper M, editors. Autonomy, Oppression and Gender. New York: Oxford University Press; 2014. p. 15-41.
33. Dea S, Weinstock D. Harm reduction: a research agenda. Health Care Analysis. 2020;28(4):299-301.
34. Scully J. Opinion: Why I so desperately need a medically assisted death. Ottawa Citizen. 2 Feb 2024.
35. Kemp C. Manitoba woman devastated over delay in MAID for mental illness. CBC News. 4 Feb 2024.
36. Doherty AM, Axe CJ, Jones DA. Investigating the relationship between euthanasia and/or assisted suicide and rates of non-assisted suicide: systematic review. BJPsych Open. 2022;8(4):e108.
37. Husak DN. Paternalism and autonomy. Philos Public Aff. 1981;10(1):27-46.
38. Brock DW. Paternalism and autonomy. Ethics. 1988;98(3):550-65.
39. Scoccia D. Paternalism and respect for autonomy. Ethics. 1990;100(2):318-34.
40. Dembo J, Schuklenk U, Reggler J. “For their own good”: A response to popular arguments against permitting medical assistance in dying (MAID) where mental illness is the sole underlying condition. Can J Psychiatry. 2018;63(7):451-56.
41. Downie J, Schuklenk U. Social determinants of health and slippery slopes in assisted dying debates: lessons from Canada. J Med Ethics. 2021;47(10):662-69.
42. Janz H. Plagued to death by ableism: What the COVID-19 pandemic and the expansion of eligibility for MAID reveal about the lethal dangers of medical and systemic ableism in Canada. Can J Bioeth / Rev Can Bioeth. 2023;6(3-4):137-41.
43. Whitelaw S, Lemmens T, Van Spall HG. The expansion of medical assistance in dying in the COVID-19 pandemic era and beyond: Implications for vulnerable Canadians. Can J Gen Intern Med. 2022;17(2):17-21.
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