Reconceptualizing Vulnerability: How Layers of Vulnerability Can Help Us Better Understand Medical Assistance in Dying
DOI :
https://doi.org/10.7202/1126622arMots-clés :
aide médicale à mourir, AMM, euthanasie, vulnérabilité, suicide assisté par un médecin, éthique, CanadaLangue(s) :
AnglaisRésumé
L’aide médicale à mourir (AMM) a été légalisée au Canada en 2016. Depuis lors, les critères d’admissibilité ont été élargis grâce à des défis juridiques et à des législations. Durant cette expansion, plusieurs cas ont été rapportés, mettant en lumière des personnes se voyant offrir ou ayant accès à l’AMM en raison d’un manque de soutien pouvant autrement atténuer leur souffrance. De ce fait, des conversations renouvelées ont eu lieu sur la nécessité de protéger les personnes vulnérables. Nous remettons en question la conception traditionnelle de la vulnérabilité basée sur des sous-populations, qui traite les individus comme appartenant à certains sous-groupes prédéfinis. À la place, nous soutenons le modèle relationnel et contextuel de la vulnérabilité, tel que proposé par la bioéthicienne féministe Florencia Luna. Cette conception considère la vulnérabilité comme composée de couches superposées avec des effets en cascade. Nous soutenons que cette approche est préférable tant sur le plan conceptuel que pratique et nous l’appliquons dans le contexte de l’AMM. Cette approche plus nuancée de la vulnérabilité offre des perspectives et des orientations aux gouvernements et aux décideurs politiques. Plus spécifiquement, nous formulons trois recommandations politiques et pratiques qui reconnaissent et tentent de traiter les différentes manières dont les patients peuvent se retrouver vulnérables : 1) un amendement au langage du gouvernement fédéral concernant la « protection des vulnérables » dans la législation sur l’AMM; 2) des évaluations de l’AMM améliorées, qui filtrent mieux les déterminants sociaux de la vulnérabilité et utilisent une approche multidisciplinaire pour y répondre; et 3) la création d’un organisme de surveillance composé de membres issus de divers groupes d’intervenants ayant une expertise ou une expérience particulière en lien avec certaines des sources de vulnérabilité les plus pertinentes.
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© Alessandro Manduca-Barone, Julia Brassolotto, Duff Waring 2026
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