Understanding How Canadian Physicians and Public Stakeholders Rationalize MAiD Amid Bill C-7: A Critical Analysis
DOI :
https://doi.org/10.7202/1124208arMots-clés :
soins palliatifs, méthodes qualitatives, aide médicale à mourir, AMM, projet de loi C-7, Canada, point de vue des médecins, opinion publiqueLangue(s) :
AnglaisRésumé
Malgré sa légalisation, l’éthique de l’aide médicale à mourir (AMM) reste controversée en raison de l’évolution des critères d’admissibilité et des implications qui en découlent pour les personnes souffrant de maladies non terminales, notamment de troubles mentaux. Compte tenu de la disponibilité croissante de l’AMM, il est important de comparer les discours de la société et ceux des médecins afin d’éclairer l’élaboration de politiques et de lois en matière de santé qui reflètent les valeurs et les préoccupations des différentes parties prenantes. Cet article présente une analyse qualitative critique de deux types de données : 1) les réponses à des entretiens menés auprès de médecins canadiens concernant la pratique de l’aide médicale à mourir, et 2) les médias numériques canadiens, dans le but de déterminer les points de convergence et de divergence entre les discours des deux types de sources. Notre analyse a permis de dégager quatre thèmes généraux : 1) l’autonomie et le choix, 2) « mourir dans la dignité » et la réduction des risques, 3) le paternalisme et la vulnérabilité, et 4) la médicalisation de la souffrance. En général, si les médecins et les autres parties prenantes se disent attachés au principe de l’autonomie du patient, toutes les parties ont exprimé leurs préoccupations concernant les inégalités systémiques et le risque que l’AMM soit utilisée comme un substitut pour traiter les déterminants sociaux plus larges de la santé.
Références
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.
Téléchargements
Publié
Comment citer
Numéro
Rubrique
Licence
© Midori Matthew 2026
Cette œuvre est sous licence Creative Commons Attribution 4.0 International.
La Revue canadienne de bioéthique applique la Creative Commons Attribution 4.0 International License à toutes ses publications. Les auteurs conserveront leur droit d'auteur sur leur publication et ils pourront, par exemple, réutiliser leur publication, mettre un lien sur leur page d'accueil ou site web institutionnel, ou déposer un fichier PDF dans un dépôt public. Toutefois, les auteurs permettent à quiconque de télécharger, réutiliser, réimprimer, distribuer, ou copier leur publication, tant que les auteurs originaux et les sources sont cités.
_smaller.png){kind=logo}
