Saturday, August 26, 2023

[Crosspost from https://aichatlog.blogspot.com/]

Medical Assistance in Dying: A Symptom, Not the Cause

We all have a responsibility to care for one another, whether we openly acknowledge it or not. Medical Assistance in Dying (MAID) exists to give people control over their destiny when they are in unbearable pain and see no other solution. If issues like preventable poverty are pushing people to seek MAID, the answer isn't to get rid of MAID. Instead, we should focus on addressing and eliminating these types of suffering, which can often be easily corrected. 

In Canada, medical assistance in dying (MAID) has proven deeply controversial. Some disabled and impoverished individuals, despairing at their situations, have opted for MAID to end their suffering (Downie & Schuklenk, 2021). This has led some to argue MAID represents a failure of society's duty of care and threatens the vulnerable (Downie & Schuklenk, 2021). However, a close examination of Canada's MAID framework reveals a stringent system designed to prevent abuse. The tragic cases of MAID for socioeconomic reasons point not to flaws in the law itself, but rather to deep inequities in how Canadian society treats its most disadvantaged members.

Canada's MAID Legislation

Canada's MAID legislation, passed in 2016, allows eligible individuals meeting strict criteria to legally seek medical help in ending their lives (Downie & Chandler, 2017). As the Government of Canada overview makes clear, the law builds in safeguards like requiring two independent medical opinions, a waiting period, and consent immediately before the procedure (Downie & Chandler, 2017). Data show the majority using MAID have terminal illnesses like cancer (Downie & Chandler, 2017). This indicates the law functions as intended for the grievously ill.

However, a minority of cases involve non-terminal conditions like disabilities (Downie & Schuklenk, 2021). Disability advocates argue this reflects coercion due to lack of social support (Downie & Schuklenk, 2021). Yet the data show socioeconomic factors like poverty and homelessness are present in only a small fraction of MAID cases (Downie & Schuklenk, 2021). While concerning, this does not necessarily demonstrate MAID's failure.

Symptoms of Social Inequity

Tragically, some disabled and impoverished persons have chosen MAID because they saw no other escape from their situations (Downie & Schuklenk, 2021). But the solution is not changing MAID laws that serve the terminally ill. Rather, these extremely rare cases represent symptoms of broader societal problems in supporting the disadvantaged (Downie & Schuklenk, 2021).

Canada urgently needs improved social supports, like national pharmacare, disability services, housing, and basic income programs. Without these, inequities persist and the most vulnerable suffer. Restricting their access to MAID as a last resort seems ethically dubious.

The way forward must involve embracing MAID as part of a spectrum of humane end-of-life choices, while resolving the deeper injustices that drive people to despair.

Conclusion

MAID provides necessary relief to those with grievous and irremediable suffering. The few tragic cases linked to socioeconomic woes are symptomatic of broader societal failures. Limiting access to MAID does not solve these inequities - only meaningful reforms can. Canada’s legislation strikes an ethical balance between individual rights and safeguards. The real solution lies in building a more just society that cares for the disadvantaged and vulnerable. Therein lies the true humanistic challenge.

References

Downie, J., & Chandler, J. (2017). Interpreting Canada's Medical Assistance in Dying Legislation. PDF

Downie, J., & Schuklenk, U. (2021). Social determinants of health and slippery slopes in assisted dying debates: lessons from Canada. PDF

Government of Canada. (2023). Medical assistance in dying. https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html

Health Canada. (2021). Fourth interim report on medical assistance in dying in Canada. 

Pullman, Dary, 2023 Slowing the Slide Down the Slippery Slope of Medical Assistance in Dying: Mutual Learnings for Canada and the US

Sodha, Sonia, 2023 (Guardian) Assisted dying seems humane, but can we protect the vulnerable from the malign?

Zandbergen, Rebecca, 2020 (CBC) Why disability advocates are worried about changes to Canada's medical assistance in dying bill

Picard, André, 2022 (Globe and Mail) We must make it easier to both live and die with dignity, but denying MAiD to those living in poverty is not the answer


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