Originally published in The Hub Canada (26 July 2023)
Recent news reports have highlighted faith-based hospitals in Canada which decline to offer medical assistance in dying (MAID). Such hospitals—which are best understood not as mere “facilities” but as communities of people advancing a shared mission of healing and care—view the termination of life as contrary to basic principles of medicine. Others, concerned about MAID access, are calling for the government to require these communities to provide MAID on-site (rather than transferring patients to other facilities), or to terminate their service agreements.
But whether to participate in MAID is a profound and complex ethical question—a question on which the B.C. Supreme Court recognized that “thoughtful and well-motivated people can and have come to different conclusions.” Those who conclude that they can not offer MAID are not medical outliers. They hold a legitimate ethical position, shared by health-care professionals, associations, and ethicists around the world, and recognized by Canadian courts as deserving of respect.
To understand why MAID remains ethically contested, it is important to clarify exactly what it involves. Contrary to what its name might suggest, “medical assistance in dying” is not the provision of medicine, personal care, or symptom management as a patient approaches their natural death (that is palliative care, which “intends neither to hasten nor postpone death”, and which the federal government, the Canadian Hospice Palliative Care Association, and the Canadian Society of Palliative Care Physicians have all recognized as distinct from MAID).
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