Group Discussion # 3

Anusha Verghese

202005824

St. Francis Xavier University

N405 – Nursing of Adults 1

Professor: Pamela Reyes

Date Submitted: May 25th, 2021

MAiD, in the opinion of many Canadian users, has overlooked three groups of individuals

who could benefit from access to the procedure. Name one of the three groups and discuss

why this group should or should not have access to MAiD.

Medical assistance in dying (MAiD) is defined as the administration by a medical practitioner or

nurse practitioner of a substance to a person, at their request, that causes their death; or the

prescribing or providing by a medical practitioner or nurse practitioner of a substance to a

person, at their request, so that they may self-administer the substance and in doing so cause their

own death. (Bill C-14, 2016)

Bill C-14, 2016, the following eligibility criteria were specified when patients.

a. but for any applicable minimum period of residence or waiting period, would be eligible

for health services funded by the government in Canada.

b. at least 18 years of age and capable of making decisions with respect to their health.

c. have a grievous and irremediable medical condition.

d. have made a voluntary request for medical assistance in dying that was not made as a

result of external pressure; and

e. Have given informed consent to receive medical assistance in dying after having been

informed of the means that are available to relieve their suffering, including palliative

care” (Bill C-14 2016).

Furthermore, the bill deliberately deemed three important groups ineligible for MAiD:

mature minors, patients wishing to access MAiD at the direction of an advance medical
 directive and patients with a mental illness as the sole underlying medical condition (Bill C-

14 2016).” (NCBI Medical Assistance in Dying. Nov 2019).

In his penultimate post for the DWDC ,2019 blog, Dr. David Amies examines the Council of

Canadian Academies’ report (CCA,2019) on the possible implications of extending assisted

dying access to individuals whose sole underlying medical condition is psychiatric in nature.

There were five key areas of disagreement concerning MAID MD-SUMC, as per the report from

panel members.

Firstly, it disagreed about balancing two risks: ending the life of a person with a mental disorder

whose condition would have improved and who would have regained the desire to live, versus

denying MAID to someone who would not have improved and who would have to live on with

intolerable suffering. Secondly, there must be a fundamental difference between MAID where

death is reasonably foreseeable (e.g., cancer) and most cases of MAID MD-SUMC, where death

is not reasonably foreseeable. The panel saw the first instance being about changing the manner

and timing of death and the second being about death that is brought about for those likely to

have many years of life left. (CCA, DWDC 2019)

Thirdly, they disagreed on whether it is possible to know how to distinguish between individuals

who have made an autonomous, well-considered decision to employ MAID MD-SUMC and

those whose desire to die represents a symptom of their mental disorder. Fourthly, they

disagreed on whether permitting MAID MD-SUMC would or would not adversely affect suicide

prevention strategies. Fifthly, they could not agree on whether decisions about MAID are

different from other important decisions (e.g., refusing life-sustaining treatment). Are there
ethical and practical distinctions between medical professionals actively ending someone’s life

or allowing them to die through non-intervention? (CCA, DWDC 2019)

In general, the panel group stated that all adults, including those with mental disorders, are

presumed to have the legal capacity to make important medical decisions about themselves.

Evidence does, however, reveal that some psychiatric illnesses impair decision-making abilities

and that different assessors may disagree about whether or not a particular person possesses this

ability. Furthermore, in those requesting MAID MD-SUMC, their desire to end their lives may

be a symptom of their mental state and it can be difficult for attending health professionals to

identify this distinction. (CCA, DWDC 2019).

 REFERENCES

Konder, R. M., & Christie, T. (2019). Medical Assistance in Dying (MAiD) in Canada: A Critical

Analysis of the Exclusion of Vulnerable Populations. Healthcare policy = Politiques de

sante, 15(2), 28–38. https://doi.org/10.12927/hcpol.2019.26073

Dr. David Amies, July 11, 2019: Exploring assisted dying for individuals whose sole underlying

medical condition is a mental disorder - Dying with Dignity Canada.

NCBI- Medical Assistance in Dying, Nov 2019, Canada: A critical analysis of the exclusion of

vulnerable population, Medical Assistance in Dying (MAiD) in Canada: A Critical Analysis

of the Exclusion of Vulnerable Populations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7020802/