Canadian doctors encouraged to bring up medically assisted death before their patients do

In most jurisdictions in the world with legalized euthanasia, doctors are explicitly prohibited, or strongly discouraged from raising assisted dying with a patient.

The request must come from the person.

But a guidance document produced by Canada’s providers of medically assisted death states that doctors have a professional obligation to bring up MAID as an option, when it’s “medically relevant” and the person is likely eligible, as part of the informed consent process.

There is no legal restriction on who can raise the subject of MAID with someone with a grievous and irremediable illness, disease or disability, provided the intent is not to induce, persuade or convince the person to request an assisted death, says the Canadian Association of MAID Assessors and Providers.

But some ethicists argue that introducing death as a “treatment option,” without the person suggesting it first, is seriously problematic, especially within the expanding realm of MAID, and that people could be unduly influenced to choose to have their life intentionally ended, given the power dynamics of the doctor-patient relationship.

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Given how shallow relations are with virtually all of our doctors, this seems to be a very dangerous slope. I can see a deeply trusted friend bringing this subject up but not someone whose relationship is fundamentally professional and financial. In most cases, this will result in an immoral, even cruel, suggestion that will shock and confuse the patient, not help them. I am concerned almost as much about the moral impact on doctors who make these suggestions even with the best intentions. There will be exceptions, as there always are, but in the main this is not a good general rule to apply broadly as policy. Moreover, given the disaster of Western medical responses to covid, this is a good time for medical professionals to STFU on what they think is best for everyone else. ABN

UPDATE: Another relevant point in this matter is old age and/or the time period near to a person’s death is a very important part of human life. In Buddhist thought the human realm is the only realm where enlightenment can occur. As people age and/or approach death, they are often better able than ever to reflect on their lives and make extremely valuable changes in their thinking and behavior. These changes can change the course of their “mind stream” or karma, thus having enormous impact on future lives. It is a mechanistic view of the world that sees grave illness or old age as nothing more than a worn out machine that should be trashed or killed. From a Buddhist point of view, it is a big mistake to think like that, especially when such thoughts may lead to destroying a person’s last opportunities to make valuable realizations in this life. The old and dying should be cared for with reverence and consideration. To care for an old or dying person is the same as caring for a Buddha. Or as the Buddha put it: “Whoever would tend to me should tend to the sick.” Or, “Caring for any bhikkhu is the same as caring for the Buddha.” Both of these quotes are in the context of caring for Buddhist monks who did not have families to care for them but the principle applies to all of us. Life has meaning from beginning to end and in all its many forms. ABN

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