Abstract
Medical assistance in dying (MAiD) has received considerable attention from many in the field of bioethics. Philosophers, theologians, lawyers, and clinicians of all sorts have engaged with many challenging aspects of this issue. Public debate, public policy, and the law have been enhanced by the varied disciplinary analyses. With the legalization of MAiD in Canada, some attention is now being turned to issues that have historically been overshadowed by the debate about whether to permit MAiD. One such issue is voluntary stopping eating and drinking (VSED) as an alternative to MAiD. In this paper, I will apply a legal lens to the issue. An understanding of whether VSED is legal provides a foundation for ethical reflection on whether it ought to be permitted. Is it permitted for those who prefer VSED to MAiD? Is it permitted for those who do not qualify for MAiD under our current legislation – for those who do not have a grievous and irremediable medical condition, for mature minors, for individuals whose sole underlying medical condition is a mental disorder and who do not otherwise meet the eligibility criteria, and for individuals who have lost capacity but had completed an advance directive?
Highlights
Medical assistance in dying (MAiD) has received considerable attention from many in the field of bioethics
There are individuals who are experiencing enduring and intolerable suffering and could meet the eligibility criteria for MAiD, but who would not have access to it or who would not choose it
First: what are the legal implications if an individual seeking MAiD plays a role in their death’s reasonable foreseeability? In other words, can an individual whose medical circumstances do not make their natural death reasonably foreseeable commence voluntary stopping eating and drinking (VSED) as a way of causing their natural death to become reasonably foreseeable? [5,6] This paper focuses solely on individuals pursuing VSED all the way to death
Summary
Medical assistance in dying (MAiD) has received considerable attention from many in the field of bioethics. Health care providers risk civil and criminal liability for forcing artificial nutrition or hydration against a competent adult’s wishes, a valid personal directive, or a substitute decision-maker basing a refusal of consent on prior capable informed expressed wishes of a previously competent adult. As concluded by Justice Christine Gosselin of the Court of Quebec (QCCQ) in R v Morin, after summarizing the relevant Supreme Court of Canada (SCC) jurisprudence, “counselling” for the purposes of s.241(1) “concerns speech that, assessed objectively, aims to induce, persuade or convince a person to commit suicide.” [25]9 Health care providers in the context of VSED would be telling a patient about VSED as a possible pathway to death because they have an obligation to disclose all treatment options and alternatives; VSED is an alternative. They should not face criminal liability for aiding suicide
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