Abstract
Ever since medical assistance in dying (MAID) became legal in Canada in 2016, controversy has enveloped the refusal by many faith-based institutions to allow this service on their premises. In a recent article in this journal, Philip and Joshua Shadd have proposed 'changing the conversation' on this issue, reframing it as an exercise not of conscience but of an institutional right of self-governance. This reframing, they claim, will serve to show how health-care institutions may be justified in refusing to provide MAID on moral or religious grounds. I argue that it will not make it easier to justify institutional refusal, and is likely to make it harder.
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