Medical Assistance in Dying and Palliative Care: Shared Trajectories

Area of Science:

• Bioethics
• Palliative Care
• Medical Law

Background:

• Medical Assistance in Dying (MAID) and palliative care frequently exhibit an adversarial relationship in legal jurisdictions.
• Historically, early palliative care practices were once viewed as medically assisted death or homicide.
• Contemporary criticisms of MAID, such as 'ableism,' echo historical justifications for withdrawing life support or ceasing life-prolonging therapies.

Purpose of the Study:

• To explore the historical and ethical parallels between Medical Assistance in Dying (MAID) and palliative care.
• To challenge the notion that palliative care providers' opposition to MAID is justified by their ability to alleviate all suffering.
• To advocate for the complementary and synergistic potential of MAID and palliative care for patient and family well-being.

Main Methods:

• Historical ethical and legal analysis of palliative care and MAID.
• Comparative examination of patient motivations and justifications for MAID versus palliative care interventions.
• Philosophical critique of arguments opposing MAID based on the scope of palliative care.

Main Results:

• Significant historical and ethical commonalities exist between the evolution of palliative care and MAID.
• Concerns regarding autonomous decision-making in MAID are equally applicable to established palliative care practices.
• The opposition to MAID by some palliative care providers may stem from an overestimation of palliative care's capacity to resolve all suffering.

Conclusions:

• Palliative care and MAID are not inherently mutually exclusive and can be integrated.
• Palliative care providers can opt out of MAID participation without negating the potential synergy between the two fields.
• Recognizing the shared history and ethical underpinnings can foster a more collaborative approach to end-of-life care.