Clinical Ethicists and Medical Assistance in Dying (MAiD): Possible Roles and Challenges

Area of Science:

• Bioethics
• Medical Ethics
• Healthcare Policy

Background:

• Assisted dying (AD) presents complex ethical challenges for healthcare institutions and clinical ethicists (CEs).
• The specific roles, legitimacy, and scope of CE involvement in AD remain underexplored in existing literature.
• Understanding CE contributions is crucial for navigating the ethical landscape of AD.

Purpose of the Study:

• To address the gap in literature regarding the involvement of clinical ethicists in assisted dying.
• To outline professional standards guiding CE practice in AD contexts.
• To propose a typology of roles CEs have occupied in the emergence and institutionalization of AD, drawing on Canadian experiences.

Main Methods:

• Review of professional standards for clinical ethicist practice.
• Examination of the Canadian MAiD (Medical Assistance in Dying) landscape.
• Analysis of case experiences from CEs within a Quebec healthcare institution.

Main Results:

• Identified a range of CE roles across micro to macro levels of involvement in AD.
• Demonstrated how CE roles reflect both practical contributions and normative considerations.
• Highlighted the benefits and challenges of CE participation in ethically complex AD domains.

Conclusions:

• CE involvement in assisted dying is valuable but presents unique challenges.
• A typology of CE roles can inform institutional engagement with ethics expertise in AD.
• Further reflection is needed on foundational normative questions concerning CE participation in AD policy and practice.