Navigating the Ethical Tension Between Autonomy and Protection in Medically Assisted Dying: A Spiritual Care Approach

This article examines several ethical, legal, and spiritual aspects of Medical Assistance in Dying (MAiD) in Canada, a practice that has been legalized in Canada since June 17, 2016. The article identifies the underlying ethical tension of patient autonomy, and the principle of care providers protecting vulnerable populations. The article reviews how the legal framework of MAiD has evolved in Canada, where now individuals with any irremediable medical condition have access to this program; and where the care community appears divided regarding MAiD options for people's mental health. The article looks at the ethical, legal impacts of MAiD for medical providers, with a specific focus on their moral conscience; mental health wellbeing; duty to "do no harm". Spiritual care providers have a role to play in MAiD situations, as they act as a non-judgmental supportive presence who honor their own ethical limits, as well as the various belief systems of their patients. Utilizing a case example and ethical frameworks, the article advocates for compassionate care for individuals in serious and persistent suffering that is rooted in patient centered care, as honoring dignity and personhood with safeguards against potential abuse. The overall recommendation in this exploratory article is for equitable interdisciplinary care that includes considerations of ethics, spiritual care and legalities.