Between Safeguard and Constraint: Navigating Patient Autonomy in Protective Laws for Medical Assistance in Dying

Area of Science:

• Bioethics
• Medical Law
• Public Health Policy

Background:

• Growing global legalization of Medical Assistance in Dying (MAiD).
• Divergent legal frameworks balance autonomy with safeguards.
• Need to examine autonomy within specific MAiD legislation.

Purpose of the Study:

• Analyze the notion of autonomy in Spain's MAiD legislation.
• Assess if safeguards inadvertently undermine autonomy.
• Explore the tension between protection and self-determination.

Main Methods:

• Case study analysis of Spain's MAiD legislation.
• Examination of eligibility requirements for the "euthanasic context."
• Analysis of how safeguards impact patient autonomy.

Main Results:

• Spain's MAiD law imposes stringent eligibility criteria.
• Protective measures, like multiple assessments, may increase vulnerability.
• Safeguards can lead to epistemic injustice, diminishing autonomy.

Conclusions:

• Spain's MAiD safeguards may create a "trap of protection."
• Highly protective laws risk undermining individual self-determination.
• Re-evaluating the balance between safeguarding and respecting autonomy is crucial.