Joint Centre for Bioethics, University of Toronto, Toronto, Ontario, Canada.
Department of Bioethics, The Hospital for Sick Children, Toronto, Ontario, Canada.
J Med Ethics. 2020 Jan;46(1):53-54. doi: 10.1136/medethics-2019-105664. Epub 2019 Aug 8.
In their summary and critique, Gamble, Gamble, and Pruski mischaracterise both the central arguments and the primary objectives of our original paper. Our paper does not provide an ethical justification for paediatric Medical Assistance in Dying (MAID) by comparing it with other end of life care options. In fact, it does not offer arguments about the permissibility of MAID for capable young people at all. Instead, our paper focuses on the ethical questions that emerged as we worked to develop a policy for responding to MAID requests at our tertiary paediatric institution. Following the Supreme Court of Canada's recent decriminalisation of MAID, our hospital needed to answer immediate on-the-ground questions such as: 'What are we going to do if an 18-year-old patient in our care requested MAID today, as is now their legal right? How should we protect their privacy? What is the best way to ensure patients are informed when making these decisions?' On these important questions, Gamble, Gamble, and Pruskiare silent.
在他们的总结和批评中，Gamble、Gamble 和 Pruski 错误地描述了我们原始论文的中心论点和主要目标。我们的论文并没有通过将儿科辅助死亡（MAID）与其他临终关怀选择进行比较来为儿科 MAID 提供伦理辩护。事实上，它根本没有就有能力的年轻人的 MAID 可允许性提出任何论点。相反，我们的论文侧重于在我们努力为我们的三级儿科机构制定回应 MAID 请求的政策时出现的伦理问题。在加拿大最高法院最近将 MAID 合法化之后，我们的医院需要立即回答一些实际问题，例如：“如果我们照顾的一名 18 岁患者今天要求 MAID，现在他们有法律权利，我们该怎么办？我们应该如何保护他们的隐私？确保患者在做出这些决定时知情的最佳方法是什么？”在这些重要问题上，Gamble、Gamble 和 Pruski 保持沉默。
