Carpenter Travis, Vivas Lucas
Unity Health Toronto, Toronto, Ontario, Canada.
Department of Medicine, University of Toronto, 30 The Queensway, Toronto, Ontario, M6R 1B5, Canada.
BMC Med Ethics. 2020 Jun 3;21(1):46. doi: 10.1186/s12910-020-00486-2.
It has historically been a crime in Canada to provide assistance to someone in ending their own life, however, this paradigm was inverted in 2015 when the Supreme Court of Canada (SCC) ruled that restrictions on this practice, within certain defined parameters, violated the right to life, liberty, and security of the person. Subsequently, recent legal and policy decisions have highlighted the issue of how to balance the rights of individuals to access MAiD with the rights of care providers to exercise conscience-based objections to participation in this process. We argue that there is significant harm and ethical hazard in disregarding individual and institutional rights to conscientious objection and since measures less coercive than the threat of regulatory or economic sanctions do exist, there should be no justification for such threats in Canada's health care systems.
在加拿大，历史上向他人提供协助以结束其生命是一种犯罪行为。然而，2015年这一模式发生了转变，当时加拿大最高法院裁定，在某些特定参数范围内对此类行为的限制侵犯了生命权、自由权和人身安全权。随后，最近的法律和政策决定凸显了一个问题，即如何在个人获得医疗协助死亡（MAiD）的权利与医疗服务提供者基于良心拒绝参与这一过程的权利之间取得平衡。我们认为，无视个人和机构基于良心拒服的权利会造成重大伤害和道德风险，而且既然存在比监管或经济制裁威胁更不具强制性的措施，那么在加拿大的医疗保健系统中，此类威胁就没有正当理由。
