Cattell Cameron, Mack Cheryl
Department of Philosophy, University of Waterloo, Waterloo, ON.
Assistant Clinical Professor, John Dossetor Health Ethics Centre, Department of Pediatrics, University of Alberta, Edmonton, AB.
Healthc Policy. 2025 Feb;20(2):25-30. doi: 10.12927/hcpol.2025.27561.
We seek to highlight key ethical considerations that arise as Canada considers an expansion of medical assistance in dying (MAiD) to include advance requests. To do so, we will first highlight the ethical and practical concerns that arise with advance care planning and advance directives in general and then draw attention to the unique considerations that arise with advance requests for MAiD. Finally, we will take a closer look at the concerns that will arise with an expansion to include the population with dementia. We will argue that the stakeholder concerns for a vulnerable population such as dementia patients are significant. Legislative frameworks will need to address these concerns to ensure the safety of individual patients and support the role of surrogates and healthcare providers in this process.
我们旨在强调加拿大在考虑扩大医疗协助死亡（MAiD）范围以纳入预先请求时出现的关键伦理考量。为此，我们将首先强调一般情况下预先护理规划和预先指令所引发的伦理和实际问题，然后提请注意预先请求MAiD所引发的独特考量。最后，我们将更深入地审视将痴呆症患者纳入其中所引发的问题。我们将论证，利益相关者对痴呆症患者等弱势群体的担忧至关重要。立法框架需要解决这些担忧，以确保个体患者的安全，并在此过程中支持代理人和医疗保健提供者的作用。
