Reasons Advance Directives for MAID Are Not Permitted
An advance directive is not allowed in Canada as it does not comply with the law and current regulations. For example, the ordinance requires the patient to give informed consent solely before the procedure (Pesut et al., 2019). Moreover, a request requiring consent and verification by both parties cannot be made in advance and has to be made before the MAID procedure (Pesut et al., 2019). Thus, the advance directives simply cannot be considered valid because they do not meet the legal requirements. At the same time, a standard waiver of resuscitation or other procedures can be filed in this format since it does not imply special action on the part of the nursing staff.
Arguments For and Against Permitting Advance Directives for MAID
Arguments in favor of permitting advance directives:
- Reducing the burden on the loved ones and relatives of the patient by determining their wishes and position, and relieving them of the need to make a decision.
- Respecting a person’s right to dispose of their end of life in advance in case the ability to think and make decisions is damaged or lost (Pesut et al., 2020).
- Opposition to the occurrence of situations in which a person is kept alive against their will or because of a lack of prior instructions or relatives.
Arguments against permitting MAID advance directives:
- Inconsistency with the current legal framework, without changing, which advance directive cannot be accepted for MAID.
- The situations matching the terms of the advance directives can be misinterpreted or misunderstood.
- Patients’ desires at the time of need for MAID may differ from when the directive was created, and their opinions may change (Wiebe et al., 2021).
- Possible additional ethical or legal issues in the context of determining final decision-making and those responsible for it (Konder & Christie, 2019).
Personal Position on Permitting Advance Directives for MAID
From an ethical and personal point of view, the authorization of advance directives for MAID should be accepted. However, such a change requires taking into account the legal part and adjusting it, as well as taking into account all the potential disadvantages. It should primarily assist people in controlling their end of life, which can be important for general human rights (Collier & Haliburton, 2021). However, a refinement of the procedure is needed to reduce potential errors in interpreting and understanding the patient’s desires. Moreover, each particular decision should be approved only after fully considering and matching all the conditions described with the patients’ stipulated wishes.
References
Collier, C., & Haliburton, R. (2021). Bioethics in Canada: A philosophical introduction (3rd Canadian edition). Canadian Scholars, an imprint of CSP Books Inc.
Konder, R. M., & Christie, T. (2019). Medical assistance in dying (MAiD) in Canada: A critical analysis of the exclusion of vulnerable populations. Politiques de Sante [Healthcare Policy], 15(2), 28–38. Web.
Pesut, B., Thorne, S., Schiller, C., Greig, M., Roussel, J., & Tishelman, C. (2020). Constructing good nursing practice for Medical Assistance in Dying in Canada: An interpretive descriptive study. Global Qualitative Nursing Research, 7, 2333393620938686. Web.
Pesut, B., Thorne, S., Stager, M. L., Schiller, C. J., Penney, C., Hoffman, C., Greig, M., & Roussel, J. (2019). Medical Assistance in Dying: A review of Canadian nursing regulatory documents. Policy, Politics & Nursing Practice, 20(3), 113–130. Web.
Wiebe, E., Green, S., & Wiebe, K. (2021). Medical assistance in dying (MAiD) in Canada: Practical aspects for healthcare teams. Annals of Palliative Medicine, 10(3), 3586–3593. Web.