New research has added to the ongoing debate surrounding the legality of medical aid in dying programs. The question of when individuals should be allowed to seek medical aid in dying is a contentious issue that evokes strong emotions and arguments. Many states in the U.S. and countries globally have started to legalize or expand the practice of medical aid in dying, also known as MAID. MAID involves a medical provider prescribing medication to a patient so they can end their own life, distinct from euthanasia where a doctor actively ends a patient’s life. Eligibility for MAID programs typically requires a severe illness diagnosis with a prognosis of less than six months, often seen in late-stage cancer patients. Critics of MAID are concerned about potential dangers with loosening eligibility criteria, citing cases in countries like the Netherlands where individuals have received MAID for mental suffering alone or non-terminal conditions like myalgic encephalomyelitis/chronic fatigue syndrome.
Critics fear that as these programs expand, cases like these will become normalized and medical providers may inadvertently push MAID onto vulnerable populations instead of those who would benefit most. Proponents argue for less restrictive guidelines to allow more individuals, including those with disabilities, the option to choose MAID to avoid unnecessary suffering. Last year, the Canadian government delayed plans to expand MAID eligibility to include mental illness until 2027 due to concerns about the health system’s ability to assess these cases properly.
A recent study published in JAMA Internal Medicine analyzed data from 20 jurisdictions where MAID is practiced to understand who is choosing and receiving MAID. The study found that the majority of MAID recipients had cancer or ALS, even though these conditions accounted for a minority of all deaths. James Downar, head of palliative care at the University of Ottawa, discussed the study’s findings and implications for the future of MAID. The research aimed to explore the types of illnesses (e.g. cancer, ALS) of individuals receiving MAID at the end of life compared to dying naturally, revealing that ALS patients were most likely to receive MAID followed by cancer patients.