Abstracts
Abstract
Medical Assistance in Dying (MAID) is a legal federal framework for medical practitioners to assist in the cessation of life upon request from eligible patients who seek assisted death in order to die peacefully and with dignity. MAID’s ‘mentally competent’ eligibility criteria currently create confusion for social workers because they provide little guidance on how to best implement the desired practices intended to support the aims of MAID. Secondly, current criteria pose challenges for vulnerable populations, particularly patients with amyotrophic lateral sclerosis (ALS). ALS patients who are deemed mentally incapable are denied access to MAID, suffering in pain every day until they die. Canada’s MAID policy infringes on their autonomy, and removes their choice to die with dignity. This injustice calls for further reconsideration of the ways MAID can be reformed to serve dying Canadians who are falling through the cracks of MAID. Policy recommendations include inclusion of advanced directives and substitute decision makers. Due to this unequal access in health care services, this concern constitutes a social work issue. Recommendations for social work include increasing competency, and advocacy regarding the provision of MAID.
Keywords:
- Amyotrophic Lateral Sclerosis,
- End-of-life,
- Medical Assistance in Dying
Résumé
L’Aide médicale à mourir est un cadre juridique fédéral qui permet aux professionnels de la santé d’aider les patients admissibles qui en font la demande à mettre fin à leurs jours de façon paisible et dans la dignité. Le critère d’admissibilité entourant la compétence mentale crée actuellement de la confusion chez les travailleurs sociaux parce qu’il fournit peu de directives sur la meilleure façon de mettre en oeuvre les pratiques souhaitées pour appuyer les objectifs de l’aide médicale à mourir. Les critères actuels posent également des obstacles pour les populations vulnérables comme les patients atteints de sclérose latérale amyotrophique (SLA). Les patients atteints de SLA qui ne sont pas jugés « mentalement compétents » se voient refuser l’accès à l’aide médicale à mourir et doivent continuer de vivre dans des douleurs jusqu’à leur mort. La politique canadienne en matière entourant l’aide médicale à mourir donne ainsi un accès inégal aux services de soins de santé pour ces patients, porte atteinte à leur autonomie et à leur droit à l’autodétermination en leur enlevant le choix de mourir dans la dignité. Cette injustice exige que l’on reconsidère les façons de réformer l’aide médicale à mourir afin de servir les Canadiennes et les Canadiens près de la mort qui passent ainsi au travers des mailles du filet de l’aide humanitaire. Le présent article contient des recommandations stratégiques comme l’inclusion de directives préalables et de décideurs substituts, ainsi que des recommandations à l’intention des travailleurs sociaux, y compris l’accroissement des compétences et la sensibilisation aux dispositions entourant l’aide médicale à mourir.
Mots-clés :
- Sclérose latérale amyotrophique,
- fin de vie,
- aide médicale à mourir
Appendices
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