Caring for each other through the ethical challenges of MAiD in Canada

By Mary Kathleen Deutscher Heilman and Tracy J. Trothen

Medical Assistance in Dying (MAiD) generates strong emotions among Canadians. What has been striking to us is the fact that while academics have been engaged in an epic battle about who has a right to what protections under the law, the average person seems to want the answer to two questions: 1) Where do I go if I want MAiD? 2) Will I have to be part of MAiD if I don’t want to be?

The genesis of this article came upon the authors quite unexpectedly. We met at a convention in the Canadian province of Saskatchewan where Dr. Trothen was giving a presentation on moral distress and Dr. Heilman was tasked with keeping the speaker entertained during the awards banquet. It did not take us long to realize that Dr. Heilman’s work on the role of conscience in healthcare spoke the same language as Dr. Trothen’s work on moral distress.

We hope that this article will bring the conversation back to a discussion of the goals that are important for Canadians. In our estimation, most Canadians are more concerned about accessing care than they are about how and by whom this care is provided. We would like to see this goal of accessing a particular service, including MAiD, be achieved without causing serious significant moral distress to healthcare professionals, caregivers and, ideally, anyone else involved.

Our paper creates a bridge between the literature on moral distress and the literature on conscientious objection. We hope that we have provided an avenue through which further research can be initiated, particularly into the long-term consequences of making conscientious objection easy or not so easy. We also hope that our paper will provide a space for policy work that fosters the well-being of healthcare professionals as a prerequisite to providing excellent care.

We look forward to continuing this discussion.


Paper title: Conscientious Objection and Moral Distress: A Relational Ethics Case Study of MAiD in Canada

Authors: Mary Kathleen Deutscher Heilman and Tracy J. Trothen

Affiliations: St. Paul’s Hospital (Grey Nuns) of Saskatoon and Queen’s University

Competing interests: There are no competing interests for either author.

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