Canadian Medical Assistance in Dying: Provider Concentration, Policy Capture, and Need for Reform.

IF 17 1区 哲学 Q1 ETHICS American Journal of Bioethics Pub Date : 2025-01-10 DOI:10.1080/15265161.2024.2441695
Christopher Lyon, Trudo Lemmens, Scott Y H Kim
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Abstract

Canada's rapid rise in deaths from euthanasia and physician assisted suicide, termed Medical Assistance in Dying (MAID) in the country, now ranks it second only to the Netherlands in terms of MAiD deaths as percentage of overall deaths, with one province already hosting the highest rate of all jurisdictions in the world. Analyzing Health Canada's annual MAID reports, which show that up to 336 out of 1837 providers are likely responsible for the majority of MAID deaths in a given year, we discuss how the rapid increase likely reflects not a broad Canadian consensus but the capture of a policy-making and implementation process by a small group of activists and clinicians colonizing medicine to become an ideologically driven vehicle for expanding MAID access and delivery. As a remedy and to reprioritize patient safety and protection against premature death, a more transparent, relevant, and safeguarded compliance regime based on evidence-based, multi-perspective policy-making is needed.

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加拿大死亡医疗援助:提供者集中,政策捕获和改革的需要。
加拿大因安乐死和医生协助自杀而死亡的人数迅速增加,在该国被称为医疗协助死亡(MAID),就医疗协助死亡人数占总死亡人数的百分比而言,目前加拿大仅次于荷兰,其中一个省的死亡率已经是世界上所有司法管辖区中最高的。加拿大卫生部的年度MAID报告显示,1837名提供者中有多达336名可能对某一特定年份的MAID死亡负责,我们分析了快速增长如何可能反映的不是加拿大的广泛共识,而是一小群活动家和临床医生将医学作为扩大MAID获取和提供的意识形态驱动工具的决策和实施过程。作为一种补救措施,并重新优先考虑患者安全和防止过早死亡,需要一个基于循证、多角度决策的更透明、更相关和有保障的合规制度。
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来源期刊
American Journal of Bioethics
American Journal of Bioethics 社会科学-科学史与科学哲学
CiteScore
12.30
自引率
26.90%
发文量
250
审稿时长
6-12 weeks
期刊介绍: The American Journal of Bioethics (AJOB) is a renowned global publication focused on bioethics. It tackles pressing ethical challenges in the realm of health sciences. With a commitment to the original vision of bioethics, AJOB explores the social consequences of advancements in biomedicine. It sparks meaningful discussions that have proved invaluable to a wide range of professionals, including judges, senators, journalists, scholars, and educators. AJOB covers various areas of interest, such as the ethical implications of clinical research, ensuring access to healthcare services, and the responsible handling of medical records and data. The journal welcomes contributions in the form of target articles presenting original research, open peer commentaries facilitating a dialogue, book reviews, and responses to open peer commentaries. By presenting insightful and authoritative content, AJOB continues to shape the field of bioethics and engage diverse stakeholders in crucial conversations about the intersection of medicine, ethics, and society.
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