["For their own good". Medical assistance in dying: a right for whom?]

Background: The admission criteria to the medical assistance in dying (MAID) procedures (Euthanasia - E; Physician Assisted Suicide - PAS) represent a much debated issue. In most of the jurisdictions where MAID is legal, the unbearable suffering due to a terminal illness constitues the main admission condition. In contrast, those suffering from either a mental disorder or an existential discomfort are excluded. Some consider the exclusion of the former group to be protective towards those deemed vulnerable because they are not able to make free and informed decisions, while the latter is excluded to align the legal approaches to the prevailing moral models. Others consider these stances discrimination.

Purpose: To prove that when someone requests MAID, his suffering should be first and foremost investigated not only and not so much for its causes, but, above all, for its key role played in understanding the MAID request.

Contents: After reviewing the specific aspects of suffering in relation to his three determinants - existential suffering, mental disorder, terminal illness - the article provides the evidence that: a) such a conditions, although completely different from each other, share the same psychological processes leading to the unbeaerable suffering and then to the request for MAID or to the suicide ideation/completion; b) there is no scientific data supporting a discrimination access to MAID on the basis of the presence/absence of a terminal illness.

Conclusions: Using the unbearable suffering due to a terminal illness as the sole criterion for admission to MAID violates the principle of autonomy, and, lacking scientific evidence, it does not clarify where the line is drawn between those who should be entitled to MAID and those who should not.