Background
Medical assistance in dying was legalized in Canada following the Carter v. Canada ruling of 2015. In spite of legalization, the ethics of medical assistance in dying remain contentious, with a paucity of research regarding physicians’ moral perspectives on the matter. By asking physicians if they perceive the major bioethical accounts as clinically useful, we seek to distinguish between aspects of the contemporary bioethical landscape which are useful at the bedside and those which are divorced from the realities faced by clinicians.
Methods
We applied a qualitative interpretive phenomenological approach to examine the convergence and divergence of physicians’ subjective experiences and bioethical distinctions in providing MAiD and WLT.
Results
21 interview transcripts were thematically analyzed and coded, which generated four overarching themes: 1) moral differences between MAiD and WLT; 2) the causal role of the medical practitioner; 3) semantic appropriateness of ‘killing’ versus ‘allowing to die; and 4) intent of the physician. Overall, physicians emphasized the importance of understanding the realities of patients at the bedside prior to engaging in bioethical abstraction of MAiD’s legitimacy.
Conclusions
In order to have practical utility for clinical practice, it is essential for bioethicists to engage in dialogue with patients and their medical providers pursuing MAiD or WLT. Esoteric debates that are divorced from the realities of terminal illness do not assist physicians with navigating the ethical terrain of ending a patient’s life. This research captures meaningful accounts regarding MAiD and WLT that is rooted in the lived experience of the providers of these services in order for bioethical debates to have substantive impact in clinical practice and in legislation surrounding future health policies.