Physicians’ moral distinctions between medical assistance in dying (MAiD) and withdrawing life-sustaining treatment in Canada: a qualitative descriptive study
Abstract Background Medical assistance in dying (MAiD) was legalized in Canada following the Carter v. Canada ruling of 2015. In spite of legalization, the ethics of MAiD remain contentious. The bioethical literature has attempted to differentiate MAiD from withdrawing life-sustaining treatment (WLT...
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2025-02-01
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| Online Access: | https://doi.org/10.1186/s12910-025-01176-7 |
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| author | Midori Matthew Kieran Bonner Andrew Stumpf |
| author_facet | Midori Matthew Kieran Bonner Andrew Stumpf |
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| description | Abstract Background Medical assistance in dying (MAiD) was legalized in Canada following the Carter v. Canada ruling of 2015. In spite of legalization, the ethics of MAiD remain contentious. The bioethical literature has attempted to differentiate MAiD from withdrawing life-sustaining treatment (WLT) in an effort to examine the nature of the moral difference between the two. However, this research has often neglected the firsthand experiences of the clinicians involved in these procedures. 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 descriptive approach to explore physicians’ experiences and bioethical distinctions in providing MAiD and WLT. Results Semi-structured interviews were conducted with 21 physicians, and the transcripts were thematically analyzed to identify common patterns and divergences in their perspectives. Three core themes were found: (1) consensus on MAiD’s moral equivalence with WLT despite differences between the practice, (2) discord regarding the use of the term ‘killing’, and (3) disjuncture between bioethical debates and practice. Theme 1 comprised of three sub-themes: (1.1) no moral difference between MAiD and WLT, (1.2) physician versus underlying medical condition as cause of death, and (1.3) relief of suffering. 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. Theoretical 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. |
| format | Article |
| id | doaj-art-e5da5200ac674ae7915dfe92ce03718e |
| institution | Kabale University |
| issn | 1472-6939 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Ethics |
| spelling | doaj-art-e5da5200ac674ae7915dfe92ce03718e2025-02-02T12:41:39ZengBMCBMC Medical Ethics1472-69392025-02-012611910.1186/s12910-025-01176-7Physicians’ moral distinctions between medical assistance in dying (MAiD) and withdrawing life-sustaining treatment in Canada: a qualitative descriptive studyMidori Matthew0Kieran Bonner1Andrew Stumpf2Department of Health Research Methods, Evidence, and Impact, McMaster UniversityDepartment of Sociology and Legal Studies, St. Jerome’s UniversityDepartment of Philosophy, St. Jerome’s UniversityAbstract Background Medical assistance in dying (MAiD) was legalized in Canada following the Carter v. Canada ruling of 2015. In spite of legalization, the ethics of MAiD remain contentious. The bioethical literature has attempted to differentiate MAiD from withdrawing life-sustaining treatment (WLT) in an effort to examine the nature of the moral difference between the two. However, this research has often neglected the firsthand experiences of the clinicians involved in these procedures. 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 descriptive approach to explore physicians’ experiences and bioethical distinctions in providing MAiD and WLT. Results Semi-structured interviews were conducted with 21 physicians, and the transcripts were thematically analyzed to identify common patterns and divergences in their perspectives. Three core themes were found: (1) consensus on MAiD’s moral equivalence with WLT despite differences between the practice, (2) discord regarding the use of the term ‘killing’, and (3) disjuncture between bioethical debates and practice. Theme 1 comprised of three sub-themes: (1.1) no moral difference between MAiD and WLT, (1.2) physician versus underlying medical condition as cause of death, and (1.3) relief of suffering. 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. Theoretical 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.https://doi.org/10.1186/s12910-025-01176-7Medical assistance in dying (MAiD)Withdrawing life-sustaining treatmentQualitative studyBioethicsPhysician perspectivesCanada |
| spellingShingle | Midori Matthew Kieran Bonner Andrew Stumpf Physicians’ moral distinctions between medical assistance in dying (MAiD) and withdrawing life-sustaining treatment in Canada: a qualitative descriptive study BMC Medical Ethics Medical assistance in dying (MAiD) Withdrawing life-sustaining treatment Qualitative study Bioethics Physician perspectives Canada |
| title | Physicians’ moral distinctions between medical assistance in dying (MAiD) and withdrawing life-sustaining treatment in Canada: a qualitative descriptive study |
| title_full | Physicians’ moral distinctions between medical assistance in dying (MAiD) and withdrawing life-sustaining treatment in Canada: a qualitative descriptive study |
| title_fullStr | Physicians’ moral distinctions between medical assistance in dying (MAiD) and withdrawing life-sustaining treatment in Canada: a qualitative descriptive study |
| title_full_unstemmed | Physicians’ moral distinctions between medical assistance in dying (MAiD) and withdrawing life-sustaining treatment in Canada: a qualitative descriptive study |
| title_short | Physicians’ moral distinctions between medical assistance in dying (MAiD) and withdrawing life-sustaining treatment in Canada: a qualitative descriptive study |
| title_sort | physicians moral distinctions between medical assistance in dying maid and withdrawing life sustaining treatment in canada a qualitative descriptive study |
| topic | Medical assistance in dying (MAiD) Withdrawing life-sustaining treatment Qualitative study Bioethics Physician perspectives Canada |
| url | https://doi.org/10.1186/s12910-025-01176-7 |
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