Can a Case Be Made for Expanding Medical Aid in Dying within the United States?

• In Event: 3129 - Section on Medical Sociology Refereed Roundtables (1 hour)
  In Refereed Roundtable 60min: Table 29. Issues in Aging and Dying

Abstract

Background. As a number of U.S. states are actively campaigning for the legalization of medical aid in dying (MAiD), questions regarding how to improve the existing legislation and develop improved legislative models have become of central concern. Discussions of whether and how to expand access to MAiD often ignore a number of important, but contentious issues.

Objective. To draw upon evidence from a variety of jurisdictions, including those in the United States as well as other countries where MAiD is legal, to help better inform debates and to foster new more efficacious legislation that could be replicated, with minor modifications, across the United States and abroad.

Methods. We draw upon evidence, both quantitative and qualitative, including the relevant legislation in various states, countries, and other relevant jurisdictions (e.g. , DC in the United States, Québec in Canada, etc.), quantitative empirical medical studies, and newspaper articles in addition to 19 semi-structured interviews some in-person and others via Skype or phone with 9 healthcare professionals who have direct experience providing MAiD, 7 representing organizations supporting or in opposition to MAiD, 2 bio-ethicists, and 1 lawyer specialized in end-of-life law. Our participants were located in the U.S. (Colorado, California, Oregon), the Netherlands, Belgium, Switzerland, and Canada.

Results. We find evidence suggesting that expanding MAiD legislation in the United States to include individuals with some degenerative diseases, some forms of mental illness, and possibly even to mature minors, would be of benefit to many of those seeking MAiD. Additionally, the legalization of advance requests would expand access to individuals with dementia, while the legalization of physician-administered MAiD would improve access for those who are unable to orally self-administer medication. The evidence suggests that for the foreseeable future the expansion of MAiD programs in the United States is most likely to proceed on a state-by-state basis.

Authors

• Cristina I. Zubizarreta, Boston College

• John B. Williamson, Boston College