To die, to sleep, perchance to dream? A response to DeMichelis, Shaul and Rapoport

In developing their policy on paediatric medical assistance in dying (MAID), DeMichelis, Shaul and Rapoport decide to treat euthanasia and physician-assisted suicide as ethically and practically equivalent to other end-of-life interventions, particularly palliative sedation and withdrawal of care (W...

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Bibliographic Details
Published in:Journal of medical ethics 2019-12, Vol.45 (12), p.832-834
Main Authors: Gamble, Joel L, Gamble, Nathan K, Pruski, Michal
Format: Article
Language:English
Subjects:
Anaphylaxis
Anesthesia
Assisted suicide
Bacteria
Bioethics
care of dying minors
Death & dying
Drug dosages
end of life care
Ethics
euthanasia
Medical ethics
Pain
Palliative care
Patients
Pediatrics
Physicians
Response
Responses
right to refuse treatment
Suicides & suicide attempts
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Summary:In developing their policy on paediatric medical assistance in dying (MAID), DeMichelis, Shaul and Rapoport decide to treat euthanasia and physician-assisted suicide as ethically and practically equivalent to other end-of-life interventions, particularly palliative sedation and withdrawal of care (WOC). We highlight several flaws in the authors’ reasoning. Their argument depends on too cursory a dismissal of intention, which remains fundamental to medical ethics and law. Furthermore, they have not fairly presented the ethical analyses justifying other end-of-life decisions, analyses and decisions that were generally accepted long before MAID was legal or considered ethical. Forgetting or misunderstanding the analyses would naturally lead one to think MAID and other end-of-life decisions are morally equivalent. Yet as we recall these well-developed analyses, it becomes clear that approving of some forms of sedation and WOC does not commit one to MAID. Paediatric patients and their families can rationally and coherently reject MAID while choosing palliative care and WOC. Finally, the authors do not substantiate their claim that MAID is like palliative care in that it alleviates suffering. It is thus unreasonable to use this supposition as a warrant for their proposed policy.
ISSN:0306-6800
1473-4257
DOI:10.1136/medethics-2019-105393