Dignity Or Ableism: The Ethical Implications Of Medical Aid In Dying (MAID)

The U.K. recently proposed a bill that would legalize medical aid in dying (MAID), which caused a social media debate regarding the potential consequences if it is legalized. While MAID requires the recipient to be terminally ill and mentally competent, there have been cases in Canada that have abused the practice. As a result, some people are strongly against the procedure, while others believe dying with dignity is a compassionate act for those who desperately need it.

MAID is like euthanasia, but they slightly differ. The first mention requires the terminally ill person to administer the fatal medication, while euthanasia uses a medical practitioner to administer the drug. While the procedure is legal in several countries like Canada, Spain, Australia, and Switzerland, it is only legal in ten U.S. states and the District of Columbia. With potential legalization in the U.K., people on social media weighed in on how ableism, defined as the discrimination against disabled people, can influence who is eligible for the procedure. However, proponents of MAID center around bodily autonomy and the ability to opt out of terminal pain as a right.

Supporters of MAID feel that how a person chooses to live their life is their choice, which should also be extended to how they choose to die. They argue that their body is their choice, so why should others care about what they choose to do with it? In addition, harm reduction through compassionate death for the terminally ill is an important aspect of why supporters favor the procedure. Caretakers of terminally and chronically ill patients also expressed that seeing their loved ones endure a declining lifestyle was painful to witness. Others who were initial supporters of MAID changed their minds after learning about the extreme cases in Canada that approves the procedure for non-terminally ill patients.

The slippery slope of disabled people internalizing the idea of being a burden to their loved ones is another reason former supporters are against the procedure. Due to ableism, disabled people who are societally challenged in managing their disabilities can subconsciously be inclined to seek MAID.  Even though the intention is harm reduction, the consequences based on Canada’s program implementation are alarming. MAID approval in Canada has occurred for poor and disabled people who are housing insecure and unable to afford their medication or medical procedures. People also cited research that reported how some healthcare providers in Canada received pleasure in administering euthanasia, which is alarming because it can prematurely influence their suggestion of such programs for patients who don’t need it. So, while former supporters understand the desire for a dignified death, the implementation of the program is more concerning for them.

Those opposed to the procedure claim the government cannot be trusted when deciding on who should live or die. They assert that the government’s motive is not rooted in a dignified death but rather in getting rid of the “undesirable people” in our society, such as the disabled, poor, and homeless. As homelessness is becoming more criminalized in the U.S., there is a concern that MAID will be suggested as a viable solution for poor people. In addition, countries such as Canada, the Netherlands, and Switzerland have previously granted MAID approval for mentally disabled patients, which means they did not have to be terminally ill to receive the procedure.

The ethical implications of MAID, as witnessed in Canada, lead to a bigger question about disability justice and access to health care. Our society is very ableist; to the point that it is embedded within our daily vocabulary, which includes words such as crazy, insane, degenerate, and dumb. We are conditioned to discriminate against disabled people, because they are considered undesirable in a capitalist society that values able-bodied people who can produce labor. We are taught to undermine their voices and exclude them from society, because they are not desirable enough to be seen. However, anyone can become disabled, especially as we age, which is why addressing ableism and socioeconomic factors that prevent access to health should be prioritized.

Addressing ableism requires unlearning our conditioned beliefs and attitudes toward disabled people and treating them with dignity while they are alive, not just in death. It requires addressing the systemic implications of capitalism that lead people to opt for MAID, as opposed to palliative or hospice care. We should be asking ourselves if people with terminal illnesses had all the resources required to lead a comfortable life, would they still choose assisted death as an option? Can programs like MAID truly be ethical when people lack basic needs, including healthcare, in an ableist system?

While euthanasia is helpful for terminal patients, non-terminal disabled people who can live a comfortable life just by being given the proper resources become the target. Does the result of dignity in death justify the collective harm of disabled people? Only you can answer that, but it’s important to remember that even if you aren’t disabled, poverty could potentially make you susceptible to MAID in the future. You must center disabled voices in these conversations.