Introduction
Medical Assistance in Dying (MAID) represents a profoundly contentious ethical issue within healthcare and nursing, particularly in jurisdictions like Canada where it has been legalized. This essay explores MAID, defined as the provision of medical aid to end a patient’s life at their request, typically in cases of terminal illness or unbearable suffering (Government of Canada, 2023). The purpose is to present a balanced view by articulating both sides, while stating my position as a nursing student against MAID, grounded in Islamic teachings and personal values. This issue is crucial to society as it intersects with fundamental questions of autonomy, sanctity of life, and healthcare equity, influencing policy, professional practice, and public trust. The discussion will outline the societal importance, my position with supporting evidence and values, an opposing viewpoint, and the application of an ethical framework—specifically, deontological ethics informed by religious principles. Ultimately, I argue that opposing MAID aligns best with preserving life’s intrinsic value.
Societal Importance of Medical Assistance in Dying
MAID holds significant societal importance due to its implications for end-of-life care, individual rights, and healthcare systems. In Canada, where MAID was legalized in 2016, it addresses the needs of patients experiencing irremediable suffering, with over 13,000 cases reported by 2022 (Government of Canada, 2023). This practice raises ethical debates about balancing patient autonomy against potential risks, such as coercion or unequal access in rural areas (Panchuk & Thirsk, 2021). Societally, MAID challenges cultural norms around death and dying, potentially normalizing euthanasia while straining healthcare resources and professional ethics. For nurses, it necessitates navigating conscientious objections, which can impact workforce retention and patient care equity (Pesut, Thorne & Greig, 2020). Furthermore, as populations age and chronic illnesses rise, MAID’s expansion could influence global healthcare policies, underscoring the need for robust ethical scrutiny to prevent slippery slopes toward broader eligibility criteria (Herx, Cottle & Scott, 2020). Thus, debating MAID is essential for fostering a compassionate society that respects diverse values without compromising vulnerable groups.
My Position Against Medical Assistance in Dying
As a nursing student guided by Islamic principles, I firmly oppose MAID, viewing it as incompatible with the sanctity of life. Islam teaches that life is a sacred trust from Allah, and intentionally ending it, even in suffering, contravenes divine will (Madadin et al., 2020). The Quran emphasizes patience in adversity, stating, “And do not kill yourselves. Indeed, Allah is to you ever Merciful” (Quran 4:29), which underpins my personal belief that enduring hardship fosters spiritual growth. Professionally, this aligns with nursing codes emphasizing preservation of life and non-maleficence, such as the Canadian Nurses Association’s (2017) Code of Ethics, which prioritizes dignity without endorsing euthanasia.
Evidence supports this stance, highlighting risks like the “normalization” of euthanasia in Canada, where provider concentration may lead to policy capture and inadequate safeguards (Lyon, Lemmens & Kim, 2024). Studies show that requests for MAID often stem from existential distress rather than solely physical pain, suggesting alternatives like palliative care could suffice (Wiebe et al., 2018). My position is underpinned by personal values of faith-driven compassion, professional commitments to holistic care, and institutional ethics, such as Alberta Health Services’ (2016) Code of Conduct, which stresses protecting life. Indeed, opposing MAID promotes a healthcare ethos focused on alleviating suffering through supportive means, arguably preventing ethical erosion.
Opposing Position in Favor of Medical Assistance in Dying
Conversely, proponents of MAID argue it upholds patient autonomy and relieves intolerable suffering, presenting a compassionate alternative to prolonged agony. This view posits that individuals with terminal conditions should have the right to a dignified death, grounded in evidence from Canadian data showing most requests arise from loss of autonomy or unbearable pain (Wiebe et al., 2018). Legally, Canada’s framework ensures eligibility only for competent adults with grievous conditions, minimizing abuse (Government of Canada, 2023). Supporters, including some healthcare professionals, value utilitarianism, prioritizing the greatest good by reducing suffering and respecting self-determination (Conceptual, legal, and ethical considerations, 2024).
This position likely stems from personal values of individualism and empathy for suffering, professional emphases on patient-centered care, and institutional frameworks like Interior Health’s (2019) ethics guide, which supports decision-making autonomy. Speculatively, advocates may prioritize secular humanism over religious doctrines, viewing MAID as an extension of bodily rights, similar to abortion or refusal of treatment. However, this perspective sometimes overlooks rural nursing challenges, where conscientious objections complicate access (Panchuk & Thirsk, 2021). Therefore, while grounded in evidence of improved end-of-life quality, it risks undervaluing life’s inherent worth.
Application of an Ethical Framework to Support My Position
To bolster my opposition to MAID, I apply deontological ethics, a duty-based framework emphasizing absolute moral rules regardless of outcomes (Frolic & Holland, 2023). Rooted in Kantian philosophy, deontology holds that actions like intentional killing are inherently wrong, aligning with Islamic prohibitions against euthanasia (Madadin et al., 2020). In nursing, this framework supports conscientious objection, as seen in rural settings where nurses invoke deontological duties to preserve life (Pesut, Thorne & Greig, 2020).
Applying deontology to MAID, the categorical imperative demands treating persons as ends, not means; thus, assisting in death violates the duty to protect life, even if it alleviates suffering. This contrasts with consequentialist approaches favoring MAID for outcomes like reduced pain. Evidence from Canada illustrates deontology’s relevance: the “cautionary tale” of normalization warns against eroding duties, potentially leading to expanded criteria including mental illness (Herx, Cottle & Scott, 2020). As a nurse, this framework reinforces my values by prioritizing non-negotiable principles over situational ethics, ensuring consistent care. Furthermore, integrating Islamic deontology—viewing life as sacred—strengthens this application, promoting palliative alternatives that honor duties without compromise.
Conclusion
In summary, MAID presents a divisive ethical issue in nursing, balancing autonomy against life’s sanctity. Its societal importance lies in shaping compassionate healthcare amid aging populations. My position against MAID, rooted in Islamic values and deontological ethics, is supported by evidence of risks like normalization and alternatives in palliative care. While proponents emphasize relief from suffering through autonomy, underpinned by utilitarian values, I believe opposition best upholds moral duties and prevents ethical slippery slopes. Ultimately, prioritizing life’s preservation fosters a more equitable, faith-respecting society, encouraging nurses to advocate for supportive end-of-life options.
References
- Alberta Health Services. (2016) Alberta Health Services: Code of conduct. Alberta Health Services.
- Canadian Nurses Association. (2017) Code of ethics for registered nurses. Canadian Nurses Association.
- Conceptual, legal, and ethical considerations in physician-assisted suicide: An overview. (2024) UUM Journal of Legal Studies, 15(2), pp. 707-744. Available at: https://doi.org/10.32890/uumjls2024.15.2.12.
- Frolic, A.N. and Holland, T. (2023) An ethics framework for medical assistance in dying: Supporting ethical decision-making in the practice of MAiD. Bioethics, 37(1), pp. 11-20.
- Government of Canada. (2023) Medical assistance in dying. Government of Canada.
- Herx, L., Cottle, M. and Scott, J. (2020) The “normalization” of euthanasia in Canada: The cautionary tale continues. World Medical Journal.
- Interior Health. (2019) Interior Health ethics framework and decision-making guide. Interior Health.
- Lyon, C., Lemmens, T. and Kim, S.Y.H. (2024) Canadian medical assistance in dying: Provider concentration, policy capture, and need for reform. American Journal of Bioethics, 24(5), pp. 6-25. Available at: https://doi.org/10.1080/15265161.2024.2441695.
- Madadin, M., Al Sahwan, H.S., Altarouti, K.K., Altarouti, S.A., Al Eswaikt, Z.S. and Menezes, R.G. (2020) The Islamic perspective on physician-assisted suicide and euthanasia. Medicine, Science and the Law, 60(4), pp. 278-286. Available at: https://doi.org/10.1177/0025802420934241.
- Panchuk, J. and Thirsk, L.M. (2021) Conscientious objection to medical assistance in dying in rural/remote nursing. Nursing Ethics, 28(5), pp. 766-775. Available at: https://doi.org/10.1177/0969733020976185.
- Pesut, B., Thorne, S. and Greig, M. (2020) Shades of gray: Conscientious objection in medical assistance in dying. Nursing Inquiry, 27(1), e12308. Available at: https://doi.org/10.1111/nin.12308.
- Wiebe, E., Shaw, J., Green, S., Trouton, K. and Kelly, M. (2018) Reasons for requesting medical assistance in dying. Canadian Family Physician, 64(9), pp. 674-679. Available at: https://www.cfp.ca/content/64/9/674.full.
