Controversial Topics in Medical Assistance in Dying: Both Sides Now

Abstract: Medical Assistance in Dying (MAiD) has posed a challenge to psychiatrists, palliative medicine practitioners, and bioethicists since it was legalized in Oregon 25 years ago. This session will tackle four of its most controversial aspects: 1) whether it is appropriate to call it suicide; 2) should people with mental illnesses be eligible for this death-hastening practice; 3) does the Canadian protocol represent an improvement on the American practice; and 4) should MAiD include patients with neurodegenerative disorders, e.g. Alzheimer’s disease.

Joni Mitchell’s “Both Sides Now” is one of the singer’s most beloved songs with its iconic line, “Well something’s lost, but something’s gained/ In living every day.” The lyrics describe a romantic way of seeing things and the changing perspective that may come with time. A unique feature of this session is that each of the 4 speakers will present arguments both in favor and in opposition to some of MAiD’s debatable issues.

We greatly desire that our audience of consultation psychiatrists will arrive at their own opinions based on available information. The speakers will emphasize active learning and encourage participation by frequently polling the audience about its opinions of these matters. At least 20% of the session will be interactive.

15 minutes- Thomas Strouse, MD, the inaugural holder of the Maddie Katz Chair in Palliative Care Research and Education at UCLA, works as a psycho-oncologist and palliative care physician. He was involved in the adoption of the California EOL Options Act and will present, “Assisted Suicide vs Assisted Dying: What’s in a Name?”

15 minutes- Jay Nathanson, MD, MPH, is a member of the ACLP Bioethics SIG and an assistant professor at the University of Toronto. He will present, “MAiD for Patients Who Have a Mental Disorder as Their Sole Underlying Medical Condition: Can We Determine Irremediability of Psychiatric Conditions?”

15 minutes- Madeline Li, MD, is an associate professor in the Department of Psychiatry, University Health Network and a clinician scientist in the Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital. She will present, “The Good, the Bad, and the Ugly of the US/Canadian MAiD Programs.”

15 minutes- Lew Cohen, MD, is a professor emeritus at Tufts University and UMass-Chan Medical Schools, and the recent author of “Winter’s End: Dementia and Dying Well.”

15 minutes- Audience contributions, brainstorming opportunities, sample questions, and discussion.

The Bioethics SIG will sponsor this session designed for C-L psychiatrists from all levels of experience who care about end-of-life issues.