When death is desired: A case of MAiD & the CL psychiatrist.

Physician-assisted dying (PAD) includes both euthanasia and medical aid in dying (MAiD). Euthanasia is illegal in the United States, while MAiD is legal in some jurisdictions. This paper reviews a case in which a patient successfully carried out a MAiD request, with the consultation-liaison psychiatry department involved at various stages of care. The case highlights end-of-life care issues, debates, and treatment modalities for individuals requesting MAiD. The authors suggest MAiD will remain a sensitive and controversial topic and that clinicians should engage in the debate to facilitate informed decision making.

Study at a glance

Abstract

Since physician-assisted dying (PAD) has become a part of the clinical dialogue in the United States (US) and other Western countries, it has spawned controversy in the moral, ethical, and legal realm, with significant cross-country variation. The phenomenon of PAD includes 2 practices: Euthanasia and medical aid in dying (MAiD). Although euthanasia has been allowed in different parts of the world, in the US it is illegal. MAiD has been enacted into law in some jurisdictions. As the practice involves people at the end of life (EOL), often with cancer, and sometimes struggling with psychiatric symptoms; they gain added salience in the field of Consultation-Liaison (CL) Psychiatry in general and Psycho-Oncology in particular. The current paper reviews a case where a patient did request for MAiD and successfully carried it through, this case became more salient, as the CL Psychiatry department was intimately linked at various stages of care for the patient. In describing the case several other aspects of EOL care issues were touched upon, and the various debates as well as treatment modalities, for an individual requesting for medical aid in dying were described. MAiD will possibly remain a sensitive and controversial topic of discussion across the spectrum of healthcare, and as responsible and compassionate advocates for the patients, clinicians need to engage more with the debate surrounding it and facilitate informed decision making. We believe that the present case will throw light on to this enigmatic practice and help in furthering the dialogue surrounding MAiD.