When the decision to die interferes with the duty to heal

Abstract Background This commentary was inspired by an encounter M. M. experienced while shadowing a physician in 2024. The physician referred an otherwise healthy patient between 64 and 74 years old for a routine colonoscopy due to relevant risk factors. However, instead of the anticipated report,...

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Main Authors: Maya Morcos, Amir-Ali Golrokhian-Sani
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Archives of Public Health
Online Access:https://doi.org/10.1186/s13690-025-01615-2
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author Maya Morcos
Amir-Ali Golrokhian-Sani
author_facet Maya Morcos
Amir-Ali Golrokhian-Sani
author_sort Maya Morcos
collection DOAJ
description Abstract Background This commentary was inspired by an encounter M. M. experienced while shadowing a physician in 2024. The physician referred an otherwise healthy patient between 64 and 74 years old for a routine colonoscopy due to relevant risk factors. However, instead of the anticipated report, they received a letter from the specialist stating their refusal to complete the procedure. The reason cited for refusal: medical assistance in dying (MAiD). In the meeting with the specialist, the patient mentioned that they were considering pursuing MAiD for depression in 2026 - a choice that, notably, would not be available for solely mental health conditions until March 17, 2027. Results/Conclusion Here, we consider multiple angles centred around how we should treat MAiD, particularly when it intersects with decisions related to life expectancy. Policy reform is necessary to address this potential form of discrimination across all subspecialties in medicine, advocating instead for collaborative, case-by-case decision-making between physicians and patients to discuss their goals of care and risks. To this end, we propose a four-pronged approach, including guidelines, medical ethics training, patient-targeted education, and further research.
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spelling doaj-art-d0924a8bad294fd7b8eeb2d0ea4166de2025-08-20T03:53:08ZengBMCArchives of Public Health2049-32582025-05-018311410.1186/s13690-025-01615-2When the decision to die interferes with the duty to healMaya Morcos0Amir-Ali Golrokhian-Sani1Faculty of Medicine, University of OttawaFaculty of Medicine, University of OttawaAbstract Background This commentary was inspired by an encounter M. M. experienced while shadowing a physician in 2024. The physician referred an otherwise healthy patient between 64 and 74 years old for a routine colonoscopy due to relevant risk factors. However, instead of the anticipated report, they received a letter from the specialist stating their refusal to complete the procedure. The reason cited for refusal: medical assistance in dying (MAiD). In the meeting with the specialist, the patient mentioned that they were considering pursuing MAiD for depression in 2026 - a choice that, notably, would not be available for solely mental health conditions until March 17, 2027. Results/Conclusion Here, we consider multiple angles centred around how we should treat MAiD, particularly when it intersects with decisions related to life expectancy. Policy reform is necessary to address this potential form of discrimination across all subspecialties in medicine, advocating instead for collaborative, case-by-case decision-making between physicians and patients to discuss their goals of care and risks. To this end, we propose a four-pronged approach, including guidelines, medical ethics training, patient-targeted education, and further research.https://doi.org/10.1186/s13690-025-01615-2
spellingShingle Maya Morcos
Amir-Ali Golrokhian-Sani
When the decision to die interferes with the duty to heal
Archives of Public Health
title When the decision to die interferes with the duty to heal
title_full When the decision to die interferes with the duty to heal
title_fullStr When the decision to die interferes with the duty to heal
title_full_unstemmed When the decision to die interferes with the duty to heal
title_short When the decision to die interferes with the duty to heal
title_sort when the decision to die interferes with the duty to heal
url https://doi.org/10.1186/s13690-025-01615-2
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