ETHICS CONSULTATION IN MEDICAL AID IN DYING

Abstract: Medical Aid-In-Dying (AID) is legal and available in 11 U.S. jurisdictions and is available to approximately 25% of the U.S. population. AID raises ethical issues when patient suitability, actual clinical practice and legal requirements pose conflicts for health care providers. The Academy of Aid-In-Dying Medicine (AADM) provides a national Ethics Consultation Service (ECS)that any provider may access for advice and deliberates much like a hospital ethics committee. ECS members include physicians, nurses, philosophers and lawyers and have extensive experience in ethics consultation.
In this session 4 members of the AADM ECS will discuss cases and themes which have arisen in our work over the past 3 years. Presenter 1 will set a framework for the issues discussed. Presenter 2 will discuss situations where hospice policies may act as barriers to patients’ access to MAID. Moral distress of hospice providers, restrictive hospice polices (such as “leave-the-room”) and the nature of the hospice-patient relationship may conflict with patient autonomy to choose MAID. Presenter 3 will discuss the case of a patient who was unable to self-administer the AID prescription and will discuss ethical concerns regarding the legal requirement of self-administration. Presenter 4 will consider a case of an illness with variable disease progression and the moral distress that may arise when prescribing providers disagree about eligibility for MAID.
Each presenter will use 10 minutes, to leave ample time for discussion.

Keywords: Medical Aid in Dying, Patient Autonomy, Legal constraints