Practical and ethical complexities of MAiD: Examples from Quebec

Background: Legally practiced assisted dying is an ethically complex area in need of empirical and conceptual work. International research suggests that providing assisted dying may be experienced as rewarding and meaningful but also emotionally and psychologically taxing, associated with feelings of loss and loneliness. Yet little research has been published to date, which attends to the long-term effects of providing assisted dying. In this article, I contribute to filling this gap in the literature using the Canadian province Quebec as an illustrative case. Medical aid in dying (MAiD) in the form of physician provided euthanasia has been a lawful end of life healthcare option in Quebec since December 2015 and significant research is currently emerging from this jurisdiction. Methods: In this article, I draw on nine in-depth interviews with Quebec physicians, all of whom engaged with end of life care in different ways. Results: Four of the interviewed physicians provided medical aid in dying (MAiD) and five did not. The major themes of MAiD in relation to aggressive treatment, conscientious objection and uneven distribution of work emerge, and it appeared clearly that MAiD was experienced and thought of as qualitatively different to other end of life procedures. Conclusions: Our findings expose a complexity and contentiousness within the practice, which remains under researched and underreported and indicate avenues where more research is needed.