MAID and psychiatric illness Flashcards
What is the distinction between euthanasia and physician assisted suicide?
It depends on who administers (physician or self done)
What is the argument for why PAS is preferred?
Pragmatic reason: protection against a last second change of mind
What is the argument for why euthanasia is preferrable?
It is safer, and some are not able to physically do it
Why would we reject the terminology MAID?
It suggests euthanasia but it could be PAS
Why should we use the term suicide over “aid-in-dying”?
It prevents the question about wither one is eligible or not as aid suggests that it should only be given to terminally ill
How is MAID criteria determined in the USA?
It only provides for one who is likely to die in 6 mos
What is the movement against PAD?
Some argue that suffering can be addressed by palliative care
What was the case of Brittany Maynard?
Terminal brain cancer decided palliative care was not enough as her condition would become very full of suffering long-term, but it became an exception in the USA where she was allowed PAD
What is the role shift associated with MAID?
Providers shift from curers to relieving physical suffering, and providing a strong death
What does Steinbock argue about incurable illness eg. ALS?
It would be inconsistent to not allow them to die and call their suffering less than others
Why did the “24 and ready to die” girl provide an argument for MAID?
She changed her mind after being allowed access to euthanasia as perhaps less despair, and a feeling of being seen
What is the problem with identifying Treatment-Resistant-Depression?
There is no consensus on adequate treatment before something is considered treatment-resistant. People are suspicious of the efficacy of ANY treatment
What is the argument for psychiatric treatment and future predictions?
Patients should be able to make decisions based on what is available to them and not based on potential future treatments
What is the assumption made about competence and MAID in depression?
If a patient is allowed MAID, it is assumed they are competent enough to make their own descision
What are the two features of competence?
Decision relative: One can be incompetent in high level mathematics but competent in suicide
It is a threshold concept: people are competent or not
What are the three proponents of medical competence in decision making?
- Understanding the information
- Reasoning the information and weigh outcomes
- Appreciate the significance of all the information
What does Rooney argue?
Excluding psychiatric patients from MAID is discriminatory. Careful regulation is better than blanket exclusion
What is irremediableness?
A condition when no reasonable treatment options remain
What utility calculation is made with irremediableness?
False positives are ok, it is ok to let people who aren’t irremediable die in order to let people who actually are irremediable access MAID
Study 1 in the Rooney paper described TRD as what?
A depressive episode resistant to 2-6 treatments, with low rates of remission (3.6% first year, 7.8% at 2 years)
Study 2 in the Rooney paper described TRD as what?
Having higher rates of remission, but still being plausible as irremediable
What is the cost of banning MAID for TRD?
Individuals facing agony, failed suicide attempts, consequences of successful suicide
What does the term vulnerability mean?
Someone who is more vulnerable to the idea of committing suicide may have the scales tipped by the suggestion or mention of it
What is the problem with the word vulnerability according to Rooney?
It is too broad and unclear
