The Moral Status of Medical Assistance in Dying (MAID)

Should Cases of Treatment Resistant Depression Qualify?

Abstract

This paper contains two parts. In Part I, I argue that the provision of medical assistance in dying (MAID) to competent patients with an irremediable illness-causing great suffering is of no greater moral concern than the practice of refusing life-sustaining treatment, as they are both supported by the same fundamental bioethical principles. In Part II, I argue that although MAID is morally permissible in many cases, we should not yet allow MAID for treatment-resistant clinical depression. We currently lack criteria to determine with reasonable certainty if any case of depression is irremediable or not due to missing data and publication bias in the available research evidence on the effectiveness of typical treatment methods. These issues might mislead physicians and patients to judge a given case of depression irremediable when it is not, leading to a premature death which deprives the patient of a real chance of recovery, which constitutes maleficence.