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Raj777's avatar

Thank you. Tax return netfile specific questions are being placed about organ donations.

They want our organs.

John Fernandes's avatar

We need to stop pretending that MAiD exists in a vacuum.

In a well-resourced system with timely access to psychiatry, rehabilitation, chronic pain care, palliative medicine, and social supports, the autonomy argument is different. In our current system, autonomy is often exercised in the context of scarcity.

I had a quadriplegic patient referred from the Emergency Department. Instead of coordinated rehabilitation, specialist advocacy, and aggressive functional planning, the pathway he encountered included a MAiD referral. Orthopedics assessed him and suggested MAiD as an option, then disengaged.

He was not dying. He was not untreatable. He was complex. He required access, time, and coordinated care. The system could not deliver that. Death was easier to access than rehabilitation.

When a curable or manageable patient is offered MAiD because care is fragmented or inaccessible, that is not compassion. That is system failure dressed as choice.

We are drifting toward a model where MAiD functions as a pressure release valve for underfunding and dysfunction. It is faster to assess eligibility for death than to secure long-term rehab, psychiatric follow-up, housing, or chronic pain resources. That should alarm us.

Physicians are trained to restore function and relieve suffering. If our response to system barriers becomes medicalized death rather than aggressive advocacy for care, we are redefining our profession.

The debate should continue. But if we expand MAiD faster than we expand access to meaningful alternatives, we are not strengthening autonomy. We are narrowing it.

And that is a dangerous shift.

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