The Ethics of Dying: Deciphering Pandemic-Resultant Pressures That Influence Elderly Patients' Medical Assistance in Dying (MAiD) Decisions

The Impact of the COVID-19 Pandemic on Unassisted Suicide and Assisted Suicide Rates in French-Speaking Switzerland: Differences by Gender

Aims: Most studies on the impact of COVID-19 have shown a decrease or no change in unassisted suicide rates, but effects on assisted suicide have not been studied. We aimed to estimate the association between the COVID-19 pandemic and both types of suicide. Methods: Between 2017 and 2021, 1280 assisted suicides and 535 unassisted suicides were recorded in three Swiss cantons. We conducted descriptive and time series analyses on monthly suicide rates, categorized by gender. Results: Among women, a decrease in assisted suicide rates was found during the acute phases of the pandemic. Among men, assisted suicide rates increased gradually from the onset of the pandemic. Regarding unassisted suicide rates, no significant change was observed in women, while in men, there was a decrease, which was larger at the end than at the onset. Conclusions: COVID-19 had contrasting effects on assisted and unassisted men and women suicide rates.

Should Physician-Assisted Suicide or Euthanasia be Legalized in the United States? A Medically Informed Perspective

There is a pressing debate in the United States concerning the implied physicians' obligation to do no harm and the status of legalizing physician-assisted suicide (PAS). Key issues that underpin the debate are important to consider. These include: (1) foundational medical beginnings; (2) euthanasia's historical and legal background context; and (3) the key arguments held by those for and against legalization of PAS. This paper reviews the major claims made by proponents for the legalization of PAS and the associated complexities and concerns that help underscore the importance of conscience freedoms. Relief of suffering, respect for patient autonomy, and public policy arguments are discussed in these contexts. We argue here that the emphasis by healthcare providers should be on high quality and compassionate care for those at the end of life's journey who are questioning whether to prematurely end their lives. If medicine loses its chief focus on the quality of caring-even when a cure is not possible-it betrays its objective and purpose. In this backdrop, legalization of PAS harms not only healthcare professionals, but also the medical profession's mission itself. Medicine's foundation is grounded in the concept of never intentionally to inflict harm. Inflicting death by any means is not professional or proper, and is not trustworthy medicine.

The impact of coronavirus disease 2019 on medical assistance in dying

PURPOSE OF REVIEW

The COVID-19 pandemic and measures to contain its impact are drastically altering end-of-life and grief experiences around the world, including the practice and experience of medical assistance in dying (MAiD).

RECENT FINDINGS

Recent published literature on the impact of COVID-19 on MAiD can be described under the following categories: studies investigating the impact of COVID-19 on MAiD from the healthcare providers' perspective; studies investigating the impact of COVID-19 on MAiD from the patient/family perspective; and opinion papers that review the impact of COVID-19 on MAiD from a legal-ethical perspective. Most of these studies were either conducted in Canada or included mostly Canadian participants.

SUMMARY

Recent published research on the impact of COVID-19 on MAiD highlights the tensions between COVID-19 restrictions and individual control over the circumstances of dying, and the resulting impact on patient and family suffering and on moral injury for their MAiD providers. These reports may help inform risk mitigation strategies for the current pandemic and future similar public health crises that acknowledge the value of humane, family-centered care at the end of life.