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Canada has followed the pattern of Benelux nations by legislating sufferingSuffering as the pivotal eligibilityEligibilitycriterionCriterion for euthanasiaEuthanasia/assisted death without requiring terminal prognosis as is needed in most permissive jurisdictions. This chapter will explore the relationship between sufferingSuffering and Medical Assistance in Dying (MAID) and the ways in which sufferingSuffering is understood in the Supreme Court of Canada, the federal Criminal Code legislation and by health care assessors. Based on this analysis, we will argue that the resulting sufferingSufferingeligibilityEligibilitycriterionCriterion leaves the law (...) open to unintended forms of interpretation, thus instituting perhaps the most unbounded and risk-prone form of assisted death in the world. A review of the literature on sufferingSuffering, the wish to dieWish to die, and reasons for MAIDReasons for MAID requests found sufferingSuffering of severe illness to be frequently associated with unstable mental health, social, and existentialExistential variables that are often amenable to therapy or remediation. While sufferingSuffering remains a powerful motivating force to seek opportunities to relieve distress, its use as an eligibilityEligibilitycriterionCriterion for MAID has significant ambiguity in its’ characterization of ‘enduring’ and ‘irremediable’ and thus fails to protect against abuse for the vulnerable. (shrink)

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The chapter explores the sufferingSufferingassociated with MAIDMedical Assistance in Dying (MAID) giving special attention to assessmentAssessment and the psychological responses elicited in caregivers highlighting the need for all MAIDMedical Assistance in Dying (MAID) enquiries to activate a period of intense assessmentAssessment and the provision of detailed treatment alternatives. This chapter calls for a renewed commitment to compassionCompassion (‘sufferingSuffering together with’) as the communal dynamic to relieve and assuage such sufferingSuffering. Using the four domains of ‘total pain’ (Saunders in The management (...) of terminal malignant disease. Edward Arnold, London, UK, 1978), we summarize the evidence for the multiple opportunities available to ‘relieve often and comfort always.’ Finally, we review evidence on the impactImpactof MAIDMedical Assistance in Dying (MAID) suggesting that the overall burden of sufferingSuffering in Canada has increased since legalization. (shrink)

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