Conscientious refusal to provide medically assisted dying

Medical assistance in dying (MAiD) became legal in Canada in June 2016. Since that time, many health-care practitioners and health-care institutions have undertaken to provide it, and thousands of Canadians have taken advantage of it. At the same time, a significant number of both practitioners and institutions have refused provision of MAiD for various reasons, including conscience-based objections to it. In this article, I argue that refusal by practitioners could, and should, be tolerated but only where it could be accommodated in practice groups without unduly burdening willing providers or adversely affecting patient access. My conclusion about refusal by institutions is less compromising. In this case, the cost to vulnerable patients of MAiD being delayed or denied is much greater and the burdens of conscience (if we may call them that) to institutions are insignificant. Since it cannot be accommodated without seriously impairing both patient access and patient well-being, refusal by publicly funded health-care institutions to offer MAiD must be completely disallowed.