Medical assistance in dying (MAID) for minors in Canada: considering children's voices
Notice bibliographique
Résumé
The Special Joint Committee on Physician Assisted Dying has recommended the extension of current medical assistance in dying (MAID) legislation in Canada (Bill C-14) to include mature minors. A mature minor is anyone under the age of 18 demonstrating sufficient capacity to understand their medical condition, and the risks and benefits of available treatments. Although mature minors are the only minors being considered under the current recommendations regarding future legislation, Canadian health care professionals are already being approached with inquiries about MAID for minors who do not meet mature minor criteria. Current eligibility criteria for MAID include a requirement of informed consent, and that of intolerable suffering. Most minors are presumed, by the law and in health care practice, not to have the capacity to consent. Parents/guardians would therefore have to act as surrogate decision makers. Reliance on parents/guardians as surrogate decision makers increases the risk of inaccurately assessing the more subjective eligibility criteria for MAID, particularly suffering intolerably, by excluding the subjective perspective of the minor regarding her own intolerable suffering. Health care professionals' accounts of a minor's intolerable suffering also increase this risk. When factored into determinations of a minor's eligibility for MAID, inaccurate assessments of intolerable suffering raise concern about justice in the context of MAID for minors. This research began with a hypothesis that the subjectivity of suffering makes it important to incorporate the sufferers' own voice in an accurate assessment of intolerable suffering. This thesis explores how the child's voice, as representative of the child's experience, can be useful in adequately assessing that a minor is suffering intolerably, and thus factor into determinations of that child's eligibility for MAID. The conceptual framework of children's agency from the New Sociology of Childhood literature provides a theoretical foundation for elicitation of the child's voice, and hence a plausible means of assessing the intolerable suffering of a minor. The 'child's voice' refers to communication from the child using words, illustration, actions, assistive devices, or silence, that serves as a metaphor for children's perspectives, and may provide epistemological access to a child's experience. This thesis demonstrates that children's voices can provide valuable information for decision-making pertaining to MAID for a minor; however, it is not clear whether the insight that children's voices can provide in assessing intolerable suffering is sufficient for the context of MAID for minors. This thesis identifies this matter as something that would have to be considered in greater detail if considering an extension of MAID legislation to all minors in the future.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,023 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,025 | 0,011 |
| Communication savante | 0,007 | 0,003 |
| Science ouverte | 0,002 | 0,007 |
| Intégrité de la recherche | 0,003 | 0,008 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».