Medical Assistance in Dying: Challenges for Psychiatry
Bibliographic record
Abstract
Medical Assistance in Dying (MAiD), which comprises euthanasia and medically assisted suicide, is practiced in a growing number of countries and jurisdictions. In countries where it is permitted, the individual who requests it must be experiencing severe pain and suffering, but not all countries require the individual to be terminally ill. In some countries the suffering may be caused by a mental disorder in the absence of physical illness or disease. The consideration of mental illness as the sole indication for MAiD is likely to be considered in more jurisdictions. However, the ethical duties of a doctor to promote health, reduce suffering and protect life may conflict with one another when viewed from the perspective of MAiD. Arguments in favour of including mental illness as a sole qualifier for MAiD include the respect for the autonomy of the individual, and the equivalence of mental illness with physical illness. Arguments against, include the view that the protection of life is paramount, and the “slippery slope” of ever more permissive practices that fail to protect the vulnerable in society. Given the ethical and other practical concerns, there is a need for psychiatric bodies internationally to provide guidance on this issue.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.024 | 0.028 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.011 | 0.031 |
| Scholarly communication | 0.011 | 0.014 |
| Open science | 0.004 | 0.015 |
| Research integrity | 0.021 | 0.034 |
| Insufficient payload (model declined to judge) | 0.017 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".