The Waxing & Waning of Informed Consent: Medical Assistance in Dying and the Question of Advance Requests
Bibliographic record
Abstract
This paper traces the impact of the principle of informed consent on Canadian legal developments in the area of advance directives, medical assistance in dying (MAID), and (where the two converge) advance requests in the context of MAID. I show how recognition of the principle of informed consent has not only served to justify developments in the law facilitating advance directives; it has also played an important role in justifying the legalization, under specific circumstances, of MAID. The paradigmatic case of informed consent is where a clearly competent, fully informed adult effectively communicates with their physician, contemporaneously to the administration of treatment. Deviation from these conditions raises questions about how to apply the principle. I examine the claim that the ascendance of the informed consent principle has eclipsed other principles while obscuring the role that the professional judgment of physicians plays in the provision of medical treatment. I analyse this claim in relation to conflicts over prolongation of so-called futile treatment and access to MAID. I then argue why the capacity requirement, barring advance requests for MAID, is justified.
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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 | 0.052 | 0.073 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.011 | 0.119 |
| Scholarly communication | 0.010 | 0.020 |
| Open science | 0.002 | 0.009 |
| Research integrity | 0.021 | 0.023 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".