Bibliographic record
Abstract
Since June 2016, federal law in Canada has permitted eligible adults to request medical assistance in dying (MAiD). Until March 2021, however, the law stipulated that only those whose natural death was “reasonably foreseeable” were eligible to access MAiD. At that time, the legislation was changed to permit MAiD for anyone with a “grievous and irremediable medical condition,” including mental illness. For the latter category, however, a series of delays in enacting the legislation has postponed it until March 2027. Using publicly available sources, including testimony at Senate hearings on this issue, this paper explores debates among psychiatrists on the issue of extending MAiD to those suffering solely from mental illness. While some psychiatrists claim that the denial of MAiD for grievous and irremediable mental illness is paternalistic and discriminates against the mentally ill, others argue that there is a lack of scientific evidence to support the idea that any mental illness is irremediable and that high-quality mental healthcare can alleviate suffering, making MAiD unnecessary. Still others point to the vulnerability of people with mental illness and their potential lack of capacity for decision-making, as well as to inequities in access to mental healthcare despite Canada’s publicly funded healthcare system. This paper analyzes these competing discourses and argues that one stems from an ethical stance of reasoning from first principles, while the other is based on a feminist ethic of care. Additionally, I suggest that the arguments against MAiD for grievous and irremediable mental illness are rooted in Cartesian dualism, which posits a clear distinction between mind and body. Ultimately, I conclude that MAiD, as a new conceptual category of death, remains in a liminal state, and that the debates over MAiD in Canada also reflect debates about the nature of embodied life.
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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 | 0.006 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.011 | 0.035 |
| Scholarly communication | 0.013 | 0.016 |
| Open science | 0.002 | 0.012 |
| Research integrity | 0.007 | 0.014 |
| Insufficient payload (model declined to judge) | 0.016 | 0.003 |
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".