Advocacy considerations regarding medical aid in dying for people with nonterminal chronic illnesses and disabilities

Rehabil Psychol. 2025 May;70(2):119-122. doi: 10.1037/rep0000506.

ABSTRACT

OBJECTIVE: Medical aid in dying (MAID) has long been a contentious issue in both professional ethics and within the disability community. Some view it as an affirmation of self-determination and autonomy, while others view it as a codification of ableism, potentially to the point of eugenics. With Canada’s recent expansion of MAID eligibility to people with nonterminal chronic illnesses and disabilities, discussions about the ethics of MAID legislation have been renewed, particularly among people with disabilities.

METHOD: This commentary reviews the common arguments for and against MAID, with a focus on the views, concerns, and opinions within the disability community. New concerns from within the disability community relating to Canada’s expansion of MAID to people with nonterminal disabilities are also discussed. Finally, the relation of these concerns to the foundational principles of rehabilitation psychology is discussed.

RESULTS: The disability community has historically had a divided view on MAID, with some viewing it as an enactment of ableism and others viewing it as an enactment of self-determination. Expansion of MAID eligibility to individuals with nonterminal illness and disabilities also raises concerns about governments prioritizing MAID over community support for people with disabilities.

CONCLUSION/IMPLICATIONS: MAID, especially as applied to individuals with nonterminal illness, is an ethically complex issue in the disability community that addresses many of the foundational principles of rehabilitation psychology. Thus, the decision of advocating for and against MAID in people with nonterminal disabilities is a complicated decision for rehabilitation psychologists. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

PMID:40310203 | DOI:10.1037/rep0000506