Hard Choices: How Does Injustice Affect the Ethics of Medical Aid in Dying?

Cambridge Quarterly of Healthcare Ethics:1-12 (forthcoming)
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Critics of medical aid in dying (MAID) often argue that it is impermissible because background social conditions are insufficiently good for some persons who would utilize it. I provide a critical evaluation of this view. I suggest that receiving MAID is a sort of “hard choice,” in that death is prima facie bad for the individual and only promotes that person’s interests in special circumstances. Those raising this objection to MAID are, I argue, concerned primarily about the effects of injustice on hard choices. I show, however, that MAID and other hard choices are not always invalidated by injustice and that what matters is whether the injustice can be remediated given certain constraints. Injustice invalidates a hard choice when it can, reasonably, be remedied in a way that makes a person’s life go better. I consider the implications of this view for law and policy regarding MAID.



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Brent Kious
University of Utah

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Is There a Duty to Die?John Hardwig - 1997 - Hastings Center Report 27 (2):34-42.
Informed Consent and Relational Conceptions of Autonomy.N. Stoljar - 2011 - Journal of Medicine and Philosophy 36 (4):375-384.

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