Advances in Medical Ethics
Open Access

Abstract

Medical Assistance in Dying in a Profit-Driven Health System: Ethical and Equity Challenges in the United States vs. Canada

Joseph A. Zwillenberg*, Jacob Schwell, Eric M. Teichner, Cameron Haghshenas, Shiv Patil and F. Majdan, MD, FACP, FCPP

Ethics Medical Assistance In Dying (MAID), a legal end-of-life option in Canada with expanding eligibility, now accounts for a growing proportion of deaths across the country. Implemented within a universal, publicly funded health system, MAID is offered alongside a relatively robust continuum of care, including palliative and hospice services. In contrast, possible implementation in the United States fragmented; profit-driven healthcare model raises ethical concerns about how MAID might function if legalized. This paper critically examines the ethical implications of introducing MAID into the United States, where financial incentives, private insurance, and unequal access to care has the potential to distort patients’ end-of-life choices. Through comparative analysis, real-world case studies, and hypothetical vignettes, we argue that without significant reform, MAID in the United States risks becoming a tool of abandonment particularly for disadvantaged patients such as those from low-income, disabled, and marginalized populations.

Published Date: 2025-04-03; Received Date: 2025-03-03