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Institutional non-participation in assisted dying: Changing the conversation

机译：制度不参与辅助死亡：改变谈话

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Whether institutions and not just individual doctors have a right to not participate in medical assistance in dying (MAID) is controversial, but there is a tendency to frame the issue of institutional non-participation in a particular way. Conscience is central to this framing. Non-participating health centres are assumed to be religious and full participation is expected unless a centre objects on conscience grounds. In this paper we seek to reframe the issue. Institutional non-participation is plausibly not primarily, let alone exclusively, about conscience. We seek to reframe the issue by making two main points. First, institutional non-participation is primarily a matter of institutional self-governance. We suggest that institutions have a natural right of self-governance which, in the case of health centres such as hospitals or hospices, includes the right to choose whether or not to offer MAID. Second, there are various legitimate reasons unrelated to conscience for which a health centre might not offer MAID. These range from considerations such as institutional capacity and expertise to a potential contradiction with palliative care and a concern to not conflate palliative care and MAID in public consciousness. It is a mistake to frame the conversation simply in terms of conscience-based opposition to MAID or full participation. Our goal is to open up new space in the conversation, for reasons unrelated to conscience as well as for non-religious health centres who might nonetheless have legitimate grounds for not participating in MAID.
机译：无论是机构和不仅仅是个别医生是否有权在死亡（女仆）中没有参加医疗援助（女仆）是有争议的，但倾向于以特定方式框架制度不参与问题。良心是这个框架的核心。除非良知地区的中心物体，否则假设非参与的健康中心是宗教和完全参与。在本文中，我们寻求重新解决问题。机构不参与是合理的，不仅仅是唯一的关于良心。我们试图通过制作两个要点来重新解决问题。首先，机构非参与主要是制度自治问题。我们建议机构拥有自然的自治权，在医院或宾馆等保健中心的情况下，包括选择是否提供女佣的权利。其次，有各种合法原因与良心无关，保健中心可能不提供女仆。这些范围从考虑因素，例如具有姑息治疗的潜在矛盾的潜在矛盾，并且关注不与公共意识混淆姑息治疗和佣人。在基于良心的反对对佣人或全部参与方面，这是一个错误的框架。我们的目标是在谈话中开辟新的空间，理由与良心无关的理由以及可能仍可能仍然没有参加女佣的合法理由。

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