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Correspondence to Professor Mara Buchbinder, Department of Social Medicine, UNC-Chapel Hill, Chapel Hill, North Carolina, USA; [email protected]
Bennett Tucker[1] decided to use medical aid in dying (MAID) after a course of cancer lasting more than 20 years. After a prolonged illness, he hoped to avoid a prolonged death. As a resident of Vermont with a terminal illness and a life expectancy of less than 6 months, Bennett had the option to obtain a lethal prescription under the state’s MAID law. His oncologist supported his goals and agreed to prescribe the medication.
Bennett’s devoted wife, Noreen, had cared for him for years. Eventually, however, bathing, dressing and catheterising a man over 6 ft tall became too physically taxing for Noreen, a petite woman in her 60s. Tired and discouraged that Bennett was not getting better, Noreen had resigned herself to hiring full-time nursing support in their home when Bennett woke Noreen one night and said, ‘I can’t breathe. I can’t do this anymore’. The next day, he announced to Noreen and their three adult children that he was ready to take the lethal dose of medication stored safely in their home.
This essay considers how we are to understand the decisions of people like Bennett to end their lives under MAID statutes and the role of influencing others. Bioethical concerns about the potential for abuse in MAID have focused predominantly on the risk of coercion and other forms of undue influence.1–6 From this perspective, Noreen represents a potential threat to Bennett’s autonomous decision-making because she has something to gain from his death: relief from caregiving burden.
We do not know whether and to what extent Bennett may have been influenced by his wife’s mounting struggle to manage his care on her own. Yet it seems very unlikely that Bennett was pressured to end his life using MAID. He had expressed interest in the option years earlier; it was only a matter of when. Regardless, we are less concerned here with uncovering Bennett’s true motives for pursuing MAID than we are in acknowledging a wider range of relational influences that may have shaped Bennett’s decision for MAID.
Most bioethical analyses of relational influences in MAID have been made by opponents of MAID, who argue that MAID...