One of medicine's thorniest ethical questions concerns the lengths to which a physician should go to ameliorate suffering, including the use of medical means to hasten death. Yet, particularly for those who care for patients with, or for those who live with, serious illness, this question is all but inevitable. In this episode, Stefanie Green, MD, the current president of the Canadian Association of Medical Assistance in Dying Assessors and Providers, shares her experiences helping patients die and how she views this branch of medicine. Dr. Green has been at the forefront of the change in legal regulation and clinical practice around medical assistance in dying (MAiD) in Canada. In her 2022 book, This is Assisted Dying, she shares the delicate, challenging, and humane moments she has witnessed while navigating this unique work.

Disclaimer: This episode does not advocate for or against medical assistance in dying. Rather, it seeks to understand why a clinician may choose to perform this work. If you are experiencing suicidal thoughts or a crisis, please call or text 988 to reach the Suicide & Crisis Lifeline, available 24 hours a day, 7 days a week.

In this episode, you will hear about:

• How Dr. Green transitioned from a career in maternity care to medical assistance in dying (MAiD) - 5:14
• A brief legal history of MAiD in Canada, beginning with Rodriguez v British Columbiaand including the sea change that came with Carter v. Canada - 6:39
• An overview of how MAiD works today in Canada - 12:14
• How MAiD works in the United States, specifically in California, and the role of prognosis in a patient’s eligibility for MAiD - 15:43
• Dr. Green’s reflections on how two decades working in maternity prepared her for MAiD - 20:45
• The specific process by which Dr. Green helps her patients die - 24:13
• The first patient encounter in which Dr. Green provided MAiD - 27:53
• Reflections on the frame of mind Dr. Green must adopt in order to perform this work - 35:04
• How Dr. Green processes the difficult emotions arising from her work - 43:22
• Dr. Green’s reflections on her role as a patient advocate when handling family conflicts at end of life - 47:50
• Advice for clinicians about connecting with patients through empathetic presence - 51:35

Dr. Stefanie Green is the author of This is Assisted Dying.

You can follow Dr. Stefanie Green on Twitter @DocSGreen.

Visit our website www.TheDoctorsArt.com where you can find transcripts of all episodes.

If you enjoyed this episode, please subscribe, rate, and review our show, available for free on Spotify, Apple Podcasts, or wherever you get your podcasts. If you know of a doctor, patient, or anyone working in health care who would love to explore meaning in medicine with us on the show, feel free to leave a suggestion in the comments or send an email to info@thedoctorsart.com.

Copyright The Doctor’s Art Podcast 2023