Subjectivity, Suffering, and Epistemic Injustice in MAID

The expansion of MAID (Medical Assistance in Dying) to Canadian patients suffering primarily from mental health conditions raises many practical and ethical challenges. This paper examines the potential threat of epistemic injustice in the accurate assessment of mental health patients seeking MAID. The MAID assessment process relies heavily on medical practitioner knowledge of patient suffering, which is difficult when the suffering is primarily psychological. These difficulties are compounded by the threat of epistemic injustice: the injustice to one's status as a knower, including one's knowledge of their own suffering. By using Miranda Fricker's (2007) framework of epistemic injustice, this paper identifies areas where testimonial and hermeneutical injustices may negatively impact the assessment process. It concludes by suggesting a number of ameliorative interventions.