PhD graduate applies her expertise to overlooked group in medical assistance in dying

During her graduate studies, Kathryn Morrison worked both inside and outside the classroom to support ethical challenges in pediatric end of life decisions. Her research and interests lie in the theoretical ethics of Medical Assistance in Dying (MAiD) for mature minors — capable children under 18 years-old.

When she began her PhD, Kathryn took her interest in academic bioethics one step further by attempting to solve practical issues in healthcare. One such practical issue, and the subject of Kathryn’s Applied Philosophy dissertation explores the notion of extending MAiD eligibility to one of the vulnerable populations, mature minors — a challenging topic which presents conflicting legal and ethical obligations to children.

Protecting children's interests

This research area came to light when MAiD was legalized on June 17, 2016, following a landmark Supreme Court of Canada decision, Carter v. Canada (2015). The law currently denies three groups access to MAiD: mature minors, persons making advanced directives, and persons with mental illness as a sole underlying condition (this last population is scheduled to become eligible in 2023). Kathryn explains that the three demographics are excluded from MAiD access due to concerns that they may be unable to autonomously request and consent to the procedure.

“Child welfare is crucial,” Kathryn says. “We have a stronger legal duty to protect children’s interests than those of adults, and we organize society such that children are treated differently to shield them as a vulnerable group.” At the same time, child self-determination is also an important obligation. “Children have a legal right to decision-making autonomy corresponding to their level of maturity. This tension between welfare and self-determination hinges in part on whether children can make genuinely autonomous choices, a source of considerable debate among child development experts.”

Kathryn broadened her clinical ethics skillset with three ethics internships: an Applied Research Placement at Sunnybrook Health Sciences Centre, a Summer Studentship at SickKids, and a Clinical Ethics Internship at William Osler Health System. She says, “These internships helped me to develop a familiarity with common clinical ethics issues, legislation guiding consent to treatment in Ontario health systems, and ethics quality improvement practices.” 

Applied Philosophy

As part of the first cohort for the Applied Philosophy PhD program, Kathryn was able to engage in unique learning opportunities, and she grew professionally from her internship experiences. “I enjoyed meeting and working with experts and mentors in both academic and practical settings. I also enjoyed the process of reflecting on the practical applications of my research, which I feel has enriched the quality of my work.”

In 2021, she completed an Ethics Fellowship with the Program for Ethics and Care Ecologies (PEaCE) at Hamilton Health Sciences (HHS). Alongside her Fellowship, she served as a MAiD Coordinator that assisted patients and families in navigating the institutional and legal safeguarding process to qualify for MAiD, arranged referrals, and organized and supported physicians and interprofessional staff in conducting eligibility assessments and MAiD provisions. 

“This experience of observing how the health care system implements changes to law and policy, and the role of an ethicist in supporting resolution of these challenges really had an impact on me,” she says. “I look forward to supporting patients, families and healthcare workers through ethical issues by conducting clinical ethics consultations, policy work and research related to MAiD now and in the future.”