# On the topical issue of assisted dying: the insurmountable challenges of human existence, and the right to exit

**Authors:** Tobore Onojighofia Tobore

PMC · DOI: 10.3389/fpubh.2026.1695897 · Frontiers in Public Health · 2026-02-05

## TL;DR

This paper argues that medical-assisted dying should be legally available to anyone experiencing unbearable suffering, regardless of medical conditions or age.

## Contribution

The paper proposes broadening MAID eligibility to include all individuals based on self-defined suffering.

## Key findings

- Current MAID eligibility criteria are unfair due to the subjective nature of suffering.
- Denying MAID to those with non-eligible conditions is unjust as suffering is not limited to medical diagnoses.
- MAID eligibility should be determined by the individual experiencing suffering, not third parties.

## Abstract

Although the issue of medical-assisted dying or medical aid in dying (MAID, euthanasia, and medical-assisted suicide) has a long history, it has become an increasingly important topic in recent years. Around the world, many governments remain opposed to MAID. In places where MAID is legally permitted, it is highly regulated, and typically, unbearable suffering limited to a few serious and incurable medical conditions determines eligibility. MAID eligibility based on unbearable suffering but limited to a few medical conditions is unfair because suffering is inescapable in life, is not limited to medical conditions, and is highly subjective. Indeed, the subjectivity and individual differences in the experience of pain and suffering make it inaccurate to suggest that suffering is lesser for a person dealing with trigeminal neuralgia, extreme poverty, treatment-resistant depression, or the grief of losing a loved one compared to someone with a MAID-eligible condition. The subjectivity and individual differences in the experience of suffering mean that its intolerability can only be fairly defined by the individual experiencing it. So, the use of a third party (e.g., a physician) to evaluate severity, burdensomeness, or prognosis in determining MAID eligibility unfairly restricts people suffering who may not meet the clinical or physician’s threshold of intolerability. Also, suffering is often imposed on humans by forces outside their control, making denying the right to exit suffering with dignity through MAID unfair. In this position paper, an argument is made for MAID to be made broadly legal without age limits and available to anyone who requests it based on patient-defined unbearable suffering or fear of future suffering.

## Full-text entities

- **Genes:** CMAHP (cytidine monophospho-N-acetylneuraminic acid hydroxylase, pseudogene) [NCBI Gene 8418] {aka CMAH, CSAH}, APOL1 (apolipoprotein L1) [NCBI Gene 8542] {aka APO-L, APOL, APOL-I, FSGS4}
- **Diseases:** child maltreatment (MESH:C562515), heart attacks (MESH:D009203), infections (MESH:D007239), Cardiovascular diseases (MESH:D002318), rheumatic, neurological, and gastrointestinal diseases (MESH:D005767), end-stage renal disease (MESH:D007676), psychosis (MESH:D011618), endocrinological, (MESH:D004700), intellectually disabled (MESH:D008607), death (MESH:D003643), terminally ill (MESH:D007153), hip fractures (MESH:D006620), Back pain (MESH:D001416), atherosclerosis (MESH:D050197), epilepsy (MESH:D004827), cognitive decline (MESH:D003072), disabilities (MESH:D009069), Infectious (MESH:D003141), spondylolysis (MESH:D013169), Devastating neuromuscular diseases (MESH:D009468), African human trypanosomiasis (MESH:D014353), intimate partner abuse or aggression (MESH:D010554), dementia (MESH:D003704), Parkinsonism (MESH:D010302), trigeminal neuralgia (MESH:D014277), abuse of older people (MESH:C000719191), impulsiveness (MESH:D007174), depression (MESH:D003866), Chronic pain (MESH:D059350), Black Death (MESH:D010930), schizophrenia (MESH:D012559), anxiety (MESH:D001007), Alzheimer's (MESH:D000544), memory decline (MESH:D060825), lysosomal failure (MESH:D051437), mental illness (MESH:D001523), Drug and alcohol addiction (MESH:D019966), aneurysms (MESH:D000783), rupture (MESH:D012421), MAID (MESH:D064806), lupus nephritis (MESH:D008181), Cancer (MESH:D009369), sexual violence (MESH:D050035), Pain (MESH:D010146), behavioral addictions (MESH:D000437), mitochondrial dysfunction (MESH:D028361), injury (MESH:D014947), neurodegenerative disease (MESH:D019636), inflammation (MESH:D007249), intervertebral disc herniation (MESH:D007405), Acute pain (MESH:D059787), blind (MESH:D001766), complex regional pain syndrome (MESH:D020918), fat accumulation (MESH:D004620), genetic defects (MESH:D030342), locked-in syndrome (MESH:D000080422), primary immunodeficiencies (MESH:D000081207), Posttraumatic stress disorder (MESH:D013313), paralysis (MESH:D010243), MAS (MESH:D000069279)
- **Chemicals:** MAID (-), 5-HT (MESH:D012701), alcohol (MESH:D000438)
- **Species:** Homo sapiens (human, species) [taxon 9606], Enterococcus gallinarum (species) [taxon 1353], Yersinia pestis (species) [taxon 632]

## Full text

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## References

146 references — full list in the complete paper: https://tomesphere.com/paper/PMC12916393/full.md

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Source: https://tomesphere.com/paper/PMC12916393