Medical and social aspects of euthanasia of palliative patients in Ukraine, Switzerland, Canada, the USA and Israel

Medical Assistance in Dying (MAiD) is legally used in such countries as the Netherlands, Belgium, Luxembourg, Switzerland, Colombia, Canada, Australia, Spain, Germany, and the USA. Portugal and New Zealand are considering legal euthanasia laws. MAiD is performed by injecting a lethal substance into a terminally ill person by a doctor or the patient himself. Euthanasia is one of the services that palliative patients need in the last months and days of their lives. The availability of MAiD increases the country's ranking in the Quality of Death Index and reduces the need for euthanasia tourism. Ukraine needs the legalization of MAiD, as well as the improvement of the palliative and hospice care system in general. The research was conducted using the methods of systematic analysis, the comparative method and the bibliosemantic method with the search for literary sources and legal acts in Google, Google Scholar and PubMed, with an emphasis on Ukraine, Switzerland, the USA, Canada and Israel. During the comparative analysis, it was concluded that the Canadian model of the MAiD is optimal for Ukraine, taking into account the experience of its construction, society's perception and problems related to the application of the legislative norms of the MAiD. The Canadian health care system, the MAiD practice is guided by the social perception of its work models. Legislators respond sensitively to thorough scientific research and court decisions, which respect state and social institutions. The analyzed results of scientific research in Switzerland, the USA and Israel warn researchers and legislators against possible abuses in the implementation of MAiD. But at the same time, they attest to the importance of an accessible MAiD procedure for terminally ill palliative patients, which should be available for the realization of the right to a dignified death along with quality palliative medicine for the realization of the right to a dignified life. Keywords: palliative and hospice care, health care system reform, Medical Assistance in Dying, Quality of Death Index, right to life, right to die.