Many times over my years in family practice, I sat with people as they navigated some of the most tender and difficult crossroads of their lives. A teenager facing an unplanned pregnancy, a cancer patient thinking about medical assistance in dying, the person wrestling with depression and suicidal thoughts—the question that kept surfacing was: Who’s life is it anyway?
We talk a lot in medicine about “autonomy,” the right of a person to make their own choices. And I believe deeply in that. But I’ve also seen how complicated it gets. None of us live in a vacuum. Every decision touches families, children, friends, communities. That’s where the tension lies: between honoring the individual and considering the ripple effects on others.
MAiD has been legalized in Canada. We recognize the rights of a person who is facing severe suffering or impending death to have the choice to ask for help to end their life and their suffering. At the same time we’ll do everything we can to protect someone contemplating suicide because of their anguishand suffering. We offer counselling, medications, and community support.
On the surface that seems contradictory. The suicidal person feels there are no other options other than ending their lives. Our goal is to help them to see a way to get back from that edge,and we protect them from themselves.
The patient with terminal cancer who has endured every possible treatment may simply want peace. The person with ALS may request MAiD, not out of despair, but out of a clear-eyed wish for dignity. The line isn’t neat, but the conversations are real and human.
Abortion is another place where values clash. Women argue—rightly—that they should have control over their own bodies and reproductive choices. Contraception and safe abortion allow women to decide if and when to bring life into the world. Yet opponents point to the rights of the unborn, asking when life truly begins. Religion often plays a decisive role here: some traditions say life begins at conception,some, when the child takes their first breath. The ethical dilemma sharpens in families already struggling. If one more child compromises the well-being of existing children, does choosing not to continue a pregnancy protect the greater good of the family?
These stories remind me that questions about life and death are never simple. They’re shaped by faith, family, economics, and mental health. They’re about the individual, yes—but also about the people around them.
In the end, I don’t think there’s one neat answer to “Who’s life is it anyway?” What I’ve learned is that it’s always both—the individual’s and the community’s. My role as a physician was not to decide for people, but to walk alongside them, offering compassion, clarity, and respect for choices made at life’s hardest crossroads.
