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TRPC4/TRPC5 are critical for neuronal modulation by transcranial focused ultrasound in retrosplenial cortex in male mice.

Authors: Wu C, You J, Sheng T, Li GF, Zhang C, Liu L, Xu LZ, Xiong W, Yang F, Yang W, Qiu WB, Zheng HR, Li XY
Journal: Nature communications
mental health psychology open access

Abstract

There are currently 32 jurisdictions in the world, distributed across Europe, America, and Oceania, where some form of assisted dying has been decriminalized []. Medical Assistance in Dying (MAiD) presents a complex intersection of ethics and law around individual autonomy. A central debate revolves around the role of legal frameworks designed to protect individuals during their decision‐making. Depending on local regulations and constitutional options, each country lays the foundation for the right to MAiD based on different concepts. In some legal systems (e.g., in Austria and Germany), personal autonomy and the assurance that the patient's decision is free from coercion and based on informed consent are fundamental. However, in other legal systems (e.g., in Canada and The Netherlands), the primary focus is to alleviate suffering, and the legislation emphasizes compassion rather than solely focusing on the right to make decisions about their lives. Differential emphasis on one condition or the other has direct implications on the eligibility criteria for MAiD. This has a tangible impact on some conditions, such as dementia. In the Netherlands, for example, patients with mild dementia who have previously requested MAiD through an advance directive are not eligible if they are not perceived to be experiencing unbearable suffering. Regardless of where the focus is placed, legal systems establish guarantees and safeguards to protect persons' autonomy while accessing MAiD. A protective legal framework for MAiD might both foster and or restrict patient autonomy. This question is critical, as numerous countries strive to design and implement protective legal frameworks for the legalization of MAiD. Therefore, it is imperative to critically examine the benefits as well as the potential risks these protective laws pose, both to prevent such outcomes and to enhance access to safe MAiD within existing models. This article analyzes the legislation on MAiD from a relational autonomy perspective, understood as the view that individual autonomy is shaped and enabled by social relationships, power structures, and social conditions, rather than exercised in isolation [, pp. 3–31]. First, together with this theoretical framework, we incorporate and explain the lenses of and . According to Miranda Fricker [], epistemic injustice refers to the harm inflicted on individuals in their capacity as knowers. In healthcare settings, epistemic injustice occurs when prejudice leads patients' testimony to be unfairly dismissed, or when they lack the conceptual resources to properly understand and communicate their health experiences. Pathogenic vulnerability is a form of vulnerability that is created or intensified by social, institutional, or policy responses, where attempts to protect or assist individuals paradoxically increase their exposure to harm instead of reducing it []. These concepts serve as the basis for analysing what we describe as the potential in the context of MAiD.