MAID will likely never be provided routinely to individuals with BPD, as the features of BPD make providing MAID ethically and in good conscience nigh on impossible. Firstly, affective instability (mood swings) causes the person with BPD to experience often overpowering emotional states, and that translates into impulsive behaviour. Secondly, when a person with BPD has low quality of life, this often stems from a mix of childhood adverse events, and remaining in an environment that either enables or triggers problem behaviours associated with BPD. Furthermore, the common presentation of individuals with BPD also carrying a dual diagnosis of substance misuse disorder, confounds attempts to establish any meaningful picture of their psyche, due to the impact of illicit drugs on their BPD symptoms.
Without even thinking of all of that, the greatest barrier denying BPD patients to ending their lives through a medical clinic, is the fact that BPD is treatable. Treatability is roughly understood by measuring a willingness to make mistakes, learn and apply new skills, accept a life of sobriety, and be stable enough to undergo a period of distress and change. Compared to more debilitating illness, such as bipolar or schizophrenia, BPD people are far more in control of their quality of life, are more often that not capable of finding some happiness or quality of life, and when willing and able, can transition through good help into a life they prefer to live over choosing a life of self destructive behaviour. In essence, BPD isnt consistently severe enough to warrant the ending of a life of someone with BPD. It neglects the potential for an individual with BPD to have a life worth living.
