Physician Assisted Suicide and Health Care Costs

hospice 774985Physician Assisted Suicide and Health Care Costs

Physician-assisted suicide is legal in 3 states in the United States and under debate in many more. Physician-assisted suicide is when a physician provides a prescription for a lethal dose of drugs, meant to end the suffering of a terminally ill patient who chooses to end their life with dignity rather than prolonged suffering.

The patient, in turn, takes the medication themselves of their own will. This is not to be confused with euthanasia, which can be with or without the patient’s knowledge or agreement, is usually administered through lethal injection by a physician.

A major concern with legalized physician assisted suicide is that of motivation by the doctors. Many fear that doctors will begin to encourage a patient to end their life because their medical expenses have become burdensome to others or are beyond the means of the patient. Many managed care organizations and hospitals provide financial incentives to physicians to limit health care expenses. Some imagine a bonus being offered to doctors based on how many patients they convince to take part in physician-assisted suicide. While this may be a stretch, there are other considerations.

Main Economic Objections To Physician Assisted Suicide Can Be Categorized As:

  • Physicians or health care providers like hospitals or managed care groups will pressure patients to opt for assisted suicide in order to reduce health care spending to meet their financial incentives.
  • Concern that families may put pressure on patients to choose physician-assisted suicide to stop spending money on health care that may otherwise be left to the family upon the patient’s death. Family members may also pressure a patient to opt for suicide to avoid spending their own money on the patient’s care.
  • Patients may choose physician-assisted suicide on their own to save money. Often patients feel financial pressure to spare their loved-ones unnecessary expense.

Health Care Costs in the United States totaled over $2.3 trillion dollars in 2007. According to a study in 1995, physician-assisted suicide would save approximately $627 million dollars. In 1995, this amounted to less than 0.07% of all health care costs in the United States. This study assumed 2.7% of patients who die each year in the United States (62,000 people) would be eligible and participate.

This assumption is based on the Netherlands, where euthanasia and physician-assisted suicide are legal, experience approximately 3,100 cases or 2.3% of euthanasia and 550 cases or 0.4% of physician-assisted suicide.  Based on these numbers where these practices have been legal for some time, legalized euthanasia and physician-assisted suicide are not likely to save any significant portion of health care costs.

Opponents argue that HMOs and insurance companies would begin to limit expensive procedures to patients who are suffering from terminal illnesses including cancer, AIDS, and Multiple Sclerosis. Despite their stage of illness, it can be argued that they are terminal and deny services and coverage of treatment. Others suggest that the number of people who would qualify for physician-assisted suicide would be so small that it would really make little difference in overall health care costs.

One study suggests that even though the total system-wide savings is small, the impact to an individual company or an individual family would be powerful enough financial incentive to encourage the practice, perhaps, where it was not intended. For example, a large managed care organization with over 1.5 million enrollees would save over $3 million a year if the predicted number of patients (approximately 350) opted for physician-assisted suicide.

The financial impact on a patient’s family would likely be more dramatic, especially in situations where a patient does not have health insurance. This study estimates that the family of an average patient could save upwards of $20,000 by choosing physician-assisted suicide. Other studies as well show that terminally ill patients already consider the costs of their care when making end-of-life treatment decisions. Many fear that patients would be more likely to physician-assisted suicide into consideration as a more attractive alternative with the added bonus of saving their family money and the burden of longer care.