Euthanasia and Cost Containment: Moral Perspectives

AUSCP NewsJim Bacik

Around the world there is a growing movement to legalize physician assisted dying.  At least 19 countries allow it, opening up the practice to some 200 million individuals. In the United States, the Supreme Court decided in 1967 that the Constitution does not protect the right of competent, terminally ill patients to commit suicide with the assistance of a physician, effectively leaving it up to each state to decide about the legality of physician assisted dying.  In 1994, Oregon passed the “Death With Dignity Act” that allows terminally ill residents of the state to end their lives through the voluntary self-administration of a lethal dose of a medication expressly prescribed by a physician for that purpose.  By 2022, nine other states have legalized physician assisted suicide, including California and New Jersey.  Thirty-three states have laws explicitly prohibiting assisted dying, including Ohio and Michigan.

In the United States, advocates of legalization point out that a well-timed decision to end life could save a lot of money for both federally funded programs and private purchasers of health care.  Hemlock Society founder Derek Humphry calls cost containment the “unspoken argument” for the legalization of assisted suicide.

In an article on “Dying Well, Assisted Suicide, and the Law,” Cathleen Kaveny, one of our best commentators on Catholic Social Teaching (CST), argues against legalizing physician assisted dying. She begins by insisting that there are “solid nonsectarian reasons” against legalization. To support her case, she cites a 1994 New York State Task Force on Life and the Law that unanimously concluded that legalization would be profoundly dangerous for large segments of the population, especially poor and marginalized persons.

Kaveny, who has degrees in law and theology, sees legalization of suicide as a slippery slope gradually expanding options and incentives for early death.  She imagines physicians subtly encouraging terminally ill patients to choose a painless legal way to end their lives. Legalization of assisted suicide could easily lead to legalizing euthanasia which involves a physician administering a lethal drug. The  right to die granted to terminally ill patients could easily be expanded to chronically ill persons. The right of competent persons to choose assisted suicide could logically be extended to surrogate decision makers on behalf of non-competent patients who are suffering.  For Kaveny, the slippery slope is steep and dangerous to the common good.

The cost containment argument for legalization has gained momentum in the last decade as the cost of care for terminally ill patients has risen, constituting as much as 10% of the nation’s health care expenditures.  In this situation, dying patients may feel a duty or responsibility to end their life quickly.  Recognizing the challenge posed by rising health costs, Kaveny insists that multiplying assisted suicides is not a wise or moral solution.  Such a policy denies the fundamental dignity of all human beings and erodes our capacity to assist those who most need our care.  Furthermore, it fails to recognize that dying can be an important life experience for the terminally ill person and for their loved ones.  Our real task as a society is to act with justice and charity so that everyone has access to basic health care which always includes comfort care and pain control for terminally ill persons.  As Pope Francis put it: “We are called to accompany people toward death. But not provoke death or facilitate assisted suicide.  Indeed life is a right, not death, which must be welcomed, not administered.”

How do I view using euthanasia for cost containment?

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