Assisted suicide will bring about ‘reduction in health care spending,’ report claims
null / Credit: Video_Creative/Shutterstock Washington, D.C. Newsroom, Jan 25, 2024 / 10:30 am (CNA).
The implementation of assisted suicide will “save” the Canadian health care system between $ 34.7 and $ 136.8 million per year, a new report published in the Canadian Medical Association Journal claims.
The report, titled “Cost analysis of medical assistance in dying in Canada,” was authored by two Canadian health researchers, Aaron Trachtenberg of the University of Manitoba and Braden Manns of the University of Calgary, and published Tuesday.
Their report said that as assisted suicide is more fully implemented it will save the Canadian health system and patients millions as well as shorten terminally ill patients’ lifespans by an average of one month.
“As death approaches, health care costs increase dramatically in the final months. Patients who choose medical assistance in dying may forgo this resource-intensive period,” the report said. It estimated the savings to be in the tens of millions of dollars per year.
What is MAID?
The Canadian Parliament legalized assisted suicide, under the name of medical assistance in dying (MAID), in 2016. The Parliament again passed another bill in 2021 that further expanded the country’s assisted suicide laws, allowing those suffering from exclusively mental health problems to also apply for MAID.
Although the two phrases are often used interchangeably, assisted suicide is not the same as euthanasia. According to the American Medical Association’s code of ethics, euthanasia necessarily involves “the administration of a lethal agent by another person to a patient,” meaning the person performing the euthanasia (e.g., a medical doctor) is directly responsible for ending the patient’s life.
Assisted suicide, on the other hand, involves the active participation of a patient in ending their own life.
Currently, Canadian law allows assisted suicide for patients who are at least 18 years old, have a “grievous and irremediable medical condition” (including mental health issues), and make a voluntary request for assisted suicide and give informed consent to the procedure. Patients must also be eligible for government-funded health services, which means that only Canadians can receive MAID.
What did the report say?
Trachtenberg and Manns based their report on projections from data gathered from the Netherlands and Belgium, where assisted suicide has been legal for decades.
They said that “the implementation of medical assistance in dying is a major event in Canadian history” and that “if Canadians adopt medical assistance in dying in a manner and extent similar to those of the Netherlands and Belgium, we can expect a reduction in health care spending in the range of tens of millions of dollars per year.”
The report estimated that MAID will “eventually play a role in 1%–4% of all deaths in Canada,” which they said is approximately 2,680 to 10,722 of Canada’s total 268,056 yearly deaths (as estimated between 2014 and 2015).
Whether MAID accounts for 1% or 4% of total Canadian deaths, the report said that the financial savings will be significant and will far exceed the expenses to facilitate the MAID program, which are estimated at $ 1.5 million to $ 14.8 million in direct costs.
According to the report, 80% of patients who will opt for MAID will have cancer, 50% will be aged 60–80 years, 55% will be men, and 60% of patients will have their lives shortened by one month while 40% of patients will have their lives shortened by one week.
The report said that though they “are not suggesting medical assistance in dying as a measure to cut costs,” their analyses “suggest that the savings will almost certainly exceed the costs associated with offering medical assistance in dying to patients across the country and that the inclusion of medical assistance in dying in the services covered by universal health care will … release funds to be reinvested elsewhere.”
What is the Catholic position?
Lucia Silecchia, a law professor specializing in Catholic social thought at the Catholic University of America in Washington, D.C., told CNA that evaluation of assisted suicide in terms of potential money to be saved pose a grave threat to human life.
“Discussions focusing on the money saved if someone takes his or her life prematurely commodifies human life in a view that values efficiency and usefulness over the innate dignity of innocent human life,” she said. “This can lead those at their most vulnerable to believe that a MAID statute does not merely create a so-called ‘right’ to die but may even impose an unwritten ‘duty’ to do so.”
“To justify or advocate for the taking of life to save money places a price tag on priceless human persons,” she went on. “It sends the message that some lives are worth saving, and others are not.”
Silecchia said that end-of-life medical care is a nuanced topic that demands serious consideration, beginning from the perspective of valuing and protecting human life.
“Taking innocent human life — one’s own or another’s — is impermissible,” she said. “However, it is not morally required to pursue every possibility of extraordinary care — or what Pope John Paul II called ‘extraordinary or disproportionate means’ — when to do so is medically futile or the potential benefits are not justified by the burden. This is a question that requires far more attention and discussion.”
When it comes to Canada’s MAID program and other assisted suicide programs, Silecchia said that they are “based on a false sense of compassion for a person who is suffering greatly.”
“True compassion involves a willingness to bear the sufferings, or passion, of another with them,” she said. “MAID, instead, takes life from such a person and is, in the words of John Paul II, a ‘false mercy’ and a ‘grave violation of the law of God.’”
According to Silecchia, studies have shown that “those who opt for MAID do so not because of excruciating physical pain but because they fear being a burden or loss of dignity.”
“It is in providing care, support, and love for those who suffer and in rethinking our conception of what a ‘dignified’ life and a ‘dignified’ death entail that attention must be paid,” she said.
Is assisted suicide legal in the U.S.?
Assisted suicide is legal in 10 U.S. states and the District of Columbia. The states where assisted suicide is legal are California, Colorado, Hawaii, Montana, Maine, New Jersey, New Mexico, Oregon, Vermont, and Washington.
Silecchia said that she expects “high-profile battles about this legislation in numerous states” in the “next year or two.”
As recently as this month, Catholic and pro-life groups in New York and Massachusetts have been urging citizens to oppose assisted suicide laws currently being considered in their states.
Silecchia explained that the U.S. Supreme Court has “ruled that there is no constitutional ‘right to die.’ However, the question of MAID — or ‘assisted suicide’ — has been steadily advancing on the state level.”
Currently, most states’ assisted suicide laws on the books “do not authorize physicians or others to administer lethal drugs to patients. Rather, they authorize the provision of those drugs to the patient who self-administers them,” Silecchia said.
Though she said that assisted suicide is permissible in some dozen U.S. jurisdictions, “close to 20 other states have bills relating to assisted suicide at some stage of the legislative process.”
She pointed out that Vermont recently became the first state to pass an assisted suicide statute that waived its residency requirement.
“This is a significant legal development as it would permit anyone from states that do not permit this to travel to Vermont to do so,” she explained. “This can rapidly make this a ‘national’ issue rather than one confined within the borders of individual states.”
