Canada's Supreme Court mandated assisted suicide to be legal last year and tasked their parliament to write a new law. Part of the debate is whether to force doctors to refer their patients to dispatchers if they don't want to be a part of that process.
One news item that crossed over my Facebook feed this afternoon was of a Vancouver abortionist who's also a "right-to-die" advocate. She already practices Youthinasia and would be willing to do euthanasia on BC's Asians or any other interested party.
One things that comes to mind is that depressed and/or terminally ill folks are often a drain on society and governments or insurance companies who are stuck with the tab of caring for such people might prefer assisted suicide as a cost-cutting exercise. British Columbia is in the middle of a political flap over cancelling highly subsidized bus passes for disabled folks; this is one way to trim the budget in that category, not to mention the other costs of ministering to said folks.
Hospice treatment in a hospital is often doctor-assisted starvation, giving pain meds and letting people starve/dehydrate themselves to death (not hard when appetite is gone and eating hurts) when treatment isn't going to work anymore. My mother-in-law went through that last summer. It seemed like the hospital was a bit too eager to recommend hospice; on one level, it is merciful to face the end gracefully rather than painfully, but one wonders if a budget-trimming motive might be on the minds of caregivers.
In Canada in the not too distant future, one could see hospice cutting to the chase and recommending assisted suicide as the quicker and less painful alternative to assisted starvation. In a country where government picks up the tab for health care, it would be a budget-saver.
Such attitudes might extend beyond assisted suicide to whether to offer help to terminally ill patients. The anti-cancer drug Opdivo came to mind, which has been advertised quite a bit lately, even making an appearance on the Super Bowl broadcast.
The narrator begins, “For adults with an advanced lung cancer called squamous non-small, previously treated with platinum based therapy, it’s not every day that something this big comes along”. The scene changes as we watch the father and son look around a city scene where flashed across the city’s buildings is a bright sign that reads, “A chance to live longer.” We then see other healthy middle aged men and their spouses looking up and smiling at the “A chance to live longer” sign.
Technically, the advertisement is accurate. Clinical trials showed that compared to a group who took conventional chemotherapy, those taking the drug nivolumab lived an average of 90 days longer. Is this a huge clinical advance? Well, it depends on your perspective. Some patients feel 90 days doesn’t sound like much, while others say they would give their right arm to live another 90 days – but only if their quality of life was high. But, before you decide if would you take the drug, also consider that the drug costs about $150,000 for the initial treatment, and then about $14,000 a month. Not all insurance will cover the cost.
$50,000/month ($150K/3 months) is the expect cost of living on here. One can see the temptation for insurers to pass on paying that if they can.
In a single-payer setting, eventually the government will need to be doing drug R&D since they will be likely to demand generic-drug rates from drug companies and thus taking the profit out of making drugs. The current drugs would be cheaper, but new drugs might not see the light of day if the government essentially nationalizes your patents by monopsonistic (single buyer) pricing practices.
Would the government be willing to spend the present value of those future $150K doses (assuming the firm making their required return on investment) in R&D to get folks to live a bit longer? Maybe not, especially if they can get a better bang for the buck with other drugs. Such a red-light decision would be a Palinesque death-panel, deciding not to give folks that life-extending option.
What's the dollar value of a human life? The value of a few extra months? Tacky questions, but ones that are faced regularly by governments and insurers.