Economics Of Assisted Suicide

Allowing terminally ill people to end their own lives with the help of their doctors would have little effect on the nation's health care costs, reducing bills by less than one-tenth of 1 percent, according to a new analysis.

Some who oppose physician-assisted suicide argue it would provide an ethically repugnant temptation to save money. In their view, doctors might encourage the hopelessly sick to kill themselves quickly rather than run up big hospital bills in their dying days.

Two ethicists on opposing sides of the assisted suicide debate conducted an analysis to see if the savings would truly be meaningful.

"It's not a money-winner," concluded Dr. Ezekiel J. Emanuel of Harvard Medical School.

Emanuel opposes physician-assisted suicide, while his co-author, ethicist Margaret P. Battin of the University of Utah, favors it. They reported their conclusions in Thursday's New England Journal of Medicine.

In the United States, only Oregon permits assisted suicide. Its Death with Dignity Act lets doctors prescribe deadly doses of drugs to those with less than six months to live.

No one knows precisely how many Americans would choose assisted suicide if they could. So the researchers assumed the figure would be similar to that in the Netherlands, where physician-assisted suicide is legal and routine.

There, it accounts for 2.7 percent of all deaths. If Americans chose this option at the same rate, it would amount to 62,000 deaths each year.

The researchers estimated that by opting for suicide, these people would forgo an average of four weeks of life. Since the medical bills for the last month of life for those who die naturally is $10,118, this would add up to $627 million annually.

This is less than 0.07 percent of total U.S. health care costs.

"From the system standpoint, the financial advantage is minimal or nonexistent," Emanuel said.

"If you believed there would be dramatic savings, they show there won't be," Daniel Callahan, a bioethicist at the Hastings Center in Garrison, N.Y., who opposes assisted suicide, said. "But $600 million is not chicken feed."

By DANIEL Q. HANEY