1906, a year most remembered for the San Francisco earthquake, also notes the first time in which assisted suicide entered the national spotlight. During this year, famous physician and health commissioner of Milwaukee, Walter Kempster, administered a lethal dose of morphine to a woman who was suffering traumatic self-inflicted third degree burns.
However, unlike more recent stories of assisted suicide — such as the infamous 1999 trial Dr. Kevorkian — this case did not spark a national debate, call activists to picket medical practices, or even cause Kempster to hold a public apology.
The Johns Hopkins University’s Bulletin of the History of Medicine explains, “While Americans openly and vigorously argued the merits of euthanasia at the turn of the twentieth century — a phenomenon that has all too often been overlooked — they did so with minimal reference to individual self-determination or personal autonomy; instead, most advocates and opponents of the practice spoke in terms of the collective welfare.”
In light of the many fears of rapidly increasing health care costs and finding a sustainable structure to support an aging U.S. population, returning to the aforementioned 1906 viewpoint of the collective welfare of assisted suicide provides an economic argument in which these growing costs of care and fears of an uncontrollable dependency ratio may be abated.
As it stands, Medicare, Medicaid, and Social Security comprise nearly half of the United States’ federal budget — assisting those in need is a clear prerogative of the U.S. government. Moreover, the average costs of care to those that are terminally ill during their last two years of life is, as the Dartmouth Institute for Health Policy and Clinical Practice’s Atlas Project reports, between $35,000 and $90,000 based on the patients geography.
Likewise, even without account for psychological and emotional stressors, these costs of the last two years of life are, on average, the highest costs a person with a terminal illness will face. With that being said, these costs are not internalized. A 60 Minutes report, The Cost of Dying, explains that Medicare paid $55 billion for doctor and hospital bills for the final few months of a person with a terminal illness’ life, but with only 70 to 80% of those charges having an impact. A benefit from increased assisted suicide would be the ability to reallocate these inefficient funds back into programs with higher efficiencies. With medical care costs continually rising faster than the consumer price index, a subtle economic solution can be made which could potentially tie the bi-partisan debate of the "right-to-life" together.
Economists Leo Chan and Donald Lien at the University of Texas provide an economic model that treats the decision of assisted suicide as a valuation of a real option (a way businesses manage tangible assets). To simplify their model, it is best to break the argument into three main components. The first component is the benefit of euthanasia as soon as the diagnosis is made — this accounts for the costs of treatment, pain and suffering by both the terminally ill and society. The second component is the cost of ending a life — which is comprised of medical costs of administering euthanasia, legal costs, and the pain and suffering incurred by the patient and society.
The third component is the medical, political, and social environment. Overtime, both of the first two values decrease, in regards to the third component influencing the outcomes. With this, Chan and Lien argue that there is an optimal point at which these two values can be maximized. In essence, there is a time when assisting a terminally ill patient to commit suicide is socially optimal, as it reduces the costs and suffering to the terminally ill and society as a whole.
In the end, it is imperative to remember that promoting assisted suicide for the terminally ill is not the same as telling people to mindlessly kill themselves upon their own volition just to reduce the Fed’s debt. While part of the previously made economic argument aims to reduce the fiscal costs of care to society and mitigate the losses to Medicare and other policies, the amount of pain and suffering incurred by the ill and their loved ones is just as much a factor influencing the total outcome.
Conclusively, while one side of the debate of euthanasia versus dying naturally rages on, this economic model promotes a life of happiness — and a death dignity — where keeping someone alive who is suffering tremendously can often be worse than death. While there is no correct way to die, there is a most rational if we are able quantify the benefits of life and death.