Medically assisted deaths could save millions in health care spending: Report

[Hydrogen]

Across Canada, journal calculates up to $136.8 M in savings

New research suggests medically assisted dying could result in substantial savings across Canada's health-care system.

Doctor-assisted death could reduce annual health-care spending across the country by between $34.7 million and $136.8 million, according to a report published in the Canadian Medical Association Journal on Monday.

The savings exceedingly outweigh the estimated $1.5 to $14.8 million in direct costs associated with implementing medically assisted dying.

"The take-away point is that there may be some upfront costs associated with offering medical assisted dying to Canadians, but there may also be a reduction in spending elsewhere in the system and therefore offering medical assistance in dying to Canadians will not cost the health care system anything extra," said Aaron Trachtenberg, an author of the report and a resident in internal medicine at the University of Calgary.

Cost has to be a part of the discussion

The researchers used numbers from the Netherlands and Belgium, where medically assisted death is legal, combined with Canadian spending data from Ontario. Trachtenberg stressed that means the work is theoretical and needs to be readdressed when Canada starts collecting large scale data at home.

After June 17, 2016 when Bill C-14 became law, provinces began rolling out their plans to deal with requests for doctor-assisted death.

Manitoba has set up a Medical Assistance in Dying team (MAID). More than 100 patients have contacted MAID, with 24 receiving medically assisted deaths as of Jan. 6.

"In a resource-limited health care system, anytime we roll out a large intervention there has to be a certain amount of planning and preparation and cost has to be a part of that discussion," Trachtenberg said, adding the provinces' differing plans could impact the cost structure of implementation.

"It's just the reality of working in a system of finite resources."

The report estimated that about one to four per cent of Canadians will die using physician-assisted death. Of those, 50 per cent will be between the ages of 60 and 80.

The report estimates a 50-50 split between men and women.

About 80 per cent of patients will have cancer and 60 per cent will have their lives shortened by one month while 40 per cent will have their lives shortened by one week.

End-of-life care has high costs in Canada

Health-care costs increase substantially among patients nearing the end of their life, Trachtenberg said.

"Canadians die in hospitals more often than, say, our counterparts in America or Europe and … we have a lack of palliative care services even though we are trying to improve that. And therefore people end up spending their final days in the hospital," he said.

"Hospital-based care costs the health care system more than a comprehensive palliative care system where we could help people achieve their goal of dying at home."

The report used Manitoba as an example, where 20 per cent of health care costs are attributable to patients within the six months before they die, despite their representing only one per cent of the population. Patients who choose medical assistance in dying may forego this resource-intensive period, the report said.

"Whenever we roll out a large-scale intervention there has to be a discussion around costs. But we do not suggest that costs should ever be considered at an individual level," Trachtenberg said.

"We are not suggesting that patients or providers consider costs when making this very personal and intimate decision to request or provide medical assistance in dying."

The report also emphasized that it is only a cost analysis and doesn't include the clinical effects on patients. Patient-level research will need to be done before true economic evaluation of medical assistance in dying in terms of cost-effectiveness and utility can be done, the report said.


https://www.cbc.ca/news/canada/manitoba/medically-assisted-death-could-save-millions-1.3947481

....


Suicide rates trend upwards during times of economic crisis. Alcohol, substance abuse, guns, pills, chemicals, leaps off tall bridges and buildings are typical options in societies where euthanasia is illegal. Could it be better for the process to be painless and institutionalized, in contrast to alternatives?

The discussion on euthanasia reminds me of abortion. People will do it whether its legal or illegal, in which case might it be better to offer better safer and friendlier alternatives.

Years ago, someone I know tried unsuccessfully to commit suicide by taking pills. Luckily they received medical attention quickly and had their stomach pumped. Visiting them in the hospital, the doctor said a teenage girl died by taking pills only a few days earlier. They claimed that it was a very painful process as the organs shut down one by one, and a terrible way to die.

While euthanasia might not be a perfect solution, perhaps it might be more humane than some of the alternatives.

[Hispo]

I personally find medically assisted death a topic which is hard to stomach.
We all have read or heard about the right to live and right to have access to healthcare... but having the "right" to die would open several new and scary implications to the population of a country or the world.

If Death becomes a right and if we normalize it even further, what would be the limits?
If a young adult decides their life is not worth living anymore, would any kind of intervention to prevent it be considered illegal? against their rights?

Would crisis-lines be abolished?

[Gyfts]

It's dystopian for state induced suicide, let alone state induced suicide to save on medical bills. State plays no role in voluntary execution of its population.

It starts with medical assisted deaths for people with chronic conditions, and slowly that window begins to expand far beyond what its original intent was. In Canada, you can apply for medically assisted suicide only exhibiting symptoms of depression. So no physical pain, but the state will gladly help execute you should you be so inclined.

Also, Canada has "free" healthcare. State is incentivized to save costs through medically assisted suicide.

[lovesmayfamilis]

I wonder what should be going on in the souls of doctors who will take on the duties of God. I will not raise my hand to solve such questions. Maybe there are problems with the education of professional doctors in Canada if their rates are lower than in other countries. In any case, any human life should have value, and doctors must be with the patient until the end, following the Hippocratic oath, and not solve the problems of the healthcare system by killing "unnecessary" patients.

[Dickiy]

I personally find medically assisted death a topic which is hard to stomach.
We all have read or heard about the right to live and right to have access to healthcare... but having the "right" to die would open several new and scary implications to the population of a country or the world.

I agree, even though the goal is for good things to reduce state budget spending, I personally don't understand the idea of medically assisted death, I think this is like slow killing, and of course, this violates human rights.

This country is dominated by the service industry and about three-quarters of Canadians do it, of course, this will create fear for citizens because the dream of a happy old age will disappear. it looks like Canadian citizens will choose to flee other countries, and of course, this will be dangerous for the stability of the economic cycle, it could even be worse than now.

While euthanasia might not be a perfect solution, perhaps it might be more humane than some of the alternatives.

I am very sad to hear this
I think they should have a better and wiser alternative in limiting state spending that doesn't harm their citizens and the country other than this.

[Genemind]

I personally find medically assisted death a topic which is hard to stomach.

I totally agree, it's absurd they allow medically assisted deaths just to save money. The world is revolving around money nowadays and life just becomes second to it. Ever since I was in college this had been a debate about whether Euthanasia is acceptable or not. We are slowly losing humanity, the government cares more about money than saving lives. Even if it's a terminally-ill patient, I would rather try my best for that patient to have his last breath than to take it with my own hands. Life is precious, and no one else should take it away other than God.

[Dunamisx]

Suicide rates trend upwards during times of economic crisis. Alcohol, substance abuse, guns, pills, chemicals, leaps off tall bridges and buildings are typical options in societies where euthanasia is illegal. Could it be better for the process to be painless and institutionalized, in contrast to alternatives?

We need a long lasting solution to stop all these forms of menace of human lives and this has to begin with every individuals decision in contributing to life rather than taking away from it or rendering it more complicated for others to enjoy their living, we have many factors and areas of live that need to be balanced and reconfigured to suit the best standard for human existence, we also need love to make things apace for us all, except if we will keep deceiving ourselves from the reality of truth about how live should be.

[Ucy]

Is there a place in the World where euthanasia is done without the consent of the patient? If yes, imagine how wrong that is like abortion. Abortion is done without the consent of the child hence is considered murder. By the way, the consent is taken away from those who deserve to die due to crime they committed. They are killed whether the consent is given or not. Euthanasia is a delicate matter that should be treated with care. I do not think it's moral to do that for economic reasons. Life must be preserved by all means. Do not attempt to put pressure on people (who probably have chance of surviving) due to economic reasons

[Findingnemo]

I don't think they will make things such simple because medical market is one of the biggest money circulating market so if government decides to save millions then how hospitals can make money. And even though we say we have right to die but in most countries it is illegal even they got hanged later of attempt of suicide charge which is ironic but they never wanted to let the death so easy or else there will be lot of chaos and loss of business for big medical companies.

[Gozie51]

Euthanasia is a delicate matter that should be treated with care. I do not think it's moral to do that for economic reasons. Life must be preserved by all means. Do not attempt to put pressure on people (who probably have chance of surviving) due to economic reasons

I was reading all the posts above posted to see if what I feel like asking is there and this side of your post corroborate what enquiry I have. At what point should euthanasia be permissible? This is the issue for me because I might not really be against it totally because there some health challenges that the pains are really excruciating and whose natural result is still death. So how do we reach to this level where it will be the most reasonable thing to do. It is difficult to take someone else life but some are not just bearable to see the person living.

[Hispo]

I personally find medically assisted death a topic which is hard to stomach.
We all have read or heard about the right to live and right to have access to healthcare... but having the "right" to die would open several new and scary implications to the population of a country or the world.

I agree, even though the goal is for good things to reduce state budget spending, I personally don't understand the idea of medically assisted death, I think this is like slow killing, and of course, this violates human rights.

What worries me is that this "right to die" thing could get pushed to be accepted into situations which are perfectly solved otherwise with the help of modern medicine. It would be very dangerous if in the future people are offered to end their life in the case they cannot afford a medical treatment or in case of severe depression, very dystopian.

[OgNasty]

I personally find medically assisted death a topic which is hard to stomach.
We all have read or heard about the right to live and right to have access to healthcare... but having the "right" to die would open several new and scary implications to the population of a country or the world.

If Death becomes a right and if we normalize it even further, what would be the limits?
If a young adult decides their life is not worth living anymore, would any kind of intervention to prevent it be considered illegal? against their rights?

Would crisis-lines be abolished?

I assume this is how population control will begin in countries with socialized healthcare systems.  First, everyone will cheer as they all get access to free medical care.  Then they'll discover that the wait times and care received are horrendous.  In order to combat that problem the government will first allow people to begin having their lives ended with medical procedures, then when budgets continue to grow out of control they will look for new cost saving measures.  You get X disease, it's too expensive to care for you, so you'll be medically euthanized for the good of the population.  Want to have kids?  Sorry, you said there were only 2 genders so we're going to sterilize you.  Born with an uncurable disease, sorry, we can't afford to treat you, euthanasia. 

[Hispo]

-snip-

Want to have kids?  Sorry, you said there were only 2 genders so we're going to sterilize you.  

I am aware (since I have read some of your posts around) that you hold political views which go against to the political left in your country (I assume you are American).

But that example is a little bit extreme, considering USA citizens have the constitution to protect (in theory) their free speech and since you mentioned healthcare under the control of the government, would not be incompatible to your rights?

[BADecker]

When people commit suicide, it's always because they have talked themselves into the idea that suicide is the best option for their situation and circumstances. But now government wants to assist them in their decision just to save money? Often it is government that has made the situation so bad for people that they consider suicide in the first place.

I would recommend that anybody who assists even only one person to commit suicide - no matter what they call it - suicide himself/herself immediately... first.

[Hispo]

When people commit suicide, it's always because they have talked themselves into the idea that suicide is the best option for their situation and circumstances. But now government wants to assist them in their decision just to save money? Often it is government that has made the situation so bad for people that they consider suicide in the first place.

I would recommend that anybody who assists even only one person to commit suicide - no matter what they call it - suicide himself/herself immediately... first.

From what I have learn personally by myself and others.
Suicide is about a desperate attempt to get rid of psychological pain. For example, there have been instances of people who had very good economical, political and social positions but they decided to kill themselves anyways.

While I agree a mismanagement of policies by a government can worsen the life of millions of people, mental illnesses will always exist not matter times are good or not.

[Bananington]

Medically assisted death may be wise for the aged who have lived the full span of their lives and at the ending of it are suffering, not been able to do some things without assistance, or are managing some excruciating medical conditions. A medically assisted death which will be signed either by them or a close next of kin, can be economically wise. But in the case of making suicide legal, giving people a right to end their lives at any time, it can turn out a very bad decision with many consequences.

[BADecker]

When people commit suicide, it's always because they have talked themselves into the idea that suicide is the best option for their situation and circumstances. But now government wants to assist them in their decision just to save money? Often it is government that has made the situation so bad for people that they consider suicide in the first place.

I would recommend that anybody who assists even only one person to commit suicide - no matter what they call it - suicide himself/herself immediately... first.

From what I have learn personally by myself and others.
Suicide is about a desperate attempt to get rid of psychological pain. For example, there have been instances of people who had very good economical, political and social positions but they decided to kill themselves anyways.

While I agree a mismanagement of policies by a government can worsen the life of millions of people, mental illnesses will always exist not matter times are good or not.

Try DL-phenylalanine for mental/psychological pain.     

[Hispo]

When people commit suicide, it's always because they have talked themselves into the idea that suicide is the best option for their situation and circumstances. But now government wants to assist them in their decision just to save money? Often it is government that has made the situation so bad for people that they consider suicide in the first place.

I would recommend that anybody who assists even only one person to commit suicide - no matter what they call it - suicide himself/herself immediately... first.

From what I have learn personally by myself and others.
Suicide is about a desperate attempt to get rid of psychological pain. For example, there have been instances of people who had very good economical, political and social positions but they decided to kill themselves anyways.

While I agree a mismanagement of policies by a government can worsen the life of millions of people, mental illnesses will always exist not matter times are good or not.

Try DL-phenylalanine for mental/psychological pain.     

Took a look at it, it would make some sense it could help with some symptoms of depression, since it seems to be a precursor for the synthesis of neurotransmitters like dopamine and others. Interestingly enough, I had never heard of this substance being mentioned together with other commercial antidepressants like Fluoxetine, Sertraline or Paroxetine.

[OgNasty]

-snip-

Want to have kids?  Sorry, you said there were only 2 genders so we're going to sterilize you.  

I am aware (since I have read some of your posts around) that you hold political views which go against to the political left in your country (I assume you are American).

But that example is a little bit extreme, considering USA citizens have the constitution to protect (in theory) their free speech and since you mentioned healthcare under the control of the government, would not be incompatible to your rights?

The government having the ultimate say so in anything goes against my rights in my opinion.  A few years ago I would have thought it was inconceivable that the government would have the power to exclude people from society for refusing an experimental vaccine.  I would have thought that "lockdowns" and "masks" were something we'd see in China.  I never thought people would lose their jobs or their children for refusing the vaccine.  I would have told you that you were insane to even think that could happen in the US.  People losing their jobs for saying, "all lives matter."  That was a real thing here.  It's all so insane I can't believe that real life adults think that this is the way a society should operate.  Our once great nation used to be the home of the brave.  Now it's the home of the woke and if you aren't woke then you are the enemy and your life must be ruined.  It's a problem.

[Zlantann]

Suicide rates trend upwards during times of economic crisis. Alcohol, substance abuse, guns, pills, chemicals, leaps off tall bridges and buildings are typical options in societies where euthanasia is illegal. Could it be better for the process to be painless and institutionalized, in contrast to alternatives?

The discussion on euthanasia reminds me of abortion. People will do it whether its legal or illegal, in which case might it be better to offer better safer and friendlier alternatives.

Years ago, someone I know tried unsuccessfully to commit suicide by taking pills. Luckily they received medical attention quickly and had their stomach pumped. Visiting them in the hospital, the doctor said a teenage girl died by taking pills only a few days earlier. They claimed that it was a very painful process as the organs shut down one by one, and a terrible way to die.

While euthanasia might not be a perfect solution, perhaps it might be more humane than some of the alternatives.

There is no much difference between euthanasia and suicide. The only difference is that euthanasia is legal suicide. I have seen sick people in very pitiable and hopeless condition that I even wish they die the next second because of the suffering and pains they are forced to endure. But even in such situation I believe nobody has the right to kill himself because there can still be a miracle.

But promoting euthanasia because it saves cost is going to the extreme for me. With little hope on the part of the patients and more efforts by medical practitioners some of these people that might want to apply for euthanasia might recover. We shouldn't legalize suicide because it would save us some cost because life is priceless.

It is also important to note that euthanasia might not reduce suicide. In euthanasia the patent or sick person must prove that he/she is terminally ill and/or is in great distress and pain. And the doctors must equally prove that the patent has no or insignificant chances of surviving. Most people that commits suicide are young and healthy people that would have been alive today if they received the needed guidance or assistance. We shouldn't give people the permission to kill themselves.