In a December 2018 report from the Hastings Center, authors Lindsey M. Freeman, Susannah L. Rose and Stuart J. Youngner find that financial pressures do not influence the decision to request medical aid in dying (referred to as “physician assisted death” or “PAD” for short in their paper). They argue that monetary concerns are more likely to influence whether an individual pursues aggressive life-extending care at the end of life, not medical aid in dying. Among the key points the authors make:

• “…a substantial majority of patients that complete [medical aid in dying] are enrolled in hospice care, so they have already made a choice to forgo aggressive [and expensive] treatment.
• Medical aid in dying “in the United States is much more closely regulated than the practice of limiting life-sustaining treatment.”
• “The limitations on [medical aid in dying] eligibility, often termed ‘safeguards,’ are designed to protect against abuses and misuses of the practice.”
• “…the requirement that the patient’s request be evaluated by two physicians would make it less likely that financial considerations are coercing patients into making a decision against their authentic preferences.”

The authors conclude that the fact that “an inadequate social safety net does not justify banning [medical aid in dying].” Furthermore, “to allow the shortcomings and failures of our current health care and economic system to forbid a potentially beneficial service such as [medical aid in dying] fails to address the pertinent issues facing society today.” Instead, the authors advocate for systemic reform to address the larger inequalities in the health care system.

The full article is available at: https://www.ncbi.nlm.nih.gov/pubmed/30586187

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