The Economics of “Right-to-Die” Legislation

By Trey Cawley

Human Skull on top of a Book.

A study from Sam Houston State University examines a new economic perspective on the politically charged issue of physician-assisted suicide legislation.

The article looks for links between physician-assisted suicide legislation, also known as “right-to-die” laws, and economic and social factors within industrialized countries. It also examined the factors that can lead to the national adoption of physician-assisted suicide legislation as a policy solution to problems such as rising healthcare costs.

Dr. Victoria Titterington.“Lots of people are looking at this in a lot of different ways,” said Dr. Victoria B. Titterington of the College of Criminal Justice and principal investigator of the study. “What was important about our effort, even though it generated modest results, is that we were putting it in economic terms by focusing as much on the economics of it as we were on the human element.”

The countries examined included the 19 industrial democracies of Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Ireland, Italy, Japan, Luxembourg, New Zealand, The Netherlands, Norway, Sweden, Switzerland, the United Kingdom and the United States. Among the economic and social factors that were included in the study were:

  • Money spent on healthcare
  • Percentage of people 65 in the population
  • Religious diversity
  • Homicide rates
  • Suicide rates

Australia, Belgium, Luxembourg, The Netherlands, Switzerland, and the United States are six countries that have or had laws that allow physician-assisted suicide.The policy debate about right-to-die legislation has increased as populations begin to age rapidly due to better, and more expensive, health care service and a shrinking birth-rate. Legal physician-assisted suicide is already on the books in the European countries of Switzerland, Belgium, The Netherlands and Luxembourg as well as Australia for a limited time in 1996. It is estimated that 3 percent of all deaths in The Netherlands involve physician-assisted suicide.

A sign post depicting a road that forks into life and death and asks to choose which direction.Although more limited in scope, physician-assisted suicide legislation in the United States has a sizable history with the practice legal in the states of Oregon, Washington, and Montana. Meanwhile, countries such as Germany and France have had heated political debates about this issue throughout their societies.

“From a policy stand point, it has everything to do with what individuals themselves, at the end of what they imagine to be the end of their life wish,” said Dr. Titterington. “Do they or don’t they have the right to ask for that assistance? Cases where they’re incapacitated and families make their decisions have the same issue; do families have the right to request that or not? It’s a big policy issue for the medical community as well because the Hippocratic Oath suggests ‘do no harm,’ with physician-assisted suicide considered antiethical to their own professional standards.”

The study found that there is an association among the factors examined and right-to-die legislation. Four of the six countries with physician-assisted suicide ranked in the top half of the factors examined as well as France and Germany, which are discussing adopting similar legislation.

By examining these economic and social factors, Dr. Titterington and colleagues seek to understand the extent to which societies will resolve to lengthen human life. The study is meant to help further the debate about right-to-death legislation and foster growth into more research on the issue. Regardless, this a debate that will become more and more important globally as time moves forward.

“The whole world is aging, and all developed countries are getting older,” Dr. Titterington said. “Japan is a good example of that as the proportion of people over the age of 60 is growing almost exponentially. So we do expect this to be a topic that will gain increasing public focus.”

The study by Dr. Titterington with her colleagues, Ph.D. graduate Pierre Rivolta and Dr. Scott Schraufnagel of North Illinois University, can be found in the July issue of Sociological Spectrum found here

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