Navigating the Future of Healthcare: The Case for Insurance Coverage of Assisted Suicide Services

In May 2017, the Washington Times reported a peculiar claim made by a Nevada physician. According to the physician, insurance companies in states with legalized assisted suicide have denied coverage for costly, life-extending treatments for their patients. Instead, these companies have offered to assist with end-of-life services.

Nevada, a state in the United States, was at the forefront of the assisted suicide debate. The legislation, known as SB239, aimed to legalize physician-assisted suicide and was put to a vote. During the legislative process, Nevada lawmakers heard testimonies from clergy, palliative care providers, and hospice professionals, all of whom expressed support for assisted suicide. Ultimately, Governor Joe Lombardo vetoed the "medical-aid-in-dying" bill.

While there are various definitions, we will focus on medical aid in dying. This refers to the practice where a mentally competent adult with a terminal illness receives a prescription medication from their doctor. The patient can choose to self-administer this medication to peacefully end their life. Mercy killing and end-of-life care are often challenging decisions with complex financial, legal, ethical, moral, and medical implications.

From a financial standpoint, the case is straightforward. Caring for terminally ill patients is extremely costly. Some experts suggest that the United States spends excessively on high-tech healthcare for dying patients. Many commentators observe that 27 to 30 percent of the Medicare budget is allocated to the 5 percent of Medicare patients who die annually. They also highlight that expenditures increase significantly as death approaches, with the last month of life accounting for 30 to 40 percent of the medical care expenditures incurred during the final year of life. For many, savings from reduced use of expensive technological interventions at the end of life are both necessary and desirable.

Many countries are legalizing physician-assisted suicide. As this trend continues, assisted suicide is becoming recognized as a healthcare service. This shift means that there will be service providers offering assisted suicide. Consequently, there is a need for payment for these services, and, like most healthcare services, health insurance should be available to cover this aspect of care.

While controversial for now, this may not be the case in the near future. The French national complementary insurance company for teachers, MGEN (Mutuelle Générale de l’Éducation Nationale), recently published an IFOP survey on end-of-life care. MGEN president Matthias Savignac commented, 'The issue of end-of-life care is primarily a matter of dignity and individual freedom. We cannot assume that our existing rights are unquestionable; we must defend them by advocating for new rights. MGEN has been engaging in collaborative efforts by bringing together thousands of its members, elected officials, activists, employees, and healthcare professionals."

Of course, others view this as a conflict of interest. Many question whether these insurance companies should be advocating for universal access to palliative care rather than pushing for the legalization of euthanasia. They also inquire whether it is appropriate for insurance companies to promote the euthanasia mindset, a straightforward and economical solution.

The economic argument for assisted dying is straightforward and compelling. However, society must also address the ethical, moral, and legal implications. It is becoming evident that assisted dying may become a socially acceptable practice, similar to abortion, which was a fiercely divisive issue just a few decades ago. This shift reflects a growing emphasis on individual autonomy and healthcare dignity.

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