Discussion leader: Jim Phillips
Just because we can extend life, should we? The U.S. is expected to spend $2.8 trillion on health care in 2012. Medicare alone will cost taxpayers $590 billion, with over 25% going toward patients in their last year of life. If health care is a scarce resource, limited by its availability and our ability to pay for it, should government step in to ration care, deciding whose life is worth saving? In other words, how much is an extra month of life worth?
For The Motion
The U.S. spends more on health care than any other industrial nation—in 2012 we are expected to spend $2.8 trillion. We cannot afford our health care system and expensive end-of-life care costs are a major contributor to this problem.
Rationing means getting better value for the trillions we spend every year.
Rationing already happens. Medicare decides what it will reimburse, private insurance decides what they will cover, and individuals go without care and medicine every day when they can’t afford it.
We must ration based on cost-effectiveness, not on an individual’s ability to pay.
If we spent less on those who, with or without treatment, have only a few months left to live, we would be better able to help those who may have decades.
Against The Motion
The government should not have the power to determine who lives, who dies, and who gets treatment based on calculations of quality and quantity of life.
Health care costs can be reined in without rationing care.
Targeting “end-of-life” care specifically would result in very little cost savings.
Rationing care will lead us down a moral slippery slope. How many years of life is enough? Who is productive and worthy, and who is not?
In 1994, Oregon voters passed the Death with Dignity Act, which legalized physician-assisted suicide for the terminally ill. Since then, it has become legal in 4 more states, including New Mexico, where the state court ruling that it is constitutional is under appeal. Is it, in the words of the American Medical Association’s code of ethics, “fundamentally incompatible with the physician’s role as healer”? Will these laws lead to a slippery slope, where the vulnerable are pressured to choose death and human life is devalued? Or do we need to recognize everyone’s basic right to autonomy, the right to end pain and suffering, and the right to choose to die with dignity?
For The Motion
The right to die as one chooses—and to decide when life is no longer worth living—is integral to human freedom, liberty, and personal autonomy. Neither the government, nor religious institutions, should impose their own conceptions of morality upon individuals who are not harming others.
As an option in end-of-life care, aid in dying would allow terminally ill, mentally competent individuals to retain dignity and bodily integrity in the face of insurmountable pain and suffering.
In places where assisted suicide is legal—namely, Oregon and the Netherlands—there is no evidence that the law is being abused, that vulnerable populations are being targeted, or that patients are being coerced by doctors and/or their families to choose death.
If physician-assisted suicide remains illegal, lesser and more dangerous alternatives—shooting oneself, enlisting doctors or family to break the law, DIY suicide—will spread in its place.
Against The Motion
If assisted suicide is legalized, we will be led down a slippery slope towards pervasive medical killing, endangering vulnerable populations—disabled, elderly, minority, or poor—whose lives are seen as a burden on society.
If pain is treated effectively, there is no need to treat the patient as if the patient were the “problem to be eliminated.”
Starting with the Hippocratic Oath, medical professional codes prohibit killing, holding the intrinsic value of human life and dignity above all other ethical principles. Assisted suicide erodes the doctor-patient relationship and has grave potential for misuse and abuse.
Many physicians do not want to have God-like power over others, and they should not be pressured, against their own convictions, to assist in a patient’s suicide.
As people approach the end of their lives, they and their families commonly face tasks and decisions that include a broad array of choices ranging from simple to extremely complex. They may be practical, psychosocial, spiritual, legal, existential, or medical in nature.
End-Of-Life Policy Solutions: A Cautionary Note
Ethical Issues Surrounding End-of-Life Care: A Narrative Review
How to Curb the High Cost of Caregiving
HOW TO ENROLL IN VETERANS HEALTH INSURANCE (TRICARE)
How to grow old in your own home
Paying for Care
Problems and Solutions in End-of-Life Healthcare