Systemic Euthanasia

The escalating economic and social cost of supporting the aged beyond natural lifecycles leads to wider acceptance of assisted suicide.

Given the certainty of imbalanced population growth and the increasingly ageing population, some claim that there are people born today who, if they wish, could live for over 200 years. With the current record at 120 and a host of people already living past 115, there is little doubt that, with technology advancing as quickly as it is, physically adding another 80 years or so is looking possible. Whether or not mental capacity can be sustained for that long may be a greater challenge, but the world will certainly get used to more and more centenarians. In the UK alone there are over 9,000 of them today.

While this may be all well and good at an individual level, many see that, from a societal perspective, the ageing population is presenting us with a major financial burden, especially given that current pensions were not really designed for people living much beyond 75. With increasing dependency ratios in many nations and escalating healthcare costs across the board, some people have been asking the rather difficult questions around whether we can continue to cope with this level of mass long-term ageing.

An increasing number of healthcare professionals see that life-sustaining treatment is frequently not cost-effective. In the US, acute hospital care accounts for over half (55%) of the spending for Medicare beneficiaries in the last two years of life. In many other countries, the high costs of surgery, intensive care and life-extending drugs used towards the end of a patient’s life adds up to nearly 80% of total healthcare costs. A recent study in Brazil confirmed that over 70% of total healthcare costs occur in the twelve months before death. And a story on Bloomberg a couple of years ago highlighted the case of one US resident whose healthcare costs totalled $618,616, almost two-thirds of it for the final twenty-four months, and, according to his wife ‘much of it for treatments that no one can say for sure helped extend his life’.

Given such predictable trends, a question increasingly being raised in governments and medical policy groups is whether we should continue to put in all these resources and effort, in many cases only to delay the inevitable by a few months. In a US future of health workshop, the question was asked: ‘When will the US adopt the Do Not Resuscitate policy used by the National Health Service in the UK?’ A DNR order on a patient’s file means that a doctor is not required to resuscitate a patient if his or her heart stops and is designed to prevent unnecessary suffering. This is used when a patient is in hospital and the benefits of treatment are seen to be outweighed by the burdens of future quality of life. Some regard this as a form of passive euthanasia. At the workshop it was argued that ‘if the US were to adopt the same policy, the savings to the healthcare budget would be enormous and unnecessary suffering of patients who had little hope of long-term recovery would be avoided’. However, this is just one step and others are proposing even more significant changes.