The healthcare system's deadly shift: euthanasia as a solution

While ethical concerns surrounding assisted suicide raise troubling questions about how society values human life, these issues are deeply intertwined with systemic failures in the healthcare system. In "Euthanasia out of control", The Gold Report explored how the decision to legalize assisted suicide often stems from inadequate care and support. A broken healthcare system and weak and weakening safeguards have enabled egregious abuses to take place.

Now, we turn to the structural aspects of healthcare that create barriers to life-affirming options, such as insurers denying life-prolonging treatments, the troubling normalization of assisted suicide as a medical solution, and systemic issues like doctors' time constraints and errors in diagnosis. Addressing these failures is key to implementing changes that promote life instead of facilitating death.

Insurers pay for suicide, not treatment

Disabled individuals who are contemplating suicide are not given suicide prevention treatment as their non-disabled counterparts, but suicide drugs, writes President and CEO of the American Association of People with Disabilities Helene Berger. Legalizing assisted suicide devalues their lives by creating a double standard where some lives are more valuable than others.

The legalization of assisted suicide also devalues the lives of people with disabilities because it creates a double standard — insurance companies and state agencies readily offer to pay for life-ending drugs for individuals with disabilities and serious health conditions when they ask for death, but provide suicide prevention services to non-disabled individuals who make the same request.

Prioritizing cost over lives

Berger highlighted instances where insurers in California and Oregon refused to pay for medical care to prolong life but were more than willing to cover the drugs for assisted suicide. 

For example, Reno, Nevada physician Dr. Brian Callister was told by two different insurance companies that they would not cover curative therapies for his patients in California, but would cover assisted suicide. Dr. Callister also noted that two women in Oregon had similar experiences.

Dr. Brian Callister, a physician from Reno, Nev., was told by two separate insurance medical directors that assisted suicide would be covered for his California patients, but the curative therapies Dr. Callister had prescribed to save their lives would not.

Callister confirms the concerns of health care advocates, saying that “since assisted suicide became legal in California and Oregon, the practice of medicine across the West has been irreparably harmed for patients who still want their diseases treated but are now simply offered the cheaper option of a quick death.” “

California mom Stephanie Packer also complained about her insurance company refusing to provide needed drugs once California legalized assisted suicide, as reported by Bradford Richardson for the Washington Times. Packer, who had scleroderma was looking forward to trying a new drug to treat her condition.  

"And I was going back and forth [with the insurance company], and finally I had heard back from them, and they said, ’Yes, we’re going to get it covered, we just have to fix a couple of things,’” she continued.

But shortly after California’s End of Life Option Act, which authorizes physicians to diagnose a life-ending dose of medication to patients with a prognosis of six months or less to live, went into effect, Ms. Packer’s insurance company had a change of heart.

. . . 

Ms. Packer said her doctors have appealed the insurance company’s decision twice, to no avail. She said the assisted-suicide law creates an incentive for insurance companies to deny terminally ill patients coverage.

While a Google search did not reveal other such instances of offering suicide drugs instead of treatment in California, Oregon, or other US states (although it is common in Canada) insurers often deny pre-authorization requests for treatment by determining that the treatment would be futile. 

Diagnosis/prognosis

Six months to live 

One of the objections to assisted suicide by The United States Conference of Catholic Bishops is that terminal illness is poorly defined and does not distinguish between people who will die within six months (the benchmark for allowing euthanasia) even with care and those who are only expected to die in that time period if they don’t receive the treatment they need. 

Assisted suicide laws typically appear to limit eligibility to terminally ill patients who are expected to die within six months but don't distinguish between persons who will die within six months with treatment and those who will die within six months without treatment. This means that patients with treatable diseases (like diabetes or chronic respiratory or cardiac disease) and patients with disabilities requiring ventilator support are all eligible for lethal drugs because they would die within six months without the treatment they would normally receive.

Maybe even longer

Not only is terminal illness poorly defined, but doctors are often mistaken about the prognosis and patients frequently outlive their diagnosis by months and even years.

In 2007, Frank Greve, writing for MCClatchity DC, found that many people who enter hospice don't die. In fact, he stated that approximately 100,000 hospice patients could be expected to get new leases on life that year.

While no one could give definite reasons for why this would be true, one theory is that some patients weren't declining, their care was. Given the care they needed in hospice, they were able to recover.

New treatments and technologies may also change the prognosis of an illness. Therapeutic hypothermia, dropping the person's core temperature, for example, protects the brain and can now save comatose patients who would have previously died.

Algorithms used following cardiac arrest are no longer universally valid. Walk into an intensive-care unit and you might see a comatose patient swaddled in cooling blankets, surrounded by ice packs, a drip running cold fluids through their veins. Therapeutic hypothermia aims to protect the brain from a lack of blood flow. Before this technique, neurologists could start to ascertain prognosis in a comatose patient even by day three. Watch if the pupil dilates with light, see if the eye blinks as a wisp of cotton wool touches the cornea. But for comatose patients who have been rendered hypothermic, everything changes. Dropping core temperature by just five degrees entirely alters the brain’s reaction to these tests. The old algorithm falls apart. A new one takes its place. Don’t pull the plug. (Emphasis added.)

In other instances, patients have been misdiagnosed with a terminal illness that they didn’t have. Dr. Jack King in his book on the subject, "Why they want to kill us," maintains that any doctor who tells someone they are going to die is a fool.

. . . [P]rognoses are subjective and they are wrong more often than they are right. I could fill London with people who have been told to prepare themselves for death but who have lived for many years. The advocates for euthanasia assume that it is possible to decide that an illness is fatal. Anyone (doctor or nurse) who announces that an illness is fatal is a fool. I doubt if I am alone in having seen patients who have been told that they were incurable, recover and enjoy long lives – not uncommonly outliving the physician who had told them they were dying. . . .

Two examples that Dr. King provided of people who had been misdiagnosed were a 45-year-old woman whose inoperable liver tumor was actually found to be benign and a 65-year-old man whose neurodegenerative disease was the side effect of statin drugs.

A 45-year-old mother of two was told that she had an inoperable tumour on her liver. With no family present, she was told that she had between two months and two years to live. (How any doctor can offer such a bizarrely wide prognosis is difficult to understand.) In fact, she had a benign liver tumour. She was not told of the error for a month. It was a year before the woman had recovered from the trauma of the mistaken diagnosis. But what if she had been persuaded to accept euthanasia? . . .

A 65-year-old man was diagnosed with Motor Neurone Disease and told that he was terminally ill with just six months to live. He was told to choose a hospice. He later found that his symptoms were actually caused by the statins he was taking. When he’d been told he was terminally ill, he stopped the statins and his symptoms disappeared.

Death - another form of medical treatment

Canada not only legalized assisted suicide but also euthanasia where the doctor does the killing. Assisted suicide, initially available to people with terminal illnesses, was expanded to allow disabled people with many years ahead of them to choose to be killed prematurely; physicians are required to inform patients that euthanasia is another option available to them as a medical “treatment.” Like the California and Oregon insurers who offered suicide drugs but not payment for treatment, Canadians are regularly offered suicide even when they want to and could live better lives with proper support, which is often denied to them.

Not as peaceful as it looks

Assisted suicide is also not the peaceful death it’s sold as. Dr. Joel Zivot, an anesthesiologist with two and half decades of experience using the drugs prescribed for assisted suicide, has shown that the drugs cause people to die by drowning. The deaths look peaceful because the muscle relaxants they are given paralyze them. 

Real solutions for real problems

Mercy Health CEO Emeritus Michael D. Connelly considers assisted suicide to be a solution for a symptom  — patients wishing to die, but does not address the root cause of the problem — a broken healthcare system. He proposes three strategies to address systemic failures and offer tangible solutions to serve patients better.

1. Reevaluate payment structures for primary care physicians
   ‍Current medical billing systems that rely on coding make healthcare unnecessarily complex and fail to account for essential services, such as doctor-patient conversations and care coordination. Adjusting these systems could allow for more meaningful patient-physician interactions, including discussions about end-of-life options.
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2. ‍More information and education about palliative care and hospice
   ‍Palliative and hospice care, while critical, are often underutilized. Better education and awareness about these care options could provide patients with alternatives to assisted suicide, offering relief from suffering without the need for life-ending decisions.
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3. ‍Provide support to families dealing with end-of-life fears
   ‍Education and open dialogue about death and the dying process can help ease fears that may lead some patients to consider assisted suicide. Offering families the resources to navigate these emotional challenges could improve the quality of care and decision-making.

Expanded solutions

The following suggestions build upon Connelly’s solutions to address prognosis errors and misdiagnoses, which also contribute to the push for assisted suicide.

1. ‍Enhancing diagnostic accuracy through revised payment structures could address misdiagnosis or overly pessimistic prognoses, ensuring patients receive appropriate and timely care.
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2. ‍Support for families could be expanded to include education about diagnostic findings, treatment options, and the emotional aspects of end-of-life care, fostering informed decision-making.
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3. ‍Increased focus on palliative and hospice care education could emphasize these services, ensuring patients and families understand their options for managing suffering without feeling pressured to choose death.

The Dangers of Normalizing Assisted Suicide

In the following interview, Epoch TV's "American Thought Leaders" host Jan Jakeliek sits down with lawyer, author, and chair of the Discovery Institute Center on Human Exceptionalism Wesley J. Smith who shares his concerns about the normalization of assisted suicide and euthanasia. He argues that legalizing these practices presents a dangerous shift in societal views on life and death, making it difficult for a country to maintain an anti-suicide stance once it endorses the practice. Smith also challenges the narrative that assisted suicide is a compassionate response to suffering, emphasizing that existential concerns, not just physical pain, drive many people toward this option. In fact, he maintains that providing assisted suicide is not compassion but abandonment.

Watch the full interview below to hear more of Smith's arguments and insights into the ethical implications of legalizing assisted suicide.

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Related articles:

• Euthanasia out of control‍
• ‍Is Canada profiteering from euthanasia and transplants — like the CCP?
• Are MAiD organ donors really dead when their organs are harvested? Waiting five minutes after the heart stops may not be long enough
• Are organ donors dead when their organs are harvested? 'If you’re really dead, then no organs can be extracted'
• Is organ harvesting driving euthanasia? The ugly truth about why Canada leads in MAiD organ donor transplants‍
• The harsh reality of euthanasia: Exposing the myth of a peaceful passing
• Euthanasia by the numbers: Canadian doctors have already killed the equivalent of a small city‍
• Is euthanasia compassionate if offered to those who don’t want to die and doctors misjudge imminent death?
• White coat euthanasia: A license to kill in the name of care?
• Medical Assistance in Dying (MAID) - a cruel way to die but not to the onlooker
• Disabled in Canada? Doctors may pressure you to end your life

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