High Health Costs Ignite Efforts To Legalize Assisted Suicide

When Stephanie Packer, a terminally ill mother of four, contacted her insurance to confirm coverage for her treatment plans, she was shocked to learn they were refusing to pay. Instead, for less than the cost of a Snickers bar, she could choose to end her life.

Explainer High Health Costs Ignite Efforts To Legalize Assisted Suicide

Proponents of legislation allowing physicians to prescribe lethal medication to the terminally ill refer to it as "Medical Aid in Dying" (MAID). In 2016, California became the fifth state to legalize physician-assisted suicide with the enactment of the "End of Life Options Act."

Opponents of MAID express concerns that such legislation creates dangerous incentives. Dr. Brian Callister, an advocate against physician-assisted suicide and director of Academic Hospital Medicine at the University of Nevada, argues that it is cheaper for insurance companies to provide lethal medication than to cover treatment. He stated, "the cheapest thing in the world for an insurance company is to collect your premiums and then, when you actually need to use them, it’s ‘Oh, your life’s not worth living. Here’s some pills. Go kill yourself.’"

The ethical implications of MAID raise complex questions. While some argue that financial pressures could unduly influence decisions, others cite legitimate reasons such as pain and helplessness. Final Exit Network, a right-to-die advocacy group, suggests that dementia patients should have the option to minimize their suffering, citing a potential "loss of self-hood" as a reason.

Currently, MAID laws in 11 states require patients to be terminally ill with six months left to live. Dr. Thaddeus Pope, a bioethicist and law professor at Mitchell Hamline School of Law, supports expanding MAID applications beyond terminal illness. He stated, "I’m the best judge of what’s best for me. So, if this is intolerable, if you can’t live with this anymore, then who am I to say, ‘Yes, you can live with it, and you’re going to.'"

Packer, however, argues that financial considerations can lead to coercion. She noted, "Life insurance can still go to families even if someone kills themselves, using this option. So, ‘I have no money for treatment, and I’ve got life insurance. I can take care of my family that way.’ And to say that that’s not coercion, to say that that doesn’t affect somebody’s decision — it’s ridiculous."

The interpretation of a six-month prognosis can also be more flexible than it appears. Dr. Callister pointed out that a person with diabetes who stops taking medication could technically be considered terminal. Statistics from Oregon show that over two percent of deaths resulting from lethal medications in 2024 involved individuals with metabolic or endocrine diseases.

The debate over MAID also includes controversial conditions such as anorexia. Matt Vallière, executive director of the Patients Rights Action Fund, expressed concern that current laws could allow individuals with eating disorders to access lethal drugs. Dr. Jenifer Gaudiani, a specialist in eating disorders, has advocated for MAID for patients with anorexia who meet terminal criteria.

Compassion and Choices, a national organization advocating for end-of-life options, rejects the term "suicide" in relation to MAID. They argue that medical aid in dying is distinct from assisted suicide and euthanasia. Their approach includes methods like "Voluntary Stopping Eating and Drinking" (VSED) as a pathway to a terminal diagnosis.

Oregon was the first state to pass MAID legislation in 1997, known as the "Death with Dignity Act." Since its inception, 4,481 people have received medication, with 3,243 dying from ingestion. Notably, 1,238 individuals received lethal medication without supervision. Dr. Callister raised concerns about potential abuse of the law, suggesting that vulnerable individuals could be coerced into taking lethal medication.

In June 2025, New York became the 12th state to legalize MAID, continuing the trend of expanding end-of-life options across the country.