Tuesday, November 24, 2015

The Cost of Physician-Assisted Suicide.

By Margaret Dore, Esq., MBA*
Updated November 25, 2015 

It is often assumed that legalizing physician-assisted suicide will save states money. Don’t be so sure. In Oregon, legalization is correlated with an increase in other suicides, the cost of which is "enormous."

More Suicide

Oregon's law legalizing physician-assisted suicide went into effect “in late 1997.”[1] Since then, Oregon has reported a small, but steadily rising number of deaths.[2]

Oregon's other suicides, which are tracked separately, have also increased. Indeed, by 2000, Oregon's suicide rate for other suicides was "increasing significantly."[2] By 2007, Oregon's suicide rate for other suicides was 35% above the national average.[3] By 2010, Oregon's suicide rate for other suicides was 41% above the national average.[4]

The Financial Cost

The financial cost of these other suicides (and suicide attempts) is huge for Oregon, a smaller population state. The Oregon Health Authority states:
The cost of suicide is enormous. In 2010 alone, self-inflicted injury hospitalization charges exceeded 41 million dollars; and the estimate of total lifetime cost of suicide in Oregon was over 680 million dollars. (Footnotes omitted).[5]

It is well known that suicide is contagious.[6] Oregon's increased suicide rate for non-physician-assisted suicides is consistent with a suicide contagion. Legal (legitimized) physician-assisted suicide has encouraged other suicides.

The high cost of suicide is due to many factors including that "failed" suicides can leave people disabled, requiring long term care. There is also the sometimes extreme expense of "suicide by cop," which occurs when a suicidal person threatens the police or civilians in order to be killed by the police.[7]

Suicide By Cop

Consider a recent case in Oregon where a man was killed by deputies.[8] They responded to a 911 call reportedly involving a victim stabbed by a man who also had a gun.[9] They found a man with a hatchet who refused to drop it.[10] When he moved towards them, they shot him.[11] The 911 call had come from man's cell phone; they did not find a stabbing victim; the Medical Examiner ruled the death a suicide.[12]

The financial cost of suicide by cop can be extremely high when suicidal persons take other people with them. In 2001, Californian Andy Williams, at age 15, had a "grand plan" of suicide by cop.[13] He went to school with a gun, killed two schoolmates and wounded 13 others.[14] In 2013, a newspaper reported him as incarcerated and ineligible for parole until age 65.[15] His "failed" suicide was obviously an expensive incident, which has ongoing cost.

There can also be financial costs incurred to defend police against excessive force lawsuits and to pay resulting judgments. Bernard Farber, editor of a law enforcement journal, states:
That such shootings may result in substantial liability is clearly illustrated by [a Florida case. T]he family of a man shot dead after he threw a knife at officers and screamed, "Suicide by cop!," received a $1.25 million settlement.[16]

States thinking that physician-assisted suicide will be good for their bottom lines may find that it does anything but.

* Margaret Dore is a lawyer in Washington State where assisted suicide is legal. She is also president of Choice is an Illusion, a nonprofit corporation opposed to assisted suicide and euthanasia. She is a former Law Clerk to the Washington State Supreme Court and a former Chair of the Elder Law Committee of the American Bar Association Family Law Section. She has been licensed to practice law since 1986.

* * *
[1]  Oregon's Death with Dignity Act, Report for 2014, p.1 (stating that the act was "enacted in late 1997") , available at http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf
[2]  Id.
[3]  Oregon Health Authority News Release, 09/09/10, at http://www.oregon.gov/DHS/news/2010news/2010-0909a.pdf ("Oregon’s suicide rate is 35 percent higher than the national average. . . .  After decreasing in the 1990s, suicide rates have been increasing significantly since 2000").
[4]  Oregon Health Authority Report, "Suicides in Oregon, Trends and Risk Factors" (2012 Report), p.1, "Key Findings" ("In 2010, the age-adjusted suicide rate among Oregonians of 17.1 per 100,000 was 41 percent higher than the national average"), available at http://www.oregon.gov/oha/amh/CSAC%20Meeting%20Shedule/Suicide-in-Oregon-report.pdf
[5]   Id, p.3
[6]  See e.g., Copycat Suicide (also discussing contagion and suicide clusters) at https://en.wikipedia.org/wiki/Copycat_suicide
[7]  Bernard J. Farber,"Suicide by Cop," 2007 (8) AELE Mo. L. J. 101, at http://www.aele.org/law/2007LRAUG/2007-08MLJ101.pdf.
[8]  Steve Mayes, "Death of Colton man killed by deputies ruled a suicide; case will not go to a grand jury," The Oregonian, April 8, 2015, at http://www.oregonlive.com/clackamascounty/index.ssf/2015/04/case_of_colton_man_killed_by_d.html
[9]  Id.
[10]  Id.
[11]  Id.
[12]  Id.
[13]  Rebecca Jacobson, “School Shooter: ‘My Grand Plan Was Suicide by Cop,’” PBS Newshour, 02/18/13,  http://www.pbs.org/newshour/updates/science-jan-june13-andywilliams_02-18
[14]  Id.
[15]  Id.
[16]  Farber supra at note 7.