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Poverty: Not a Justification for Banning Physician-Assisted Death.

Lindsey M Freeman, Susannah L Rose, Stuart J Youngner

    The Hastings Center Report
    |December 27, 2018
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    Physician-assisted death (PAD) is not unduly influenced by financial pressures at end-of-life decisions. Economic factors impact life-extending care choices more than PAD requests, and poverty does not invalidate patient autonomy.

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    Area of Science:

    • Medical Ethics
    • Health Economics
    • End-of-Life Care

    Background:

    • Critics fear physician-assisted death (PAD) legalization disproportionately harms economically disadvantaged individuals.
    • Concerns exist regarding economic influences on medical decisions, particularly at the end of life.
    • The intersection of poverty, autonomy, and end-of-life choices requires empirical examination.

    Purpose of the Study:

    • To investigate the influence of financial pressures on end-of-life medical decisions, specifically physician-assisted death (PAD).
    • To assess whether poverty compromises patient autonomy in end-of-life decision-making.
    • To critique the distinction between PAD and withdrawal of life-sustaining care in the context of economic factors.

    Main Methods:

    • Empirical evidence analysis to examine financial influences on medical decisions.
    • Assessment of patient autonomy in the context of poverty and end-of-life choices.
    • Ethical and practical critique of current end-of-life care policies and decision-making frameworks.

    Main Results:

    • Financial pressures significantly influence decisions regarding aggressive life-extending care, more so than requests for PAD.
    • Poverty, even with an inadequate social safety net, does not inherently invalidate patient autonomy for PAD requests.
    • Distinguishing between PAD and withdrawal of life-sustaining care based on financial pressure is deemed irrational.

    Conclusions:

    • Economic considerations play a role in end-of-life decisions, but not in a manner that invalidates physician-assisted death (PAD) requests.
    • Patient autonomy is not necessarily compromised by poverty when making end-of-life choices, including PAD.
    • Focus should shift towards addressing systemic flaws in the American healthcare system rather than restricting PAD based on economic concerns.