Follow the Money: Oregon pays for assisted suicide but not suicide prevention for adults.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Wesley Smith

Bioethicist, lawyer and cultural commentator, Wesley Smith, examines the Oregon policy of paying for assisted suicide in an article that was published, today, in the Weekly Standard.

In his article, Smith first comments on the celebration of Brittany Maynard's death, that became a massive campaign by the assisted suicide lobby, as compared to the near silence surrounding the life and death of Lauren Hill, who had the same condition but choose to live, continue to play basketball on her college team and raise money to fight cancer.

Smith examines the policies that have led to 859 Oregonians dying by assisted suicide, a state that also has the second highest "other suicide" rate that is 41% higher than the national average. Smith states:

A government’s priorities dictate its spending choices. Oregon uses federal and state money for youth suicide prevention. But even though one in five suicides in Oregon occurs among “older adults,” the anti-assisted-suicide Physicians for Compassionate Care found that the Oregon Health Authority does not fund adult suicide prevention services. As an OHA bureaucrat responded when answering an inquiry from a state legislator, “Staff resources to work on older adult suicide development have not been developed in OHA.” 

In contrast, Oregon does fund assisted suicides under Medicaid, using state funds (federal Medicaid dollars cannot legally pay for assisted suicide). So Oregon taxpayers pay the costs of terminally ill adults seeking death, but no state funds are dispensed to prevent adults from killing themselves. 

Not only that, but Medicaid is explicitly rationed under Oregon law. As one example, some poor patients with late-stage cancer are denied life-extending (as opposed to curative) chemotherapies, but assisted suicide is never rationed. Indeed, readers might recall that Barbara Wagner and Randy Stroup​—​two terminally ill cancer patients​—​were denied Medicaid coverage for chemotherapy in 2008, but told in their rejection letters that the state would fund their suicides.

In fact, the Oregon Health Authority has explicitly stated that assisted suicide is "covered" for the poor. Smith quotes:

It is the intent of the Commission that services under [the Oregon Death with Dignity Act] be covered for those that wish to avail themselves to those serv­ices. Such services include but are not limited to attending physician visits, consulting physician confirmation, mental health evaluation and counseling, and prescription medications.

As Smith says, the message is obvious:

No poor Oregonian will ever be rationed out of assisted suicide​—​after all, what “end of life treatment” could be more cost effective? The message is unequivocal: The state will always pay the tab of the poor wanting to kill themselves, but will not necessarily pay for their fight to remain alive.

Smith concludes his article by re-stating Oregon's spending priorities:

Asked about Oregon’s funding priorities, oncologist Dr. Kenneth Stevens, president of Physicians for Compassionate Care, lamented, “You would think with the concern about the state’s high geriatric suicide rate and the similar crisis among military veterans, the state would fund suicide prevention for adults and the elderly.” 

That would be true in an anti-suicide culture. But that isn’t Oregon. By following the money, we can see what the state cares most about: facilitating some​—​rather than preventing all​—​adult suicides.

The Oregon suicide rate has experienced a steady increase since 2000 and last year alone, Oregon assisted suicide rate increased by 44%.

• Oregon's suicide rate continues to increase faster than the national average.
• Assisted suicide and the suicide contagion effect.
• Assisted suicide increased by 44% in Oregon - 2014 assisted suicide report.