McArthur: ‘Assisted suicide costs will be covered by reduced demand for palliative care’

Liam McArthur MSP has confirmed his view that the cost of assisted suicide in Scotland, including the requisite lethal drugs, will be met by the corresponding reduction in demand for end-of-life care.

The architect of Scotland’s assisted suicide Bill told Holyrood’s Finance and Public Administration Committee that potential savings in the provision of palliative care would render his Bill “cost-neutral”.

McArthur prefaced his opening statement to MSPs by declaring that he received financial backing from Dignity in Dying, Humanist Society Scotland and Friends at the End in pursuit of his campaign.

Utilitarian costing

Members of the Committee questioned McArthur about the costings in his Financial Memorandum, published to accompany his Assisted Dying for Terminally Ill Adults (Scotland) Bill.

Referring to the cost of lethal drugs for assisted suicide, the memorandum states: “Community Pharmacy Scotland estimated that, as an example, one substance that may be used in such circumstances would cost an estimated £80 for each dose provided to a terminally ill adult to end their own life.

“On the basis of the estimate of 25 people having an assisted death in year one following the Bill’s enactment, rising to 400 by year 20 it can be estimated that the cost of the required substances would be around £2000 in year one, rising to £32,000 per year by year 20.”

The document concluded that the cost of enacting the Bill would be negated by any savings made “where palliative care is not, or is no longer, required” because those needing it have been helped to kill themselves.

‘Commensurate cost-saving’

McArthur informed MSPs the memorandum acknowledged that “the legislation is likely to result in savings as well as costs and that broadly speaking it is anticipated to be cost neutral.

a commensurate cost-saving due to a person no longer receiving care for however long they may have lived

“This is because there is a cost associated with the processes involved in a person being assessed and potentially provided with assistance to end their own life, such as clinical and associated administration costs, and a commensurate cost-saving due to a person no longer receiving care for however long they may have lived.”

Michael Marra MSP noted that the financial implications of McArthur’s proposals for the hospice sector were not mentioned in the memorandum.

Referring to a Westminster Health Committee report, McArthur claimed there was no evidence to suggest legalising assisted suicide had “a detrimental effect” on the quality of palliative care, but added that such considerations were beyond the scope of his Bill.

Impact

However, a recent study by bioethicist Professor David Albert Jones found “clear evidence” of harm in the quality and provision of end-of-life care following the introduction of assisted suicide or euthanasia in other countries.

In his review, Prof Jones found that between 2012 and 2019 the 20 countries in Western Europe without assisted suicide increased funding for end-of-life care by 25 per cent.

During the same period in Belgium, the Netherlands, Luxembourg and Switzerland – countries where assisted suicide or euthanasia is legal – funding grew by just 7.9 per cent.

Prof Jones also cited “mounting evidence” that the pressure to facilitate assisted suicide was causing some palliative care doctors to leave the profession.