I’m wrapping my head around the thorny issue of assisted suicide and how it could affect well-established norms in the insurance industry.
The topic of assisted suicide has long been controversial. The term ‘suicide tourism’ – arguably a form of medical tourism – has been coined to describe people travelling to another jurisdiction to undergo assisted suicide. Earlier this year, 104-year-old Australian scientist, David Goodall, flew from Western Australia to Switzerland with the help of two right-to-die societies. Mr Goodall’s story attracted a lot of media attention given his age and circumstances; he was not in a state of terminal illness.
Under Swiss law, the assisted suicide process cannot be prosecuted unless the assistance is motivated by selfishness. The incidence of assisted suicide in Switzerland has risen over time, however; it remains ‘rare’. To give you an idea of quantum, the Swiss Federal Statistical Office, indicates that there were 965 assisted suicides in 2015 compared to 205 in 2005.
There are a number of organisations supporting those grappling with the decision to exercise ‘the right to die’. These organisations apply criteria to determine who is eligible for their assistance. Exit International, for example, is an end of life organisation, which was founded in 1997. It believes that “it is a fundamental human right for every adult of sound mind, to be able to plan for the end of their life in a way that is reliable, peaceful and at the time of their choosing”. The organisation believes that control over our life and our death is a fundamental civil right from which no one of sound mind should be excluded.
“it is a fundamental human right for every adult of sound mind, to be able to plan for the end of their life in a way that is reliable, peaceful and at the time of their choosing”.
This facilitative approach is in stark contrast to the number of human rights organisations calling for an end to the practice of assisted suicide, consistent with the legal stance adopted by many countries.
Assisting suicide is illegal in the UK according to the Suicide Act 1961. I read, in a British Medical Journal publication, about an argument presented to the court. The argument set out the conflict between two fundamental aspects of the European Convention on Human Rights – the right to life (Article 2) and the provision dealing with the prohibition of torture (Article 3). Among its conclusions the court deemed that Article 2 might permit the state to allow assisted suicide, but it does not require the state to allow it. With regard to Article 3, the court argued there was a right to live with dignity, not to die with dignity..
I understand that physician-assisted suicide is legal in a number of US states. The option is open to individuals with a terminal illness as well as a prognosis of six months or less to live.
In Canada, medically assisted dying and assisted suicide became legal in 2016, to end the suffering of terminally ill adults. The assistance is specifically unavailable to minors and to be eligible for consideration, patients need to meet specific criteria. Further, to prevent suicide tourism, it is available only to residents eligible for Canadian healthcare coverage.
In 2017, the Washington Times published an opinion piece which stated: “insurance companies take advantage of patients seen as too expensive to keep alive”. The article probed the issue of abuse of the assisted suicide laws by insurance companies in cases where, it would appear, paying for treatment seems at odds with the prognosis offered to the patient.
Suicide exclusions are common in life insurance contracts, and typically apply for an initial period, to avoid the risk of someone buying a policy with the intention of committing suicide (a form of adverse selection). The Washington Times article highlights a very different practice and a morally questionable one. With statistics indicating an upward trend in this type of end-of-life issue, there are no doubt complex dimensions to consider in any related debates.
Please share your thoughts!