Six Fortune 500 companies, through their affiliated charitable vehicles, have facilitated significant donations to Compassion & Choices, a U.S. nonprofit advocating for expanded access to physician-assisted suicide and other end-of-life practices. Compassion & Choices promotes medical aid in dying (MAID) through voluntarily stopping eating and drinking (VSED), palliative sedation that “advances the time of death,” and dementia directives that allow patients to refuse food and fluids.
Companies may consider support for “choice,” “autonomy,” and “death with dignity” consistent with socially progressive philanthropic programs. However, physician-assisted suicide is a violation of the patient-doctor trust and a red line that is being crossed by providers. This represents yet another example of corporations using company resources to support and fund social causes that bear no connection to their core business operations or fiduciary interests. The American Medical Association’s Code of Medical Ethics states that physician-assisted suicide is “fundamentally incompatible with the physician’s role as healer” and warns that it could pose serious societal risks.
Corporate involvement raises another uncomfortable question: What happens when death becomes the least expensive healthcare option?
Healthcare systems respond to financial incentives. This is particularly relevant to large corporations operating self-funded employee health plans. Unlike employers purchasing traditional insurance, self-insured employers generally pay covered medical expenses directly as claims occur. The Department of Labor confirms that these employers therefore bear the financial cost of covered healthcare themselves.
For a terminally ill patient, months of cancer treatment, specialty medications, hospitalization, intensive care, or other life-extending treatments can cost tens or hundreds of thousands of dollars. Assisted death can cost dramatically less. Legalization therefore creates an unavoidable financial conflict: the institution responsible for paying for expensive treatment may simultaneously benefit financially when future treatment expenses end.
Corporate-linked financial support for assisted-suicide advocacy warrants serious scrutiny. When the institution paying for a patient’s care may financially benefit from that care ending sooner, the meaning of genuine, uninfluenced “choice” becomes far more complicated.