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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

What are the cost and resource implications of voluntary assisted dying and euthanasia?

Peter Hudson https://orcid.org/0000-0001-5891-8197 A B * , David Marco https://orcid.org/0000-0001-8634-3036 A , Richard De Abreu Lourenco https://orcid.org/0000-0002-5978-8774 C and Jennifer Philip https://orcid.org/0000-0002-3312-0645 D
+ Author Affiliations
- Author Affiliations

A Centre for Palliative Care, c/o St Vincent’s Hospital and The University of Melbourne, 41 Victoria Parade, Fitzroy, Vic. 3065, Australia.

B End of Life Research Department, Vrije Universiteit Brussel, Belgium.

C Centre for Health Economics Research and Evaluation, University of Technology Sydney, NSW, Australia.

D The University of Melbourne, St Vincent’s Hospital and the Victorian Comprehensive Cancer Centre, Melbourne, Vic., Australia.

* Correspondence to: phudson@unimelb.edu.au

Australian Health Review 48(3) 269-273 https://doi.org/10.1071/AH24016
Submitted: 24 October 2023  Accepted: 16 January 2024  Published: 6 February 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objectives

Voluntary assisted dying (VAD) legislation has now been passed in all Australian states. Although VAD has been operating in many settings worldwide for a considerable time, the specific costs associated with VAD seem unclear. The aim of this study was therefore to outline the common resource implications associated with VAD.

Methods

A rapid literature review and grey literature search were undertaken.

Results

We found a paucity of empirically informed detail regarding the actual costs required to implement VAD. Hence, we tabulated a list of potential costs that could be used for subsequent evaluation and a future research agenda.

Conclusions

There is a lack of publicly available information related to the costs associated with implementing VAD. Given that this is a significant change in policy and many multidisciplinary practitioners may be directly or indirectly involved in VAD it is important that associated costs are clearly outlined so that appropriate resources can be allocated.

Keywords: equity, ethics, health economics, health funding and financing, health policy, health services management, health systems, palliative care, voluntary assisted dying.

References

Okninski ME. Voluntary Assisted Dying in Australia-Key Similarities and Points of Difference Concerning Eligibility Criteria in the Individual State Legislation. J Bioeth Inq 2023; 20(1): 13-16.
| Crossref | Google Scholar | PubMed |

Gajjar D, Hobbs A. Assisted dying. Assisted dying, Post Brief 47. UK Post Parliament; 2022. pp. 4–47.

Chochinov HM. Medical Assistance in Dying, Data and Casting Assertions Aside. J Palliat Med 2022; 26: 9-12.
| Crossref | Google Scholar | PubMed |

Worthington A, Regnard C, Sleeman KE, et al. Comparison of official reporting on assisted suicide and euthanasia across jurisdictions. BMJ Support Palliat Care 2022;
| Crossref | Google Scholar | PubMed |

Regnard C, Worthington A, Finlay I. Oregon Death with Dignity Act access: 25 year analysis. BMJ Support Palliat Care 2023;
| Crossref | Google Scholar | PubMed |

Ward V, Freeman S, Banner D. Hospice Care Provider Perspectives of Medical Assistance in Dying in a Canadian Hospice That Does Not Provide Medical Assistance in Dying. Can J Nurs Res 2022; 54(1): 3-14.
| Crossref | Google Scholar | PubMed |

Hunt RW. Voluntary assisted dying in Australia: emerging questions. Med J Aust 2023; 219: 208-210.
| Crossref | Google Scholar | PubMed |

State Government Victoria. Voluntary assisted dying review begins. 2023. Available at https://www.premier.vic.gov.au/sites/default/files/2023-07/230731-Voluntary-Assisted-Dying-Review-Begins.pdf?utm_source=miragenews&utm_medium=miragenews&utm_campaign=news [accessed 8 September 2023].

Hartling L, Guise JM, Kato E, et al. EPC Methods: An Exploration of Methods and Context for the Production of Rapid Reviews. 2015. Available at https://effectivehealthcare.ahrq.gov/products/rapid-review-production/white-paper

10  Rawlings D, Tieman J. Care Search palliative care knowledge network. 2008. Available at https://researchnow.flinders.edu.au/en/publications/caresearch-an-online-palliative-care-resource-to-support-oncology [Accessed 2 September 2022]

11  Veritas Health Innovation. Covidence systematic review software. 2023. Available at www.covidence.org

12  Ciancio AL, Mirza RM, Ciancio AA, et al. The Use of Palliative Sedation to Treat Existential Suffering: A Scoping Review on Practices, Ethical Considerations, and Guidelines. J Palliat Care 2020; 35(1): 13-20.
| Crossref | Google Scholar | PubMed |

13  Lizano-Díez I, Amaral-Rohter S, Pérez-Carbonell L, et al. Impact of Home Care Services on Patient and Economic Outcomes: A Targeted Review. Home Health Care Manag Pract 2022; 34(2): 148-162.
| Crossref | Google Scholar |

14  Kinchin I, Mitchell E, Agar M, et al. The economic cost of delirium: A systematic review and quality assessment. Alzheimers Dement 2021; 17(6): 1026-1041.
| Crossref | Google Scholar | PubMed |

15  Safer Care Victoria. Voluntary Assisted Dying Review Board report of operations (2018-2019). 2019. Available at https://www.safercare.vic.gov.au/best-practice-improvement/publications/VADRB-2018-19

16  Safer Care Victoria. Voluntary Assisted Dying Review Board Report of Operations (June to December 2019). 2019. Available at https://www.safercare.vic.gov.au/best-practice-improvement/publications/VADRB-june-to-december-2019

17  Trachtenberg AJ, Manns B. Cost analysis of medical assistance in dying in Canada. CMAJ 2017; 189(3): E101-E105.
| Crossref | Google Scholar |

18  Office of the Parliamentary Budget Officer. Cost Estimate for Bill C-7 “Medical Assistance in Dying”. 2020. Available at https://distribution-a617274656661637473.pbo-dpb.ca/241708b353e7782a9e5e713c2e281fc5ed932d3d07e9f5dd212e73604762bbc5

19  The State of Queensland. Voluntary Assisted Dying Bill 2021 Explanatory Notes. 2021. Available at https://documents.parliament.qld.gov.au/tp/2021/5721T708.pdf#:~:text=The%20Bill%20provides%20that%20one,suffering%20that%20the%20person%20considers

21  Patients Rights Action Fund. Assisted Suicide Laws are Dangerous and Discrimatory. 2024. Available at: https://patientsrightsaction.org/.

22  Booth S, Eleftheriou P, Moody C. Implementing voluntary assisted dying in a major public health service. Med J Aust 2021; 214: 343-346.
| Crossref | Google Scholar | PubMed |

23  Haining CM, Willmott L, Towler S, White BP. Access to voluntary assisted dying in Australia requires fair remuneration for medical practitioners. Med J Aust 2023; 218(1): 8-10.
| Crossref | Google Scholar |

24  Safer Care Victoria. Voluntary Assisted Dying Review Board. Annual Report July 2022 to June 2023. 2023. Available at https://www.safercare.vic.gov.au/sites/default/files/2023-08/VADRB%20Annual%20Report%202022-23.pdf

25  McIntosh E, Luengo-Fernandez R. Economic evaluation. Part 2: Frameworks for combining costs and benefits in health care. BMJ Sex Reprod Health 2006; 32(3): 176-180.
| Crossref | Google Scholar |