Presentation Type

Poster

Abstract

Background: Medical Care for patients nearing the end of their lives is an extremely complicated bioethical topic. From determining what is futile care, to finding a clear and concise definition of patient death, the field of bioethics explores a huge variety of issues regarding end-of-life (EOL) care. Cost is a major issue that is discussed with reservation in bioethical literature. Purpose: This project explores the bioethical dilemmas associated specifically with the costs of EOL care. Methods: Database wide searches in Pubmed, EconLit, JSTOR, and Web of Science using the search words “End-of-Life care costs” yielded data regarding the costs of EOL care for patients, their families, and society. Special considerations such as pediatric EOL care and physician assisted suicide were explored using the data bases listed above as well as the current data reports from Oregon’s Death with Dignity Act. Searches in Philosopher’s Index, and PhilPapers using the search term “End-of-Life care” provided the bioethical framework of the project. Conclusions drawn from the economic review were integrated into the bioethical framework, yielding novel bioethical considerations for EOL care. Findings: Multiple studies have found that close to 30% of Medicare’s annual spending (approximately $60 billion) is spent on the 6% of patients who die that year. Of that $60 billion, about one third is utilized in the last 30 days of life. However, even considering Medicare and private insurance coverage, patient out-of-pocket costs in the last 5 years of life averaged about $39,000 and exceeded total household assets 25% of the time. This disproportionate spending elicits major bioethical concerns of futility, autonomy, and justice. Significance: This research represents one of the first bioethical analyses of EOL care focusing explicitly on cost implications. It conceivably serves as a starting point for the considerate inclusion of financial discussions in EOL decision making.

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Humanities

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Apr 28th, 3:00 PM Apr 28th, 4:00 PM

An Exploration of the Bioethical Dilemmas Associated with the Costs of End-of-Life Care

UC South Ballroom

Background: Medical Care for patients nearing the end of their lives is an extremely complicated bioethical topic. From determining what is futile care, to finding a clear and concise definition of patient death, the field of bioethics explores a huge variety of issues regarding end-of-life (EOL) care. Cost is a major issue that is discussed with reservation in bioethical literature. Purpose: This project explores the bioethical dilemmas associated specifically with the costs of EOL care. Methods: Database wide searches in Pubmed, EconLit, JSTOR, and Web of Science using the search words “End-of-Life care costs” yielded data regarding the costs of EOL care for patients, their families, and society. Special considerations such as pediatric EOL care and physician assisted suicide were explored using the data bases listed above as well as the current data reports from Oregon’s Death with Dignity Act. Searches in Philosopher’s Index, and PhilPapers using the search term “End-of-Life care” provided the bioethical framework of the project. Conclusions drawn from the economic review were integrated into the bioethical framework, yielding novel bioethical considerations for EOL care. Findings: Multiple studies have found that close to 30% of Medicare’s annual spending (approximately $60 billion) is spent on the 6% of patients who die that year. Of that $60 billion, about one third is utilized in the last 30 days of life. However, even considering Medicare and private insurance coverage, patient out-of-pocket costs in the last 5 years of life averaged about $39,000 and exceeded total household assets 25% of the time. This disproportionate spending elicits major bioethical concerns of futility, autonomy, and justice. Significance: This research represents one of the first bioethical analyses of EOL care focusing explicitly on cost implications. It conceivably serves as a starting point for the considerate inclusion of financial discussions in EOL decision making.