Death and dignity: Terminal illness and the market for non-treatment

Margaret M. Byrne, Peter Thompson

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


We construct a stochastic model of illness, death and treatment choice to analyze two proposals - legally-binding advance directives and insurer-paid compensation schemes - to reduce the incidence of aggressive and possibly futile end-of-life treatment. We assess whether, in a competitive insurance market, the proposals are consistent with (i) individual rationality in selection of competitive insurance contracts; (ii) medically ethical treatment provision; and (iii) reductions in end-of-life expenditures. We conclude that binding advance directives are always medically unethical, while compensation schemes are medically ethical. We derive the compensation schedule arising in a competitive equilibrium, and show that it reduces aggressive treatment and satisfies individual rationality.

Original languageEnglish (US)
Pages (from-to)263-294
Number of pages32
JournalJournal of Public Economics
Issue number2
StatePublished - May 2000


  • Health care
  • Health expenditures
  • Health insurance
  • I3
  • Quality of life
  • Terminal illness

ASJC Scopus subject areas

  • Economics and Econometrics
  • Finance


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