Artillery Row

When is suicide not suicide?

The vulnerable need our support, not lethal drugs

It was as perplexing as it was predictable to see avowed campaigners for assisted suicide jump on recently released figures from the Office for National Statistics (ONS) indicating that people living with severe health conditions are significantly more likely to commit suicide. Bizarrely, the pro-assisted suicide lobby seem to consider that the best public health response to increased numbers of people wanting to take their own lives is to endorse and assist suicide.

The Commons overwhelmingly rejected assisted suicide

Specifically, the ONS data shows suicide rates are nearly two and a half times higher than average among people suffering from a range of serious conditions. On the face of it, this is, of course, highly disturbing and a matter of serious public health concern. Upon closer inspection, the ONS figures reveal that the rate of suicide in patients with severe health conditions, including cancers with low survival rates, substantially increases in the immediate aftermath of the diagnosis. This is the period when people are naturally gripped by fear and uncertainty. As time passes, the relative rate of increase tails off.

Rather than respond to this apparent problem of patient accompaniment in the early days of a severe diagnosis, Dignity in Dying, originally known as the Voluntary Euthanasia Legalisation Society when they were formed in the 1930s, have bafflingly claimed premature death to be the best solution in cases of severe health conditions. This is despite the fact that the ONS data addresses health conditions that, whilst serious, are not necessarily considered terminal — such as chronic obstructive pulmonary disease (COPD), which the NHS says “varies from person to person” in outcome.

Nuance, it seems, matters little to those committed to legalising assisted suicide by any dark avenue available. This will come as no surprise to those who recently read Dignity in Dying’s (now deleted) tweet which dishonestly and disgracefully claimed that most dying people are abandoned in their hour of need save for the few who are injected with lethal drugs abroad.

Most disingenuously of all, Baroness Meacher, a respected crossbench Member of the House of Lords,who is trying to push a Bill through the Upper Chamber to introduce assisted suicide — has claimed, without evidence, that most MPs now back a change to the law.  

The pandemic has served to remind us of the fragility of life

Recent parliamentary history would disagree. The House of Lords has debated and rejected assisted suicide this session. In March, the Lords voted to reject plans put forward by the eminent Conservative peer Lord Forysth which would have compelled the Government to bring forward a draft Bill to introduce assisted suicide. Meanwhile, Baroness Meacher’s own private member’s bill has provoked over two hundred amendments in concern at its problematic provisions. 

Similarly, the Commons overwhelmingly rejected assisted suicide in 2015 by 330 votes to 118. Proponents of changing the law fail to spell out what has changed in the past six and a half years that necessitates reopening this debate, nor can they point to changing evidence or a medical college which supports their case.  

If anything, the pandemic has served only to remind us of the fragility of life, and the sacrifices made in order to protect the vulnerable in our society. It is perverse then, for those who claim to speak of “dignity” in death to argue that this is actually an opportunity to ease access to lethal drugs. This is especially so in the case of higher suicide rates early in the diagnoses of severe conditions, where the focus should be on early intervention to help those suffering. 

No doctors’ groups in the UK support legalising assisted suicide, nor do any major disability rights organisations. Indeed, the law has just been changed to give patients, for the first time, a legal right to palliative care on the NHS in every part of England. As medical professionals have repeatedly pointed out, there are clear signs of the stagnation of palliative care in countries that have legalised assisted suicide, such as Belgium and the Netherlands.

Over time, a growing body of evidence has emerged which shows rising suicide rates in countries and overseas territories where assisted suicide has been legalised. The US state of Oregon, which is often held up by campaigners as a model for others to follow on changing the law, has seen a 32% increase in non-assisted suicides since legislation. Closer to home, a comparison of suicide rates in the Netherlands and Germany is very revealing in showing a higher rate of suicide in the former, where assisted suicide has been legalised, in contrast to the latter.

The causes of suicide are deep-rooted, and require a meaningful examination of the serious and complex mental health problems that can accompany suicidal ideation. The ONS data does not take into account pre-existing mental health problems, nor a patient’s engagement with palliative care. If Dignity in Dying and their political actors were serious about addressing this public health concern, they would recommend that people diagnosed with severe health conditions are classified as a high risk group in the cross-government suicide prevention workplan, rather than confront them with the “choice” of a lethal injection.

Surely no one in our society can seriously argue that the solution to a rise in people taking their own lives is to make it easier for them to do so. Often well-meaning but ultimately misguided campaigners would do well to focus on doing more to treat suicidal ideation, and supporting vulnerable people so that they have access to the treatment they need. Suicidal ideation is always and everywhere a cry for more care not less.

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