Suicide Prevention Researchers Leave Out Assisted Suicide

It almost never works. A learned article in a medical or bioethical journal regrets our suicide crisis and calls for greater prevention efforts. And yet, somehow, the authors never once name the elephant in the room, i.e. the impact of ubiquitous suicide promotion through ‘death with dignity’ activists, stimulated by media commentators, in popular culture features and as promoted by politicians.

It just happened again. An article published in the AMAs JAMA Psychiatry: promises to make the upward trend of our rising suicide numbers, but doesn’t even mention suicide assistance as contributing to the problem:

To drive this research agenda, we are working on research that indicates that suicide prevention efforts in health care can significantly reduce the risk of suicide. Nearly 30% of those killed visited health care in the seven days before suicide; half were seen in health care in the past 30 days; and about 90% had visits in the year before death. Second, applying universal screening in emergency care can double the number of individuals identified in mainstream care.

Likewise, applying risk prediction algorithms to electronic health records can improve the prediction of suicide attempts and deaths, especially when the data is enriched with screening information. Third, there is a growing number of effective interventions and care practices, including medications and psychotherapies, a brief intervention of the safety plan and follow-up efforts at high-risk, critical points of care transition, such as ‘caring communication’ contacts and telephone calls for encouraging continued social connection and care involvement. These practices can improve function and reduce the number of suicide attempts by 30% to 50% in the following year. The NAASP recommends that these practices be combined in a healthcare system and that healthcare organizations strive for this ‘Zero Suicide’ approach.

I’m all for it. But pretending suicidal deaths are not “suicides”, as most laws require, doesn’t mean they aren’t suicides, and just sweep that aspect of our crisis under the carpet.

Active suicide promotion for the sick and disabled is something new in our history. Unless suicide prevention researchers include the impact of such advocacy in their studies, assess the consequences of the ‘some suicides are good’ message communicated by laws that legalize physician-prescribed death, and the shameful failure of physicians and Hospice professionals investigate appealing to prevention services when someone asks for death assistance where suicide assistance is legal, for good reason.

To paraphrase Lincoln, we can’t be half of suicide prevention and half of suicide promotion. Sooner or later we will all be one or the other.

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