Friday, October 21, 2016

The danger of suicide contagion—and why assisted suicide makes it worse

An Oct. 19 story published in Newsweek discusses a recent outbreak of suicides among teenagers in Colorado. Suicide contagion—when one suicide leads to others, sometimes producing a "suicide cluster"—is a well-established social phenomenon. And young people are especially susceptible.

"[S]uicide is likely becoming more contagious, thanks in large part to social media," writes Max Kutner in the Newsweek article. He explains:
Suicide prevention advocates tend to blame television and newspaper coverage for inspiring copycats, but for teens, social media are a growing problem. Instagram pages for kids who kill themselves sometimes contain hundreds of comments. Many are about how beautiful or handsome the deceased were, how they can finally rest in peace and how there should be a party for them in heaven. Dr. Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention, says the message seems to be that if you kill yourself, you'll not only end your suffering but also become the most popular kid in school. Teens sometimes have more than 1,000 Instagram followers, so kids far beyond one school or community can see digital shrines to dead friends. Moutier says those posts can seem as if they're romanticizing death.
Suicides nationwide are on the rise. Efforts to prevent these tragedies, particularly among young people, must be more vigorously pursued. But such efforts are undermined by the current campaign to legalize assisted suicide in states across the country (including, ironically, Colorado, where assisted suicide is on the ballot in the 2016 election). Here's why.

Suicide prevention efforts rightly affirm that everyone's life matters, that people are valuable and significant, and that difficult circumstances or feelings don't change those facts. Suicide is always tragic. It is not the solution to someone's problems.

The promotion, publicity, and legalization of assisted suicide affirms something very different. It says that sometimes suicide really is the appropriate response to an individual's circumstances or anxieties. And the government and medical profession should approve and facilitate the killing of that individual. Some lives just aren't worth living.

This message is false. It's also deeply harmful. Assisted suicide, like suicide in general, can have a contagion effect that contributes to the deaths of more people.

Consider the story of Brittany Maynard, the young woman whose example of dying by assisted suicide has been endlessly romanticized by assisted suicide advocates. Media coverage of Maynard flagrantly violated the accepted guidelines for responsible suicide reporting. Dr. Will Johnston, a Vancouver physician, recalls treating a patient who was affected: "I hospitalized a young suicidal patient ... who told me how he had done an internet search for suicide drugs after watching the slick video glamorizing Brittany."

This is suicide contagion.

A 2015 study published in the Southern Medical Journal concluded that, controlling for numerous factors, the legalization of assisted suicide has led to a 6.3 percent increase in the total (non-assisted and assisted) suicide rate. (The effect on non-assisted suicides alone was less clear—a 1.6 percent rate increase.) "You do not discourage suicide by assisting suicide," quips Dr. Aaron Kheriaty, a psychiatry professor at the University of California-Irvine School of Medicine.

Indeed, despite the claims of its proponents, assisted suicide isn't only about a few individual patients and their personal circumstances. There is a broader social impact. This is about our whole society.

Dr. Kheriaty tells the story of Valentina Maureira, a 14-year-old Chilean girl with cystic fibrosis who wanted to die by suicide after hearing about the case of Brittany Maynard. Fortunately, Maureira met another young person with the same disease who offered hope and encouragement. "With our laws, we can encourage vulnerable individuals in one of these two directions," Kheiraty says.

"What sort of society do we want to become, with regard to how we help people who report they want to end their own lives?" he asks. "Suicide is already a public health crisis; do we want to legalize a practice that will worsen this crisis?"

We must reject suicide in all of its forms.