Does legalizing physician-assisted suicide lead to a drop in the suicide rate?
As counterintuitive as it sounds, some advocates of assisted suicide have been making this argument. A new academic study, however, shows the reverse to be true: legalizing physician-assisted suicide increases the total number of people committing suicide.
This debate heated up earlier this month as Gov. Jerry Brown, D-Calif., signed a law authorizing assisted suicide in California. At the same time, the October issue of the Southern Medical Journal included a study examining the correlation between legalizing physician-assisted suicide and the overall suicide rate. The study, “How Does Legalization of Physician-Assisted Suicide Affect Rates of Suicide?”, contradicts the notion that legalizing assisted suicide would reduce the total number of suicides by helping people cope with their declining condition.
The argument by physician-assisted suicide advocates is that if ill patients have confidence that they will have access to physician-assisted suicide in the future, then they will be less likely to commit suicide today, or ever.
The study, however, showed that suicides increase when physician-assisted suicide is legalized: “Controlling for various socioeconomic factors, unobservable state and year effects, and state-specific linear trends, we found that legalizing PAS [physician-assisted suicide] was associated with a 6.3 percent increase in total suicides.” Later, the researchers commented that “the introduction of [physician-assisted suicide] seemingly induces more self-inflicted deaths than it inhibits.”
The study was intended to determine whether or not the legalization of physician-assisted suicide provides an effective form of suicide prevention for those considering non-assisted suicide. Such is the claim of the Swiss group EXIT, which advocates for the legalization of physician-assisted suicide on the basis that “the option of physician-assisted suicide is actually an effective form of suicide prevention.”
To test this claim, researchers took suicide rates from states that have already legalized physician-assisted suicide—including Oregon, Washington, and Vermont—and compared them both to the suicide rates in the same states before physician-assisted suicide was legalized, and to suicide rates in states where physician-assisted suicide is not yet legal.
According to the researchers, “There is no evidence that [physician-assisted suicide] is associated with significant reductions in nonassisted suicide for either older or younger people.” Furthermore, the data “do not suggest that on average PAS leads to delays in non-assisted suicide.”
As one might suspect, the researchers found that instead of reducing suicides, legalizing physician-assisted suicide increases them. This uptick in suicides following the legalization of physician-assisted adds another reason to the already long list of reasons that physician-assisted suicide is bad policy.
The study concludes with comments on the importance of qualitative analysis on “reviewing the circumstances and motivation of those who die by suicide in the jurisdictions that have legalized [physician-assisted suicide] and with research looking at how attitudes towards suicide vary in jurisdictions with different legal frameworks in place.”
The researchers are right: different legal frameworks can result in different views of suicide because our laws shape our culture which in turn shapes our beliefs, which in turn shapes actual suicide rates.
Beyond increasing the number of suicides, the legalization of physician-assisted suicide endangers the weak and marginalized, corrupts the practice of medicine, compromises the culture, particularly the family, and betrays human dignity and equality before law.
- The legalization of physician-assisted endangers the weak and marginalized. The poor, elderly, and mentally-ill are the ones most likely to die by physician-assisted suicide, and the safeguards intended to protect them have proved to be inadequate. Evidence from the Netherlands, where physician-assisted suicide has been legal for years, suggests that many instances of physician-assisted suicide there were non-voluntary. It is the marginalized who are most vulnerable to being pressured, tricked, or coerced into killing themselves.
- Physician-assisted suicide corrupts the practice of medicine by subverting the purpose of medicine. With the legalization of physician-assisted suicide, doctors help kill people instead of seeking to heal them. The doctor-patient relationship is also distorted through distrust, as patients begin to fear that doctors may encourage their deaths. The relative costs of suicide compared to medical care often provides perverse financial incentives for choosing suicide, furthering the pressure on the already weak patients to kill themselves, especially in jurisdictions like California, where physician-assisted suicide cannot be used as a basis for denying life insurance claims.
- Physician-assisted suicide compromises our culture, particularly the family. Intergenerational obligations will become mere options when elderly and disabled people can be eliminated because they are economically or socially burdensome on their families. Often, the family of the patient is the one requesting the suicide. Making suicide a part of the “health care” system also encourages the elderly to view themselves as burdens.
- Physician-assisted suicide betrays human dignity and equality before law by classing a group of people as legally eligible to be killed. A just legal system is one that respects the intrinsic worth of all human beings. Legalizing physician-assisted suicide, on the other hand, judges that some people have lives no longer “worth living.” This violates our nation’s commitment to equality before the law and the founding principle that all people have the right to life.
This new study again proves that physician-assisted suicide is bad policy that encourages death instead of true compassion and care. California should take note.