‘A Hidden Problem’: Research that raises more questions than it answers.

Deaths from physician-assisted suicide among terminally ill people in Oregon have been rising since the practice was legalised in 1997.  Oregon’s current death rate would result in around 1,100 such suicide deaths a year in England and Wales if we had a similar law here. 

The proponents of legalisation, for whom Oregon’s rising death rate is an inconvenient issue, suggest that around 300 terminally ill people here are already taking their own lives annually.  So what is the evidence for this claim?

The claim is based on responses to a Freedom of Information request by the campaigning group Dignity in Dying to the Directors of Public Health of each local authority in England.  Out of 139 authorities approached only 6 recorded the presence of a terminal illness in their suicide data.  This very small sample, we are told, showed that 7.36% of suicides were of people who had been terminally ill.  On this basis, the campaigning group calculates, around 300 suicides every year are of people who were terminally ill.

Let us put aside the issue of whether a 4 per cent sample is reliable as a basis for drawing any valid conclusions and let us look at what conclusions are actually being drawn.  We are told that “knowing the number of dying people who end their own lives provides an insight into the problems that the current law creates”.  The inference here is that, if we had an assisted suicide law like Lord Falconer is proposing, that would enable terminally ill people who take their own lives to do so in a regulated manner.

But would it?  We know nothing of the circumstances of these suicides involving terminally ill people.  Lord Falconer wishes to legalise assisted suicide for terminally ill people in the last six months of life, but terminal illness is a condition that can last for years.  How many of these terminally ill people who committed suicide were in the last six months of their lives – and therefore would have been able to take advantage of a law like Lord Falconer has in mind?  We do not know.  Lord Falconer’s bill is supposed to be for terminally ill people who are mentally capable, have a settled wish to end their lives and are not being pressured to do so – though, it has to be said, it contains no safeguards to ensure these conditions are met.  How many of the suicides met these criteria?  We do not know.  People commit suicide for all kinds of reasons.  How many of them ended their lives because they were terminally ill?  Again, we do not know.

That the campaigning group has undertaken research in this difficult and controversial area is commendable.  But the results provide no foundation for the conclusions that are being draw.  And there remains another question: should our response as a society to suicide among terminally ill people be to change the law to help them on their way?