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Research Unclear on Whether Assisted-Suicide Laws Increase Non-Assisted Suicide Rates

Chiropractor Fred Deutsch really doesn’t like the assisted-suicide initiative petition currently circulating in South Dakota. The conservative Christian and former legislator continues to oppo-brand the measure as “Killing Grandma in SD.” He has also sent out a letter to the editor under the group name “Vote No on Assisted Suicide.” No such group has filed a ballot question committee state of organization with the Secretary of State yet, be we’ll watch.

Deutsch contends that assisted-suicide laws increase overall suicide rates:

End-of-life suicide laws have only been successfully passed in five states, but in each of those states the over-all suicide rates among all people have substantially increased since passage of the law. In essence, it seems that legalizing suicide for one group of people sends a message to all people that it’s acceptable to take your life [Fred Deutsch, letter to the editor, posted in Dakota War College, 2017.06.05].

SDGOP flunky Pat Powers finds that point powerful and links signing the assisted-suicide petition to making more teenagers in Pierre and on the reservations kill themselves. Alas, neither Deutsch nor Powers links the claim that assisted-suicide laws increase overall suicide rates to any original research.

As usual, permit the liberal media to provide actual data.

Jones and Paton (2015) found that after passage of physician-assisted-suicide (PAS) laws, controlling for numerous factors, total suicide rates (including terminally ill folks taking advantage of the new law) increased by a statistically significant 6.3%. Jones and Paton found a smaller but statistically insignificant increase in non-assisted suicide (that would be the teenagers Pat is worried about and others).

It’s worth looking at the actual trendlines for non-assisted suicide rates in PAS states and the rest of the United States:

Jones and Paton 2015, Figure 2.
Jones and Paton 2015, Figure 2.

Oregon, Washington, Montana already had higher rates of non-assisted suicide than other states prior to the passage of their PAS laws. Those three states have still followed the general U.S. trend of declining suicides from 1990 to 2000 and increasing rates thereafter. The passage of PAS laws in those three states appears not to have caused those states to deviate from the nationwide trend. And note that in Oregon, non-assisted suicide rates stayed below what they were the year Oregon legalized PAS for most years of the following decade, until the post-recession increase that seems to be a nationwide phenomenon.

Those higher base rates of suicide may be explained by some social factors. Jones and Paton note that PAS-legalizing states have “lower rates of religious adherence” and “a lower proportion of the population that was black or Hispanic.” Religion appears to dampen suicide rates (more so among Western cultures than Eastern), and blacks and Hispanics have far lower suicide rates that whites. Those states thus already had factors that we could expect to translate into less opposition to PAS laws, not to mention higher suicide rates.

Jones and Paton cite other research that supports the notion that higher rates of suicide reinforce themselves:

Drawing on resources from the social learning theory, Stack and Kposowa demonstrate that “persons socialized in nations with relatively high rates of suicide are more likely to be exposed to suicidal role models, which provide positive definitions of suicide.” Such mechanisms increase the level of individual approval of suicide and therefore reinforce the high rate of suicide within the culture. This is analogous to the effect of media reporting that “normalizes” suicide. It may be that legalizing PAS also provides positive role models who help normalize suicide more generally [David Albert Jones and David Paton, “How Does Legalization of Physician-Assisted Suicide Affect Rates of Suicide?” Southern Medical Journal, 2015: 108(10), pp. 599-604].

Thus, Deutsch’s claim that PAS laws lead to higher suicide rates should be taken with caution and with a careful review of research. The connection could work as much in the other direction: PAS laws may be more likely in cultures that already approve, or at least don’t disapprove as strongly, of suicide. Once passed, those laws allowing terminally ill patients to commit suicide don’t clearly increase suicide among non-terminally ill people.

20 Comments

  1. jerry 2017-06-09 12:25

    Good News for Freddy!! The cult tribal republicans have risen to the occasion of “Killing Grandma in South Dakota”. His cult has teamed up to kill Medicaid for said Grandma and as a bonus, Grandpa as well. See by block granting or whatever the hell the cult devious plan is, this will take Grandma and Grandpa out of the nursing homes they have been living in under Medicaid. You put them on the street with no meds and death comes rather quickly. Nothing to worry about Freddy, you and your cult tribal republican friends have it covered. Speaking of covered, I think casket companies will see their stock’s rise. Call NOem, Thune and Rounds to let them know your feelings about “Killing Grandma in South Dakota”. Bonus points, the disabled will also be kicked to the curb with their Medicaid killing, an equal opportunity screwing!

  2. Roger Elgersma 2017-06-09 13:26

    I have heard more than once that teen suicides do not get press time because then the teen suicide rate goes up. Not sure about elderly suicide.

  3. Porter Lansing 2017-06-09 13:36

    To extrapolate the Deutsch/Powers model you’d then expect that kids who watch Grandpa suffer until his body collapses in a death heap would be given a message that it’s okay to suffer through a miserable life and it’s acceptable to do what you can to make others suffer, too. So that’s where Deutsch and Powers got their mean spirited nature and obsession with telling women what to do? Some would recognize that group as those “self-loathing theists”.

  4. jerry 2017-06-09 13:58

    The Freddy/NOem cult republican assisted suicide plan is equal opportunity as well. In NOem’s full throated support of trumpcare, she allows the opioids to continue their death march on folks under 50 in particular. http://www.peoplesworld.org/article/republican-health-plan-would-make-opioid-crisis-even-worse/ Mental health and drug addiction treatments are so Democratic, that any good cult republican would just have to eliminate them.

    Here is how this all works, you under employ workers for less, that helps to drain Social Security. Then you allow them to become addicts thus killing them off before they can draw what little is in Social Security and then you claim that there is no money in Social Security to pay Grandma and Grandpa. Pretty slick moves the little rascals have put into play.

  5. Cory Allen Heidelberger Post author | 2017-06-09 17:34

    Dang, Jerry: maybe we can co-opt Deutsch’s message to defeat the Trump party in 2018: “Don’t kill Grandma and Grandpa: Vote Democratic!”

  6. Cory Allen Heidelberger Post author | 2017-06-09 17:52

    Roger, there is an interesting journalistic question there. Does a suicide warrant news coverage? Usually the newspaper does not go beyond printing an obituary for a regular person’s death. Does killing oneself cross the threshold of public interest? Should obituaries bother to mention cause of death?

    Here’s some scholarly comment on Roger’s statement:

    Two phenomena are used to describe the association between suicidal behaviour and media exposure: the Werther effect (Gould 2001) and the Papageno effect (Niederkrotenhaler et al. 2010). The Werther effect refers to the positive correlation between media exposure of a suicide event and subsequent suicidal behaviour in the population (Gould 2001). When a suicide event occurs, a dose–response relationship is evident such that suicides increase in proportion to media attention (Gould 2003). Suicide clusters, or imitative suicides, are more frequent in teens and young adults, and suicide risk increases with the number of shared characteristics between the victims (age, gender, peers and family members) and the popularity of the suicide victim (Gould 2001). Canada, along with numerous countries, has imposed news reporting guidelines to decrease the potentially negative effect of media attention surrounding suicides (Gould 2001, 2003). In Canada, the guidelines urge the media to avoid: perpetrating the myth that suicide is unexplainable, identification with the victim through the use of pictures, descriptions of method and location, front-page coverage and sensational headlines (Nepon et al. 2008) [Leon et al., 2014].

    Keep it off the front page, refrain splashy pictures and headlines, temper the details.

    I wonder: when we scrutinized Richard Benda’s death, did we nudge anyone toward suicide?

    Another sensitive question: if young people are particularly susceptible to this contagion, can coverage of youth deaths in car wrecks and other accidents, along with coverage of the funeral, provoke sympathetic suicidal behavior?

  7. Cory Allen Heidelberger Post author | 2017-06-09 18:06

    Hmm… if journalists can formulate a rationale for not reporting suicide as a matter of public interest, can we cross-apply that rationale to say that choosing to end one’s life is a private matter with which the government should not interfere?

  8. jerry 2017-06-09 18:16

    Vote Democratic Indeed!! trump/NOem/Jackley cult republicans and their desire to destroy the moral fabric of our society. Here is exactly what NOem wants for South Dakota’s over 60 crowd, quick death by denying the basic human need of healthcare. http://www.cbpp.org/research/health/people-losing-medicaid-under-house-republican-bill-would-face-high-barriers-to I really don’t think the voters of the state have a clue on what is coming soon. Even when the hammer falls, they likely will whimper for a little before they realize that South Dakota and America herself, don’t want to be burdened with them. They are no longer useful as the vault has been raided.

    NOem voted for this pos as will Thune and Rounds. Jackley has been consistent with his hatred of the older most vulnerable crowd as well. Billie Sutton will stand for South Dakota while NOem and Jackley will stand for those who would destroy us all.

  9. Porter Lansing 2017-06-09 18:27

    Throwing going away parties before you check out of the Hotel California are prevalent and growing more popular.
    I GOOGLED “people throw parties before suicide” and there are several pages of news articles. Would suicide be an embarrassment for South Dakota people? It’s not shameful at all, here in the west. As natural as writing your last will and testament. Why overthink death? It doesn’t scare me. (Of course, my daughter is a Hospice nurse and it’s hardly a forbidden subject like in SoDak. Lighten up. You’re going to that big party in the sky.) 😇
    https://mobile.nytimes.com/2017/05/25/world/canada/euthanasia-bill-john-shields-death.html

  10. Miranda Gohn 2017-06-09 18:55

    Porter if I understand you correctly are you encouraging suicide as if it just a casual thing that is really no big deal? Suicide can be very painful and be life long scarring for those left behind. It is a very deep subject with many layers including ones spiritual beliefs.

  11. Cory Allen Heidelberger Post author | 2017-06-10 07:53

    The GOP agenda views life far more casually and heartlessly than Porter, who is talking about people making thoughtful, personal decisions about the end of their lives, as they do when they write a will. I will note that his use of the term “overthink” could use some explanation. The assisted-suicide initiative does not allow casual suicide. It requires people in dire health conditions to consult a physician and make two requests separated by at least 15 days.

  12. Miranda Gohn 2017-06-10 08:19

    Yeah right! With my comments heavily moderated and edited I’ll just leave it at that. It is no wonder the South Dakota Democratic Party is self destructing with numbers dwindling. South Dakotans are desperate for a true opposition party to help bring balance but they are looking elsewhere and I can’t blame them.

  13. Porter Lansing 2017-06-10 08:24

    What a special morning to get to “back and forth” with the one and only Miranda Gohn. I’ve watched your public persona from afar, as you’re a true South Dakota celebrity. Let me preface.
    1. Porter doesn’t have any validity or interest in your decision to have an abortion, to have your physician prescribe meds to check out or to buy a Ford or a Tesla. What I do have validity in is standing up to the bullies (mostly Catholic and born again Evangelicals) who think they can tell someone what to do and coerce them with guilt.
    2. Yes, Miranda. Suicide is a cowards way out. It’s a way of running away from problems and it leaves your family and friends scarred with the feelings that somehow they were responsible or could have stopped you, if they’d only known. Suicide isn’t euthanasia. This blog uses the term suicide because it’s going to be up for a vote and if we don’t call it the “crass” name we get attacked from the right for being deceptive.
    2. Overthink means don’t let religious guilt, thrust upon you in a time of vulnerability by people with only their own agenda (e.g. People who’ve mortally sinned and believe they can get to Heaven through others.) influence your decision. I don’t care what you decide but I do care that you get to make your own decision without being told your a bad person and being told your family will be shamed and shunned forever if you choose “choice”.
    3. Deutsch, Jones, Powers, Schoenbeck, Hickey et al have this belief I mentioned in #2. You self-consumed zealots cannot petition the Lord with prayer or by impeding a persons God given right to choose their own path.

  14. Cory Allen Heidelberger Post author | 2017-06-10 08:38

    [Quit your bawling. Your “heavy moderation” has nothing to do with the topic at hand or the SDDP and everything to do with the fact that I don’t trust you.]

  15. bearcreekbat 2017-06-10 10:14

    Open Yale on line courses has posted free philosophy lectures by Professor Shelly Kagan on the topic of death. Sessions 24, 25, and 26 address the rationality and morality of suicide. The entire series is well worth the time and thought.

    http://oyc.yale.edu/philosophy/phil-176

  16. Porter Lansing 2017-06-10 10:31

    This from DWC …
    Anonymous
    June 9, 2017 at 7:02 pm
    Fred have you read the disturbingly casual attitude in regards to assisted suicide over at the stoner blog? “Throw a party after a suicide?” Good grief! Totally off the rails!
    ~ I don’t post on the lesser blog but I’ll respond here. “If a deceased friends want to have a wake mourning the loss of a buddy, isn’t that an Irish Catholic ritual? I commented on the parties being thrown BEFORE the event by the family and deathly sick person being assisted in end of life.” *If it was me, I’d play the David Bowie album which he released the day he ended his life, instead of suffering along a few more weeks with a terminal disease diagnosis, like a good sheep. PS … Is this a stoner blog, Lynn? You funny, gurl.

  17. jerry 2017-06-10 11:03

    Cult republicans have long assisted suicide with glee. The numbers show 22 veterans suicide each day thanks to the lack of funding for mental health, so the veteran is alone and without hope. When I see that Freddy and his sidekick, Miranda are fretting about assisted suicide, I would like to remind them that with assisted suicide, it is done with a trained professional. In the Democratic world, that would be mental health. In their world, that is an added expense that would take away from their bosses bottom line, in this case, Freddy.

  18. jerry 2017-06-10 11:05

    bcb, thanks for the links. I had heard about this, but forgot. Now I will check them out.

  19. Porter Lansing 2017-06-10 11:48

    Things are different in the West. We’ve pulled that stick from our butts long ago. It’s hard to dance unless you get it out o’ there.
    SAN DIEGO — In early July, Betsy Davis emailed her closest friends and relatives to invite them to a two-day party, telling them: “These circumstances are unlike any party you have attended before, requiring emotional stamina, centeredness and openness.”
    And just one rule: No crying in front of her.
    The 41-year-old artist with ALS, or Lou Gehrig’s disease, held the gathering to say goodbye before becoming one of the first Californians to take a lethal dose of drugs under the state’s new doctor-assisted suicide law for the terminally ill.
    http://nypost.com/2016/08/11/terminally-ill-are-saying-goodbye-with-assisted-suicide-parties/

  20. jerry 2017-06-10 21:13

    Even a 100 million does not solve our dilemma on the disabled in nursing homes. This is from a wealthy state. Think of South Dakota regarding this. Freddy, the typical cult republican, did not do a damn thing about it while he was in the cabal in Pierre.

    “For Arbour hospitals, it is one problem after another
    The 89-bed Westwood Lodge is one of seven hospitals operated by Arbour Health System, which Massachusetts relies on to treat many of its sickest and most fragile mentally ill children and adults.

    The state Medicaid program pays the company more than $100 million a year, fueling its growth into an indispensable provider of mental health care in a system desperately short of psychiatric beds.

    A Boston Globe review of Arbour’s Massachusetts hospitals, as well as interviews with several dozen patients, families, and employees, found that the company repeatedly and sometimes egregiously shortchanged patient care.

    The hospitals, which serve about 16,000 patients annually, were cited again and again in state documents reviewed by the Globe for failing to provide enough staff to care for patients, properly monitor them, devise treatment plans, run therapy groups — or even keep its units clean.”

    Sometimes good people just want to end the suffering. Evangelicals should remember the death of Jesus Christ as a reminder of the passion of the Centurion Longinus that in all probability, ended his misery and suffering.

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