by Aaron Kheriaty, Washington Post, 20 November 2015
A recent study by Dr David Jones and Dr David Paton found that legalizing ‘Physician Assisted Suicide’ in Oregon, Washington, Montana and Vermont was associated with a 6.3% increase in total suicides (including assisted suicides). In particular, they noted that the introduction of ‘PAS’ did not lead to a reduction in nonassisted suicide rates.
Dr Kheriaty, an associate professor of psychiatry and director of the medical ethics program at the University of California at Irvine School of Medicine. explains how assisted suicide influences non-assisted suicide.
The debate over doctor-assisted suicide is often framed as an issue of personal autonomy and privacy. Proponents argue that assisted suicide should be legalized because it affects only those individuals who — assuming they are of sound mind — are making a rational and deliberate choice to end their lives. But presenting the issue in this way ignores the wider social consequences.
What if it turns out that the individuals who make this choice in fact are influencing the actions of those who follow?
Consider what social scientists call the Werther effect — the fact that publicized cases of suicide can produce clusters of copycat cases, often disproportionately affecting young people.
Because this phenomenon is well validated, the U.S. Centers for Disease Control and Prevention, the World Health Organization and the U.S. surgeon general have published strict journalistic guidelines for reporting on suicides to minimize this effect. It is demoralizing to note that these guidelines were widely ignored in the reporting of recent instances of assisted suicide, with the subject’s decision to end his or her life frequently presented in the media as inspiring and even heroic.
Aside from publicized cases, there is evidence that suicidal behavior tends to spread person to person through social networks, up to three “degrees of separation” away. So my decision to take my own life would affect not just my friends’ risk of doing the same, but even my friends’ friends’ friends. No person is an island.
Finally, it is widely acknowledged that the law is a teacher: Laws shape the ethos of a culture by affecting cultural attitudes toward certain behaviors and influencing moral norms. Laws permitting physician-assisted suicide send a message that, under especially difficult circumstances, some lives are not worth living — and that suicide is a reasonable or appropriate way out. This is a message that will be heard not just by those with a terminal illness but also by anyone tempted to think he or she cannot go on any longer.
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