Higher risk of suicide should prompt better mental health care, not assisted suicide

16th August 2022

Professor Katherine Sleeman and Dr Joanna Davies have responded to a recent article in the BMJ reporting on an analysis of data from the Office for National Statistics (ONS) about suicide and assisted suicide.

In the ONS analysis patients with newly diagnosed physical health conditions (predominantly heart disease and chronic obstructive pulmonary disease) were matched with control patients to examine the risk of suicide after diagnosis of physical illness. Matching accounted for various sociodemographic characteristics (age, gender, and so on) but notably did not account for mental illness or depression. There is a well-described association between physical and mental illness, so the higher risk of suicide after diagnosis of physical illness might represent a higher prevalence of mental illness in this group.

Sleeman and Davies write:

“The article in the BMJ quoted assisted dying campaigners, who argue that the ONS analysis provides evidence to support legalisation of assisted dying. We disagree. The ONS analysis tells us that, after diagnosis of some physical illnesses, the risk of suicide is higher. It provides evidence neither for nor against law change. The priority must be to understand why there is a higher risk of suicide after diagnosis of physical illness and how to reduce this.

The ONS analysis was covered extensively in the media as part of a Dignity in Dying campaign that described the cohort as “dying.” This is misleading. Overall, 72% of the cohort survived for more than two years (after which no data are provided).

It is concerning to see the ONS analysis used to support a campaign to legalise assisted dying, rather than to call for better mental healthcare and support for people with physical illnesses.”

Higher risk of suicide should prompt calls for better mental healthcare and support, not legalised assisted dying. Sleeman KE, Davies JM. BMJ. 2022 May 30;377:o1322. doi: 10.1136/bmj.o1322. PMID: 35636763