A MORE HUMAN SOCIETY
The recent tragic deaths of fashion designer Kate Spade and celebrity chef Anthony Bourdain have dramatized what The New York Times calls the “public health crisis” of suicide. That crisis was underscored on June 8 when the U.S. Centers for Disease Control and Prevention reported that the U.S. suicide rate increased almost 30 percent from 1999 to 2016.
Unfortunately, people in general, and news media in particular, have not known how to help. Even news reporting on suicide can aggravate the problem, say guidelines promoted by the World Health Organization, U.S. Surgeon General’s office, and suicide prevention organizations.
WHO urges: “Avoid language which sensationalizes or normalizes suicide, or presents it as a solution to problems”; “Avoid explicit description of the method used in a completed or attempted suicide”; and “suicide notes should not be published.”
Initial reports of Spade’s death ignored this plea, by dwelling on the specific means of death (which could be copied by impressionable people) and quoting an alleged suicide note.
By the time Bourdain died three days later, news agencies learned of these concerns and acted more responsibly. And they helped educate the public about preventing suicide.
Prevention has to reach beyond people with identified psychiatric problems, to encompass those facing stressful situations such as health problems, broken relationships and job or financial difficulties. The CDC says more than half of those taking their lives had no “known mental health condition” at the time — which, as psychiatrists observe, means that the condition was not diagnosed, not that it didn’t exist.
Experts have also identified warning signs. For example, a person may talk about wanting to die, about “feeling hopeless or having no purpose,” about “being a burden to others” (see http://reportingonsuicide.org). If someone I know shows some of these signs, I should not leave him or her alone; I should remove anything that could be used for suicide, seek medical help and call the National Suicide Prevention Lifeline at 800-273-8255 (273-TALK).
In some circles, however, this “comprehensive” effort to prevent suicide has a glaring loophole. People facing serious physical illness have been tagged by a well-funded advocacy campaign as needing suicide “assistance” rather than suicide prevention.
The leading advocacy group, “Compassion & Choices,” claims that when these patients take their lives, using drugs deliberately prescribed for that purpose, this is “aid in dying” or “death with dignity” rather than suicide. Yet the means are the same as in many other suicides; the patients are almost never evaluated for a mental disorder; in Oregon, more than half say they are doing this because they are a “burden” on others; and physical illness is well known as one “stressor” increasing one’s suicide risk.
What’s more, stories used to promote this agenda — most notably that of Brittany Maynard, the young cancer patient whose quest for doctor-assisted death in Oregon was on the cover of People magazine at most grocery checkout lines in 2014 — egregiously violated the guidelines on responsible reporting. Self-killing was glorified and presented as a solution — the only solution — to her problems.
And sure enough, suicide rates have risen — not least in Oregon, which for the past three years of the CDC study has a suicide rate (not counting “aid in dying” cases) 37 percent higher than the national average. The highest rate of all is in Montana, the only state with a court ruling allowing assisted suicide in some cases.
I applaud the renewed public effort to protect people from suicidal temptations. All of us — including physicians, lawmakers and journalists — are needed in that effort. And all of us, without exception, deserve to benefit from it.
