For decades, we’ve known that suicide is contagious and that how we talk about it matters. Now, we’re at least starting to see how crucial it is to honor the lives of Kate Spade and Anthony Bourdain without perseverating ghoulishly on how they died.
All kinds of hard, urgent conversations have followed Spade’s death, and soon after hers Bourdain’s. We’ve heard stories of survival that show suicide is in no way inevitable for those fighting an illness so pitiless that it fools many into thinking their loved ones would be fine, or better than fine, without them.
With the suicide rate in this country up dramatically over the last 20 years, this is a national public health crisis, in rural areas in particular. In Kansas, the suicide rate went up 45 percent between 1999 and 2016, and in Missouri, it spiked 36 percent during that same period.
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Spade's father, Frank Brosnahan, who died Wednesday night, just hours before his daughter's funeral in Kansas City, had said recently "that any talk that they do that helps somebody else, Katy would have liked that ... If that helped anybody avoid anything — fine, she'd be delighted."
One aspect of this conversation that hasn’t been happening, though, and that will delight no one, involves the research that shows assisted suicide is also contagious.
That’s right: Doctor-assisted suicide increases overall suicide rates among the non-terminally ill everywhere it’s made legal. Such laws have a measurable effect on those who aren’t dying, but who are suffering from depression.
A study conducted between 1990 and 2013 and published three years ago in the Southern Medical Journal found the correlation unmistakable: “Controlling for various socioeconomic factors, unobservable state and year effects, and state-specific linear trends, we found that legalizing [physician-assisted suicide] was associated with a 6.3% increase in total suicides.”
And wherever doctors could legally help their worst-off patients end their own lives, more of those in acute but treatable, transitory, psychic pain followed suit.
A study of New York cancer patients suggested that a high percentage of those terminally ill patients who expressed a “high desire for hastened death” themselves suffered from depression, so we don’t always know that even their final decisions are unclouded by a disease other than cancer.
Yet for some reason, assisted suicide for psychiatric patients is not prohibited, but increasingly accepted. An alarm-sounding March piece in the New England Journal of Medicine said, “Physicians in the Netherlands and Belgium have helped a small but growing number of patients with mental illness but no terminal condition to end their lives. In some U.S. states, attempts to extend physician-assisted death to psychiatric patients appear inevitable.’’
These same people are most vulnerable to the risk of suicide contagion, which ought to make us rethink the whole glossy, hats-off-to-you way we in the media often present assisted suicide. Last month, an NPR report on the assisted suicide of a 104-year-old Australian scientist, David Goodall, tut-tutted that American laws require those who seek it to be terminally ill. “Goodall, on the other hand, was not terminally ill,” the piece said. “But he was ‘losing his faculties of sight and sound’ and ‘his quality of life [was] fast diminishing,’ according to Exit International,” an assisted suicide advocacy group.
At 104, I don’t doubt it. But “diminishing quality of life” seems like an awfully subjective criteria.
Just this week, California reinstated doctor-assisted suicide, which is already legal in Colorado, Vermont, Washington, Oregon, Hawaii, the District of Columbia, and with a court order, Montana.
As it expands further, amid already truly frightening spikes in suicide, especially among military veterans, let’s not be afraid to look at the uncomfortable, unattended and unintended consequences. Let’s at least consider what the science says, instead of talking only about how compassionate these laws are.