New Study: Suicide Contagion and Legalized Physician-Assisted Suicide


Even before my 30 year old daughter Marie died by suicide in 2009 using an assisted suicide technique, I was writing and giving talks on physician-assisted suicide (PAS) for years. Even then, I worried about effect of the mainstream media portraying PAS as a civil right and even “courageous”, especially since the existence of suicide contagion aka “copycat suicides” was well known. I was not surprised when after Marie’s death, at least two people close to her became suicidal. Thankfully, they were saved by treatment.

Now we have even more information about this from a Southern Medical Journal a medical journal article that was published at the same time Governor Brown signed the California’s PAS law. In the study “How Does Legalization of Physician-Assisted Suicide Affect Rates of Suicide?” , researchers meticulously examined suicide rates in Washington and Oregon after those states passed PAS laws.

The results are shocking. In those states, the researchers found a 6.3% increase in total suicide with a larger increase (14.5%) among individuals 65 or older. Moreover, there was no decrease in nonassisted suicides (people taking their own lives), despite the claims of PAS advocates that legalizing PAS would reduce the overall number of nonassisted suicides. Instead, the researchers found that “Rather, the introduction of PAS seemingly induces more self-inflicted deaths than it inhibits.”

On November 20, 2015, the Washington Post newspaper published an excellent op-ed article titled “The Dangerously Contagious Effect of Assisted-Suicide Laws “ by Dr. Aaron Kheriaty, an associate professor of psychiatry and head of the medical ethics program at the University of California at Irvine. Citing the medical journal study, Dr. Kheriaty concludes that:

“Debates about physician-assisted suicide raise broad questions about our societal attitudes toward suicide. Recent research findings on suicide rates press the question: What sort of society do we want to become? Suicide is already a public health crisis. Do we want to legalize a practice that will worsen this crisis?”

Is Suicide Really a Public Health Crisis?

The national Centers for Disease Control website reports the following statistics in a section titled “Suicide and Suicide Attempts Take an Enormous Toll on Society”. Here are some excerpts:

• Suicide is the 10th leading cause of death among Americans
• More than 40,000 people died by suicide in 2012
• More than 1 million people reported making a suicide attempt in the past year.
• More than 2 million adults reported thinking about suicide in the past year.
• Most people who engage in suicidal behavior never seek mental health services.

Costs to Society
The following estimates are based on 2010 CDC data and refer to people age 10 and over.
• Suicide costs society over $44.6 billion a year in combined medical and work loss costs.
• The average suicide costs $1,164,499. (Emphasis in original)

The toll on survivors, family member or friends of a person who died by suicide is also enormous, as I can personally attest:

• Surviving the loss of loved one to suicide is a risk factor for suicide.
• Surviving family members and close friends are deeply impacted by each suicide and experience a range of complex grief reactions including, guilt, anger, abandonment, denial, helplessness, and shock

Fighting Suicide Contagion

It is tragic that suicide prevention organizations ignore the PAS issue and the mainstream media is almost uniformly sympathetic to the PAS movement despite World Health Organization and national media guidelines for suicide reporting. This has allowed PAS groups like Compassion and Choices not only to press harder for universal PAS laws but also to even change the names of such laws to euphemisms such as “End of Life Options” or “Death with Dignity” to disguise the fact that physician- assisted suicide is obviously suicide.

However, Dr. Kheriaty in his Washington Post article also talks about a related phenomenon called the Papageno effect that:

“suggests that coverage of people with suicidal ideation who do not attempt suicide but instead find strategies that help them to cope with adversity is associated with decreased suicide rates.”

I have always maintained that our stories as suicide survivors, people with disabilities or terminal illnesses, etc. offer hope and inspiration while those about PAS promote despair and hopelessness. We need to tell our stories publicly.

All of us and especially people in states that are currently targeted by groups like Compassion and Choices for legalization of PAS, need to know and share the real facts about PAS as well as suicide prevention and treatment, including the national suicide hotline number (1 (800) 273-8255) and website (  Suicide prevention and treatment can work whether people are considering PAS or killing themselves.

Addendum: Ironically, just as I was finishing this blog, I was interrupted by a call from a man living in another state with an incurable, disabling condition. He was referred to me last month when he saw a segment on a celebrity’s suicide involving the same condition and decided that he wanted to go to California to use the newly passed PAS law. I talked to this man for quite some time.

I was elated when this gentleman now told me that the resources I recommended, the people he talked to and even just the fact that someone cared did change his mind and he no longer wants to end his life. He said he now wants to start actually living again.

This man’s story shows why we must not discriminate between suicide and physician-assisted suicide when it comes to suicide prevention and treatment.

7 thoughts on “New Study: Suicide Contagion and Legalized Physician-Assisted Suicide

  1. I know this is a sensitive subject for you. I hope I’ll be able to present my case, as a right-to-die advocate without the feeling like we’re enemies or some sort.

    Let’s start with the main premise: None of us ever chose to live. You are forced into existence. You cannot consent. You cannot say no.

    PAS is a fundamental right for everyone. Without the right to die, there is no right to live. It becomes a duty. A person never chose to exist. Let the person at least choose to exit painlessly.

    More people killing themselves isn’t a tragedy. These are people ending their suffering. These people are merely exercising their right to die.

    We need to understand that just because we find our own individual lives worth living, it does not mean someone else’s life is.

    It’s terrible for the people who love them, but we need to respect their decision. We need to accept the fact that these people didn’t find life to fit for them, their environment is rigged against them and that their continued existence wouldn’t bring them any happiness.

    Suicide prevention campaigns will solve no problem. These campaigns will only increase the shaming of suicide. They do not encourage people to ask help but discourage them for speaking up. The message suicide prevention sends is that whatever you’re feeling, you are definitely wrong.

    There’s no way your life isn’t worth living. Your suicidal thoughts are irrational (=you are irrational). You have no right over your own body. You have no say in this – you are wrong. Just listen to us, repeat after us until the message is wired in.

    How can that help suicidal people?

    If we respect freedom of opinion and action, we must respect the freedom to die.

    If the suicide crisis is proof of anything, is that we’ve built a culture/society that has no room for many people. The problem is in our culture and society, not them.


    • Thank you for commenting.

      Remember the John Donne poem “No Man is an Island”?
      “No man is an island entire of itself; every man
      is a piece of the continent, a part of the main;
      if a clod be washed away by the sea, Europe
      is the less, as well as if a promontory were, as
      well as any manner of thy friends or of thine
      own were; any man’s death diminishes me,
      because I am involved in mankind.
      And therefore never send to know for whom
      the bell tolls; it tolls for thee.”

      Such a poem is timeless because it is so true. There is no such entity as an inconsequential human being and we all have a responsibility to and for each other.

      For example, I am a nurse. I will do anything for my patients-except kill them or help them kill themselves. There are many of us willing to help other people achieve the best life possible regardless of their circumstances. We know that all of us need help at times in our lives.

      I have had many people tell me that they have such psychological pain in a difficult situation that they feel death is the only option. But I have also seen the same people deal with these feelings, with or without professional help, and come through the storm with a better outlook and new wisdom even if the situation itself has not changed. No one should be cheated out of his or her natural life span because of a current feeling of despair.

      In the end, we cannot achieve the just, welcoming and cooperative society that we all want if we allow physician-assisted suicide to destroy the most basic and protective rule of a civilized society that we don’t kill or help kill each other.


      • I’m not advocating an extreme individualistic view. Too much individualism and we forget we are social creatures. Community is important.

        But we should be wary of what we sacrifice for the community. Women refuse to have sex with people for the Greater Good, so someone wouldn’t have to suffer from sexual frustration (that’s okay!). So why is living in suffering, pointlessness and emptiness is acceptable for the Greater Good?

        It’s just not a feeling of despair but a rational decision. A person can realize his life has no point, no direction. He does not want to live with his memories, with who he is. We need to give these people an exit. Some people go through it, but not everyone even wants to go through it. They have no moral obligation to do so.

        How is a society with PAS not just and welcoming? I prefer it to the cruel shaming suicide prevention networks do. Suicide prevention networks shun suicidal people. The message they send is that they have no say and no right over their body – they just need so sit there and accept life is good because some people say so.

        Compassion and empathy means that our way of life isn’t definitive. It’s accepting that just because our life is good, it doesn’t mine someone else’s. We don’t force others to eat the same ice cream, or to listen to the same music, or like the same TV shows we do. Why do we force them to live, then?

        Some people don’t want to want to die and they can find a way out. Some of us accepted suicide and found it the best way. Some of us want it even while happy. What we want from society is show us a little mercy and let us exit painlessly.


      • I hear your pain and I would like to help you. Please consider calling the Suicide Prevention Helpline at 1 (800) 273-8255.

        I would never have helped my daughter Marie kill herself under any circumstances. I would have continued fighting for her life. I wouldn’t have been holding her hand and supposedly respecting her decision to end her suffering as physician-assisted suicide supporters suggest. I loved her too much not to say “No!”

        With so many suicide deaths and attempts yearly in the United States, we cannot recognize suicide as a tragedy to be prevented if possible while simultaneously glorifying physician-assisted suicide as a courageous decision. Our most vulnerable people — young, old, dying, disabled, etc. — are listening and watching our response to the argument that some lives are just not worth living.


      • If I had a child, I wouldn’t be able to let him/her kill themselves either. It’s not because that’s the moral thing to do. I will do it to prevent my suffering.

        We don’t actually tell people that their life isn’t worth living. No one is going to force anyone to PAS. Advocates of it believe that a person can determine whether his life is worth living and not anybody else. We are not fit to choose who will live and who will die. That includes keeping people alive against their will.

        Some people don’t want to want to die and there is help for them (although it should be more readily available.). There should also be help for those who are not interested in living. Suicide prevention attempts are looked down by the suicidal since it’s a violation of their basic right.


      • No one is “forced” to stay alive. Tall buildings, cars, etc. have long been available if someone is determined to kill himself or herself. I would try to prevent the suicide of any person, regardless of medical condition, “quality of life”, etc. It is discrimination to refuse to at least try to provide suicide prevention and treatment, supportive options, etc. based solely on a person’s negative perception of his or her own life.

        Two big problems with PAS is that assisted suicide supporters demand both the participation of medical professionals and the approval of society despite the overwhelming opposition of doctors and nurses to personally participate and the obvious effect on people at risk by normalizing and even glamorizing suicide. And there are already cases of abuse or coercion here in the US as well as in countries like Holland, Switzerland and Belgium where legalized lethal overdoses have expanded to include even the mentally ill, healthy bereaved spouses, elderly people who claim they are “tired of life” and even to people who do not ask for overdoses but whose “quality of life” is judged to be poor.


Comments are closed.