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The Politics of Suicide

10/28/2012

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The following article is by Dr. Lachlan Forrow.  It's a subject that I plan on focusing on over the next few weeks.  Thoughts?

Should  a doctor in Massachusetts be legally permitted to write a prescription for a
patient to use in suicide?
On November 6, the people of the Commonwealth will decide.

This is an issue about which deeply thoughtful, caring, and principled people in Massachusetts have profoundly differing views.Each "side" has, among its most passionate advocates, people I greatly admire.The moral, practical, political, religious, and other issues that Question 2 raises for people are almost infinitely complex.But the choice each of us will face when we vote is as simple as it can be.

Just two choices.

YES.

NO.

I have serious misgivings about whether a ballot initiative is the best way for the people of Massachusetts to make decisions about profound, complex moral issues.My misgivings are especially great when, as I believe is
true of Question 2 next Tuesday, many people are going to have to cast their vote without having had the time, opportunity, or help they needed to develop a clear and accurate understanding of what those issues
are.

I am further distressed that too many of the ads, op-eds, and advocacy emails that I have seen -- from both sides -- seem to me to present seriously distorted, irresponsibly exaggeratedclaims that are designed to frighten you into voting one way or the other.If I didn't know better, I would be more frightened than ever about myself or a loved one ever having a so-called "terminal illness". 

Scaring people by misinforming or misleading them, even if you think you are doing that in order to help them do what is good for them, is wrong.The fact of our inevitable mortality is, for most of us, scary enough. Exploiting those fears for political purposes, however well-meaning, is wrong.It was wrong when Sarah
Palin and others promulgated lies about non-existent plans for alleged "death panels" during the national health care reform debates.  It is wrong today in Massachusetts when people exploit your fears to get you to vote the way they think you should on Question 2.

More specifically, I think it is wrong here in Massachusetts when scare tactics are used to frighten people into thinking that Question 2 is "a recipe for elder abuse", as if that is even remotely the intent of its proponents, or even remotely acceptable to them.  I also think it is wrong to promulgate fears that, if Question 2 passes, insurance companies will encourage you to commit suicide in order to save themselves money, as the "No on 2" website implies in a video titled "Barbara's story" that features a headline from Oregon:

"Health Plan covers assisted suicide but not new cancer treatment...Don't let her experience in Oregon happen here in Massachusetts."

I do not believe any health plan in Massachusetts would ever do that.  Suggesting that they would is insulting to them and their leaders.I sometimes disagree with our health plans and their leaders, but in my experience the leaders of Massachusetts health plans care deeply about trying to ensure that their subscribers receive the best patient-centered value out of every health care dollar spent. 

And even if leaders of a health plan in Massachusetts were one day as venal as some people believe they already are today, they are not that stupid.  The people of Massachusetts are vigilant, and even a single well-documented case of a health plan trying to encourage a patient to commit suicide in order to save money would lead to such a public backlash that that plan's "business success" would be devastatingly damaged, if not ruined forever.  As it would deserve to be.

Similarly, I think it is wrong when proponents of Question 2 suggest that, unless a doctor is legally permitted to write lethal prescriptions, you or a loved one may well be forced to endure a prolonged period of terrible physical suffering.Here is what the "Yes on 2" website says:

Patients dying of late stage cancer, and other terminal illnesses, can face weeks or months of extreme pain and suffering before death.

They clearly want you to believe that unless Question 2 passes, you are at high risk of being forced to experience unconscionable levels of suffering.  In truth, whether Question 2 passes or not, the only reason a patient in Massachusetts need ever face "weeks or months of extreme pain and suffering before death" is if their medical caregivers are utterly incompetent.

Scaring people does not usually help them think more clearly, or help them make decisions more responsibly.And for the overwhelming majority of people, no matter how they decide to vote, and no matter what the result on November 7, there is little or no reason to be scared about what happens with Question 2.

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DC Metro Suicide

10/24/2012

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A 24-year-old Maryland man killed himself by jumping in front of a Metro train on October 16th at the Farragut North station, making it the fifth suicide on Metrorail this year.

But it was the first case since Metro started posting signs in its stations -- the public face of a $250,000 suicide intervention program -- two months ago reaching out to suicidal riders.

The transit agency now has public service advertisements in every station, 100 ads in trains and some in buses urging suicidal riders to seek help on a hotline: "You talk, we listen. Together we survive." It also has posted signs in 13 stations at the end of the platforms and plans to add them to the remaining 73 stations in coming months. Since Metro's 855-320-LIFE (5433) crisis hotline went live in August, it has received 100 calls, according to the D.C. Department of Mental Health.

But Lanny Berman, executive director of the American Association of Suicidology, said no evidence shows whether such signs are effective at stopping those intent on committing suicide. And, he said, signs without a dedicated phone next to them will not be effective, as experts have found that those who commit suicide rarely have cellphones with them.

Instead, he said, agencies in Tokyo and Singapore have added barriers along platforms to prevent the deaths. "That's the only strategy we know will be uniquely effective," he said. But he acknowledged it also is the
most expensive, estimating it could cost Metro "millions and millions" of dollars.

In Tuesday's incident, the man intentionally placed himself into the path of a Shady Grove-bound train just before 11 a.m., according to Metro. Metro declined to release the man's name but said he was from District Heights.

The suicide delayed trains on the Red Line for some four hours, and slowed Orange and Blue Line trains. The transit agency had to force trains onto a single track between Dupont Circle and Judiciary Square amid the investigation and cleanup. And due to a track connection between the Red, Orange and Blue lines, Metro single-tracked trains between McPherson Square and Foggy Bottom, too.

But such suicides have far more lasting damage than delaying thousands of riders. Train operators, first responders and those who clean up the scene can face emotional trauma, as do riders who witness it. And
some of those who attempt suicide survive but are left with debilitating injuries. Three people survived such attempts this year.

Metro pledged to start a suicide intervention program in September 2009, a year with 11 suicides and three attempts. But the outreach program was delayed for nearly three years, even though Metro budgeted $250,000
for it in 2010 and commissioned an approximately $70,000 report from the American Association of Suicidology.

Last summer, the transit agency began training station managers and other front-line workers on how to spot and intervene with suicidal riders. Some station managers have been given preprogrammed cellphones to
contact clinicians if they need help, according to the D.C. Department of Mental Health, and 344 workers have been trained. Metro has said all will receive training by January.

Need help?
The American Association of Suicidology says the best intervention comes before a person heads to the
subway. The association urges friends, family and co-workers to take seriously warning signs, which
include:

» Increased alcohol or drug use
» No reason for living or lack of sense of purpose
» Anxiety, agitation, difficulty sleeping or sleeping all the time
» Withdrawal from friends, family and society

Call the National Suicide Prevention Lifeline's toll-free number, 800-273-TALK (8255), for direct
help or guidance on how to intervene.
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Suicide and Anti-Bullying.

10/14/2012

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Courtesy of CTVNews.ca Staff.

As Canadians debate the right response to a case of cyber bullying that may have pushed B.C. teenager Amanda Todd to take her own life, lawmakers will consider a private members bill that seeks to lay the groundwork for a national bullying prevention strategy in the House of Commons Monday. But the father of a teen who took his own life because of bullying says it’s time for action, not another study.

NDP MP Dany Morin will introduce the bill aimed at building an all-party committee of MPs to study the prevalence of bullying and help build a framework for a national anti-bullying strategy.

Canada does not presently have a national bullying prevention strategy.

Morin’s bill will be introduced just a few days after Todd was found dead in her Port Coquitlam home Wednesday. Police say suicide was the cause of death and the RCMP are currently investigating the case.

Todd, 15, posted a video to YouTube in early September in which she described her pain and suffering as a long-time victim of bullying, much of it through online social media.

Her death has prompted calls for stronger action against bullying, including B.C. Premier Christy Clark who said Friday that it may be time to consider criminalizing such behaviour online.

But Morin told CTV’s Question Period that his bill does not seek criminalization of bullying. The MP, who admitted to being bullied during his teen years, said criminalization is not the answer.

“I was bullied as a teenager,” he said in an interview Sunday.

“I know firsthand what bullying really is like. But when the harm has been done, when a kid has been bullied for years, bringing the criminal charges to the bully will not solve the problem. The harm has been done. That’s why I want the special committee to focus on prevention.”

Morin’s bill calls for the study of the scope of bullying in Canada, as well as increased funding and support for organizations that work to prevent it.

But Ottawa city councillor Allan Hubley said that the problems posed by bullying demand action and not more study.

Hubley lost his own teen son to suicide in October 2011, and says the time and money spent debating and studying the issue would be better spent investing in the front line resources which help teens at risk of suicide.

“There is a time for action now, instead of another study or anything like that,” he said. “We have a definition of bullying. We already know a lot of the resources that can help bullying. But the frontline resources that will help these kids when they need it most, at that moment they’re about to make that decision, they are underfunded. That’s where we need to put our energies and our efforts.”

Hubley’s son, Jamie, committed suicide at the age of 15. Jamie, who was openly gay, was bullied for years and fought depression.

Hubley, who is preparing to mark the first anniversary of his son’s death, said he believes it will take the involvement of the entire community to stop bullying, and not legislation alone.

“It’s time for the community to take responsibility and everyone get involved and say ‘Enough, no more bullying,’” he said. “We need everybody to be willing to help each other and respect each other.”

Hubley believes that, much like drinking and driving, once society attaches a stigma to bullying it will cease to be popular or a “cool thing” to do.

“We as a society have to say ‘We are all going to do our part to stop this,’” he said.

During the interview, Hubley wore a unicorn pin on his lapel in memory of his son.

“Jamie said that he wanted to be remembered as a unicorn, different on the outside, but beautiful on the inside,” he said. “So I wear my unicorn to remember my boy. Everything I’m doing is for him.”

Thoughts?

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