A HIDDEN PROBLEM:
SUICIDE BY TERMINALLY
ILL PEOPLE
.
OCTOBER 2014
T
The issue of Britons
travelling abroad to
die to exercise choice
and control over their death
receives regular media coverage.
On average one Briton is
assisted to end their life in
Switzerland every two weeks.
Less well documented is
the greater number of terminally
ill people who end their lives
here, at home in the UK. In
order to get an accurate picture
of the frequency of these cases,
we updated previous research
by the think tank Demos from
2011 which indicated that in
around 2% of suicides in
England the person ending
their own life had a terminal
illness (a potentially conservative
estimate according to the authors).1
METHODOLOGY.
In April 2014 Dignity in Dying
sent a Freedom of Information (FOI)
request to the Director of Public
Health of every local authority in
England.
2
The request was for the
number of adult suicides
3
that they
number of these suicides where it
had been noted that the person had
a terminal illness.
DATA.
72 out of 139 local authorities
in England responded to the
request. 49 provided data,
but the vast majority did
not record the presence of a
terminal illness as part of
the audit process. However,
6 authorities had done
this and provided data:
•
Total suicides recorded
by the 6 local authorities
between the years
2005 and 2013:
760
•
Number of those suicides where
the individual had a terminal
illness: 56
•
% of suicides where the
individual had a terminal illness:
7.36%
4
One local authority informed
us that they provided a template
for their coroners to use when
dealing with a suicide or potential
suicide case. This template
includes a section for any further
information that the coroner may
want to include. When responding
to the FOI request, the local
authority examined every
template that they had on record
for suicide cases, making note
of the ones where the coroner
had stated the person had a
terminal illness.
A number of local authorities
who could not provide data said
they would now routinely record the
presence of a terminal illness with
suicide cases in recognition of the
importance of these issues.
ESTIMATES OF ANNUAL
FIGURES.
In 2012 there were 4,513 adult
suicides in England.
5
Applying the
that 332 of these individuals had
a terminal illness.
KEY FINDINGS
•
The circumstances of 760
suicides were examined
in detail.
•
Based on the data, in 7% of
suicides the person had a
terminal illness.
•
When applied to national
approximately 300 suicides
by terminally ill people in
England every year.
D
uncan McArthur ended his own life, in October 2009, with
medication he had stockpiled having been diagnosed with
Motor Neurone Disease in 2006. His wife Susan
describes his death:
weak and he was getting very little sleep. Then came the day when he
told me he had made the decision and that it was time to go.
Susan was the subject of a police inquiry immediately following Duncan’s
death. There was no prosecution but the inquiry meant a funeral could not
take place until December 2009 and an inquest was not held until almost a
year later.
OCTOBER 2014
CONCLUSIONS.
the 4,500 adult suicides per year
around 300 involve a person who
has a terminal illness. However, as
indicated by the Demos research,
and the relatively low incidence
of recording terminal illness, this
may be a conservative estimate.
We would welcome further scrutiny
of coroners’ data. Knowing the
number of dying people who end
their own lives provides an insight
into the problems that the current
law creates.
The results of the FOI request
highlight that the current law does
not provide transparent, safeguarded
dying people who want to control the
manner and timing of their death.
This causes some to take matters
into their own hands – with many
dying alone, often in distressing
circumstances. If the person
ending their life by suicide
requests assistance from a friend
or family member this would
implicate the friend or family member
in the suicide, which is illegal and
carries a risk of prosecution and
potentially imprisonment.
Assisted dying legislation
would allow terminally ill patients
to request assistance to die
without fearing the legal implications
for those that care for them.
Crucially, a change in the law would
mandate safeguards before
a person could be assisted to die,
and therefore offer better protection
for terminally ill people than the
current law can offer.
One area of concern is that
terminally ill patients requesting
assisted dying may have depression.
Under a change in the law a
patient request would prompt a
mental capacity assessment by
two independent doctors alongside
CONTACT US.
Dignity in Dying, 181 Oxford Street
London, W1D 2JT
020 7479 7730
info@dignityindying.org.uk
www.dignityindying.org.uk
@dignityindying
www.facebook.com/dignityindying
A HIDDEN PROBLEM:
SUICIDE BY TERMINALLY
ILL PEOPLE
.
M
ichelle was suffering from Motor Neurone Disease when she
took her own life. Michelle wrote letters to her friends and
family and took an overdose of painkillers in her home.
She did this without her husband Chris so that he would not be
accused of assisting her.
When he entered her room the next morning she was laying on the
bed unconscious but still breathing. Chris called an ambulance and gave
them a note she had written stating she did not want to be resuscitated.
She died a few hours later.
REFERENCES
1 DEMOS stated that when they collected data “some PCTs were unable to provide full information, or were explicitly
conservative in the numbers that they provided.” http://www.demos.co.uk/publications/thetruthaboutsuicide
2 Local authorities were approached because prior to the introduction of the Health and Social Care Act 2012, the
government recommended that all Primary Care Trusts (PCTs) conduct annual audits of suicide trends in their districts.
When the PCTs were abolished the data from these audits would have fallen under the jurisdiction of local authorities.
3
4 This is the total number of suicides that the participating local authorities provided. Two local authorities could not provide
suicides between 2005 and 2013. The same methodology was applied to the number of suicides where the individual has
average number of suicides per year where the individual
had a terminal illness.
5 HM Government (2014) Preventing suicide in England: One year on. First annual report on the cross-government
outcomes strategy to save lives.
6 Lloyd-Williams M, Friedman T (2001) Depression in palliative care patients – a prospective study European Journal of
Cancer Care 10(4) 270-274
7 Ganzini L, Dobscha S (2003) If it isn’t depression…Journal of Palliative Medicine 6(6): 927-931
detailed discussions about
supportive care and treatment.
Whilst studies indicate that symptoms
of depression amongst terminally
ill patients are more prevalent than
amongst the general population,
6
it must be acknowledged that a
level of rational depression or
‘appropriate sadness’ is considered
normal in terminally ill patients
approaching the end of their life.
7
Nevertheless, if a patient was found
to have depression, this could be
treated. This is in marked contrast
to the current law under
which
many terminally ill people are taking
decisions to end their lives without
medical support or assessment.
An assisted dying law would allow
dying people choice and control over
the timing of their imminent death,
allowing them to die safely and at
home with their loved ones. It would
provide both greater choice and
better protection than the current law.
DIGNITY IN DYING
Dignity in Dying campaigns to
change the law to allow the choice
of an assisted death for terminally
ill, mentally competent adults,
within upfront safeguards.
The Samaritans’ 24-hour helpline
is 08457 909090.
