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The VE Bulletin Excerpts
'No price is too high to pay for the privilege of owning yourself' Rudyard Kipling
Vol 20: No 2 July 2003
Suicide and voluntary euthanasia On 24th November 2002 Dr
Christopher Ryan, Consultant Psychiatrist at Sydney’s Westmead Hospital
and lecturer at Sydney University, spoke to the NSW VES. A brief
summary of the issues covered follows below, based on an article in the
NSW VES Newsletter of March 2003
Dr Ryan advised the meeting
that suicide is common with approximately 2% of Australians taking
their own lives. It is the second most common form of death in young
people and the seventh most common generally. Some people find
themselves at a point in their lives where they weigh up the ‘pros’ and
‘cons’ and make a decision that death would be preferable. This may be
referred to as ‘rational suicide’ and is strongly linked to voluntary
euthanasia. This is very rare, with most suicides being impulsive due
to a crisis, or attempts motivated by serious psychiatric illness.
Impulsive suicide attempts
Impulsive actions are very
different from rational suicide in which people have a problem, but not
a crisis. Those facing a crisis situation, often a relationship
breakdown, are more likely to find a solution through having supportive
friends, reasonable self esteem, a good social network, intelligence,
being skilled at solving problems, not normally expressing impulsive
behaviour and, accordingly, holding a moral prohibition against
impulsively taking life. However not everyone has all of these personal
qualities, and some have none.
Serious psychiatric illness
Major depression, which
affects approximately 10% of the population at some time, is the most
likely reason for people taking their own lives. There are two forms of
depression, normal depression with which everyone is familiar; being a
response to devastating life events such as loss of a family member. It
is a normal part of being human and tends to resolve itself over time.
However major, or medical, depression results in sufferers becoming
worse over time with loss of appetite, loss of sleep and a depth of
sadness not normally experienced by many. Suicidal responses are
therefore very different from rational suicide and people often cannot
comprehend reasons for such action. Major depression is an illness in
its own right and often a result of a chemical imbalance in the brain.
It is largely treatable by medication.
Suicide and voluntary euthanasia
An argument often put forward against
voluntary euthanasia is that it would increase the suicide rate.
However Dr Ryan disagrees. It is more likely to lower it slightly. The
number of rational suicides is tiny and while it is likely that
voluntary euthanasia legislation may increase the number of rational
suicides, the overall numbers would remain small. If everyone knew they
could seek voluntary euthanasia from doctors; and that discussions were
not out of bounds, some of those people contemplating non-rational
suicide, and those with major depression may speak to their own doctors
and hopefully be diagnosed and successfully treated. Dr Ryan supports a
brief psychiatric review as part of legalising voluntary euthanasia.
The Australian Suicide Prevention Information and Resource Exchange has a website at www.ichr.uwa.edu.au/sp It has a wide range of resources, but is not a crisis service
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