Suicide risk for terminally ill people more than double general population, ONS data indicates
People with severe and potentially terminal health conditions are more than twice as likely to take their own lives than the general population, new data from the Office for National Statistics (ONS) published today (Wednesday 20 April 2022) has indicated. The ONS examined suicide rates among people with a range of health conditions with poor prognoses and found that those with low survival cancers are at 2.4 times higher risk of suicide than those without, those with chronic obstructive pulmonary disease (COPD) also at 2.4 times higher risk and those with chronic ischemic heart conditions are at nearly 2 times higher risk. The data comes after several suicides and suicide pacts involving terminally ill Brits have come to light, with Dignity in Dying research estimating that up to 650 terminally ill people are taking their own lives every year in the UK in lieu of the safe, legal choice of assisted dying.
The ONS data was commissioned last April by the then Secretary of State for Health and Social Care, the Rt Hon Matt Hancock MP, at a meeting of the All Party Parliamentary Group on Choice at the End of Life in order to inform the assisted dying debate. Mr Hancock commented at the time that “anyone who believes in high quality public discourse would want to see an independent and impartial set of facts on which we can then have a discussion.” It followed the publication of preliminary data from the ONS in February 2021 which indicated that one in seven suicides are by people with experience of cancer, neurological, heart or lung disease.
The ONS then examined suicide rates among people diagnosed with low survival cancers, COPD and chronic ischemic heart conditions in England between 2017 and 2020 in comparison with a control group with similar socio-economic characteristics. These conditions were chosen due to the “reasonable risk of death in those that are diagnosed”. The ONS found that people with these conditions were more than twice as likely to take their own life, with people with low survival cancers and COPD at the greatest risk.
This data comes after research from Dignity in Dying estimated that up to 650 terminally ill people a year are taking their own lives in lieu of a safe, legal option to die on their own terms, with up to 10 times as many attempts. This is in addition to the pre-pandemic average of 50 Brits a year who travel to Switzerland for an assisted death (costing at least £10,000) and 6,400 a year who suffer in pain as they die in the UK despite access to the best possible palliative care.
Several suicides and suicide pacts involving terminally ill people have come to light in recent weeks, including former Formula 1 boss Max Mosley, who took his own life using a firearm dying of cancer; Mr Hunter, a British expat who is facing a murder charge in Cyprus after helping his terminally ill wife to die and surviving an attempt to end his life alongside her; Dr Christopher Woollard, a professor with terminal cancer who stole and crashed a plane to end his life; Mr & Mrs Norris, a couple suffering with serious health complications who took their own lives together; and Mr Smith of East Sussex, who after surviving an attempt to end his own life alongside his terminally ill wife of almost 50 years, has pled guilty to manslaughter by reason of diminished responsibility.
The Crown Prosecution Service (CPS) has recently proposed updates to its guidance on suicide pacts and so-called ‘mercy killings’, which carry a potential charge of manslaughter or murder respectively, clarifying that it is not in the public interest to prosecute where the deceased was seriously ill with a clear and settled wish to die and where the assistance was compassionately motivated. This mirrors existing guidance for cases of ‘assisting or encouraging a suicide’ and has been welcomed by Dignity in Dying, however it does not change the law; a blanket ban on assisted dying remains which only Parliament can address.
Gareth Ward, 45, from Rayleigh in Essex, was phoned by his terminally ill father Norman, 75, just moments before he took his own life last June:
“I immediately called the emergency services and my family but tragically my sister arrived first. Dad would have been devastated to learn that any of us had discovered him. He had meticulously planned it to minimise the impact on us; cleaning the house from top to bottom, sorting the garden, arranging and paying for his funeral, timing his death so that no one was due to visit.
“Dad was in a world of pain every day after the prostate cancer spread to his bones and lungs, his weight had plummeted and he suffered a stroke which severely affected his mobility and vision. He would talk flippantly of ending his life but no one thought he would do it, or that he’d have the strength to retrieve his gun from the locked box in the attic.
“What Dad did was not suicide; he was just trying to take control in the only way he could. I have no doubt that had there been the option of an assisted death he would have taken it. We could have all been there, gathered around his bed to say goodbye. He could have died calmly rather than in the most horrific manner possible.”
Marjorie Wallace CBE, Chief Executive of mental health charity SANE, said:
“It is unforgiveable and inhumane that people who are dying should have to resort to ending their lives alone and abandoned, but this data indicates that this the case for many under the current law. For those who are nearing the end of life and wish to ease the dying process, their motivation is to shorten death, not shorten life, and therefore traditional suicide prevention measures are not an appropriate response. Instead we need a change in the law on assisted dying so that terminally ill people can explore their wishes fully and openly, access mental health support where necessary, and choose to be able to die on their own terms in safety and with protection.”
The Rt Hon Andrew Mitchell MP, co-chair of the All Party Parliamentary Group on Choice at the End of Life, said:
“That so many terminally ill people feel their only option is to take their own life is a damning indictment on end-of-life choice in this country, and entirely unacceptable in a healthcare system that supposedly values patient safety and compassion. Parliamentarians on all sides of this debate have demanded that we conduct it based on the best possible evidence. It is now incumbent that we act on this new evidence, which indicates serious failings in the protection of our terminally ill citizens and which demands that we investigate in full the deeply concerning impact of the current law.”
Sarah Wootton, Chief Executive of Dignity in Dying, said:
“Dignity in Dying has long raised the alarm that terminally ill people are taking their own lives under the ban on assisted dying. This data proves that these deaths are not isolated tragedies but warning signs that the current law has serious patient safety implications for dying people which can no longer be ignored.
“Without a safe, legal option to die on their own terms, hundreds of terminally ill people every year are taking matters into their own hands using whatever means are at their disposal, from stockpiled medication to firearms, often dying lonely, premature and painful deaths or begging loved ones for compassionate but illegal help. The vast majority are abandoned at their time of need with no medical support or oversight, with only a fortunate few able to access a peaceful assisted death overseas.
“Under safeguarded assisted dying legislation, patients would be far better able to discuss their concerns for the end of life openly and honestly with their loved ones and medical team, improving awareness of and access to all end-of-life care options and better allowing concerns about mental health or capacity to be identified and addressed. Only those with a terminal prognosis and full mental capacity as confirmed by independent doctors and a judge would be able to access this option, providing much-needed transparency and regulation where there is presently none.
“Those who block reform on assisted dying are defending a law that puts vulnerable people at risk and fails to provide adequate choice or protection – the very basics of good end-of-life care. The data today confirms that the blanket ban on assisted dying is not only uncompassionate and unequal, but deeply unsafe for our terminally ill citizens, and it must act as a clarion call for Parliament to examine the full impact of the current law. This is not simply a matter for debate but of patient safety, of the utmost urgency.”
Dignity in Dying campaigns for a change in the law to allow assisted dying as a choice for terminally ill, mentally competent adults, subject to strict safeguards and alongside access to high quality palliative care. This reform is supported by 84% of the public (Populus, 2019) and over 68,000 have signed a government petition calling for a full and fair debate on assisted dying.
A Private Member’s Bill on Assisted Dying brought by Dignity in Dying Chair Baroness Meacher passed its Second Reading unopposed in the House of Lords in October, though it is unlikely to be allotted time for Committee Stage before all non-government bills automatically fall at the State Opening of Parliament next month. In Scotland, a public consultation on an Assisted Dying Bill Proposal recently received an unprecedented response, with a report due in the coming months and a vote in the Scottish Parliament expected next year. Jersey’s Parliament voted in principle for the legalisation of assisted dying in November following recommendations from a citizen’s jury on the topic, with draft legislation expected later this year. In the Isle of Man, a Private Member’s Bill on assisted dying is expected to be introduced in the coming months.
Around the world more than 200 million people have access to assisted dying laws, including one in five Americans, two in three Australians and all New Zealanders.
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For further information and interviews with parliamentarians, Dignity and Dying spokespeople and case studies please contact Molly Pike, Media and Campaigns Officer at Dignity in Dying on 07929 731181 or email: molly.pike@dignityindying.org.uk