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The effect of assisted dying on suicidality: a synthetic control analysis of population suicide rates in Belgium

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Abstract

Adoption of assisted dying has rapidly grown, but many groups caution that these policies can cause suicide contagions. If those urging caution are correct, jurisdictions with these policies will experience increased suicides. This study aimed to determine the changes in population suicide rates in Belgium before and after its 2002 policy using the synthetic control method (SCM) and generalized synthetic control method (GSCM). As comparisons we used additional European Union members that have not adopted these policies. GSCM showed an average annual suicide rate increase of 0.73 per 100,000 population (95% CI − 5.7 to 7.2; p = 0.80). Placebo testing based on the SCM analysis showed equal outcomes for Belgium and the comparisons. This study failed to show evidence of association between implementation of legislation legitimizing assisted dying and population suicide rates. The threat of suicide contagion has influenced policy discussions in the past, but this study suggests that there is presently no indication for policy-makers to view suicide contagions as a concerning side effect of assisted dying legislation.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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  1. University of Ontario Institute of Technology, 2000 Simcoe Street North, Oshawa, ON, L1G 0C5, Canada

    Harmeet Nanner

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  1. Harmeet Nanner
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Correspondence to Harmeet Nanner.

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Conflict of interest

I am a volunteer member of the Disability Advisory Council, a group that operates under Dying with Dignity Canada (DWDC). DWDC is a Canadian organization with charitable status that advocates for all aspects of end of life care, including medical assistance in dying. DWDC, its staff, its volunteers, and other members of DWDC have no relationship to, did not contribute to, and provided no support with any aspect of this article. This article is entirely my personal endeavour.

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This study did not include human participants. Data were obtained from free and open access databases.

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Nanner, H. The effect of assisted dying on suicidality: a synthetic control analysis of population suicide rates in Belgium. J Public Health Pol 42, 86–97 (2021). https://doi.org/10.1057/s41271-020-00249-8

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