2 ms·

If suicide is directly correlated to mental illness, then what of euthanasia and assisted suicide? Anyone who applies to end their own life would be incompetent

If suicide is directly correlated to mental illness, then what of euthanasia and assisted suicide? Anyone who applies to end their own life would be incompetent to make that choice, due to mental illness.

dredmorbius 3y ago
Those modalities should be discernable when looking at data by age (assisted death tends to occur at older ages) and, with a slightly greater data burden, comorbidities. When looking at data, an otherwise healthy 20 year old, and an 80-something with multiple chronic and/or terminal Dx's, would stand out. The challenge in looking at population-level data is that the Dx may well not be available, though other indicia might suggest this (e.g., residence is an assisted-living or long-term care facility). In practice, studies are frequently limited to available data, and proxies are frequently used. These may not be appropriate for specific individuals, but at scale, the law of large numbers and general correlation are your friends.
- bill_joy_fanboy 3y ago
  Like you said, I think looking at younger ages is sufficient. In 1999, teen (15-19) suicide was at around 8/100k, and it's now around 11/100k. It's lower in absolute numbers than in the general population, but there's still a disturbing uptick. https://www.charliehealth.com/research/the-us-teen-suicide-rate-is-on-the-rise https://www.charliehealth.com/research/the-us-teen-suicide-r...
  - NoZebra120vClip 3y ago
    It would be interesting to know how many people committing suicides were on SSRIs or antipsychotics, etc. at the time. These drugs are known to induce suicidal ideations (and ideations of violence, aggression, and homicide) and have carried black-box warnings. Sometimes, the cure is worse than the disease. Oh sorry, not a cure.
    - Timon3 3y ago
      At the same time it would be interesting to know how many had these ideas before SSRI. If you've been feeling suicidal for a long time, and SSRIs haven't improved your condition, you might feel hopeless enough to commit the act - without SSRIs being any kind of cause.
      - NoZebra120vClip 3y ago
        The fact of having a prescription for psychotropic drugs is a knowable thing, albeit jealously guarded by HIPAA and lawsuit-averse manufacturers. Perhaps it is less knowable whether the victims were taking those drugs and had "therapeutic" levels in their systems at time of death. But it would be extremely unknowable whether or not they had experienced suicidal ideations, and how long they had had them. Because the most you will get is a note in the medical chart, based on a verbal claim by an unreliable narrator.
        Timon3 3y ago
        Then it seems like a pretty terrible idea to just assume they increase the likelihood of social ideation more than they prevent, no?
        NoZebra120vClip 3y ago
        Tell that to the pharmaceutical manufacturers who ran clinical trials, received guidance from the FDA, and have been required to black-box-label the drugs according to the suicidal ideations which were scientifically proven to increase due to taking the drugs. I don't know where you got "assume"?

dredmorbius 3y ago

Those modalities should be discernable when looking at data by age (assisted death tends to occur at older ages) and, with a slightly greater data burden, comorbidities. When looking at data, an otherwise healthy 20 year old, and an 80-something with multiple chronic and/or terminal Dx's, would stand out. The challenge in looking at population-level data is that the Dx may well not be available, though other indicia might suggest this (e.g., residence is an assisted-living or long-term care facility). In practice, studies are frequently limited to available data, and proxies are frequently used. These may not be appropriate for specific individuals, but at scale, the law of large numbers and general correlation are your friends.

bill_joy_fanboy 3y ago
Like you said, I think looking at younger ages is sufficient. In 1999, teen (15-19) suicide was at around 8/100k, and it's now around 11/100k. It's lower in absolute numbers than in the general population, but there's still a disturbing uptick. https://www.charliehealth.com/research/the-us-teen-suicide-rate-is-on-the-rise https://www.charliehealth.com/research/the-us-teen-suicide-r...
- NoZebra120vClip 3y ago
  It would be interesting to know how many people committing suicides were on SSRIs or antipsychotics, etc. at the time. These drugs are known to induce suicidal ideations (and ideations of violence, aggression, and homicide) and have carried black-box warnings. Sometimes, the cure is worse than the disease. Oh sorry, not a cure.
  - Timon3 3y ago
    At the same time it would be interesting to know how many had these ideas before SSRI. If you've been feeling suicidal for a long time, and SSRIs haven't improved your condition, you might feel hopeless enough to commit the act - without SSRIs being any kind of cause.
    - NoZebra120vClip 3y ago
      The fact of having a prescription for psychotropic drugs is a knowable thing, albeit jealously guarded by HIPAA and lawsuit-averse manufacturers. Perhaps it is less knowable whether the victims were taking those drugs and had "therapeutic" levels in their systems at time of death. But it would be extremely unknowable whether or not they had experienced suicidal ideations, and how long they had had them. Because the most you will get is a note in the medical chart, based on a verbal claim by an unreliable narrator.
      - Timon3 3y ago
        Then it seems like a pretty terrible idea to just assume they increase the likelihood of social ideation more than they prevent, no?
        NoZebra120vClip 3y ago
        Tell that to the pharmaceutical manufacturers who ran clinical trials, received guidance from the FDA, and have been required to black-box-label the drugs according to the suicidal ideations which were scientifically proven to increase due to taking the drugs. I don't know where you got "assume"?