Dear Mr Humpherson,

On 20th April 2022 the Office for National Statistics (ONS) published a report “Suicides among people diagnosed with severe health conditions, England: 2017 to 2020”. The analysis linked Census, Hospital Episodes and Mortality data to explore the risk of death by suicide following diagnosis (or first treatment) of severe physical health conditions. The report found a higher risk of suicide following diagnosis (or first treatment) of a severe physical health condition (Ischaemic Heart Disease, COPD, poor prognosis cancers and degenerative neurological conditions) compared to a matched population without diagnosis (or first treatment) of the same physical health condition. The analysis also found that the risk of suicide was highest immediately following the diagnosis, and reduced thereafter.

I am writing because of concerns about the way the data have been interpreted and used by assisted dying campaigning groups to call for legalisation of assisted dying, something that (1) the data cannot support, and (2) potentially puts people with treatable mental illness at risk.

First, the data provide no evidence to support the case for assisted dying (neither do they provide evidence against it). In the analysis the groups were matched by socio-demographic characteristics, but a history of mental illness or previous self-harm was not taken into account. It is therefore impossible to know whether the suicides that occurred were as a result of treatable mental illness, as an initial reaction
to devastating news given badly, or an enduring rational choice. It is of course only in the latter case that assisted dying legislation would be relevant.

Second, the campaigning messages undermine the most important conclusion of the work which is of the need for targeted mental health support for people following diagnosis of serious physical health conditions. We know that there is a link between physical and mental illness, and time of diagnosis of physical illness can be associated with psychological distress. The risk of suicide was highest following
diagnosis and reduced thereafter, which indicates a need for support at the time of diagnosis, including assessment and treatment of depression.

The Dignity in Dying campaign repeatedly described the cohort as ‘dying’. A Twitter campaign called on supporters to write to their MPs with the words “New ONS data shows the suicide rate of dying people is more than double the general population”. However, there is nothing in the data to say that those who died by suicide were ‘dying’ from their physical health condition. Clinical experience tells us that people
can live for years, often decades, following diagnosis of Ischaemic Heart Disease or COPD. Indeed, the ONS data reveals that 72% of the cohort were alive after 2 years. To describe the cohort as dying is highly misleading.

This misinformation was also disseminated in by press articles that came out on the day of the report publication, quoting the distortion of the data findings by the campaign group. I look forward to hearing from you and, in particular, how you can correct this serious misinformation and try to avoid it in the future. This type of research is novel and important as it can help us understand demographic trends in public health.

With kind regards,
Ilora Finlay
Prof Baroness Finlay of Llandaff FRCP FRCGP FMedSci FHEA FLSW

Related links:

Response from Sir Robert Chote to Baroness Finlay – Suicides among people diagnosed with severe health conditions