University of Ontario Institute of Technology, 2000 Simcoe Street North, Oshawa, ON, L1G 0C5, Canada.
J Public Health Policy. 2021 Mar;42(1):86-97. doi: 10.1057/s41271-020-00249-8.
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.
辅助自杀的采用迅速增加，但许多团体警告称，这些政策可能导致自杀传染。如果那些呼吁谨慎的人是正确的，那么实施这些政策的司法管辖区的自杀人数将会增加。本研究旨在使用合成控制法（SCM）和广义合成控制法（GSCM），确定比利时在 2002 年政策前后的人口自杀率变化。作为比较，我们使用了未采用这些政策的其他欧盟成员国。GSCM 显示，每 10 万人的平均自杀率每年增加 0.73（95%CI-5.7 至 7.2；p=0.80）。基于 SCM 分析的安慰剂测试显示，比利时和比较结果相同。本研究未能证明立法合法化辅助自杀与人口自杀率之间存在关联的证据。自杀传染的威胁过去曾影响政策讨论，但本研究表明，目前决策者没有理由将自杀传染视为辅助自杀立法的一个令人担忧的副作用。
