Tag Archives: suicide

Canada’s doctor-assisted suicide killed 10,064 in 2021

Canada’s healthcare is free to the user. It’s paid for by taxes, and it includes a benefit you can’t get in the US: free, doctor assisted suicide, euthanasia. This is a controversial benefit, forbidden in the Hippocratic oath because it’s close to murder, and includes the strong possibility of misuse of trust. Assistance by a trusted professional can be a bit likes coercion, and that starts to look like murder — especially since the professional often has a financial incentive to see you off.

From Charlie Hebdot (a French, humor magazine): The medical association refuses to participate in euthanasia — Why? People are already dining quite well on their own waiting in the emergency room.

In 2021, according to Statistics Canada, Canada assisted the suicide of 10,064 people, 3.3% of all Canadian deaths. There were about 4,000 more, non-assisted suicides. In Quebec, the Canadian Provence where Medical Assistance in Dying (MAiD) is most popular, 5.1% of deaths result from MAID. The Netherlands has a similar program that results in 4.8% of deaths. In Belgium, it’s 2.3%. These countries’ suicide rates are far higher than in the US, and account for far more deaths, per capita than from guns in the US. My guess is that suicide is common because it is free and professional. It’s called “Dignity in Dying,” in Europe, a title that suggests that old folks who don’t die this way are undignified.

In Canada, about 80% of those who requested MAiD were approved. A lot of the remainder were folks who died or changed their mind before receiving the fatal dose. If you attempt suicide on your own, it’s likely you won’t succeed, and you may not try again. With doctor assisted suicide, you’re sure to succeed (even if you change your mind after you get your lethal shot?)

In Canada you don’t have to be terminally ill to get MAiD, you just have to be in pain, and extreme psychological pain counts. Beginning March 17, 2024, depression will be added as a legitimate reason. According to Canadian TV news, depressives are lining up (read some interviews here). Belgium and Netherlands allows elders to be euthanized for dementia, and children to be euthanized on the recommendation of their parents. France passed similar legislation, but the doctors refused to go along, see cartoon. I applaud the French doctors.

Rodger Foley says he’s being pressured to ask for medical suicide, picture from the NY Post

There have been persistent claims that Canadian doctors and nurses push assisted suicide on poor patients, telling them how much bother they are and how much resources they are using. There has been an outcry in British and American newspapers, e.g. here in the Guardian, and in the NY Post, but not in Canada, so far. Rodger Foley, a patient interviewed by the NY Post, recorded conversations where his doctors and nurses put financial pressure on him. “They asked if I want an assisted death. I don’t. I was told that I would be charged $1,800 per day [for hospital care]. “I have $2 million worth of bills. Nurses here told me that I should end my life.” He claims they went so far as to send a collection agency to further pressure him. In another case, a disabled Canadian veteran asked for a wheelchair ramp, and was told to apply for MAiD.

Even without outside pressure, many people seeking MAiD often cite financial need as part of the reason. A 40 year old writer interviewed by Canadian television said that he can’t work and lives in poverty on a disability payment of just under $1,200 a month. “You know what your life is worth to you. And mine is worthless.”

The center of the argument is the value of a person in a social healthcare state when their economic value is less than the cost of keeping them alive. Here, Sabine Hossenfelder, an excellent physicist, argues that the best thing one could do for global warm and to preserve resources is to have fewer people. Elon Musk says otherwise, but Ms Hossenfelder claims this only shows he is particularly unworthy. There’s a Germanic logic here that gave us forced euthanasia in the 1940s.

I find euthanasia abhorrent, especially when it’s forced on children, the elderly, and depressed folks. I also reject the scary view of global warming, that it is the death of the earth. I’ve argued that a warm earth is good, and that a cold earth is bad. Also, that people are good, that they are the reason for the world, not its misfortune. It seems to me that, if suicide aid must be provided, state-funded hospitals should not provide it. They have a financial incentive to drop non-paying, annoying patients. That seems to be happening in Canada. A patient must be able to trust his or her doctor, and that requires a belief that the doctor’s advice is for his or her good. Unfortunately, Canadian politicians have decided otherwise. I say hurray for the doctors of France for not going along.

Robert Buxbaum, April 25, 2023. The medical profession is shady even when you pay for services, see Elvis Presley’s prescription. There’s always a financial interest. Even based on old data, the US is not a particularly high-murder country if suicide is considered murder.

Coffee decreases your chance of Parkinson’s, a lot.

Some years ago, I thought to help my daughter understand statistics by reanalyzing the data from a 2004 study on coffee and Parkinson’s disease mortality, “Coffee consumption, gender, and Parkinson’s disease mortality in the cancer prevention study II cohort: the modifying effects of estrogen” , Am J Epidemiol. 2004 Nov 15;160(10):977-84, see it here

For the study, a cohort of over 1 million people was enrolled in 1982 and assessed for diet, smoking, alcohol, etc. Causes of deaths were ascertained through death certificates from January 1, 1989, through 1998. Death certificate data suggested that coffee decreased Parkinson’s mortality in men but not in women after adjustment for age, smoking, and alcohol intake. They used a technique I didn’t like though, ANOVA, analysis of variance. That is they compare the outcome of those who drank a lot of coffee (4 cups or more) to those who drank nothing. Though women in the coffee cohort had about 49% the death rate, it was not statistically significant by the ANOVA measure (p = 0.6). The authors of the study understood estrogen to be the reason for the difference.

Based on R2, coffee appears to significantly decrease the risk of Parkinson’s mortality in both men and women.

I thought we could do a better by graphical analysis, see plot at right, especially using R2 to analyze the trend. According to this plot it appears that coffee significantly reduces the likelihood of death in both men and women, confidence better than 90%. Women don’t tend to drink as much coffee as men, but the relative effect per cup is stronger than in men, it appears, and the trend line is clearer too. In the ANOVA, it appears that the effect in women is small because women are less prone Parkinson’s.

The benefit of coffee has been seen as well, in this study, looking at extreme drinkers. Benefits appear for other brain problems too, like Alzheimer’s. It seems that 2-4 cups of coffee per day also reduces the tendency for suicide, and decreases the rate of gout. It seems to be a preventative against kidney stones, too.

There is a confounding behavior that I should note, it’s possible that people who begin to feel signs of Parkinson’s, etc. stop drinking coffee. I doubt it, give the study’s design, but it’s worth a mention. The same confounding is also present in a previous analysis I did that suggested that being overweight protected from dementia, and from Alzheimer’s. Maybe pre-dementia people start loosing weight long before other symptoms appear.

Dr. Robert E. Buxbaum, and C.M. Buxbaum, December 15, 2022

Race and suicide

Suicide is generally understood as a cry of desperation. If so, you’d expect that the poorer, less-powerful, less-mobile members of society — black people, Hispanics, and women — would be the most suicidal. The opposite is true. While black people and Hispanics have low savings, and mobility, they rarely commit suicide. White Protestants and Indians are the most suicidal groups in the US; Blacks, Hispanics, Jews, Catholics, Moslems, Orientals, are significantly less prone. And black, non-Hispanic women are the least suicidal group of all — something I find rather surprising.

US, Race-specific suicide, all ages, Center for Disease control 2002-2012

US, Race-specific suicide, all ages, Center for Disease control 2002-2012

Aha, I hear you say: It’s the stress of upward mobility that causes suicide. If this were true, you’d expect Asians would have a high suicide rate. They do not, at least not American Asians. Their rate (male + female) is only 6.5/100,000, even lower than that for Afro-Americans. In their own countries, it’s different, and Japanese, Chinese, and Koreans commit suicide at a frightening rate. My suspicion is that American Asians feel less trapped by their jobs, and less identified too. They do not feel shame in their company’s failures, and that’s a good, healthy situation. In Korea, several suicides were related to the Samsung phones that burst into flames. While there is some stress from upward mobility, suggested by the suicide rates for Asian-American females being higher than for other woman, it’s still half that of non-hispanic white women, and for women in China and Korea. This suggests, to me, that the attitude of Asian Americans is relatively healthy.

The only group with a suicide rate that matches that of white protestants is American Indians, particularly Alaskan Indians. You’d figure their rate would be high given the alcoholism, but you’d expect it to be similar to that for South-American Hispanics, as these are a similar culture, but you’d be wrong, and it’s worthwhile to ask why. While men in both cultures have similar genes, suffer financially, and are jailed often, American Indians are far more suicidal than Mexican Americans. It’s been suggested that the difference is religiosity or despair. But if Indians despair, why don’t Mexicans or black people? I find I don’t have a completely satisfactory explanation, and will leave it at that.

Age-specific suicide rates.

Age-specific suicide rates, US, all races, 2012, CDC.

Concerning age, you’d probably guess that teenagers and young adults would be most suicidal — they seem the most depressed. This is not the case. Instead, middle age men are twice as likely to commit suicide as teenage men, and old men, 85+, are 3.5 times more suicidal. The same age group, 85+ women, is among the least suicidal. This is sort-of surprising since they are often in a lot of pain. Why men and not women? My suspicion is that the difference, as with the Asians has to do with job identification. I note that middle age is a particularly important time for job progress, and note that men are more-expected to hold a job and provide than women are. When men feel they are not providing –or worse –see themselves as a drag on family resources, they commit suicide. At least, this is my explanation.

It’s been suggested that religion is the consolation of women and particularly of black women and Catholics. I find this explanation doubtful as I have no real reason to think that old women are more religious than old men, or that Protestants and Indians are less religious than Hispanics, Asians, Moslems, and Jews. Another difference that I (mostly) reject is that access to guns is the driver of suicide. Backing this up is a claim in a recent AFSP report, that women attempt suicide three times more often than men. That men prefer guns, while women prefer pills and other, less-violent means is used to suggest that removal of guns would (or should) reduce suicide. Sorry to say, a comparison between the US and Canada (below) suggests the opposite.

A Centers for Disease Control study (2012) found that people doing manual labor jobs are more prone to suicide than are people in high-strew, thinking jobs. That is, lumberjacks, farmers, fishermen, construction workers, carpenters, miners, etc. All commit suicide far more than librarians, doctors, and teachers, whatever the race. My suspicion is that it’s not the stress of the job so much, as the stress of unemployment between gigs. The high suicide jobs, it strikes me, are jobs one would identify with (I’m a lumberjack, I’m a plumber, etc. ) and short term. I suspect that the men doing these jobs (and all these are male-oriented jobs) tend to identify with their job, and tend to fall into a deadly funk when their laid off. They can not sit around the house. Then again, many of these jobs go hand in hand with heavy drinking and an uncommon access to guns, poison, and suicidal opportunities.

zc-percentage-total-suicides-by-method-2000-2003-ca-2007-us

Canadians commit suicide slightly more often than Americans, but Canadians do it mostly with rope and poison, while more than half of US suicides are with guns.

I suspect that suicide among older men stems from the stress of unemployment and the boredom of sitting around feeling useless. Older women tend to have hobbies and friends, while older men do not. And older men seem to feel they are “a burden” if they can no-longer work. Actor Robin Williams, as an example, committed suicide, supposedly, because he found he could not remember his lines as he had. And Kurt Gödel (famous philosopher) just stopped eating until he died (apparently, this is a fairly uncommon method). My speculation is that he thought he was no longer doing productive work and concluded “if I don’t produce, I don’t deserve to eat.” i’m going to speculate that the culture of women, black men, Hispanics, Asians, etc. are less bound to their job, and less burdened by feelings of worthlessness when they are not working. Clearly, black men have as much access to guns as white men, and anyone could potentially fast himself to death.

I should also note that people tend to commit suicide when they lose their wife or husband; girlfriend or boyfriend. My thought is that this is similar to job identification. It seems to me that a wife, husband, or loved one is an affirmation of worth, someone to do for. Without someone to do for, one may feel he has nothing to live for. Based on the above, my guess about counseling is that a particularly good approach would be to remind people in this situation that there are always other opportunities. Always more fish in the sea, as it were. There are other women and men out there, and other job opportunities. Two weeks ago, I sent a suicidal friend a link to the YouTube of Stephen Foster’s song, “there are plenty of fish in the sea” and it seemed to help. It might also help to make the person feel wanted, or needed by someone else — to involve him or her is some new political or social activity. Another thought, take away the opportunity. Since you can’t easily take someone’s gun, rope, or pills — they’d get mad and suspicious –I’d suggest taking the person somewhere where these things are not — a park, the beach, a sauna or hot-tub, or just for a walk. These are just my thoughts, I’m a PhD engineer, so my thinking may seem odd. I try to use numbers to guide my thought. If what I say makes sense, use it at your own risk.

Robert Buxbaum, June 21, 2017.Some other odd conclusions: that Hamilton didn’t throw away his shot, but tried to kill Burr. That tax day is particularly accident prone, both in the US and Canada, and that old people are not particularly bad drivers, but they drive more dangerous routes (country roads, not highways).

Murder rate in Finland, Japan higher than in US

The murder rate in Finland and Japan is higher than in the US if suicide is considered as a type of murder. In the figure below, I’ve plotted total murder rates (homicide plus suicide) for several developed-world countries. The homicide component is in blue, with the suicide rate above it, in green. In terms of this total, the US is seen to be about average among the developed counties. Mexico has the highest homicide rate for those shown, Japan has the highest suicide rate, and Russia has this highest total murder rate shown (homicide + suicide): nearly double that of the US and Canada. In Russia and Japan, some .02% of the population commit suicide every year. The Scandinavian countries are quite similar to the US, and Japan, and Mexico are far worse. Italy, Greece and the UK are better than the US, both in terms of low suicide rate and low homicide rate.

  Combined homicide and suicide rates for selected countries, 2005.


Homicide and suicide rates for selected countries, 2005 Source: Wikipedia.

In the US, pundants like Piers Morgan like to use our high murder rate as an indicator of the ills of American society: loose gun laws are to blame, they say, along with the lack of social welfare safety net, a lack of support for the arts, and a lack of education and civility in general. Japan, Canada, and Scandinavia are presented as near idyls, in these regards. When murder is considered to include suicide though, the murder-rate difference disappears. Add to this, that violent crime rates are higher in Europe, Canada, and the UK, suggesting that clean streets and education do not deter crime.

The interesting thing though is suicide, and what it suggests about happiness. According to my graphic, the happiest, safest countries appear to be Italy and Greece. Part of this is likely weather , people commit suicide more in cold countries, but another part may be that some people (malcontents?) are better served by dirty, noisy cafés and pubs where people meet and complain, and are not so well served by clean streets and civility. It’s bad enough to be a depressed outsider, but it’s really miserable if everything around you is clean, and everyone is polite but busy.

Yet another thought about the lower suicide rates in the US and Mexico, is that some of the homicide in these countries is really suicide by proxy. In the US and Mexico depressed people (particularly men) can go off to war or join gangs. They still die, but they die more heroically (they think) by homicide. They volunteer for dangerous army missions or to attack a rival drug-lord outside a bar. Either they succeed in killing someone else, or they’re shot dead. If you’re really suicidal and can’t join the army, you could move to Detroit; the average house sold for $7100 last year (it’s higher now, I think), and the homicide rate was over 56 per 100,000. As bad as that sounds, it’s half the murder rate of Greenland, assuming you take suicide to be murder.

R.E. Buxbaum, Sept 14, 2013