Established on September 9, 2013, the French National Suicide Observatory (“ONS”) recently published their 3rd report entitled “Ethical issues in suicide prevention, the specific case of teenage suicide “. Published on February 5, 2018 the report declares that the suicide rate in France decreased by 26% between 2003 and 2014, although it still remains one of the highest in Europe, ranking 10th out of 32, behind Finland, Belgium and a number Eastern countries.
According to the French Center for Epidemiology on the medical causes of death of Inserm (“CépiDcInserm”), 8,885 suicides were officially reported in metropolitan France in 2014. This figure is equivalent to 24 deaths per day, or one death every hour. Since the report only tallies deaths which are recorded as voluntary, the figure of 8,885 suicides may be underestimated by 10%; the actual figure could reach 10,000.
One section of the report deals with the suicidal behavior of young people, a major public health concern, which was not evaluated in the previous two Observatory reports. After car accidents, suicide is the second leading cause of death among 15-24 year-olds, accounting for 16% mortality in 2014. Although this suicide rate is relatively low compared to other age groups, it seemed pertinent to evaluate this phenomenon. The suicide of a young person has an undeniable effect on his loved ones, his acquaintances, the media and society in general.
In metropolitan France, the average suicide rate was 17 per 100,000 inhabitants for the years 2012-2014. More men committed suicide than women (23.1 vs. 6.8 per 100,000). Suicide rates increase sharply with age according to this report. The highest rate was between ages 45-54, and after age 75, with respective numbers of 33.4 and 59.4 per 100 000 men. In addition, suicide rates are higher in the northern half of France. Significant differences were also observed in socio-professional categories, especially among farmers (296 deaths recorded in the years 2010-2011).
In 2015, following an attempted suicide, 78,128 patients were hospitalized in a medical or surgical ward; a figure that has remained stable since 2013. Among these patients, who are mainly female, there is a 1st peak for young girls aged 15-19 (averaging 39 per 10,000) and a 2nd peak in the 45-49 year-old group (averaging 27 per 10,000). On January 26, 2018, the Health Minister, Agnès Buzyn, in a speech on psychiatry announced that over the next 2 years, she intends to implement psychiatric help for patients discharged from hospitals after an attempted suicide.
This recent report contains a section focused on the ethical issues of suicide prevention, in particular a possible «right-to-die” issue, stating that according to “French law, the right to die constitutes a right of freedom (one is free to kill oneself) but not a right to be helped to die (one cannot claim assistance in dying as a due). In countries that allow the “right-to-die”, it is important to look at the implications on suicide prevention. There are concerns about the difficulty of organizing suicide prevention in countries where assisted or medically-assisted suicide or even euthanasia are legally authorized or under discussion. Suicide may thus be more considered more readily as a possible option, without genuinely exploring other alternatives “(…)”. The report encourages further research on listening lines, developing off-site, or remote support methods, emergency prevention, and the relationship between end-of-life legislation and suicide prevention. It also recommends targeting research on prevention in young people, where there is still much to discover.