Turmoil over a report by the French National Suicide Observatory
In its 6th report issued at the end of February 2025, the National Suicide Observatory (ONS), in addition to its statistical analysis, devotes an entire section to “assisted death” insidiously ignoring the warnings by health professionals concerning the incompatibility of assisted suicide practices with suicide prevention.
The ONS is a consultative organisation established by decree in 2018. Its objective is “To inform the various players through statistical analyses, research studies and strategic documentary monitoring, in order to reinforce suicide prevention”. It is in that context that the Observatory publishes a report every two years, presenting statistical data and themed articles.
The suicide rate could reach its floor level
From a statistical point of view, the authors report that following a falling trend in the number of suicides since 1980, it would appear that the rate could have reached a floor level. However, with 9,200 suicide deaths in 2022, the suicide rate has reached a figure of 13.3 deaths per 100,000 inhabitants in France, a level which is higher than the average (10.2) recorded for the European Union.
Although the suicide rate for young people is low (2.7 per 100,000 for the under 25s), it is noted that the suicide rate for young women, although it is the lowest, increased by 40% between 2020 and 2022 (increasing from 1.15 to 1.6 per 100,000). Although these are small figures, this unexpected increase requires investigation. Social effects indeed need to be explored, “such as eco-anxiety, the increasing weight of mediatised socialising in general”.
A study is considering several investigation themes on the subject in order to adapt the prevention policy at a time in 2025 when mental health has been declared by the government as a major national cause. “Suicidal behaviours indeed constitute one of the most serious outward signs of mental health problems, and their understanding is essential for the elaboration of effective prevention policies”.
The ONS points to the increase in the suicide rate with age, a phenomenon which has been observed in all European states. Men aged between 85 and 94 represent the highest risk with a rate of 35.2 per 100,000. The authors considered the “taboo” of suicide of the aged and “the ill-being of our elders, in the context of the ageing of the population”.
The results of the “Malâge” survey reveal a difference between the behaviours of men and women: “with men, suicidal behaviours occur at a time of crossroad type changes: step changes, such as entering a care home, representing a loss of decision-power both over their partner and over their everyday life”.
The ill-being of old-aged women with suicidal behaviours is “built-up over long periods, in which the role of care tasks is central: some are so committed to it that they wish to accompany their partner in death, whereas others attribute their suicide attempts to the exhaustion caused by the expectations of their loved-ones and an unbearable domestic and family workload, at a moment in life when economic and social support are vulnerable.” In such a context one might have expected a more detailed study to better accompany and apprehend old age.
An astonishing report on “assisted death”
The conclusions of the report on “assisted death” issued by the ONS are at the very least astonishing. Under the heading “Ill-being, suicide and assisted death: Better understanding the multiple challenges of the end of life”, the report covers a broad reflection on the theme of old age “on the representations of the end of life, the consequences of multiple invalidating pathologies and the loss of independence; fundamental questions which emerge from an analysis of the international literature on Medical Assistance in Dying (MAiD)”.
In fact, the population of the aged most concerned by assisted suicide requests and/or euthanasia are those in the nations which have legalised such practices. The stated objective is to “provide references and understanding keys in relation to the complex French debate being called for on euthanasia – “without taking sides” relative to it by elaborating an inventory of the available and notable knowledge”.
Behind the questioning which appears in the conclusion to the report, in particular whether assisted dying (euthanasia/assisted suicide) could inspire new approaches to suicide prevention, such thinking is quite concerning. Requests for euthanasia or assisted suicide “could thus be considered in a perspective close to that for suicide prevention policies, rather than total opposition”.
In other words, the request for euthanasia, if the practice is authorised, could therefore allow patients to “project themselves to a future where they would be relieved of all suffering and anxiety” and in so doing, would open a space for negotiation with the health professionals which would “contribute to reducing the urgency of the will of patients to die”. Such an approach is a incredible source of confusion. Indeed, the expressions “request to end it”, or willing to die, constitute a delicate humanitarian challenge.
In France, health professionals are encouraged to consider what underlies such requests in order to be able to respond in the most humane way possible. Once the legalisation of induced death exists, it will become difficult to question a request to end it if the conditions established by the legislation are fulfilled. Especially since in all the nations concerned, the conditions have been extended to psychic disorders and to people whose life expectancy is not in jeopardy.
In the context of suicide prevention, this assumption is worrying in a report which pays homage to Pr. Michel Debout, a psychiatrist and member of the National Suicide Observatory, who died in December 2024 and who in September 2023 stated: “With a law which authorises assisted suicide, there is a risk that some people who are suffering could consider it as a solution.”
