Five things to know about physician suicide

by Canadian Medical Association Journal

Physician suicide is an urgent problem with rates higher than suicide rates in the general public, with potential for extensive impact on health care systems.

07 may 2019--A "Five things to know about ..." practice article in CMAJ (Canadian Medical Association Journal) provides an overview of this serious issue.

Five things about physician suicide:

• As the only means of death more common in physicians than nonphysicians, suicide is an occupational hazard for physicians.
• Firearms, overdose and blunt force trauma are the most common means, with benzodiazepines, barbiturates and antipsychotics being the most commonly used drugs.
• Increased suicidal ideation begins as early as in medical school, with nearly 1 in 4 students surveyed reporting suicidal ideation within the last 12 months.
• Complaints to regulatory bodies are associated with higher rates of suicidal ideation.
• Suicidal physicians face unique barriers to care, including concerns regarding confidentiality, and fears of stigmatization and discrimination from peers, employers and licensing bodies.

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More information: CMAJ (2019). www.cmaj.ca/lookup/doi/10.1503/cmaj.181687

Journal information: Canadian Medical Association Journal 

Provided by Canadian Medical Association Journal 

Swiss organisation extends assisted suicide to elderly

A Swiss assisted suicide group has expanded its services to help elderly patients who are sick but not terminally ill end their lives, it said Thursday.

23 may 2014--Exit A.D.M.D., a group that provides assisted suicide in the French-speaking part of Switzerland, officially broadened the scope of who it can help during its general assembly last month, its leader Doctor Jerome Sobel told AFP.

The group's larger sister organisation, Exit, which operates in the German and Italian speaking parts of the country, is planning to follow suit in a few days, he added.

"We are helping people who are sick and opt for quality of life over a quantity of time surviving with a poor quality of life," Sobel said, insisting the organisation's activities remained "well within Swiss law."

"Passive" assisted suicide has been legal in Switzerland since the 1940s, provided the person is in his or her right mind and anyone helping them is not motivated by self-interest or financial gain.

A number of groups work to help the terminally ill and those suffering who wish to end their lives to do so, usually by supplying them with a lethal dose of a drug they must administer themselves.

Exit A.D.M.D., which only assists in suicides for people who live in Switzerland, helped 155 people—mainly terminally ill cancer patients—end their lives last year.

Exit helped 459 people end their lives in 2013.

Sobel said the membership of his group is ageing and many people had demanded that it officially include the infirm but not terminally ill elderly among those it is willing to help.

He said that if a person over the age of 75, who is for example already deaf and going blind, "calls us and asks us to help them, we will help them."

"If we don't, some might accuse us of abusing them, since forcing them to continue living can be torture," he explained.

Last year, the European Court of Human Rights called on Switzerland to clarify the guidelines for assisted suicide after an octogenarian who wanted to end her life failed to convince doctors to assist her because she was not ill enough.

Sobel said his group's decision to broaden the official scope of who to assist in dying had not been impacted by that case.

© 2014 AFP

USPSTF: Evidence lacking for primary care suicide screening

21 may 2014-The U.S. Preventive Services Task Force (USPSTF) has concluded that the current evidence is insufficient to evaluate the balance of benefits and harms of suicide screening in the primary care setting. These findings are presented in a final recommendation statement published in the May 20 issue of the Annals of Internal Medicine.

Michael L. LeFevre, M.D., M.S.P.H., on behalf of the USPSTF, updated the 2004 recommendation on screening for suicide risk. Researchers from the USPSTF reviewed the literature for the accuracy and reliability of suicide screening instruments; benefits and harms of screening for risk; and benefits and harms of treatments to prevent suicide.

Based on the current evidence, the researchers concluded that the balance of benefits and harms of screening for suicide risk cannot be assessed. The recommendation applies to adolescents, adults, and older adults without psychiatric disorders, in the primary care setting.

"More research is needed to better understand current screening tests, to develop new ones that can better identify people without symptoms who are at risk for suicide, and to create effective treatment programs for those who are identified ashigh risk," Task Force member Linda Baumann, Ph.D., said in a statement.

More information: Full Text

Suicides linked to work-related stress up in Japan

By MARI YAMAGUCHI
26 may 2008--The number of people who committed suicide or tried to in Japan because of work-related stress has doubled in the last five years, a government report said, illustrating the growing anxiety many here feel from increased workloads and competition.
The Health Ministry report said 81 people committed suicide or tried to commit suicide because of stress at work in fiscal year 2007 — up from 66 in 2006 and 40 in 2003. It did not specifically say how many of the 81 committed suicide.
The report also found that a record high 268 people — including the 81 — developed work-related mental conditions such as depression. The report was published Saturday in Japanese newspapers.
Japan has one of the highest suicide rates in the world. About 32,160 people killed themselves in 2006 — the latest government statistics available for a full year. The report comes as the country battles a series of suicide fads including the latest string that involves people mixing household chemicals to create lethal fumes.
People in their 30s and 40s were most prone to stress due to working too many hours or personal relationships at work, the report said. Some of the workers had worked about 160 hours of overtime a month, it said. A typical work week in Japan is 40 hours.
"Many people endure their sufferings alone, trying not to show their weakness" to colleagues, the mainstream newspaper Yomiuri said in a commentary. "We urge employers to work harder to create a stress-free working environment."
The report based its findings on the number of people who committed suicide or attempt to whose families received workers compensation for their deaths or injuries.
Under the Japanese labor law, an employer has to pay compensation to employees or their families for work-related accidents, illnesses and deaths. The families of suicide victims fill out applications to receive the compensation, and the government determines their eligibility.
If illnesses or deaths are proven to be work-related, employees or their families can receive a one-time payment or an annual stipend based on his or her base salary.
Separately, the government granted workers compensation last year to 392 other people who had strokes, heart attacks and other brain and cardiac illnesses, including 142 who died.
Most of the cardiac and brain patients were people who worked excessively long hours, the report said.
More than one-third of them reported working between 80 and 100 hours of overtime a month, with another 25 percent saying they worked between 100 and 120 hours of overtime monthly. About 10 percent of them did more than 160 hours of overtime, or an average of five extra hours a day, including the weekend.
Under the Health Ministry guidelines, the family an employee who died after filing monthly overtime of 80 hours or more is usually entitled to receive compensation.