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I don’t doubt the humane motives of #AssistedDying campaigners. Or that public opinion is sympathetic. So why did the Bill fail?
Short 🧵
louis appleby
27.3K posts
louis appleby
@ProfLAppleby
researcher & govt adviser on suicide prevention & mental health. may also tweet on nature, arts & whatever happens.
Manchester/Anglesey
Joined May 2012
- We need to see an end to that line about choosing a living daughter or dead son. It is not based on evidence. May add to distress in young people & mislead worried parents. Deeply insensitive to 200 families/yr to whom the suicide of a teenager is more than a slogan.
- Children with gender distress may face bullying, isolation & family conflict, reasons to be alert to suicide risk. Empathic support is vital but evidence that puberty blockers reduce risk is weak & unreliable. Invoking suicide in this debate is mistaken & potentially harmful.
- It’s a week since the Govt published my report on suicide in young people with gender dysphoria. What did the reaction tell us about the necessary dialogue with the public on issues of evidence? 🧵
- Thanks to those genuinely asking how I went about my examination of data on suicides by patients with gender dysphoria at the Tavistock. I’ll put together a thread soon. In meantime, suggest reading the report which explains my remit & data source.
- People have raised clarifying q’s about my review of suicides in young gender dysphoria patients. And there have been a number of - let’s call them misunderstandings. A short summary then, tracking from aim to data source to conclusions.🧵
- If palliative care was fully funded, access to it universal, pain relief controlled by patient, mental health a key component of care, how great would be the need for #AssistedDying? Need to know this because otherwise we are talking about AD as the solution to a flawed system.
- Unambiguous conclusion on risk assessment tools in today’s NICE guidance on self-harm. Don’t use them. Risk is individual, complex, dynamic & can’t be reduced to a number. Assessment should be personal, collaborative, leading to a practical plan to keep safe.
- Attacks on #SupremeCourt decision are following a familiar pattern: didn’t hear from the right people, biased from the start, its conclusions misrepresented, abuse. As with #CassReview & other reports. The gulf between campaigns & evidence is wide.
- My conclusions so far? Start with the fundamental issue. Young people with gender dysphoria face bullying, family conflict, isolation - risk factors for suicide. The risk is real. It is also complex. Single causes are unusual. Depression/anxiety are common. Also treatable.
- That fake statistic, a “200% rise” in suicide since lockdown, has reappeared just as further restrictions are considered. Reminder •suicide rate has not risen in pandemic •alarming claims can add to distress of people already struggling •check source of any stat before sharing
- So we’re back to claims about suicide in young trans people. A few indisputables: •young ppl with gender dysphoria may be at risk - co-existing mental disorder, autism, bullying, etc. •no reliable evidence that puberty blockers reduce risk •”dead child” rhetoric is dangerous.
- It’s become common to see an academic dropping off Twitter to escape abuse. It starts with a tweet or media appearance commenting on evidence from their field of study. Someone takes exception to their message, outrage spreads. Their timeline becomes a torrent of hostility.
- Another reminder of the serious risk to young people when we •make claims about suicide they may identify with •ignore all evidence on discussing suicide publicly •omit to mention the many supports available. Whatever the motive, this is reckless & indefensible.
