Suicide prevention must include preventing all suicides.

Emotions play a big part in our responses. We rightly feel the tragedy of young lives lost and understandably are drawn to the thought that he or she had yet many years ahead of them. We are also easily tempted to thoughts of sympathy or at least understanding at an elder suicide. Aided sometimes by media portrayal, we find some consolation in the thought that they had 'a good life'.

This is quite normal, but it is a very unsound basis for public policy. Suicide is suicide. Regardless of the method, it is a violence against oneself. It is also the ultimate expression of hopelessness, often in a fog of depression where nothing is truly as it seems. Despite what some would say and despite some portrayals in the media, it is never truly a rational act.

But there's also another element at play here; an 'elephant in the room'. The connection between suicide and euthanasia is very real; the only substantive difference is who makes the person dead. Whenever we see stories in our media of an older person who has or who plans to suicide the connection is made between their circumstances and a supposed need for euthanasia laws. Whether their particular circumstances would make them a candidate under particular lawful regime is never discussed but rather assumed.

Add to that the fact that suicide advocates are also intrinsically bound up in euthanasia advocacy and we begin to see, I think, why suicide prevention agencies struggle to articulate concern. It may be that some in the suicide prevention area actively or tacitly support euthanasia; but it is also just as likely, perhaps more likely, that the whole autonomy question bound up with the emotive context of serious illness creates dissonance.

Is the context of a terminal illness really that different that we are prepared as a society to accept that some suicides are okay? Is the context of aging and having had a 'good life' good enough a reason to accept that some suicides are okay? And, ultimately, what is the subtle and maybe not-so-subtle message we are allowing to hold sway in our society if we continue to allow such contexts to undermine or cloud the suicide prevention message? Make no mistake: anything less than total opposition to all suicides tends to support the observation that some suicides are okay; that some lives simply are not worth living.

The Fairfax reporting included the story of Judi Taylor and the death of her son Lucas at age 26 using Nembutal obtained via advice from an online network. When Judi spoke at our conference in Adelaide in May, some three years after Lucas' tragic death, her pain was still evident. Such is the tragedy of suicide; the unanswered questions; the understandable, 'If only…' Judi's courage and that of others who have chosen to speak out, inspires and encourages me. In the midst of all of this, Judi remains thoughtful and charitable when she observed that 'the deaths among younger people were an "unintended consequence" of the voluntary euthanasia movement putting out information online on suicide methods.'

Unintended or not, the consequences of allowing such public advocacy to continue are made painfully obvious in Judi's story. Judi is not alone. There are others; sadly, there most likely will be others.

Can we stop these macabre practices? I don't really know. What I do know is that serious attempts to do so along with a clear, public declaration against such practices, will save lives.

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