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An Exploration of How Suicide is Policed in the United States

March 6, 2020 9:14 am Alex Hulvalchick

On July 13 of 2014, 18-year-old Conrad Roy III died by suicide from carbon monoxide poisoning. Nearly 3 years after his death, Roy’s girlfriend Michelle Carter was convicted for involuntary manslaughter after incriminating text messages and phone calls between the two showed Carter encouraging Roy to commit suicide. Some of the messages included suggestions by Carter to Roy on how he should go through with the act. The pair was reported to be on the phone together while Roy sat in his truck as it filled with toxic fumes. Carter was sentenced to 15 months at Bristol County House of Corrections in Massachusetts but has since been released 3 months early for good behavior. This case was the first in United States history where someone was convicted of manslaughter using text messages as the crux of guilt.

In a similar case, Massachusetts’s prosecutors are charging Inyoung You, another young woman whose boyfriend committed suicide following harassment by You. Alexander Urtula took his own life on May 20, 2019, the same day he was to graduate from Boston College. In the months leading up to his death, You allegedly manipulated Urtula into becoming isolated from those close to him by threatening bodily harm to herself. Texts were also sent to Urtula from You where she told him to “go die” and “go kill himself”. Prosecutors say that You was present for Urtula’s death. She plead not guilty on the charge of involuntary manslaughter in late November. According to statistics from the Center for Disease Control, suicide rates in the state have risen by 35.3% from 1999 until 2016. Across the country, suicide rates are the highest they have been since World War II.

Suicide rates have been steadily increasing in the United States starting in 2000 according to statista.com. Data collected from 1950 to 2017 shows men consistently have higher rates of suicide ranging from 17.7 deaths to 22.4 deaths per 100,000. In contrast, women’s rates range from 4.1 deaths to 7.1 per 100,000. Below is a representation of that data.

The cases of both Conrad Roy III and Alexander Urtula highlight issues of mental health in the youth of the United States. On average, from 2000 to 2017, there were 10.83 deaths by suicide per 100,000 people aged 15 to 24. While the group with the highest rate goes to ages 45 to 54, there is startling data showing a sharper increase in deaths among young adults. The rate jumped from 11.1 to 14.46 within 5 years. No other age group had such a sharp increase. Further evidence from the National Center for Health Statistics shows that suicide is the second leading cause of death for Americans age 15 to 24.

This increase has been attributed to multiple factors from the rise in depression diagnoses, the growing rate of addiction in young adults, and the meteoric rise of social media use among youths. The prevalence of young adults who experience a major depressive episode is over 13%, the highest of all age groups. Young adults have also gained access to addicting drugs such as opioids much easier than previous generations have. There are nearly 250 million prescriptions written annually for opioids in the United States. That number averages out to more than a bottle of pills for each adult living in the U.S. Some experts also point to the use of social media as a contributing factor, especially in the case of young girls. Studies have shown that anxiety, depression and suicidal thoughts increase in correlation with screen time. A majority of young adults, 88%, use social media with an average of 7 accounts.

In the cases of Michelle Carter and Inyoung You, both were charged with involuntary manslaughter. The question of how to charge Carter was an early dilemma as it is rare to have people held criminally liable for another’s suicide. While the women were given the same charge, the justification varied by case. Judge Lawrence Moniz stated that pushing Roy to return to the car and then neglecting to inform emergency responders to the situation made Carter liable. You’s abuse was deemed by the district attorney to have “created life-threatening conditions that she had a duty to alleviate.”

Doctors who assist their patients in ending their lives can be charged much in the same manner. After the Supreme Court ruled in 1997 that physician assisted suicide would be decided at the state level, many enacted laws against the practice. Most states charge physicians with either manslaughter or a felony. Only nine states and D.C have legalized physician-assisted suicide as of 2020. In Montana and California citizens can petition the courts for permission. There are certain criteria that must be met including the patient must have a terminal illness with a prognosis of 6 months or less to live.

Proponents for legalizing physician-assisted death justify their position by claiming that legalization would lower the yearly costs of medical expenses. They point out the fact that Medicare is the largest insurer of Americans for end of life care.  According to the Kaiser Family Foundation, Medicare spent per capita 4 times as much on those who had passed than survivors, a figure exceeding 34 grand. A study from 1998 concluded that while there would be an average cost savings of $627 million in 1995 dollars, less than 1% of the total cost. At that point, the savings are negligible. An arguably better argument for legalization is the lessening of patients suffering. If states were to allow patients to make the choice, it can help those who want to end their pain while not excessively impacting those who chose to continue treatment.

Those who advocate for keeping the practice illegal fear that patients who worry that they are a burden upon their loved ones will request that physicians assists them in their death. In these cases, the patient isn’t advocating for their own interests but rather the perceived interests or benefit of those close to them. Detractors also argue that physician assisted death goes against the ethics of profession that make up its core. Medical professionals swear the Hippocratic Oath promising to treat the ill as best to their abilities and keep their information private. Some claim that by helping ill patients end their lives, that physicians are breaking this oath and failing in their duties as a care provider.

Three of the states who have legalized the practice, Washington, Oregon, and California, publish demographic data each year. In each states law, there is language written stating that the patient has to have a terminal illness with six months or less to live.  For 2018, Oregon had 168 deaths, California had 314, and Washington had 251. 29 patients in Vermont passed using this method from July 2017 until June 2019. A majority of patients who elect to participate are suffering from cancer. Not every patient who requested the medication for the end of life procedure actually went through with ending their lives. The patients are given every chance to chance their minds if they so choose.

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