I have been surprised by some of the reaction to plans to introduce an option for bereaved families to avail of a short-form death certificate that does not include details of the cause of death. It seems much of the reaction has been disapproving, claiming such a move will do more to “blot out” the issues related to stigmatised deaths such as suicide. This is not the case.
Minister for Social Protection Joan Burton’s plans will have no impact on the collection of statistical data on suicide. Flaws remain in how such statistics are compiled but that is a separate issue.
The proposals mean, simply, the option to include or exclude the cause of death on a short-form death certificate offers a bereaved family some choice and some privacy.
They will likely need a short-form death certificate for dealing with practical matters after their loved one’s death, such as handling bank accounts, utility bills and the like. It is every person’s right, should they wish, to keep such matters private and they should be free to do so. Even in the case of the very public reporting of the death of Robin Williams by suicide, his family asked for the focus not to be on his death “but on the countless moments of joy and laughter he gave to millions”.
In our work in Console we know that bereavement by suicide can result in one of the most difficult and complicated grief journeys possible. The procedures that follow a death by suicide tend to make the journey particularly stressful for those left behind.
Public inquest
For example, there remains a legal requirement in Ireland for a public inquest after any unnatural death such as suicide. An inquest will investigate the details of what happened and events are publicly scrutinised and reviewed before a cause of death is registered.
Families are often required to give evidence. Sometimes suicide notes are shared and last discussions with the deceased are recounted. This typically causes extreme anxiety and brings public scrutiny on a family that has gone through one of the most devastating and traumatic experiences possible.
Suicide was decriminalised in Ireland in 1993 but for families bereaved by suicide an inquest can bring a sense of being on trial.
So what is in the public interest here? What alcohol was in their system? Were they taking drugs? Did they have a row with someone before they ended their life? Are such individual circumstances of public interest?
The legal requirement for an inquest after a suicide needs to be reviewed. The system needs to be relaxed so that the privacy, dignity and wishes of the bereaved family are of foremost consideration.
In jurisdictions such as Scotland and Northern Ireland (with a family’s agreement) a public inquest after suicide is not held if it is not deemed to be in the public interest and if the relevant authorities agree the death was suicide.
It is time to review and establish more person- centred, respectful, sensitive and compassionate investigatory methods after a suicide death in the Republic. We now have comprehensive knowledge and research on suicide that should allow us to progress things productively.
For every family that speaks publicly about their loss through suicide many more choose not to. Their right to privacy must be respected as equally as that of those who wish to share their story.
The national discourse on suicide has progressed a great deal since the decriminalisation of suicide in 1993 and we now have a better understanding of the broad issues connected with such deaths. Still, we have a long way to go. Comments made in recent days have stressed our collective need to face up to suicide and to not perpetuate its stigmatised past. I agree fully with this but energy would be better focused on some of the real deficits and problems rather than on the death cert change.
Soon after my brother died by suicide I was tasked with collecting his death certificate from the City Hall in Belfast.
If I’m honest, I’m still not sure if any wording on his death certificate caused me or my family any added distress.
The worst thing in the world had already happened. But being consulted, or having some simple options, input and control at such a helpless and powerless time, would undoubtedly have helped.
Ciarán Austin is director of services with Console, the national suicide prevention and bereavement charity. His brother Fionnbarr died by suicide in 2006, aged 22.