Sir, - In response to my article of December 14th, Dr Dermot Walsh (January 4th) correctly points out that the prediction of suicide in any individual belongs in the realm of unreliable predictability and, furthermore, is open to exploitation. The late Dr Michael Kelleher, writing in the Irish Journal of Psychological Medicine in the aftermath of the "X" case, made the same point when he stated: "The research evidence indicates that medicine and psychology does not have the ability to predict suicide, even with a moderate degree of success." There are no studies on the association between threats of suicide and completion of the act, since threats are so common and completed suicide is so rare. Thus, extrapolating clinically or statistically from threats to completed suicide is impossible.
All of which prompts the question: why did our courts not examine this aspect more thoroughly in the "X" and "C" cases? And where were the diligent and independent-minded journalists of the day who should have been asking that question?
Dr Walsh, correctly, in my view, states that there is no conclusive evidence that the suicide rate in women is influenced by the availability or non-availability of abortion. However there is strong supporting evidence that pregnancy is associated with a lower than normal suicide risk and procured abortion is associated with an increased suicide risk.
A review in Finland of women who committed suicide between 1987 and 1994 found the suicide rate associated with procured abortion was six times greater than that associated with birth.
A number of studies in the UK and the US have shown that pregnant women have a significantly lower incidence of suicide than non-pregnant women of the same age.
Not only is the risk of actual suicide lower in pregnancy but so also is that of attempted suicide, despite the relatively high rate of psychiatric illness in pregnant and postnatal women. - Yours, etc. B. A. Kelly,
MRCPI, DCH, Queen's Park, Monkstown, Co Dublin.