Sir, – I welcome and concur with the comments of my colleague Dr Brendan Kelly (“Psychiatry cannot provide neat solutions on suicide”, Opinion & Analysis, July 17th).
He is absolutely correct in pointing out that psychiatrists cannot predict suicide. He rightly points to the poor record of psychiatrists when placed in a position of dealing with society’s problems. He is correct also in saying that studies have not been carried out to show whether abortion has any effect on pregnant women who are suicidal.
He goes on to say that this question could only be definitively answered by a large randomised study in which suicidal women requesting an abortion were randomly allocated to having an abortion and compared to those not having one.
As he points out this would be grossly unethical, as well as impracticable.
Most of the major discoveries of the harm done to our health by social and environmental factors have not been arrived at using this experimental method due to these difficulties. For example, the finding by Richard Doll that smoking caused lung cancer was not established using this method but by following and examining, over time, the health of cohorts who smoked. These observational methods are well established in medical research and are ethical and achievable. So it is possible to answer questions about the role of abortion in reducing suicidal behaviour using observational studies of different types, although this would take longer than the experimental method described by Dr Kelly.
Regrettably the Government has proceeded to enact abortion legislation as though there was evidence that abortion helps suicidal pregnant women. Psychiatrists are being asked to gatekeep this in the absence of any evidence to support it. The Government clearly believes that, just as we willingly oversaw the incarceration of those whom society regarded as social misfits in the past, we will now provide a “neat solution” to another complex social problem as mentioned by Dr Kelly. Time will be our judge. – Yours, etc,
Prof PATRICIA CASEY,
Consultant Psychiatrist,
Mater Misericordiae
University Hospital,
Professor of Psychiatry,
University College Dublin,
Dublin 4.