Hissan Butt is a medical student at Queen’s University in Kingston, Ontario
I recently learned that two Canadian medical students died in the past three weeks. Little is known about the circumstances surrounding these deaths.
However, this has not stopped worried Canadian medical students from speculating about the causes of death. The speculation arises not because of a desire to gossip. Rather, I think, it stems partly from a lack of information and partly because of fear. At the time of writing, most believe that the students died by suicide. One university has acknowledged the death of one of the students, although the cause is not identified.
The silence is justified - we are told through unofficial sources – by a request from the families to respect their right to privacy. We are also told that talk might spark copying. Indeed, any decent person should want to respect the wishes of the bereaved families, to help them grieve and lighten their burden in this difficult time. There is no need for naming, but there is a need to talk.
Maintaining silence about suicide comes at a cost, the consequences of which may not have been considered.
First, silence breeds fear and isolation. It perpetuates and is emblematic of the stigma attached to mental illness that we health-care professionals are supposed to combat. At a time when leadership is most desired, the lack of a clear official statement alienates and confuses students. These deaths demand a collective acknowledgment of the loss and its cause, despite the excellent supports available in universities. Moreover, students have already begun responding to the news as if they were suicides. In this context, the silence sends a chilling message: In times of distress during your medical training you must suffer individually because we, as a collective, will not address systemic problems that affect you. The alienation puts vulnerable students further at risk and demoralizes student bodies across campuses.
Second, the silence continues a trend towards a lack of data on suicides in Canadian medical schools (and more broadly Canadian universities). Statistics are gathered by age group not occupation. Suicide is complex and stressful careers are thought to contribute. Reports suggest that doctors have a higher suicide rate than the public; however, little research has been done on suicide rates in Canadian medical students. If in fact these recent deaths were unacknowledged suicides, we will be choosing to remain ignorant, perpetuating unscientific claims and myth, and impeding efforts to make meaningful progress in improving medical training.
Third, in light of recent medical assistance in dying (MAID) legislation, the silence appears inconsistent with our professional roles. Future medical trainees will be expected to respect and accommodate patients’ wishes to die. Yet the unwillingness to address similar sentiments that arise in members of our profession devalues the suffering felt by our colleagues and casts doubts on our professional capacity to provide medical assistance in dying for the general population.
Remaining silent is a choice. However, we should understand its price before we make that choice.
Acknowledgement: The author would like to express his gratitude to Dr. Jacalyn Duffin for her editorial comments