Partial Restriction. Restriction lift date: 2028-12-31
A study of the social organisation of the determination and classification of deaths by suicide in Ireland
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Date
2024
Authors
Williamson, Ellen May
Journal Title
Journal ISSN
Volume Title
Publisher
University College Cork
Published Version
Abstract
There is a widely held belief that official national suicide mortality statistics underestimate the actual number of deaths in situations where the deceased has taken their own life and that, as a consequence, government resources for suicide prevention initiatives are not optimally allocated and utilised. International research supports the notion that the numbers of deaths by suicide are underestimated, and opinions regarding the level of underestimation vary. Whilst research regarding the level of underestimation is insightful in offering possible explanations relating to technical aspects of suicide statistics, less research has been conducted into the social processes which shape how suicide mortality statistics are produced and with what effect.
In Ireland, the process for determining and classifying unnatural deaths that may be due to suicide is a coronial medico-legal one where the coroner determines the medical cause, the manner and means of death. Uniquely, however, the Irish process of classifying an unnatural death that has been subject to an inquest, for the purpose of national mortality statistics, can subsequently involve a Garda giving an opinion in a confidential form as to the means of death, and the opinion being taken into account for classification purposes by the mortality coder in the Central Statistics Office .
This study interrogates the social organisation of the determination and classification of deaths by suicide in Ireland. It makes visible the procedures, practices, and key actors involved at each stage of the process of the construction of suicide statistics. It explores the role of the coroner with a particular emphasis on the beyond reasonable doubt legal requirement and explores the administrative procedures, including the impact of the procedure involving the Garda’s confidential opinion, in shaping production of the statistics. The research is based on interviews with coroners, an examination of coroners’ inquest files and a matching of coroners’ verdicts with the national mortality database.
The study powerfully evidences the way in which socio-cultural factors, including historical administrative systems, institutional norms regarding ‘how we do business around here’, and human discretion all feed into the construction and production of Irish suicide statistics. It shows that even though suicide was decriminalised thirty years ago, the legacy of the historical context of suicide as a crime persists. The research indicates that the status and power of the coronial system has not diminished in a culturally changed Ireland and demonstrates the effects of the beyond reasonable doubt requirement in determining possible suicide deaths.
Most significantly, the research exposes provisionality, contingency, inconsistencies and scope for discretion at multiple levels in the process of the determination and classification of possible suicide deaths which definitively impact official suicide statistics. The study therefore argues that there is an urgent need to develop consistent understandings, practices and processes across all actors involved in the social organisation of suicide mortality statistics. It proposes that one way to do this may be to introduce internationally recognised operational criteria which support a balance of probabilities approach to death determination and classification, as a way of developing greater standardisation, transparency, and confidence in suicide mortality statistics, and in turn, better informed public health responses to this enduring societal issue.
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Keywords
Determination and classification of suicide
Citation
Williamson, E. M. 2024. A study of the social organisation of the determination and classification of deaths by suicide in Ireland. DSocSc Thesis, University College Cork.