Medical Assistance in Dying and Suicide Rates Among Older Adults: Evidence from Canada
with Julian Reif, Jennifer Stewart, and Coady Wing
Abstract
A growing number of countries permit medical professionals to help patients end their lives, yet how these laws affect suicide (i.e., deaths without medical assistance) remains unresolved. We examine whether Canada's introduction of Medical Assistance in Dying (MAID) in 2016 affected suicide rates among adults aged 65 and older. Using annual mortality data from Canada and the United States for 2000--2023, we compare suicide rates in Canada with contemporaneous trends in U.S. states. Suicide rates in Canada declined substantially after legalization: by 3.8 deaths per 100,000 for men (19.7%) and 0.7 deaths per 100,000 for women (17.3%). These declines are consistent with partial substitution from suicide to MAID, but are much smaller than the rise in MAID deaths. As more jurisdictions consider assisted-dying laws, this pattern provides a useful benchmark for evaluating their population-level effects.
(Draft available upon request)
Measuring Infant Mortality Using Synthetic Survival Curves
with Seth Freedman and Coady Wing
Abstract
This study develops and validates a novel synthetic control framework for estimating the effects of policy interventions on survival functions. Estimating counterfactual survival functions may provide insight into the way that interventions affect outcomes with a duration structure at different follow up times. We study the performance of the method using data on linked infant birth-death data to measure survival over the first year of life for multiple birth cohorts in each US state, and simulating treatment effects from hypothetical interventions. Results from simulated placebo tests and power analysis show that a synthetic survival curve estimators produces stable counterfactual estimates and is able to detect relatively small treatment effects with high statistical power. Power analyses indicate that the method reliably detects survival rate reductions as small as 0.3% with 80% power. These validation results demonstrate the method’s potential in evaluating the effects of changes in abortion policy on infant mortality.
(Draft available upon request)
Past Research/Undergraduate Publication
Exitability and Economic Freedom: Evidence from the U.S.
International Advances in Economic Research (2017, with Josh Hall)