Does voluntary assisted dying – or euthanasia and assisted suicide – have a negative impact upon other people? It’s rare for this question to be raised in debates. If it is, supporters dismiss it – it’s my life and it’s none of their business, is the response.

And, to tell the truth, there is precious little reliable data on this. However, a recent article in the British Journal of Psychiatry should ring alarm bells for supporters of VAD. A meta-analysis by German doctors of the impact of suicide on families claims that: “The experience of losing a parent to suicide is a strong and independent risk factor for suicidal behaviour in offspring.”

They conclude that “children of parents who died by suicide should receive early attention, including identification of critical periods during which the loss is particularly harmful.”

Suicide and suicide attempts are near the top of the list of causes of mortality globally. Nearly 800,000 people die by suicide every year. “Every suicide affects not only family and friends of the decedent, but also society as a whole,” the authors point out — 135 people are exposed for every suicide death.

The data is cloudy; there is a correlation between the suicide of a parent and suicides of their children – but mechanism is far from clear. It could be genetic or environmental. It could be due to grief and shame.

Or it could be imitation: “Identification with one’s caregivers plays a role in developing a sense of self, and a parent’s self-harming behaviour and coping strategies are likely to be imitated. Offspring might thus replicate the parents’ way of solving problems, including suicide when facing difficulties in life. Imitation may also desperately be driven by an urge to understand the suicidal parent’s motives and state of mind.”

As one might expect, age is a moderating factor. When children are older, the risk seems to be lower.

This research suggests that it is very important to collect data about life trajectory of the children and spouses or partners of people who request VAD. If there is a problem, it could easily go quite unnoticed.