Rational suicide among older adults: A cause for concern?

Moore, Sharon

doi:10.1016/s0883-9417(09)90009-7

Cited by 6 publications

(11 citation statements)

References 24 publications

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“…There has been considerable debate between those in favour of 'rational suicide' [5][6][7][8] and those opposing it. [9][10][11][12][13] While both sides in the debate argue their case based on 'the good of humanity', there are significant differences.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…Lastly, by using the slippery slope argument, several authors point out the risk of the deteriorating respect for the value of human life and ageing, and the risk of societal values shifting from recognition of an individual's right-to-die to a climate enforcing a societal obligatory duty to die. 9 Many studies on the topic of 'rational suicide' in old age focus on theoretical, ethical and legal arguments. In fact, we found no empirical studies that explore the experiences and struggles of people ideating on a selfchosen death from an insider's perspective.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

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Caught between intending and doing: older people ideating on a self-chosen death

2016

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ObjectivesThe aim of this paper is to provide insight into what it means to live with the intention to end life at a self-chosen moment from an insider perspective.SettingParticipants who lived independent or semidependent throughout the Netherlands.Participants25 Dutch older citizens (mean age of 82 years) participated. They were ideating on a self-chosen death because they considered their lives to be no longer worth living. Inclusion criteria were that they: (1) considered their lives to be ‘completed’; (2) suffered from the prospect of living on; (3) currently wished to die; (4) were 70 years of age or older; (5) were not terminally ill; (6) considered themselves to be mentally competent; (7) considered their death wish reasonable.DesignIn this qualitative study, in-depth interviews were carried out in the participants’ everyday home environment (median lasting 1.56 h). Verbatim transcripts were analysed based on the principles of phenomenological thematic analysis.ResultsThe liminality or ‘in-betweenness’ of intending and actually performing self-directed death (or not) is characterised as a constant feeling of being torn explicated by the following pairs of themes: (1) detachment and attachment; (2) rational and non-rational considerations; (3) taking control and lingering uncertainty; (4) resisting interference and longing for support; (5) legitimacy and illegitimacy.ConclusionsOur findings show that the in-between period emerges as a considerable, existential challenge with both rational and non-rational concerns and thoughts, rather than a calculative, coherent sum of rational considerations. Our study highlights the need to take due consideration of all ambiguities and ambivalences present after a putatively rational decision has been made in order to develop careful policy and support for this particular group of older people.

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Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Caught between intending and doing: older people ideating on a self-chosen death

2016

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“…This is interesting because there is an ongoing debate about whether the wish to die in older people in some cases is to be considered an outcome of a rational and understandable assessment of their personal lives. Some authors suggest that suicidal ideation in some cases can be explained as a natural phenomenon of old age (Battin, 1999;Moore, 1993;Osgood, 1985;Prado, 1998;Richman, 1992). Although other authors strongly argue that suicide in the elderly can be seen and accepted as "un understandable, calculated and even normal decision" (Barnow & Linden, 1997, 2000Barnow, Linden, & Freyberger, 2004).…”

mentioning

confidence: 99%

Experiences and Motivations Underlying Wishes to Die in Older People Who Are Tired of Living: A Research Area in its Infancy

2014

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The wish to die in older people who are tired of living and the possibilities to organize death are currently being discussed within the debate on self-determination and physician-assisted suicide. Until now insight into the experiences and thoughts of people who are tired of life but not suffering from a severe depression or a life-threatening disease is lacking. Studies focussing specifically on this topic are rare. This review provides an overview of this research area in its infancy. The existential impact of age-related loss experiences play an important role in developing a wish to die. Other influencing factors are: personal characteristics, biographical factors, social context, perceptions and values. Further research to experiences and motivations underlying these specific age-related wishes to die and the existential impact of the loss-experiences seems necessary to deepen the understanding of this group of older people and for the development of policy and good care.

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“…Eleven of the studies described in Table 2 did not include research data, but were specifically focused on old age rational suicide [7,13,25,35,36,38,42,44,45,46,48]: 5 included case(s) descriptions [7,13,25,35,36]; 7 specified the professionals involved in end of life and rational suicide issues.…”

Section: Resultsmentioning

confidence: 99%

“…Criteria for rational suicide and rating scales were mentioned respectively by 3 [13,36,42] and 4 [36,42,44,46] of these studies. Battin’s and Werth/Werth & Cobia were the most frequently reported criteria for rational suicide.…”

Section: Resultsmentioning

confidence: 99%

Rational Suicide in Late Life: A Systematic Review of the Literature

2019

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Background and Objectives: The complex concept of rational suicide, defined as a well-thought-out decision to die by an individual who is mentally competent, is even more controversial in the case of older adults. Materials and Methods: With the aim of better understanding the concept of rational suicide in older adults, we performed a systematic review of the literature, searching PubMed and Scopus databases and eventually including 23 published studies. Results: The main related topics emerging from the papers were: depression, self-determination, mental competence; physicians’ and population’s perspectives; approach to rational suicide; ageism; slippery slope. Conclusions: Despite contrasting positions and inconsistencies of the studies, the need to carefully investigate and address the expression of suicidal thoughts in older adults, as well as behaviours suggesting “silent” suicidal attitudes, clearly emerges, even in those situations where there is no diagnosable mental disorder. While premature conclusions about the “rationality” of patients’ decision to die should be avoided, the possibility of rational suicide cannot be precluded.

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Rational suicide among older adults: A cause for concern?

Cited by 6 publications

References 24 publications

Caught between intending and doing: older people ideating on a self-chosen death

Caught between intending and doing: older people ideating on a self-chosen death

Experiences and Motivations Underlying Wishes to Die in Older People Who Are Tired of Living: A Research Area in its Infancy

Rational Suicide in Late Life: A Systematic Review of the Literature

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