Clinicians have different views.
Suicide can be impulsive and precipitated by mental illness. But what about when an a healthy, older person makes a calm and considered decision to end their lives?
According to Dr. Meera Balasubramaniam, a geriatric psychiatrist at the New York University School of Medicine, it is not uncommon to find individuals who are very old yet healthy, and who desire to die.
“So many of our patients are confronting this in their heads.” Dr. Balasubramaniam told The New York Times.
She recently published an article in the Journal of the American Geriatrics Society exploring the motivations of 72 year old patient who, though not terminally ill, expressed a desire to end his life “while still doing well”. Balasubramaniam considers some of the factors that may have been motivating this patient’s suicidal ideation, including a desire for a sense of control, a revulsion at the effects of aging and illness on the body, and Baby Boomer libertarian sentiment.
Is such a form of suicide something we should be accepting?
Dr. Balasubramaniam said that her own views were “evolving”. “Discussing it [with patients] doesn’t mean your advocating it”, she said.
Dr Yeates Conwell, a geriatric psychiatrist at the University of Rochester School of Medicine and suicide researcher, has deep reservations. The vast majority of older patients who end their own lives have a mental illness, typically depression, and they tend to be acting impulsively. This is not a “rational act”, but rather equivalent to the forms of pathological suicide that we seek to prevent.
“The suicidal state is not fixed,” Dr. Conwell said. “It’s a teeter-totter. There’s a will to live and a will to die, and it goes back and forth”.
When health care providers aggressively treat seniors’ depression and work to improve their health, function and relationships, he said, “it can change the equation”.
Should we be more accepting of suicide in older adults?
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