Rational Suicide, Euthanasia, and the Very Old: Two Case Reports.
Suicide amongst the very old is an important public health issue. Little is known about why older people may express a wish to die or request euthanasia and how such thoughts may intersect with suicide attempts. Palliative care models promote best care as holistic and relieving suffering without hastening death in severely ill patients; but what of those old people who are tired of living and may have chronic symptoms, disability, and reduced quality of life? Two cases of older people who attempted suicide but expressed a preference for euthanasia were it legal are presented in order to illustrate the complexity underlying such requests. The absence of a mood or anxiety disorder underpinning their wishes to die further emphasises the importance of understanding the individual's narrative and the role of a formulation in guiding broad biopsychosocial approaches to management.
Older Persons' Mental Health Service, St George Hospital, Kogarah, NSW, Australia; Academic Department for Aged Care Psychiatry, Eastern Suburbs Mental Health Service, Randwick, NSW, Australia; School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
Anne Pamela Frances
0000-0002-7811-5225
AP
Wand
School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Carmelle
C
Peisah
Academic Department for Aged Care Psychiatry, Eastern Suburbs Mental Health Service, Randwick, NSW, Australia; School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
Brian
0000-0003-1405-7932
B
Draper
Older Persons' Mental Health Service, St George Hospital, Kogarah, NSW, Australia.
Carolyn
C
Jones
Dementia Collaborative Research Centre and Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia.
Henry
H
Brodaty