Seniors & Aging

Real Life | Taking Our Own Lives, 21st- Century Style

Suicide isn’t a new idea, of course, but today’s lifestyle and attitudes are changing our thinking about it, and our methods.

Honored and respected elder-psychology Professor Bert Hayslip, in his acclaimed current CCU course “Suicide in later life: The elephant in the room?” tells us that elders, 13 percent of the population, now commit 20 percent of suicides. Why? Our culture increasingly encourages depression, incapacity, uselessness, mental illness, PTSD, loneliness, frustration and despair.

As our life expectancy lengthens, so do the impacts of those circumstances, plus insurmountable costs, and increasing numbers, severity, and duration of incapacitating diseases and physical deterioration. Loved ones don’t notice the many warning signs that we develop, because they’re off on their own, far from us.

This, too, is the age of the “right to die” movement. We’re encouraged to view the idea as a courageous, good-sense part of living, avoiding the prolonged suffering, misery, and expense of bleakly negative, joyless quality of life. Today, large numbers of us no longer adhere to religions’ suicide prohibitions. Though death notices still substitute the “code” words “suddenly” or “unexpectedly” for “suicide”, up-front openness supplants stigma and shame, which are fading away as outmoded mores. Fewer of us are deterred by guilt or shame feelings, nor perceptions that the family will be embarrassed.

We’re less likely to feel the need to divert our gaze and lower our heads when telling a friend what ended loved one’s life. The idea of suicide when “pulling the plug” isn’t an option is becoming quite popular, despite the blessings of palliative and comfort care.

“But the death certificate says ‘cardiac arrest’ or ‘pneumonia!’”

In reality, the deceased really deliberately encouraged death by willfully skipping medicine, skipping medical appointments, drinking, smoking, and thrusting themselves into hazardous environments. Most of all, many intended suicides occur by actual premeditated deliberate and willful self-starvation. If the statisticians had a way to measure how many hearts run out of nourishment, and lungs no longer can fight viruses, because of those suicidal intents, especially self-starvation, we wonder how high that 20 percent figure would soar.

After all, no longer feeling inhibited, self-starvation is a convenient, sure, dignified, non-violent, cost-free, private, quiet way to go. But, it’s slow. And the family catches on, and sometimes, though well-meaning, gives the person grief and hassle. Family, is it loving and merciful, instead, to rise above our own self-serving emotions and let loved one know that we’re OK and supportive about his/her choice and resolve, and always will love, honor and remember him/her?

Mary’s son and daughter-in-law did just that. In end-stage, she was bereft almost entirely of sight, hearing, mobility, and functional control, but still could perceive. Her dulled eyes immediately twinkled, her agonized face beamed with joy and relief, and her hands firmly gripped theirs as she relaxed from tortured agony into blissful peace. Just a few hours later, the phone call came.

“Life just isn’t worth living any more. Please just help me….”.

We all have heard it, or sooner or later will: “Let me end my suffering!” Many who crave a quick way out seek help from their healthcare providers. Suicide isn’t illegal anywhere (except maybe an obviously unprosecutable misdemeanor in a few states), but assisted suicide is legal in only a handful of states. Everywhere else your compassionate and loving assistance will arouse suspicion and can reward you with disdain and a criminal conviction and penalty. However, the “Death with Dignity” a.k.a “assisted suicide” movement is growing, and gradually is gaining legal legitimacy in more jurisdictions.

But don’t think that you can wheelchair grandma into the RV, go charging off to Oregon, Washington, Vermont, Montana, Canada, now California, and maybe soon Maryland, burst into a doctor’s office, and an hour later have pills in hand or an injection in grandma’s arm. Or grab a flight to Belgium, Sweden, Switzerland, Netherlands, or Luxembourg to do the same, either.

Assisted suicide is, of course, very serious business, medically, ethically, morally, and legally. There are many criteria and requirements. Only the person may order his/her own suicide, and only when fully aware and perfectly competent to do so — no one else can. Among other hurdles are MD-written medical certification of less than six months’ remaining life expectancy, minimum-duration residence in the state, concurrent lucid understanding by the patient and the family of his/her request, mental and cognitive awareness tests, new affidavits by the patient, waiting periods, and mandatory psychiatric and medical consultations.

You might view the safeguards as obstacles, but they’re really well-intentioned protections against impulsive and compulsive death decisions — irrevocable, once carried out — susceptible to duress, drugs, frivolity, depression, anxiety, coercion, mental incompetence, or intimidation.

It would be advisable and helpful to include the patient’s desire as a statement in his/her medical directive, if indeed the patient makes the decision long enough in advance to write it in, and even though the health care agent is legally powerless and probably morally dissuaded from ordering a killing. Also, of course, for the family’s benefit, it’s wise to have the intent be known, accepted in advance, and explained. The family also can feel better about it all, can have a helpful anti-guilt-feeling relaxer, and can have a welcome layer of legal and ethical “insulation.” The person’s last will and testament and ethical will are perfect places to express it all.

After all of this, it’s ironic and interesting to note that most assistedsuicide seekers, although successful in qualifying for the “remedy,” don’t use it, but are comforted and gratified by just having it available to use if and when they’re ever really ready to.

No doubt some opt for the self-starvation route, instead.

Today we also witness the emergence of a growing profession, the thanatologist, the expert and counsellor about all social and cultural knowledge, wisdom, and information about death and dying. A “CT” (certified thanatologist) designation is easily equivalent to a master’s degree in any other profession.

Also unlike in generations past, information about all of this abounds. Sources include literature, thanatologists, spiritual and behavioral practitioners, academics, and the Internet. If you’d like, email me for my enthusiastic referral to Dr. Hayslip and his courses.

Contact Gary Newman at gary@gnewman.org. Your ideas and comments are always welcome.

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