There is much discussion and debate within bioethics about the permissibility of physician-assisted suicide, but less discussion about suicide in general. We also spent a lot of time talking about end-of-life care and end-of-life decision-making. However, we tend to focus less on suicide in general and very little on suicide among older adults who are approaching the end of life but have no terminal disease. A recent program on NPR titled “Isolated and Struggling, Many Seniors Are Turning to Suicide” caused me to think about this.
Suicide rates in the US are generally increasing. When we think about suicide, many times we think about increases in teenage suicide rates but forget that middle-aged and older adults have higher rates of suicide than teens. Part of the reason for the higher rate of suicide in older adults is that their suicide attempts have a higher rate of resulting in death, but there are other things that put them at risk. Older adults suffer from isolation, loneliness, grief, and depression. The older we get, the more likely it is that we have lost family and friends close to us to death. That leads to the isolation, loneliness, and depression that can lead to suicide. Many older adults also live with chronic diseases which can lead to loss of ability to perform routine daily functions and cause a loss of independence. These things may also lead to isolation, loneliness, and depression. They can also result in feelings of being a burden to family members. The isolation experienced by the elderly not only leads to depression, but also makes it less likely that someone will recognize the risk of suicide and intervene.
Do our moral obligations to provide care for those at the end of life include dealing with the risk of suicide among older adults? I think they do. As physicians and other medical caregivers, it is important to recognize that suicide among older adults is a real concern and be alert to signs that a person may be at increased risk. Intervention can be lifesaving. We also have obligations as family members, neighbors, and fellow church members with those who may be at risk. Decreasing isolation can make a significant impact on the risk of suicide and all of us complaint role in that. Suicide in older adults is a real concern, and it is something we can impact.