Abstract
Rational suicide in the elderly is a concept that raises questions in several domains: definitional, philosophical, clinical and ethical. Many of the questions are not susceptible of definitive or clear-cut answers. This chapter tries to elucidate some of the arguments about the rationality and moral permissibility of suicide in the elderly, and whether doctors are obliged always to prevent, or sometimes to procure, the suicide of their rational elderly patients.
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Notes
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Bridge into the Future: Letters of Max Plowman, Andrew Dakers, 1944, p.770.
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It was first published in 1919.
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David Hume, A Treatise of Human Nature. There is a slight contradiction, or at least redundancy, in this passage. If reason can only be the slave of the passions, there is no sense in which it ought to be so, since moral judgements attach only to what might be different as a result of choice.
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Subharwal, Sunil, Essentials of Spinal Cord Medicine, Demos Medicine, 2014, p. 396.
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See From Madrid to Purgatory, Carlos M. N. Eire, Cambridge University Press, 1995.
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A Hundred Cases of Suicide: Clinical Aspects, Barraclough B., Bunch J., Nelson B., Sainsbury P., Brit J. Psych., 1974, 125, 335–73.
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Nor does it follow that the suicide of someone who is mentally unwell is necessarily irrational. He may be correctly informed as to his prognosis and the likelihood of his continuing unassuageable suffering.
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See, for example, Philip E Devine, The Ethics of Homicide, Cornell University Press, Ithaca, 1978.
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In my experience of parasuicides, many imagine attending their own funerals by a kind of disembodied hovering above them, watching with pleasure the guilt and grief of those who drove them to it.
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Ballantyne J and Sullivan M, Intensity of chronic pain—the wrong metric, N Engl J Med 373;22, 2098–9, 2015.
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I was once on a train in Germany with a German doctor in her 60s as my fellow-passenger in the compartment. The subject of euthanasia came up. ‘What would the world say’, she asked me, ‘if what was going on in the Netherlands was going on in Germany?’ Although not an argument in logic, it was certainly a powerful rhetorical question. It brought home the importance not only of considering individual cases, but the historical context in which they occur.
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David Hume, On Suicide.
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Daniels, A.M. (2017). Epilogue. In: McCue, R., Balasubramaniam, M. (eds) Rational Suicide in the Elderly. Springer, Cham. https://doi.org/10.1007/978-3-319-32672-6_15
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DOI: https://doi.org/10.1007/978-3-319-32672-6_15
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