Suicide in old age: Illness or autonomous decision of the will?

Depression, often accompanied by suicidal behavior or recurring thoughts about suicide, is one of the most common psychic impairments in old age. Statistics in Austria tell us clearly: Suicidal candidates among the elderly are likely to succeed. Especially in men, suicide has become a significant cause of death. In an age where traditional family structures are beginning to fall apart, and where the elderly increasingly feel to be a “burden” to society, unable to find their place, we tend to look at suicide more and more as a voluntary and autonomous decision, thus rationalizing it as in: “This life I would not want to live either”. But is it permissible for physicians to consider a patient, who has acted suicidal, to be “not ill,” or to have acted “with good reason”? The present paper shall critically revisit the concept of “rational suicide.” What I hope to illuminate is the tension between medical care for, and autonomy of the patient that physicians have to negotiate in their work.