Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-24T02:48:37.477Z Has data issue: false hasContentIssue false

Finitude, choice and the right to die: age and the completed life

Published online by Cambridge University Press:  30 October 2020

Chris Gilleard*
Affiliation:
Division of Psychiatry, UCL Faculty of Brain Sciences, London, UK

Abstract

This paper explores the concept of the completed life outlined in recent writing in the Netherlands on euthanasia and assisted suicide and its implications for ageing studies. Central to this theme is the basic right of people to self-determine the length of their later life, linked with the subsidiary right to assistance in achieving such self-determination. Although the notion of weariness with life has a long history, the recent advocacy of a self-limited life seems shaped by the new social movements presaged upon individual rights together with what might be called a distinctly third-age habitus, giving centre stage to autonomy over the nature and extent of a desired later life, including choice over the manner and timing of a person's ending. In exploring this concept, consideration is given to the notion of a ‘right to die’, ‘rational suicide’ and the inclusion of death as a lifestyle choice. While reservations are noted over the unequivocal good attached to such self-determination, including the limits to freedom imposed by the duty to avoid hurt to society, the article concludes by seeing the notion of a completed life as a challenge to traditional ideas about later life.

Type
Forum Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baltes, PB (2006) Facing our limits: human dignity in the very old. Daedalus 135, 1, 3239.CrossRefGoogle Scholar
Beauchamp, TL (2006) The right to die as the triumph of autonomy. Journal of Medicine and Philosophy 31, 643654.CrossRefGoogle ScholarPubMed
Beck, U and Beck-Gernsheim, E (2002) Individualization: Institutionalized Individualism and Its Social and Political Consequences. London: Sage.CrossRefGoogle Scholar
Beekman, W (2011) The Self-chosen Death of the Elderly. Trans. Boerup Y and Jonquiere R. Available at https://www.worldrtd.net/sites/default/files/newsfiles/UVW%20engels%20definitief%201.1_0.pdf.Google Scholar
Behuniak, SM (2011) Death with ‘dignity’: the wedge that divides the disability rights movement from the right to die movement. Politics and the Life Sciences 30, 1732.CrossRefGoogle ScholarPubMed
Buiting, HM, Deeg, DJ, Knol, DL, Ziegelmann, JP, Pasman, HRW, Widdershoven, GA and Onwuteaka-Philipsen, BD (2012) Older peoples’ attitudes towards euthanasia and an end-of-life pill in The Netherlands: 2001–2009. Journal of Medical Ethics 38, 267273.CrossRefGoogle Scholar
Callahan, D (1992) When self-determination runs amok. The Hastings Center Report 22, 5255.CrossRefGoogle ScholarPubMed
Callahan, D ([1987] 1995) Setting Limits: Medical Goals in an Aging Society. Washington, DC: Georgetown University Press.Google Scholar
Canetto, SS (2017) Suicide: why are older men so vulnerable? Men and Masculinities 20, 4970.CrossRefGoogle Scholar
Cohen, J, Van Landeghem, P, Carpentier, N and Deliens, L (2014) Public acceptance of euthanasia in Europe: a survey study in 47 countries. International Journal of Public Health 59, 143156.CrossRefGoogle ScholarPubMed
De Leo, D and Kõlves, K (2017) Suicide at very advanced age – the extremes of the gender paradox. Crisis: The Journal of Crisis Intervention and Suicide Prevention 38, 363366.CrossRefGoogle ScholarPubMed
Diekstra, RFW (1993) The epidemiology of suicide and parasuicide. Acta Psychiatrica Scandinavica (Supplement no. 371), 920.CrossRefGoogle ScholarPubMed
Dierickx, S, Deliens, L, Cohen, J and Chambaere, K (2015) Comparison of the expression and granting of requests for euthanasia in Belgium in 2007 vs 2013. JAMA Internal Medicine 175, 17031706.CrossRefGoogle ScholarPubMed
Domino, G (2003) Community attitudes toward physician assisted suicide. OMEGA – Journal of Death and Dying 46, 199214.CrossRefGoogle Scholar
European Union (2012) Charter of Fundamental Rights. Available at https://eur-lex.europa.eu/legalcontent/EN/TXT/PDF/?uri=CELEX:12012P/TXT&from=EN.Google Scholar
Fox, E, Kamakahi, JJ and Čapek, SM (1999) Come Lovely and Soothing Death: The Right to Die Movement in the United States. New York, NY: Twayne Publishers.Google Scholar
Gamondi, C, Pott, M, Forbes, K and Payne, S (2015) Exploring the experiences of bereaved families involved in assisted suicide in Southern Switzerland: a qualitative study. BMJ Supportive and Palliative Care 5, 146152.CrossRefGoogle ScholarPubMed
Gamondi, C, Fusi-Schmidhauser, T, Oriani, A, Payne, S and Preston, N (2019) Family members’ experiences of assisted dying: a systematic literature review with thematic synthesis. Palliative Medicine 33, 10911105.CrossRefGoogle ScholarPubMed
Hale, B (2003) A pretty pass: when is there a right to die? Clinical Medicine 3, 142148.CrossRefGoogle Scholar
Heilbrun CG, (1997) The Last Gift of Time: Life beyond sixty. New York, NY: Dial Press.Google Scholar
Kim, SYH, De Vries, RG and Peteet, JR (2016) Euthanasia and assisted suicide of patients with psychiatric disorders in the Netherlands, 2011 to 2014. JAMA Psychiatry 73, 362368.CrossRefGoogle ScholarPubMed
Kouwenhoven, PSC, van Thiel, GJMW, van der Heide, A, Rietjens, JAC and van Delden, JJM (2019) Developments in euthanasia practice in the Netherlands: balancing professional responsibility and the patient's autonomy. European Journal of General Practice 25, 4448.CrossRefGoogle ScholarPubMed
Lang, FR, Baltes, PB and Wagner, GG (2007) Desired lifetime and end-of-life desires across adulthood from 20 to 90: a dual-source information model. Journals of Gerontology: Psychological Sciences and Social Sciences 62B, P268P273.CrossRefGoogle Scholar
Lasch, C (1991) The Culture of Narcissism: American Life in an Age of Diminishing Expectations. New York, NY: W.W. Norton.Google Scholar
Lefebvre, A (2018) Human Rights and the Care of the Self. Durham, NC: Duke University Press.Google Scholar
Levitan, P (2012) Boomercide: From Woodstock to Suicide. Portland, OR: Portlandia Press.Google Scholar
Mishara, BL and Weisstub, DN (2016) The legal status of suicide: a global review. International Journal of Law and Psychiatry 44, 5474.CrossRefGoogle ScholarPubMed
Morgan, JH (2013) What to do when there is nothing to do: the psychotherapeutic value of meaning therapy in the treatment of late life depression. Health, Culture and Society 5, 324330.CrossRefGoogle Scholar
National Assembly of France (1789) Declaration of the Rights of Man. Available at https://avalon.law.yale.edu/18th_century/rightsof.asp.Google Scholar
Nieminen, L (2018) Legalisation of euthanasia in Finland: via a citizens’ initiative? European Journal of Health Law 25, 407425.CrossRefGoogle Scholar
Parks, LA, Zelman, DC and Wanlass, RL (2011) The attitudes of socially marginalized men toward physician-assisted suicide. OMEGA – Journal of Death and Dying 62, 111125.CrossRefGoogle Scholar
Pompili, M, Innamorati, M, Masotti, V, Personnè, F, Lester, D, Di Vittorio, C and Amore, M (2008) Suicide in the elderly: a psychological autopsy study in a North Italy area (1994–2004). American Journal of Geriatric Psychiatry 16, 727735.CrossRefGoogle Scholar
Raijmakers, NJ, van der Heide, A, Kouwenhoven, PS, van Thiel, GJ, van Delden, JJ and Rietjens, JA (2015) Assistance in dying for older people without a serious medical condition who have a wish to die: a national cross-sectional survey. Journal of Medical Ethics 41, 145150.CrossRefGoogle ScholarPubMed
Rurup, ML, Onwuteaka-Philipsen, BD, Wal, GVD, Heide, AVD and Maas, PJVD (2005) A ‘suicide pill’ for older people: attitudes of physicians, the general population, and relatives of patients who died after euthanasia or physician-assisted suicide in The Netherlands. Death Studies 29, 519534.CrossRefGoogle ScholarPubMed
Rurup, ML, Deeg, DH, Poppelaars, JL, Kerkhof, AM and Onwuteaka-Philipsen, BD (2011) Wishes to die in older people: a quantitative study of prevalence and associated factors. Crisis: The Journal of Crisis Intervention and Suicide Prevention 32, 194203.CrossRefGoogle ScholarPubMed
Schnabel, P, Meyboom-de Jong, B, Schudel, WJ, Cleiren, CPM, Mevis, PAM, Verkerk, MJ, Van Der Heide, A, Hesselmann, G and Stultiëns, LF (2016) Voltooid leven: Over hulp bij zelfdoding aan mensen die hun leven voltooid achten [Completed Life: On Assisted Suicide for People Who Consider Their Lives Complete]. The Hague: Adviescommissie voltooid leven.Google Scholar
Shahtahmasebi, S (2013) Examining the claim that 80–90% of suicide cases had depression. Frontiers in Public Health 1, 62.CrossRefGoogle ScholarPubMed
Shaw J, Harper L, Preston M, Wright A, Kelly M and Wiebe E, (2019) Perceptions and experiences of medical assistance in dying among illicit substance users and people living in poverty. OMEGA- Journal of Death and Dying, DOI: 10.1177/0030222819889827.Google Scholar
Sikka, T (2019) Barriers to access: A feminist analysis of medically assisted dying and the experience of maginalized groups. OMEGA- Journal of Death and Dying, DOI: 10.1177/0030222819873770.Google ScholarPubMed
Sprung, CL, Somerville, MA, Radbruch, L, Collet, NS, Duttge, G, Piva, JP, Antonelli, M, Sulmasy, DP, Lemmens, W and Ely, EW (2018) Physician-assisted suicide and euthanasia: emerging issues from a global perspective. Journal of Palliative Care 33, 197203.CrossRefGoogle ScholarPubMed
Sprung, CL, Ricou, B, Hartog, CS, Maia, P, Mentzelopoulos, SD, Weiss, M, Levin, PD, Galarza, L, De La Guardia, V, Schefold, JC and Baras, M (2019) Changes in end-of-life practices in European intensive care units from 1999 to 2016. JAMA: The Journal of the American Medical Association 322, 16921704.CrossRefGoogle ScholarPubMed
Steck, N, Junker, C and Zwahlen, M (2018) Increase in assisted suicide in Switzerland: did the socioeconomic predictors change? Results from the Swiss National Cohort. BMJ Open 8, e020992.CrossRefGoogle ScholarPubMed
United Nations, (1948) Universal Declaration of Human Rights. United Nations General Assembly 302 (2) Other Info.Google Scholar
Van Humbeeck, L, Dillen, L, Piers, R and Van Den Noortgate, N (2020) Tiredness of life in older persons: a qualitative study on nurses’ experiences of being confronted with this growing phenomenon. The Gerontologist 60, 735744.CrossRefGoogle ScholarPubMed
Vannoy, SD, Duberstein, P, Cukrowicz, K, Lin, E, Fan, M-Y and Unützer, J (2007) The relationship between suicide ideation and late-life depression. American Journal of Geriatric Psychiatry 15, 10241033.CrossRefGoogle ScholarPubMed
Van Orden, KA and Conwell, Y (2016) Issues in research on aging and suicide. Aging and Mental Health 20, 240251.CrossRefGoogle ScholarPubMed
van Wijngaarden, E, Leget, C and Goossensen, A (2015) Ready to give up on life: the lived experience of elderly people who feel life is completed and no longer worth living. Social Science and Medicine 138, 257264.CrossRefGoogle ScholarPubMed
van Wijngaarden, E, Goossensen, A and Leget, C (2018) The social–political challenges behind the wish to die in older people who consider their lives to be completed and no longer worth living. Journal of European Social Policy 28, 419429.CrossRefGoogle ScholarPubMed
van Wijngaarden, EJ, Thiel, G, Hartog, I, Berg, V, Zomers, M, Sachs, A, Uiterwaal, C, Leget, CJW, Buijsen, M, Damoiseaux, R and Mosterd, M (2020) Perspectieven op de doodswens van ouderen die niet ernstig ziek zijn: de mensen en de cijfers [Perspective on the Death Wishes of People Who Are Not Seriously Ill: The People and the Figures]. The Hague: ZonMw.Google Scholar
Värnik, P (2012) Suicide in the world. International Journal of Environmental Research and Public Health 9, 760771.CrossRefGoogle ScholarPubMed
Zamora, D (2016) Introduction: Foucault, the Left and the 1980s. In Zamora, D and Behrent, MC (eds), Foucault and Neoliberalism. Cambridge: Polity Press, pp. 15.Google Scholar