Why Not Suicide?


I've been surprised that the question of suicide has come up only once in this blog's comments, even after the two recent posts on fear (here and here). As I write there, I think that for me life will retain too much meaning to want to leave it early.

But given the attitude of most people towards Alzheimer's, why don't more choose suicide?

Certainly many think about it.

On seeing an Alzheimer's patient (or any other person) lying terminally ill and comatose in a nursing home bed, almost everyone thinks, "I don't want to die like that!" Others will feel the same when a person can't remember family or wanders around babbling. But when they get to that point, they rarely consider suicide. Why not?

For some, of course, the first and overriding issue is that suicide is morally wrong and can't be considered.

Second, while people might want to commit suicide "before I get that bad," very few people will choose suicide while their lives still retain meaning. Some people might choose to kill themselves while they're suffering greatly, but the prospect of future suffering is not enough of a motive.

If life is worth living now, we hang on to it. We are, after all, attached to life.

Third, many people with Alzheimer's lose their ability to commit suicide before they're ready to go through with it.

The novel Still Alice depicts an intellectual college professor with early-onset Alzheimer's who decides she'll suicide when it gets "too bad." She places into the medicine chest a bottle of pills strong enough to kill her and writes herself a note with exact instructions on when and how to use the pills. As she gradually declines, she gradually loses the capacity to remember or figure out what she meant. Ultimately, she wonders who this person is who is trying to kill her by writing this note to her.

Fourth, the experience of the person with Alzheimer's may not be as bad as we—who are looking in from the outside—think it would be. When we get there, we may find no reason to suicide.

As unimpaired people or as people earlier in the disease, we project how we will feel in the future but, in fact, we have little idea what our experience will be then.

In the Comments section of this blog and in emails to me, I've read beautiful stories about the happiness of patients with very advanced disease. Maybe most of them aren't suffering much at all.

Finally, one values life differently as one gets sicker.

I worked for many years in a home and hospice for homeless men with AIDS. Most of them were admitted when their symptoms were relatively mild; they'd see other patients about to die and vow to overdose before they got "that bad." As far as I know, none ever did or even tried to.

As we approach the end, to have a "meaningful life" requires less and less.

Human beings generally value their lives deeply. We may think that when we reach such-and-such a condition, our lives will lose that value. But, apparently, that's very seldom true.

My understanding is that the suicide rate for people with Alzheimer's is low.

I'm not surprised.

For my own part, I think I'll be just too curious about what the future holds to consider walking out.

An author and former physician, Dr. David Hilfiker was diagnosed in 2012 with a progressive mild cognitive impairment. His doctor thought it was Alzheimer's but additional testing proved this initial diagnosis to be wrong. Now David must learn how to come to terms with the reality of worsening cognitive issues that appear to have no cause.

Watching the Lights Go Out

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I am not a Christian, so many, if not most of you, will find my following statement against God.

I watched my godfather die a horrible death when I was 17. Since I have been an adult I have belonged t some sort of organization that supports assisted suicide (the Hemlock Society and now to Compassionate Choices). I absolutely respect my mil's wish to live out her life, as I do everyone who chooses to do so, however, I want the option, without fearing the consequences for those that help me, to end my life when I am ready. I find it particularly hypocritical when people put God into it since my God is loving, understanding and has given us free will to determine what is right for ourselves...I know many of you will hate me because of this statement but what kind of people are we to hate others for their spiritual beliefs?
Thank you all for raising the issue of suicide and sharing your experiences/thoughts on it. Having come half way around the world leaving my wife behind to care for my mother with dementia/Alzheimer's for 2+ years now, have definitely attributed to thinking about what I should/would do if I get the disease.

Ironic that our great nation the champion of freedom does not provide individual's the choice to legally/peacefully end their lives despite aging population with astronomical health costs. Understand many legal and moral complexities as well as "Do Not Resuscitate" option, but would be comforting to have avenue to peacefully end one's own life prior to debilitating diseases affecting mind/body to the point of becoming a total dependent invalid. Not trying to make any moral, religious, nor political statement, only voicing my personal thoughts. Just knowing I have option to die with dignity and some semblance of self, I feel would give me peace of mind that I do not become an unwanted burden to family and to society.

Wishing you good health.
I agree, Bewell - it doesn't make sense, does it? The western-medicine approach is to spare and prolong every life, no matter the cost. Pretty pathetic regarding the treatment of terminal illnesses, including Alzheimer's and advanced stage cancers, among others. To spend hundreds of thousands of dollars that may (or may not) buy you just a few months time, to me is morally and ethically wrong. Sometimes allowing nature to take it's course is the way to go, and if that road is too painful, then it should be an individual's decision how they want to leave this world...slowly and painfully, not giving up one day, or with the dignity we give our animals but can't (for whatever reason) give ourselves. Senseless.