Talking About Suicide

Because it's not a taboo

Reading about Virginia Eddy and Li Mou

Here are two interesting stories about women who decided they had had enough of their lives. I point out this one from China as a reminder that the issue of suicide is debated fiercely pretty much everywhere, and increasingly online.

The other story is one I came across in a new book by Jane Gross called “A Bittersweet Season: Caring for our Aging Parents _ and Ourselves.” Gross founded a popular blog called “The New Old Age” for The New York Times, and her book tells the story of her mother’s decision to die by voluntarily stopping eating and drinking. “For someone of her nature, that long, humiliating decline _ mentally or physically _ was unacceptable,” Gross writes. As she does her own research into the issue, she comes across the often-referenced article “A Conversation with My Mother” by Dr. David Eddy, published years ago in the Journal of the American Medical Association. (I’ve linked to an abridged version above, which isn’t behind a paywall.)

Both the story of Gross’ mother and of Eddy’s mother are important because they show how people who want to die and a very nervous medical establishment are finding a way around the touchy issue of assisted suicide. Even in the few states that have made steps to make assisted suicide legal, a person wishing for that assistance must be terminally ill. In the cases of these two elderly women, there was no terminal illness. “Her heart and lungs were strong. She didn’t have cancer. She wasn’t even dying, using a disease-based definition. So here we were, my mother and I, wishing she were terminally ill and feeling a bit creepy about it,” Gross writes.

Eddy’s mother was also facing a future of no longer being able to care for herself alone. “Let me put this in terms you should understand, David,” she said. “My ‘quality of life’ _ isn’t that what you call it _ has dropped below zero. I know there is nothing fatally wrong with me and that I could live on for many more years. With some luck I might even be able to recover a bit of my former lifestyle, for a while. But do we have to do that just because it’s possible? Is the meaning of life defined by its duration?”

Both women chose to stop eating and drinking, which is considered to be neither suicide nor assisted suicide. “Even the ethicists, who are queasy about medical professionals having even tangential involvement in what could be considered suicide, agree that forcing liquids down someone’s throat is an ‘unwarranted bodily intrusion,'” Gross writes.

So while the medical world had not judged either woman to be terminally ill, each was allowed to make the decision to end her life while in the company of caregivers and with access to medication to handle any discomfort. It was not a blind guessing game, it was not shameful, and it was not alone.

Both women had doctors who respected their decisions and their decision-making. What makes the story of Gross’s mother even more interesting is her mother’s past of depression and episodes of psychiatric hospitalization. Mental capacity and frame of mind are big issues around end-of-life decisions and surely are a source of a lot of hesitation by doctors. I’d like to know more about Gross’ mother and whether she faced additional challenges or doubt from doctors while making her decision. The key, perhaps, was making her plans loud and clear far ahead of time.

“We’d laid out my mother’s long-standing end-of-life philosophy so nursing home staff would see this deliberate decision for what it was, not as a depressed impulse,” Gross writes.

How far in advance should each of us start thinking about this and making our own preferences clear?

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