Is suicide among the elderly really so tragic?

Suicide among the elderly features in an Arizona Daily Star article that played up the "tragedy" of our nation's senior citizens deciding to check out when they please rather than waiting for the hand of time. The article seems to be more of a human-interest piece than a response to a pressing concern, since there's been no surge in elderly suicides in recent years. Nationally, according (PDF) to the Centers for Disease Control, the rate of suicide for adults aged 65 years and older was 14.3 per 100,000 people in 2005. This is down from the 21.8 per 100,000 rate reported in 1987. Adult men over 75 took their own lives at the rate of 37.4 per 100,000 people in 2005.

Much of the article is boilerplate about the grief and guilt felt by people left behind and the importance of watching out for signs of depression among parents and grandparents. Left unaddressed was one very politically incorrect aspect to the story: More so than any other group, the elderly may well have perfectly rational reasons for choosing to die by their own hand.

When Hunter S. Thompson shot himself at the age of 67, he was troubled by a failing body and the knowledge that his best writing was behind him. The note he left for his wife read:

Football Season Is Over

No More Games. No More Bombs. No More Walking. No More Fun. No More Swimming. 67. That is 17 years past 50. 17 more than I needed or wanted. Boring. I am always bitchy. No Fun -- for anybody. 67. You are getting Greedy. Act your old age. Relax -- This won't hurt.

Thompson not only ended his pain -- he got to go out in style, amidst headlines, with a hell of a party.

Most of us aren't gonzo writers who want to leave with a splash, but even today, when people are living not just longer lives, but healthier ones than their parents and grandparents, there's no escaping the fact that bodies eventually deteriorate. At some point, more than a few people are going to decide that their hearts are still pumping well after the quality of their lives has dropped below a level they find acceptable.

What defines an "acceptable" quality of life varies for each person. Some people are eager to live as many days as possible, others recoil at outliving family and friends, many stop taking pleasure in life when they lose their physical independence, and more than a few may make their peace with declining mobility, but have a horror of mental deterioration that erases the essence of who they are. It's an individual decision that really can't be second-guessed.

I have a male relative whose plan for long-term care as he ages consists of ending things when he can no longer care for himself. He's quite clear and matter-of-fact about it, and has held his position for many years.

I respect his decision. I'm inclined to the same course of action myself, when the time comes. If I'm still up to it those many (I presume) years from now, I think I'll take one last backpacking trip that never ends.

Given that we all must eventually die, the taboo against discussing when and how some of us might want to voluntarily check out is especially jarring. It's coming, no matter what; that seems to me to be sufficient reason to give some thought to how to confront the end.

That's not to say that every suicidal impulse should be treated as a brilliant idea -- such an irreversible act seems especially perverse among the young and healthy. But for people for whom death is a looming reality, the decision by some to slightly adjust the date, place and manner of their demise strikes me as a rational effort to take control of their ultimate fate and retain a little dignity.