Should we support the suicidal-elderly or simply let them jump?

By Paul Russell:

Philip Nitschke is surprised and dismayed that British Police tried to stop a retired English professor from committing suicide at her home near of Exeter in the UK recently.

When Police attended the home of Dr Avril Henry after Interpol had informed them that they believed that an illegal import of the drug nembutal had been delivered to the premises and that Dr Henry was suicidal, they forced entry by smashing down the front door.

Nitschke told local news that, "They (the Police) then brought in a psychiatrist, a general practitioner, and a social worker for a late night psychiatric assessment to see if she could be sectioned and take to a psychiatric hospital. They eventually left at 4am on Sunday morning.

"The smashed door was temporarily repaired with board before they left. They confiscated and took with them a small bottle of what they believed was the drug Nembutal."

In his press release Nitschke also said, "The door was smashed with glass everywhere. Professor Henry was visibly shaken, but perfectly coherent and extremely angry at the way she had been treated.

"In the 20 years I have been directing Exit, I have never seen such a heavy handed over-reaction by the police in any of the countries that Exit operates. Professor Henry is owed an apology."

Apology or not and putting aside Nitschke's histrionics, what were the Police supposed to do? What do we expect the Police to do; indeed, what should any citizen do if they become aware that a person nearby is contemplating suicide?

The simple answer is to do what can be done to stop that person taking their own life; to help them move beyond whatever it is that makes them feel that their situation is beyond hope.

Sadly as local news reports only days later confirmed, Dr Henry did take her own life in the days that followed.

Nitschke told the Guardian: "Her death was a clear case of 'rational suicide' and her decision to die at her own time and in her own place should have been respected. As it is the authorities did everything they could to make her last days on this earth a misery."

The shadowy spectre of 'Doctor Death' happened to be in the UK at the time and he admitted to visiting Dr Henry after the Police had attended her home in the first instance. He was pictured with her and the damaged front door.

How should we think about this notion of a 'rational' suicide? Clearly the psychiatrist, general practitioner and social worker who visited Dr Henry at the time of the Police intervention did not find her able to be 'sanctioned' and held against her will even though ordering nembutal was a clear indication of her intention. That is itself not proof, however, that she was totally 'in her right mind'.

That this notion of 'rational' suicide arises from a man who has a business and marketing plan built around suicide should make us very wary of accepting these assertions.

G K Chesterton once observed that, "A madman is not someone who has lost his reason but someone who has lost everything but his reason". Excusing the use of the term 'madman' my own experiences in counselling suicidal young people tend to confirm that a suicidal person can present their thoughts and intentions about ending their life in a coherent fashion. What they have 'lost' is not their ability to reason but, rather, their ability to connect their reasoning to an external point of reference.

This is why the 'stock-in-trade' counselling tactics to 'talk down' a suicidal person is to try to connect them in thought to someone or something else. Encouraging them to think of their loved ones, for example; or perhaps asking them to contract with you to refrain from self harm for a certain period of time (giving them further time to think) or to help them think about planning to do something that brings them happiness and satisfaction in the near future.

Nitschke said of Dr Henry that "She had a formidable reputation as an academic of many years standing, but her health had drastically deteriorated. She had no one terminal illness but had a myriad of problems. She was pretty much housebound."

He is asking us to consider that aging and the accumulation of ailments and illnesses associated with aging make Dr Henry's suicide somehow different from the love-lorn teen, for example. Whereas we would all readily want intervention and suicide prevention for the latter we are being asked to discriminate against the aged and infirmed by offering them, or at least allowing them, access to suicide without any intervention. This is at the very least irrational. The Police, by their actions, confirmed that society still sees suicide as a tragedy and actively seeks to intervene where and when ever possible.

Nitschke would have us look the other way. "Police need to realise that in the UK suicide is not a crime, and mental health authorities need to recognise that not everyone who seeks to end their life is in need of psychiatric intervention." he said.

I have often heard Nitschke declare that the laws about suicide are something of a paradox. While claiming that 'suicide is not a crime' and noting that assisting in suicide is still prohibited, he claims in various ways that it is silly to maintain a prohibition on assisting in something that is not itself a crime. This is, of course, not the full story; it is an mischievous abbreviation that, once again, suits the business model.

The reason that the 'aiding, abetting and counselling' prohibition has never been removed from the law is because of the acknowledged risk of a third party or parties coaching, encouraging and assisting another person to their suicide; a henious act. When Nitschke says that suicide 'is not a crime' he fails to add that this does not mean that suicide is legal but merely decriminalized; that is to say, denuded of any penalty under law. This prohibition tacitly acknowledges that people having suicidal thoughts are vulnerable to suggestion, coercion and abuse.

If in need of any further proof, committing an assault on a person by restraining them from suicide is the only place in law where assault on a person is not a crime. The Police action in breaking down Dr Henry's door needs to be seen in that light.

Nitschke sees it differently: "To try to excuse such violent and threatening behaviour against a vulnerable elderly woman as a 'concern for her well-being' lacks any credibility". He tries to have it both ways

Suicide amongst the elderly is an acknowledged and growing concern. In Australia recently this fact was used to conclude that euthanasia should be made legal. This is nothing short of an abandonment of people in significant need and tacit confirmation that, as a society, we are prepared to ignore the underlying problems faced by the elderly by callous indifference.

No-one should doubt that as people age and their world shrinks as their friends pass or move away, the onset of illnesses in situations where human supports are reduced presents a very real problem. External reference points such as access to family members, quality care and life fulfilling moments may well become less frequent; but that is no reason to undermine suicide prevention and no reason not to develop supports and resources for our elderly. If we begin to allow assessments that a person is 'housebound' or experiencing 'deteriorating health' to cloud and distort our inclinations to help, we fall into the two-fold trap of judging their lives less worthy of the natural supports of human welfare and failing to committing ourselves as a society to find structural, human remedies.

And so, while Dr Henry may well have been in some sense 'rational' she was also, undoubtedly, vulnerable. She needed the protection that the Police tried to provide and not the slick marketing to which some such people easily fall prey. Instead of actively trying to knock down the barriers designed to act as a pause for thought and a protection for such people, we need to apply ourselves, as humanity has always done, to find creative ways of dealing with a very real problem.

Note: The examples given above of emergency suicide intervention are just, that, in case of emergency. If you know someone who is suicidal please seek professional assistance as soon as possible.

You can ring Lifeline on 13 11 14.

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