Rational Suicide in Elderly Adults: A Clinician's Perspective

Meera Balasubramaniam, MD, MPH


J Am Geriatr Soc. 2018;66(5):998-1001. 

In This Article

Aging and Reflection

Erik Erikson proposed a theory of psychosocial development consisting of 8 stages from infancy to late adulthood. A psychosocial crisis of two conflicting forces and the individual's ability to sort through these forces, resulting in positive or negative development of their personality, marks each stage. According to this theory, older adults are faced with the eighth stage, namely "ego integrity versus despair." It is the stage at which individuals look back on their lives and ask themselves, "Is it ok to have been me?" They experience feelings of integrity if they feel they have led productive and meaningful lives. Conversely, unachieved goals and disappointments lead to despair.[23] In the case of Mr. A, this reflection is coming at a time when he has experienced loss of at least one long–term relationship, deterioration of his physical health, and a change in his professional identity. These losses are likely to influence his perceptions of the life he lived and thereby his decisions involving the future. A clinician must attempt to explore the relative contributions of health, professional successes, and relationships to Mr. A's lifelong identity.[16]