Friday, April 5, 2013

Rational Elder Suicide? The Beverley Broadbent case.

By Paul Russell, the founder of HOPE Australia.

Paul Russell
* Before reading this article, if you are having difficulty with depression or suicidal ideation, contact your life counts.

Health writer for the Melbourne The Age newspaper, Julia Medew, has documented the case of Beverley Broadbent who recently took her own life in what is being called 'rational suicide'.

Her article has generated a great deal of interest and the story has appeared in other local and overseas news broadcasts. it has been cast, as these kind of stories often are, as 're-igniting the euthanasia debate'.

This idea that someone can rationally commit suicide is not new. There are organisations overseas that formally advocate for this position. One such organisation, the Society for Old Age Rational Suicide (SOARS) in the UK says:
The main long-term objective of SOARS is to get the law eventually changed in the UK so that very elderly, mentally competent individuals, who are suffering unbearably from various health problems (although none of them is “terminal”) are allowed to receive a doctor’s assistance to die, if this is their persistent choice.
This is a far cry from the stated limited objectives of other 'right-to-die' type groups in the UK (and elsewhere) and this difference has been noted as a cause of some friction - particularly in reference to legislative attempts to legalise euthanasia and assisted suicide, which often have more restricted objectives.

The article about Ms Broadbent throws up a number of significant questions. How 'rational' is a desire to die? What are the obligations of the media in respect to reporting this and other similar stories?

As I have written before, there is a serious disconnect here over the issue of suicide. See, for example:

If a young person, for example, were contemplating suicide, we would instinctively want to do something to stop them. If we heard about such a case in the media, we would instinctively think how sad it was and mourn for the loss of one so young. But, somehow, we are being asked to view suicides like Ms Broadbent's differently.

The Age article paints Broadbent's interesting life and achievements, supporting, as they do, the comment that she had a 'rich and satisfying life'. She was not ill. She acknowledged that she had some of the complaints that we normally associate with aging (she was 83 years of age).

But through the length of the article, what struck me most was that Ms Broadbent lived in fear. Fear of going into a nursing home; fear of deterioration of her faculties, fear of developing an age-related disability, fear of dementia.

These fears are, in one sense, entirely understandable and even possibly normal. Their articulation, to friends and relatives, should not be dismissed. Rather, they should be acknowledged and responded to with assurances of care, love and support. But there's the rub: Ms Broadbent lived alone - she never married. While the video accompanying the story suggested that she did have friends, there was no reference to any family at all.

Had she shared her thoughts with others? Had any of them sought to re-assure her - to change her mind? We do not know. However, from what we do know it is possible to observe that Ms Broadbent did live in fear and that these fears were the motivational force driving her to her suicide.

This is hardly rational. Returning to the example of a suicidal youth, (and from my own experiences in this area working for some years with at-risk youth) their fears and concerns that drive them to the precipice will seem entirely reasonable and even logical at the time whereas a dispassionate observer would likely view them differently.

This is the nature of suicidal thinking: reality becomes significantly distorted to the point where suicide seems to be the only rational option - there seems to be no way out. At these times suicidal people can appear to be totally rational - their thought processes can be articulated well. We recognise the error in their thinking, in the first instance, precisely because they are contemplating suicide.

So, just because Ms Broadbent was articulate and had a seemingly well thought out raison d'etre does not mean that her decision to suicide was rational. Just because euthanasia advocate, Dr. Rodney Syme, did not believe that she was depressed does not make her decision any less problematic.

But Syme's apparent advocacy for 'rational suicide' is some what of a problem. Syme is the Vice President of Dignity with Dying Victoria and Chairman of Neither of these organisations supports suicide for the likes of Ms Broadbent:

From the DWDV website. DWDV does not support the following:
Assisted or supported death for individuals who are not suffering a terminal or incurable illness causing profound suffering, nor for people who are unable to properly document their choice in a state of mental competence. 
A publicly-available “peaceful pill”.
From the YourLastRight website:
Access to assisted dying is available only to those suffering intolerably and without relief from terminal illness or the advanced stage of incurable illness
As observed in the UK situation with SOARS, this apparent point of difference calls into question the limited objectives of legislation. In pushing for a limited model, is it likely that, if successful, groups like DWDV would simply celebrate their victory and then withdraw from the legislative and lobbying landscape? I think not. Legislators need to think about this.

Moving on to the question about media reporting. The Age issued a statement in relation to the Medew article as an apologia for publishing. Reporting on suicides is a sensitive issue where the possibility of such articles influencing others towards suicidal thoughts must be considered.

The Age argued a 'public interest' defence observing, as is the case, that there is a developing school of thought amongst mental health experts that reporting on suicides can be done sensitively and perhaps should be done in some circumstances. They mentioned 'a new approach'  from the Australian Press Council's guidelines about reporting that 'neither hides nor softens a major public health and community issue'. This statement is entirely subjective and offers a defence for almost anything under the rubric of subjectivity.
Yet the World Health Organisation guidelines, still remain:

• Avoid language which sensationalizes or normalizes suicide, or presents it as a solution to problems

Comment: The Age report does subtly suggest that rational suicide is 'normal'- at least in the Broadbent case. It also shows suicide as a 'way out' - a solution to problems.

• Avoid explicit description of the method used in a completed or attempted suicide
Particular caution should be exercised when the method of suicide is unusual. While this may appear to make the death more newsworthy, reporting the method may trigger other people to use this means.

Comment: Although the article takes a slightly more obscure approach to identifying the method (a good thing), the use of the term 'peaceful pill' will make the source and type obvious to many as well as providing a term for an easy 'google' search.

• Exercise caution in using photographs or video footage
Photographs or video footage of the scene of a given suicide should not be used, particularly if doing so makes the location or method clear to the reader or viewer. In addition, pictures of an individual who has died by suicide should not be used.

Comment: The article online includes a video or Ms Broadbent discussing her situation.

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