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Case Reports in Psychiatry
Volume 2016, Article ID 4242064, 5 pages
Case Report

Rational Suicide, Euthanasia, and the Very Old: Two Case Reports

1Older Persons’ Mental Health Service, St George Hospital, Kogarah, NSW, Australia
2Academic Department for Aged Care Psychiatry, Eastern Suburbs Mental Health Service, Randwick, NSW, Australia
3School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
4Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
5Dementia Collaborative Research Centre and Centre for Healthy Brain Ageing, University of New South Wales, Sydney, NSW, Australia

Received 12 August 2016; Accepted 26 September 2016

Academic Editor: Fabrice Jollant

Copyright © 2016 Anne Pamela Frances Wand et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Suicide amongst the very old is an important public health issue. Little is known about why older people may express a wish to die or request euthanasia and how such thoughts may intersect with suicide attempts. Palliative care models promote best care as holistic and relieving suffering without hastening death in severely ill patients; but what of those old people who are tired of living and may have chronic symptoms, disability, and reduced quality of life? Two cases of older people who attempted suicide but expressed a preference for euthanasia were it legal are presented in order to illustrate the complexity underlying such requests. The absence of a mood or anxiety disorder underpinning their wishes to die further emphasises the importance of understanding the individual’s narrative and the role of a formulation in guiding broad biopsychosocial approaches to management.