When elderly people are ideating on manners to end their lives, because they feel life is over and no longer worth living, it is important to understand their lived experiences, thoughts and behaviour in order to appropriately align care, support and policy to the needs of these people. In the literature, the wish to die in elderly people is often understood from a medical, psychopathological paradigm, referred to as cognitive impairment, depressive disorder, pathological bereavement, and suicidality. In this paper, we evaluate this dominant paradigm by considering three serious limitations, namely: (1) the risk of epistemic transformation; (2) the risk of reduction; and (3) the risk of obscuring the social and cultural embeddedness. Drawing on insights from our empirical–phenomenological research on the issue of elderly and the self-chosen death, this paper argues for a phenomenological perspective to counteract the medicalisation of death wishes in elderly people.
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An earlier version of this article was presented at The European Conference on Philosophy of Medicine and Health Care 2015 on Medicalisation. We thank Karin Dahlberg, Fredrik Sveneaus and Hanneke van der Meide for their comments on a previous version of this paper. This study was funded by The Netherlands Organisation for Scientific Research (NWO): Grant number 023.001.035.
Conflict of interest
The authors declare that they have no conflict of interest.
The Medical Ethical Review Committee UMC Utrecht evaluated this study. This committee confirmed that the Dutch Medical Research Involving Human Subject Act (WMO) did not apply, as participants were not patients but mentally competent citizens, and participants were not subjected to treatment or required to follow a certain behavioural strategy as referred to in the WMO (art.1b). Subsequently, official approval of this study was not required (protocol: 13-176/C).
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van Wijngaarden, E., Leget, C. & Goossensen, A. Disconnectedness from the here-and-now: a phenomenological perspective as a counteract on the medicalisation of death wishes in elderly people. Med Health Care and Philos 19, 265–273 (2016). https://doi.org/10.1007/s11019-016-9687-4