Today, in the Western world, everyone lives much longer than previously - an increase in prosperity, and many good developments in the medical sciences have made this possible. In the early stages of old age, most people can cope, perhaps setting new goals and meeting challenges as they arise. But, for so many individuals, as they move into their late 80s and 90s, there is a gradual decline, both physical and psychological.
Many very elderly people may still not suffer from a serious specific illness, but instead, from numerous, increasingly annoying health problems. When the unrelenting burdens of living, at a very advanced age, exceed the joys of being alive, competent individuals can finally reach the tipping point in wanting to die. Surely that final decision should be theirs, not made by anyone else. They know that they do not want to see themselves draining away still further before they are a completely empty self. They have become tired of the difficult and unpleasant symptoms of old age. They have to consider if they should die now or wait, thereby causing themselves and perhaps their families to suffer still more, and then die. It is surely their right when they are old and ailing to decide when is the best time to die, for themselves and for all those around them.
People are generally very frightened by the idea of suicide. Perhaps this is because it is painful to imagine that those we love might choose to die, to leave us permanently. However, if someone is suffering unbearably from the effects of old age, suicide gives that individual release from further suffering. This rational, or “balance-sheet” suicide makes excellent sense because the reasoning used can conform to normal logic.
In the UK, the main objective of the Voluntary Euthanasia Society (the first right-to-die society in the world, originally founded in 1935) was "to make it legal for a competent adult, who is suffering unbearably from an incurable illness, to receive medical help to die at their own considered and persistent request" - thus, including the possibility of doctor-assisted suicide for severely disabled individuals as well as endorsing the concept of "old age rational suicide". However, when the VES was re-structured in 2005, becoming Dignity in Dying, its main objective was limited to changing the law to provide doctor-assisted dying only for the terminally-ill (that is, those who are expected to die within six months). SOARS considers this change most unfortunate as disabled people and the very elderly can suffer much longer and more severely than the terminally-ill.
Today, it is very reassuring that in four European countries (Belgium, Luxembourg, The Netherlands and Switzerland) there is increasing support for old age rational suicide.
The Netherlands adopted adequate safeguards to permit both doctor-assisted suicide and voluntary euthanasia in 1981 - for those who had a terminal illness or suffered severely from an incurable disease. Then, in 2001, in order to examine the physical and psychological problems faced by many elderly people in that country, the Dijkhuis Commission was established (Dr Jos Dijkhuis was an emeritus professor of clinical psychology and psychotherapy). In its 2004 final report, this Commission noted that for elderly individuals who “had a hopeless outlook on their future...euthanasia legislation can indeed apply”.
Today, the main Dutch right-to-die society, Right to Die - NL ("NVVE"), has over 140,000 members (the national population is about 16,500,000). In 2008, this organization noted, regarding very elderly people, that “The total dependence on others, the loss of control over their personal life…(means) that every new day is experienced as an unbearable task…they are longing for death…they have become too old in their experience and wish to be released from their lives”. This Dutch society is undertaking further research and conferences on this important problem.
In 2010, a citizens' initiative, known as "Uit Vrije Wil" (or "One's Own Free Will") was started, seeking the legal possibility for elderly Dutch nationals to be able to have a doctor-assisted suicide if this is their competent decision. Over 120,000 signatures were quickly collected in favour of such legislation - with former parliamentarians, and many legal scholars and doctors giving their support. A draft bill has been prepared for parliamentary discussion. And, the Royal Dutch Medical Association (KNMG), in 2011, produced a supportive position paper, with its chairman noting that, among the very elderly, a "constellation of factors" could produce "unbearable and lasting suffering", when "euthanasia should be allowed".
In 2002, the European Court of Human Rights, in Strasbourg, noted (regarding the appeal made to it by Diane Pretty, who suffered from motor neuron disease) that “without in any way negating the principle of sanctity of life protected under the Convention, the Court considers that it is under Article 8 that notions of the quality of life take on significance. In an era of growing medical sophistication, combined with longer life expectancies, many people are concerned that they should not be forced to linger on in old age or in states of advanced physical or mental decrepitude which conflict with strongly held ideas of self and personal identity”.
In Switzerland, doctor-assisted suicide has been possible for several decades both for those who are terminally-ill as well as those severely disabled. In 2008, EXIT Deutsche Schweiz, the right-to die society in the German-speaking part of this country, held a conference on also providing similar assistance to Swiss citizens who are very elderly - in particular, it noted that, "it is about their own subjective and individual perception of their own dignity". And, in 2011, EXIT Deutsche Schweiz amended its statutes to reduce the "unnecessary hurdles placed in the way of the aged who are of sound mind and wish to die".
In April 2014, the General Assembly of EXIT Suisse Romande (the right-to-die society in the French-speaking area of Switzerland) officially broadened the scope of who it can help to include its elderly members who are suffering severely but were not terminally ill "since forcing them to continue living can be torture". Then, in the following month, EXIT Deutsche Schweiz, at its AGM, also agreed to widen its services so that its members who are suffering "from ailments linked to old age" can have the option of a doctor-assisted suicide.
There are three Swiss organizations - Dignitas (in Zurich), EX International (in Bern), and Lifecircle (near Basle) - which are willing to help foreigners to have a doctor-assisted suicide if they are terminally-ill, severely disabled, or elderly with medical problems, Fortunately, in May 2011, voters in the canton of Zurich rejected (by 78% to 22%) an attempt to prevent foreigners travelling there for a doctor-assisted suicide.
By 2014, at least 250 Britons have died in Switzerland with the help of one of these three Swiss organizations, and several of these individuals were excellent examples of "old age rational suicide".
SOARS is in regular contact with the leaders of the right-to-die societies in Belgium, Luxembourg, The Netherlands and Switzerland regarding their involvement in the procedures which are available for old age rational suicide in their countries.