Suicide among the Terminally Ill

Rev. Cesar, D.Min, EdD

We normally associate suicide among younger member of the society, but there are cases of suicide involving the terminally ill population. Better palliative and hospice care has rendered terminal illness chronic, resulting in a slower dying process; however, the thought that death is inevitable may drive a patient to a depressive state. Suicidal thoughts among the terminally ill are temporary and largely associated with the person’s feeling of loss of self control and anxiety for the future and chronic or advanced medical condition can be a significant factor in driving a patient to think about suicide.

Some of the most common thoughts include wishing to die early; others may actually initiate suicidal acts using the easiest means at their disposal such as overdosing on the drugs they have access to. The thoughts of suicide among terminally ill patient is common, although clinical studies have shown that patients rarely complete suicide. Studies have shown that suicidal thoughts among cancer patients are twice as high compared to the general population.

Depression accounts for about 40% of suicide ideations; but separating those who qualify for a diagnosis of depression from those who are feeling sad about their quality of life and loss of independence may be difficult to do. Caregivers should not be afraid to ask their patients simple assessment questions to determine if the patient is suicidal. It could be something like, “are you feeling depressed/too lonely/scared,” “does the thought of ending your life or hurting yourself cross your mind as you deal with your medical condition?”

Although it may be difficult to predict a suicidal act, there are certain indicators that could suggest the patient may be considered a suicide risk such as prior suicide history, depression, social isolation, lack of self-worth, feeling thatr they are becoming a burden to other especially family members, existential and spiritual concerns, among others.

We at HOPE Hospice are very much aware of the struggles being faced by our terminally ill patients and we are sensitive to the reality that a patient might entertain suicidal thoughts or ideation. Our social workers and chaplains are trained to provide counseling to assist a patient get out of an unhealthy mode of thinking so that he can be at peace during his remaining days.