The suicide rate reaches records among the elderly in Switzerland. According to our analysis, this figure is increasing, largely due to assisted suicides. And yet the taboo remains. Investigation and testimony.
“For me, suicide has always been a possibility.” Since her youth, Anne perceives voluntary death as a way to be in peace with herself. At 67, she was a member of Exit and reserves the right to call on the suicide assistance association in the event of serious illness. If she confides on the subject of her very close and agrees to speak to RTS, this Swiss still recognizes that this question often causes “discomfort” in conversations.
However, in 2023, seniors committed suicide 42 times more than the rest of the population. A figure challenging, as the subject is little discussed. Especially since this evolution is upwards. In 25 years, the share of people over 85 who ended their days has quadrupled. This proportion has doubled among the 65-84 year olds. An impressive evolution that contrasts with the younger population, where the suicide rate is decreasing, by around 30% in two decades.
But a finer analysis of the figures reveals that this high rate of seniors which die in this way is explained, largely, by a significant appeal to assisted suicide. The latter, authorized since 1942 in Switzerland, on the sole condition that he does not meet an “selfish mobile”, is supervised by associations which pose their own conditions. In the space of 25 years, he experienced a dazzling development.
The figures of 2023 are unequivocal: the more age we advance, the greater the assisted suicide share. It is 8 times higher in 65-84 year olds than in the rest of the younger population. For example, 80% of suicides among 65-84 year olds were assisted. This share is over 90% among those over 85.
Different suicides
Associating assisted and unaccomposed suicide rates does not consensus in the medical environment. According to Pierre Vandel, chief doctor and head of the mobile team of the elderly in the university service of advanced age (SUPAA) of the CHUV, “it is possible to make the choice of assisted suicide without having suicidal ideas.” He explains, however, that some of his colleagues do not distinguish between the two.
On the side of suicide assistance associations, the accumulation of these two data is disputed. “Conscious suicides are different from the others (…) Do not confuse a pathological suicide, in a desperate situation, with assisted suicide”, maintains Jean-Jacques Bise, co-president of the association Exit Switzerland Romande since 2018.
However, our figures show that the border between assisted and unrealized suicide is by not waterproof. In very elderly people, where the rate is the highest, the statistical curves of these two types of suicide intersect and thus suggest a postponement of unaccomposed suicides to assisted suicides, particularly from the 2010s.
For Anne, put an end to her life, whatever the method, “it is almost the same thing. It is an important and difficult decision to take. Choosing not to live, it’s not simple and it is not at any time of life,” she deposits. “I am not sure that being part of exit facilitates this decision -making.”
Rise in assisted suicide
Exit has been proposing since 1982 to support its members in death. First reserved for incurable patients, the association extended its services, in 2014, to people with disabling polypathologies, immediate vital danger. It is also necessary to have its full capacity for discernment and a medical file to be assisted to die.
“We do not help people tired of life,” said Jean-Jacques Bise from Exit. In case of depression, is it possible to call on exit? “In Switzerland, a psychologically sick person can be helped, but if they want to die it is for the disease, not for depression”, retorts Jean-Jacques Bise. To the question of whether depression is a pathology, the co-president of Exit responds with silence. However, Pierre Vandel, of the CHUV, argues that depression is one of the two main causes of unaccomposed suicide among the elders, with social isolation.
Jean-Jacques Bise explains the use of assisted suicide of the elders by their declining state of health, the accumulation of pathologies, but also by a generational phenomenon. According to him, very old people come from a generation who fought for self -determination. He confides: “I myself have campaigned for access to abortion, for more rights.” Then he crosses his fingers, straightens up and affirms: “Article 10 of our Constitution guarantees personal freedom. It is your right to choose how to die. It is the ultimate freedom”. The word also returns to Anne’s voice. “Suicide, freedom”, she associates them.
Disparities between genres
Another striking fact: there are strong differences between men and women. In the past 25 years, the increase in suicide rate has been swollen by the assisted suicide of women, who knew little before. They particularly used it from the 2010s. Since then, they have been putting an end to their lives almost only in this way. Men are more likely to end their life without having to use an association.
“Men express their emotions less than women, which explains the difficulty in identifying suicidal thoughts,” articulates the psychiatrist Pierre Vandel. According to him, the underestimated detection of suicidal thoughts generates the impossibility of helping them, which explains the tendency of men to commit suicide more unreachable. “Matrimonial status also plays a lot,” he continues. “For a man, being alone, because separated, divorced or widower, is a risk factor. Marriage protects men.”
Why do women have mainly used assisted suicide since the 2010s, which has increased their suicide rate? “Because they survive their spouses and find themselves alone, often with polypathologies and have the will to choose their end of life,” said the co-president of Exit, 65% of which are women. “I gave a conference in Valais the other day and in the room there were almost only women. It has the impression that the end of life is a problem that only concerns women.”
Assisted suicide and dementia
The suicide of the elderly remains taboo, despite exit forecasts: it will not decrease. Faced with aging and the rise in dementia cases, the association wants to go further, with early guidelines in the event of dementia diagnosis. A proposal that promises serious debates: without the capacity of discernment and therefore of taking the lethal substance by the person himself, the dose should be injected. This would be a euthanasia and article 114 of the Swiss Criminal Code prohibits it. “We should change the law,” defends Jean-Jacques Bise.
The interview of the illustrious project: “I have been going to an EMS to help a person. Three weeks later, I come back for the meeting of assisted suicide and it was no longer possible, it was no longer capable of discernment.” Professor Pierre Vandel has often seen people ask for assisted suicide for fear of losing this capacity. He talks about “pressure” to act quickly: “I saw lucid people who said: there, I have my ability to discern, I have to do it,” he said, taken aback.
For Anne, things are clear: “My mom suffered from Alzheimer’s and it lasted a very long time,” she breathes. “I really have the feeling that the first flagrant signs of an Alzheimer’s diagnosis would push me to call on exit, to make myself help to leave this planet quietly. But afterwards, we are never sure of our strength in these moments. Before, I was certain that it would be simple and by advancing I just I will have the courage. (…) The irreversible side of the act can all of the act. A very strong desire to die, anchored to the body. “
Salomé Laurent
Information developed in the 7:00 am newspaper in the morning
