Simon R I
Georgetown University School of Medicine, Bethesda, MD 20814.
Bull Am Acad Psychiatry Law. 1989;17(1):83-95.
The suicide rate in the United States rises consistently with age. Silent suicide is defined as the intention, often masked, to kill oneself by nonviolent means through self-starvation or noncompliance with essential medical treatment. Silent suicide frequently goes unrecognized because of undiagnosed depression and the interjection of the personal belief systems of health-care providers and family members. Elderly individuals committing silent suicide are often thought to be making rational end of life decisions. However, the elderly committing silent suicide must be distinguished from terminally ill patients who refuse further treatment in order not to prolong the act of dying. The clinical/legal issues surrounding silent suicide will be discussed.
美国的自杀率随年龄持续上升。隐匿性自杀被定义为通过自我饥饿或不遵守基本医疗治疗等非暴力手段自杀的意图，这种意图往往被掩盖。由于未被诊断出的抑郁症以及医护人员和家庭成员个人信仰体系的干扰，隐匿性自杀常常未被识别。实施隐匿性自杀的老年人常被认为是在做出理性的生命终结决定。然而，实施隐匿性自杀的老年人必须与为避免延长死亡过程而拒绝进一步治疗的晚期患者区分开来。将讨论围绕隐匿性自杀的临床/法律问题。
