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The Meaning in Life in Suicidal Patients: The Presence and the Search for Constructs. A Systematic Review
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Rational Suicide in Late Life: A Systematic Review of the Literature

Institute of Psychiatry, Università degli Studi del Piemonte Orientale, 28100 Novara, Italy
S.C. Psichiatria, Azienda Ospedaliero Universitaria Maggiore della Carità, 28100 Novara, Italy
Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy
Nîmes University Hospital, 30029 Nîmes, France
Author to whom correspondence should be addressed.
Medicina 2019, 55(10), 656;
Received: 19 August 2019 / Revised: 15 September 2019 / Accepted: 20 September 2019 / Published: 29 September 2019
(This article belongs to the Special Issue Preventing Suicide in Patients with Mental Disorders)
Background and Objectives: The complex concept of rational suicide, defined as a well-thought-out decision to die by an individual who is mentally competent, is even more controversial in the case of older adults. Materials and Methods: With the aim of better understanding the concept of rational suicide in older adults, we performed a systematic review of the literature, searching PubMed and Scopus databases and eventually including 23 published studies. Results: The main related topics emerging from the papers were: depression, self-determination, mental competence; physicians’ and population’s perspectives; approach to rational suicide; ageism; slippery slope. Conclusions: Despite contrasting positions and inconsistencies of the studies, the need to carefully investigate and address the expression of suicidal thoughts in older adults, as well as behaviours suggesting “silent” suicidal attitudes, clearly emerges, even in those situations where there is no diagnosable mental disorder. While premature conclusions about the “rationality” of patients’ decision to die should be avoided, the possibility of rational suicide cannot be precluded. View Full-Text
Keywords: rational suicide; old age; late life; aging; ageism rational suicide; old age; late life; aging; ageism
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Gramaglia, C.; Calati, R.; Zeppegno, P. Rational Suicide in Late Life: A Systematic Review of the Literature. Medicina 2019, 55, 656.

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