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Ciênc. saúde coletiva vol.17 n.8 Rio de Janeiro Aug. 2012
Talking about suicide is also talking about life and quality of life
Marília Viana BerzinsI; Helena Akemi WadaWatanabeII
The article under discussion is the result of extensive nationwide research and manages to touchingly reveal the dramatic situation of elderly individuals who decided to end their own lives by suicide. It is an important contribution to elderly studies, because it offers readers an opportunity to expand their knowledge about why elderly people decide to advance their death. The text places the issue in the spotlight as an important public health problem: it reveals that elderly individuals who commit suicide are the ones more likely not to be found and helped in time. The fact that elderly individuals use more lethal methods that younger individuals is extremely serious and this nearly always results in a fatal attempt. Is suicide committed by elderly individuals an act that aims to expose the despair of lives that have lost their social or existential meaning?
The contents of this article are unsettling and lead us to ask why we have little research about the matter. Also, we wonder why the issue is not address in preventive action taken in the healthcare sector. Example cases chosen by the authors follow the stories of six suicidal individuals. If we consider that suicide is a communication web, the report has significant impact when it alerts us to the final moments of individuals who commit suicide. Ages vary widely. Places, methods, stories and circumstances are also different. What they have in common is that individuals gave up living and communicated this through their final act. The study also contributes to the discussion about the dramatic situation experienced not only by elderly individuals, but also their families or people close to them to the extent that the methodology used in the study provided the opportunity to rebuild the path followed by elderly individuals who died by suicide until reaching their final act.
This text provides us an opportunity to think about our dangerously weak public policies involving vulnerable and fragile elderly individuals. It causes us to question directly and indirectly the social structure provide appropriate care to those people and whether social protection tools are adequate to cover the population that is ageing fast. The 51 suicide cases of elderly individuals across ten Brazilian municipalities illustrate the phenomenon, which tends to increase according to the authors. It seems to us that the deaths of those elderly individuals who died by suicide call for, among other things, a more humane world and cry out for changes that can achieve this. This is why it is our understanding that this text in fact discusses life and can influence us, the living, to consider the need to change our social behavior toward life and old age. Therefore, the elderly individual who commits suicide breaks the pattern of silence about their suffering and invades the public space; they cease to be anonymous and reveal strong and decisive messages and questions to friends, family and the society.
There is no precise and definite answer to suicide, the authors tell us. We believe that this is an issue with multiple answers, since it involves life and death coming together and pulling apart, revealing in all its essence the existential contradiction and ambiguity of the human being. According to Durkheim, suicide consists of all deaths resulting directly or indirectly from a positive or negative act, perpetrated by the victim him/herself, knowing that it would produce this result. However, as a few authors remind us, suicide is a process that does not end with death. It is a gesture of communication that aims to deepen the understanding of relationships between those who kill themselves and the society in which it happened. What is this communication or message?
For everything that has been said, this study is unquestionably relevant considering the growing number of elderly individuals in the country. Statistical data of the Brazilian Institute for Geography and Statistics (Instituto Brasileiro de Geografia e Estatística - IBGE) in its 2010 Census tell us that we are no longer a country of young people as in the 1970's and 1980's. Our country will become the sixth with the largest elderly population worldwide in the next few years. Despite that data, unfortunately population ageing has not yet been included in the agenda of most Brazilian public policies. It is undeniable that we have come a long way building the legal framework of public policies targeting elderly people. However, there is still much to be done to enforce the achieved rights. It is up to the Brazilian government to develop social and sectoral policies to enforce fundamental rights in understanding old age as a strictly personal right.
All data converge to show how public policies should consider that it is important to maintain social bonds in old age, as well as to preserve social activities that are not limited to healthcare actions. This study may be useful, among other things, to show how the following are important: social security and assistance, support for families, pro-active services that leave rooms in institutions and go to where elderly individuals are. It is important to pay special attention to elderly men who are the greatest victims, preparing them for retirement, new social roles and proposing changes to the macho culture they grew up in.
Finally, once again it is necessary to say that the article makes us think about life. Life should be enjoyed with quality. Elderly individuals need to be treated with dignity and respect and society should invest in their right and place in social life. Discrimination, prejudice, stereotypes associated with old age need to be overcome. The text also appeals to the urgent need to rebuild concepts and create new paradigms about how one grows old and experiences old age. The study contributes to this discussion and stimulates us.
Population ageing in Brazil undoubtedly challenges the government, society and families to find feasible and efficient solutions to respond to a wide range of needs of people who are growing old, aiming to reduce inequalities, inequities and investing in actions that will make sure those individuals can live in dignity and enjoy life fully, so that suicide is not an alternative to terminate one's life.
In summary, the issue of suicide requires very special attention from the entire society. The act of suicide is part of life. It is a social behavior that may be avoided to the extent that there are available alternatives to the act of desperation. Suicide is a form of communication in which people who choose it are saying that they own their own lives. The article awakens us to make sure those who have decided to end their existential passage will have a voice.
We believe that sharing information from the text will allow it to be used by elderly individuals themselves, by those who work with them in the social or health sectors, by their families, by society and by public policy managers.