When the Old Commit Suicide
Suicide among the elderly in Korea is disturbingly common, a New York Times article reports. In Korea, the article explains, parents tended to look to their children for security in old age, essentially in the place of a pension. As a consequence, they would pour their life savings into their children’s education. The suicides happen when the elderly parents find they have no resources left and the children have not stepped in. It is not clear whether the children actually refuse to help in most of these situations, but it is humiliating for the parents to ask in Korean culture, and many parents do not want the burden of providing support to compromise their children’s success.
The Times article attributes the despair of so many elderly to the breakdown of traditional Confucian attitudes. This makes a certain amount of sense. Confucianism involves a self-conscious embrace of tradition. It emphasizes respect for others and respect for self through the fulfillment of responsibility. Filial duty is therefore extremely important in a society guided by Confucian principles.
Citing the facts that the public pension system was only begun in 1988, that it does not cover many of the elderly, and that it provides only a meager allowance, the article appears to suggest that more pension benefits and social programs would alleviate the problem. I would of course need more information than I have available, especially about Korea, before attempting to evaluate this suggestion, but the facts do present an interesting chicken and egg problem.
Does the existence of a developed market economy and the accompanying social mobility inherently weaken the bonds of family and generate difficult conditions for the most vulnerable—the elderly, the mentally ill, the severely disabled, and some children (because weakening family structure inherently means more marital dissolution)? If so, advocates of the welfare state have an argument, whether it is decisive or no: public benefits could help alleviate these problems. On the other hand, the article mentions that Korea’s pension system was developed in 1988. So it could be the case that public benefits cause the weakening family structure. The logic in other contexts is obvious: when the government pays for school breakfast, for example, parents often no longer bother to provide breakfast for the kids.
In any event, the tragic situation of many Korean elderly raises questions about dependence on family—when it is healthy, and when it is not. I know of a diplomat who spent some years in Somalia. He observed that when a person became wealthy in that society, his relatives would typically descend on him for support. The degree of familial dependence therefore made social mobility difficult. Even in this country we can see that it is often a bad sign when adult children move in with their parents. And yet the traditional Korean pattern of intergenerational dependence, at least as described in the Times article, does not seem so parasitic. Surely any modern culture in which the vulnerable find themselves alone, whether or not they make the ultimately destructive and irrational decision, leaves something to be desired.
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Jul '11
Re: When the Old Commit Suicide
A trend you'll see here mostly based on the dismal, perhaps necessarily dismal health care of the elderly.
Re: When the Old Commit Suicide
It shouldn't have to be that way, should it? I hate to think of a society measuring out a person's worth -- or expended worth -- and concluding, Oh well, they might as well end it themselves.
Social Security was designed to circumvent this, originally. Demographics have made it untenable. We're going to have to figure it out.
(We have, of course: privatizing retirement accounts and backstopping them with a minimum amount of security. But that seems to be a non-starter....)
Jul '11
Re: When the Old Commit Suicide
I have two older patients that are losing a leg from vascular issues. One is getting it removed with a world of family support, the other is about to stop all her heart medications, which keep her alive, go on hospice and get fairly aggressive morphine and tranquilizer treatment, thus ending her life. One wants to live, one has had enough. I support both patients. In this brave new world we are heading in to, money for the elderly will dry up. I am positive of this. Those with loving supportive families will do better if they need elder care. Those who did not save, could not save, or have no family, are in for it.
Oct '10
Re: When the Old Commit Suicide
Dare we say it? South Korea is one of the most Christian nations on earth. Has anyone taken even a modicum of effort to ascertain whether this is true among the Christian community?
The same question might apply here in the West. Do the pathologies that beset us here occur at to the same degree among believers. And even here, when we say Christian, are we talking about people who love God and have given their lives to Christ, or people who merely acknowledge a cultural form of Christianity that has no weight in their lives.
Paul said: "They will act religious, but they will reject the power that could make them godly. Stay away from people like that!" -- II Timothy 3:5.
We Christians must beware the pride that comes from believing the Truth. We need also to humbly undertake to help those who are blind, whether deliberately or simple ignorance.
God help us if we become as the infidels, constantly seeking but unwilling to find.
Jan '12
Re: When the Old Commit Suicide
Unlike the crisis of an un-planned pregnancy (and the concomitant struggle that those involved have to engage in over the choice of whether to abort, or not), the challenge of dealing with our sick and ageing family members does not run its course after nine months.
Long before our government programs run dry, we will see state laws change to allow for more and more 'assistance' with dying.
Our national conscience has been seared over the past forty years, by the acceptance of abortion for convenience, whilst witnessing the cruel irony of tens of thousands of childless couples who have had to go abroad for foreign babies if they wanted to adopt.
What happened in one week on that ill-fated Carnival Cruise ship that lost power in the Gulf of Mexico recently, will play out across out land as families, and local and regional governments deal with the 'crisis' of the sick and elderly and the shortages of everything, including medicine, care and beds, but especially patience and kindness.
It will rapidly become a 'dog eat dog' world. This will truly be our 'decline and fall'; I just hope and pray that I am wrong.
Nov '11
Re: When the Old Commit Suicide
Barbara Kidder:
It will rapidly become a 'dog eat dog' world. This will truly be our 'decline and fall'; I just hope and pray that I am wrong. · 2 minutes ago
I fear you are right, and yet I meet many people who are going to great lengths to help the elderly in their families. Those I worry about are the ones DocJay mentions, that is those without families. While I know two nonagenarians without any family, I know many middle-aged people with little or no family support. This is quite a different situation from that described by Professor Rahe, but I can easily imagine that there will be an increase in suicide among that group of people.
Apr '12
Re: When the Old Commit Suicide
South Korea has an appallingly low birth rate, one of the lowest in the world. This is definitely part of the problem. They have high educational standards, making people feel they have to give their children an expensive private education in order to be competitive. But it's a lot easier to provide for parents when the younger generation is larger and able to share the burdens around. Obviously, this demographic problem will also make it quite difficult to build a sustainable entitlement system.
Jan '12
Re: When the Old Commit Suicide
Sandy
Barbara Kidder:
It will rapidly become a 'dog eat dog' world. This will truly be our 'decline and fall'; I just hope and pray that I am wrong. · 2 minutes ago
I fear you are right, and yet I meet many people who are going to great lengths to help the elderly in their families. Those I worry about are the ones DocJay mentions, that is those without families. While I know two nonagenarians without any family, I know many middle-aged people with little or no family support. This is quite a different situation from that described by Professor Rahe, but I can easily imagine that there will be an increase in suicide among that group of people. · 8 minutes ago
Add to the, "little or no family support", little or no savings, no church family, nor neighbors who are around during the day and you have a barren landscape, indeed.
Judging by the frequent advertisements for a 'reverse mortgage' that I see on the television, those folk who have begun to live off the equity in their homes will be consuming the only thing left that constitutes their 'value', in the eyes of those around them.
Sep '12
Re: When the Old Commit Suicide
I'd take a step further back and say that nobody's poor until someone isn't, meaning that "developed" societies create poverty by creating wealth. Next - keeping to the fundamentals - I'd say that family is the best collective strategy for managing scarcity to extend individual lives: I take care of you when you're young and can't take care of yourself, then you take care of me when I'm old and can't take care of myself.
When no Koreans were poor, scarcity management rewarded family, which Confucianism bolstered. Now that some Koreans are poor, including many old people, and young people have discovered that they can ditch Confucianism, all must decide whether to extend the lives of the old via family or yield to scarcity and death. An old Korean can unilaterally decide for himself....
Jul '11
Re: When the Old Commit Suicide
Rachel, our demographics are equally as scary considering the massive cost of medicine, our fractured families, and the tsunami of baby boomers. Many of those boomers have highly unrealistic expectations and will attempt to vote themselves the blank paycheck that is our failing Medicare system. Too many people, a massively overpriced and unwieldy system, with fewer actual producers leave us in a world of hurt. I promise all of you that this ugly situation is going to become dramatically worse. I predict a substantially higher rate of elder suicides in our country in twenty years. Heck, I may even be one rather depending on my needs. My desire to burden my family is as low as my expectations of medical quality are four decades.
Apr '11
Re: When the Old Commit Suicide
Doc. I'm married to a doc. We two are on the leading edge of the baby boomer wave. Having just come through a physical rough patch, I found it eerily fascinating to have encountered L.T. Rahe's post here in the wee hours.
Your account of your two patients left me asking the questions of myself that I've been dodging for the last several days.
These musings are rather frightening. When the easy answers don't follow . . . . I try to pull up and remind myself that our ancestors did not have the luxury of facing these dilemmas.
They would have buried children and spouses and slipped into eternity decades earlier than we.
A broader perspective affords a bit of comfort as we navigate through this dark night.
Dec '11
Re: When the Old Commit Suicide
Korea has a suicide problem. I have heard that it has the highest rate of suicide among men. I looked it up and copied it from the "Suicide in South Korea" Wikipedia page.
I hate suicide for the pain it causes for those left behind. It is very sad that people consider this a viable option. Death comes soon enough there is no need to rush things.
Edited on February 24, 2013 at 5:53pmMay '10
Re: When the Old Commit Suicide
Deeper than the economic crisis we're facing is a spiritual crisis. We have lost a reverence for life. We have conflated the meanings of value and utility. We forget God.
The only real solution is to return to Him.
A restored reverence for life means:
1) Married couples will have more babies
2) Families will care for the old and infirm
3) Suffering will be less terrible, because its redemptive power will be recognized and honored
4) Death will be less fearful, but suicide more abhorrent.
5) Religious orders and charities dedicated to caring for the sick and lonely will bloom.
We will try in vain to solve the economic problems if we don't address their underlying spiritual cause.
May '10
Re: When the Old Commit Suicide
I would not call this suicide, unless she deliberately takes a lethal dose of morphine.
There is a world of moral difference between declining treatments and interventions that prolong my life and killing myself.
Nov '11
Re: When the Old Commit Suicide
I've thought about this (not in terms of SKorea) and think it much the same as it ever was (like many social issues- there is not really more depression or stress these days, for example). The details just change.
Look around at your friends and acquaintances, especially if you of a certain age. Many are worrying over, and caring for their elderly parents. They are moving them from Arizona to where they live, most likely. It may be to Assisted Living and not their own homes (although many have little houses on their property- how blessed!) but close to where they can visit, take them shopping, have them over, etc.
On the other hand there have always been elderly whose kids don't help out, or who do not have kids or resources. I just don't believe the real numbers, either way, have changed much over 'the history of the world' except (in the US) perhaps for the better as many of the baby boomer kids actually have money.
Apr '12
Re: When the Old Commit Suicide
DocJay, our demographic problems are serious, and obviously entitlement spending is a huge, huge problem. It can't go on, but persuading the Boomers to accept less is massively difficult. I have elderly relatives who like to gripe about what Medicare won't cover or how much they have to pay. I keep my mouth shut because I'll be surprised to get anything from the government by the time I reach their age.
But here's the really sobering thing: as bad as our demographic problems are, we're the relatively bright spot in the developed world! Our birth rate only just fell below replacement these last few years. We're still hanging around 1.8 or so; South Korea has been at an abysmal 1.2 for several years. Their elder bulge problem is much worse than ours. Similar story for Japan and Singapore and some European countries are only a bit better.
Worst off, quite possibly, is the Islamic world. Their birth rates have tanked but they don't have the resources that we have even to feed their elderly. There will be serious starvation in these countries in the not-distant future.
May '11
Re: When the Old Commit Suicide
One of the things that Mother Teresa's life taught us is that the destitute and the dying have a purpose in being here something to give to us during the time they remain with us.
Jul '11
Re: When the Old Commit Suicide
L.T., the elderly are wonderful to spend time with. I enjoy my job immensely. I feel very blessed to care for them and have them as friends. Katievs, you're correct about that scenario. Hospice care is far different from assisted suicide.
Mar '12
Re: When the Old Commit Suicide
When my in-laws were discovered to have dementia (him) and alzheimers (her), we converted our basement and took them in. When my mother in-law was too far along to be cared for at home, she was put in a nursing home, and then visited daily. She was not abandoned.
We noted a lot of the people at the nursing home did not get visits. I don't know why that is, only that it was a regular observation. Some of those patients would come and sit near us, so I assume it answered a need in those patients.
In the west, it appears that a lot of people have been abandoned. Women abandoning men. Men abandoning women. Children being abandoned. A break with religion or a good philosophy (such as Confucianism) and whatever bonds it provides. Abortion as an answer. Kervorkian as an answer. Terminating the elderly and the very sick as an answer.
SKorean is probably a harbinger of what the rest of the west will be seeing.
Dec '11
Re: When the Old Commit Suicide
I am surprised that no one has commented on the statistic in comment #12.
No one is talking about the pressure cooker that Korea is. Many young people kill themselves when they cannot pass the test to get into college. Others killed themselves while they are in the prime of life after facing problems. I don't know how it is in Korea but in Japan suicide was taking an honorable way out. This seems appropriate in a Eastern mind set for parents who sacrifice for their children to self sacrifice for them at the end of life.
The life has changed a lot in Asia. At one time people had nothing and family had to pull together. Now people have so many conveniences that life is unimaginable without them. Their grandparents lived hard lives and survived. Why is it that modern man throws in the towel so soon? Why is it that killing seem so easy an option for people? Why are people caught up in "quality of life" and not "life"?