Robin Williams, Lewy Body Dementia, and the acceptability of suicide

Last updated on: November 6, 2015 at 12:46 pm by Jane the Actuary

Robin Williams, Lewy Body Dementia, and the acceptability of suicide 2015-11-06T12:46:29-06:00 Jane the Actuary

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Likely you’ve read one of the recent news reports that Robin Williams, at the end of his life, was experiencing the symptoms of Lewy Body dementia, a form of dementia which, unlike Alzheimer’s, is not characterized by memory troubles but by a host of other issues, including Parkinson-like stiffness, problems with mental sharpness, and, most unsettling for those afflicted, hallucinations. Because the symptoms tend to suggest other ailments, diagnosis is difficult, and, in Williams’ case, did not occur until the autopsy was performed, when the “Lewy bodies” can be identified in the brain itself.

My first reaction in reading these reports was, “oh, crud” because this matches, in many of its symptoms, the situation of a family member. But there was something else disturbing about these reports, and about the comments of those sharing them.

If you recall, when Williams first died, there were a raft of articles and facebook posts (among my facebook friends) saying, essentially, “Williams isn’t to blame for his suicide because he suffered from depression and couldn’t help it.” But the new line of thinking seems to go a bit further. Though I haven’t seen direct statements to that effect, it seems as if people are looking at this through the lens of assisted suicide: “Williams had dementia, and it was only going to get worse, so suicide is a rational and reasonable response, every bit as much as if he had gone to the doctor and gotten pills do to so under the label ‘assisted suicide.'”

Here’s the New York Times, for instance:

In the early stages, many people with the disease are aware of all these changes — and of their prognosis. The decline is steady, steeper than the average 10 percent drop a year in tests of cognitive function seen in Alzheimer’s; and there is no cure. Mr. Williams may have been both aware, and strong enough to act to avoid his fate.

And here’s Williams’ widow, Susan Williams, in an interview as quoted/paraphrased on CNN:

His decision to use a belt to hang himself from his bedroom door was, in Susan Williams’ opinion, his way of taking his power back, a painful choice for which she immediately forgave him.

I admit that, just now, I tried to find articles with comment sections to further bolster my impression that people have reacted with a sense that he had a good reason for suicide, and am coming up empty-handed. Perhaps readers have seen things they can share in the comments. But it’s nonetheless an impression formed not just by these two articles but by facebook comments and the like.

Which leads me to ask: how do we talk about suicide prevention if the emerging narrative are these stories of people who are deemed to have had “good reasons” to kill themselves? Do suicide hotlines first assess whether the person in question (whether they are directly calling, or if a family member is calling on their behalf) has, “objectively”, a good reason to want to live?

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