Women Most Frequently Targets of Mercy Killing; Men Most Frequently Commit the Killing, Colorado State Study Shows

A study of more than three decades worth of records of mercy-killings in the United States suggest that two-thirds of those who die are women, while the killer is usually a man, according to a Colorado State University psychologist.

The study found that a majority of mercy-killings involved women and men as opposed to male-male or female-female killings. The mercy-killer and mercy-killed were typically a couple or a child and parent, said Silvia Sara Canetto, associate professor of psychology at Colorado State. She co-authored the study, recently published in Omega-Journal of Death and Dying, with former graduate student Janet Hollenshead.

Only about a third of those described as sick had a terminal illness. However, no information on the possible terminal nature of the illness was available in half of the cases. In cases where the age of the mercy-killed was known, more than 70 percent were age 60 or older.

These figures were derived from statistics kept by The Hemlock Society, an organization that advocates mercy-killing and assisted suicide. The organization defines mercy-killing as "the killing of a terminally or incurably ill person to put him or her out of perceived misery" without necessarily knowing "the intent of the suffering person." In 85 percent of The Hemlock Society cases, no information was available on whether the victim had made an overt request to be killed.

Canetto said the most common method used in mercy-killing was shooting, followed by suffocation and poisoning.

Canetto noted that the record collected by The Hemlock Society might be skewed as a result of some unknown factor. In any case, The Hemlock Society’s record probably represents a lower limit of actual cases of mercy-killing, an unknown number of which are never reported.

Still, Canetto said, one wonders why the majority of mercy-killings involve a male killer.

"Men take lives, their own and others, more often than women," she said. "Still, it is not clear at present clear why men are more likely to mercy-kill women rather than other men."

Hemlock Society representatives have suggested that mercy-killings indicate insufficient support for terminally ill persons and for the caregiver, but Canetto said that doesn’t account for the preponderance of men among the mercy-killers, especially as women far outnumber men in caring for dependent older adults. These cases may be related to some men’s inability to accept a reversal in caring responsibilities, but Canetto said there are other key questions. How does the mercy-killing of women fit within broader social patterns of devaluing women’s lives? For example, women are offered less quality medical care than men, according to a 1991 American Medical Association report that also found women are less likely to receive critical, life-saving diagnostic and therapeutic interventions, such as kidney transplants. Canetto, in a 1995 study, discovered older women are more likely than older men to experience chronic illnesses and disabilities that may be viewed as diminishing the value and quality of their life.

Women may internalize this diminished sense of self-value and may ask to die when sick and disabled, Canetto said. However, that request may involve multiple meanings and intents, possibly masking an effort to take control or disguising a request for support and care. It may hide depression or represent an indirect request for a reason to live (i.e., "Do you care enough to want me alive and to be willing to share in my suffering?"). Canetto emphasizes one should not assume that a request to die is meant to be taken literally.

Also, despite the best of intentions, acceding to a request to be killed represents a final decision. As Canetto said, "Dying is a choice that ends all choices." The main point, however, is that killing is not made justifiable by a request to be killed (any more than slavery is justified by the person agreeing to be enslaved). There are some fundamental rights of the individual that cannot be taken away, even if the person asks.

"Many people may view women’s high rates of death by mercy-killing as an indication of men’s beneficence or of women’s healthy pragmatism, rational thinking and self-determination," Canetto said. "Yet one should be wary of those who present mercy-killing as a gift to women. These are fatal gifts, embedded in a long tradition of legitimizing women’s sacrifice."

Future research, she said, should examine how it is that mercy-killers determine "intolerable" suffering, what factors contribute to the decision to mercy-kill in response to suffering, the role of depression in the mercy-killing and factors leading depressed males to kill a dependent family member.

A final issue is the implications of the findings for public policy. Data from a variety of studies, including those of assisted suicide, suggest that older women are overrepresented among those whose death is hastened, legally and illegally, voluntarily and involuntarily.

"If older women are uniquely affected by the legalization of hastened death, then policies presented as ‘neutral,’ enhancing self-determination, dignity and choice in death, may actually be dangerous to older women.

"Many women do not have the resources, the sense of entitlement or the power and freedom to make the choice they desire, especially when they are sick and disabled," Canetto said. "And the freedom to be dead is a very peculiar freedom."