Nw novel explores idea of suicide pacts and dementia

Provocative new novel by We Need to Talk about Kevin author Lionel Shriver tackles geriatric suicide pacts – and expert warns it’s a growing real-life problem

  • Should We Stay or Should We Go by Lionel Shriver has been hailed by critics
  • Shocking novel follows elderly couple as they decide on a suicide pact together
  • Described as a ‘freewheeling meditation on mortality and human agency’
  • For confidential support, call the Samaritans on 116123 or visit a local Samaritans branch. See samaritans.org for details. 

The release of a shocking new novel following an elderly couple as they explore the idea of a suicide pact has prompted experts to warn there is an increased risk of the practice amid the Covid-19 pandemic.

Should We Stay or Should We Go by Lionel Shriver, who lives in the UK, is set to be released next week and follows married couple Kay and Cyril, who are approaching their 80s and concerned about developing Alzheimers.

Each of the chapters depicts 12 different alternative scenarios for what happens when the couple decide to take fatal doses of Seconal after concluding Britons  ‘aren’t living longer – they’re dying longer’. 

Its release comes weeks after Matt Hancock asked for data on those with terminal conditions who have killed themselves, launching a new debate on legalising assisted suicide.

Experts told FEMAIL the issue is at risk of growing, with psychological therapist Michael Padraig Acton saying: ‘Geriatric suicide pacts could definitely be on the increase, especially in times of a pandemic. 

Should We Stay or Should We Go by Lionel Shriver, who lives in the UK, is set to be released next week and follows married couple Kay and Cyril, who are approaching their 80s and concerned about developing Alzheimers

He continued: ‘People believe it’s just couples in geriatric circles, and I have come across this time and time again in my work.

‘It’s also friends, geriatric friends who no longer feel hopeful or no longer want to put pressure on their family or they’ve been diagnosed with something that is going to lead to a difficult ending for them.’

He continued: ‘All suicide is surrounded by lack of hope and isolation, and/or depressive symptoms of anxiety along the lines of “I can’t do this, I can’t make it”.

‘There’s a lack of community and community support now. We’re not really designed as humans to live in boxes and not be with other people.  

The novel follows a nurse and GP in the NHS, Kay and Cyril Wilkinson, who have treated numerous patients eroded by ageing and illnesses

‘If someone does feel isolated and hopeless, they’re anxious and concerned about their future, and they care about being a burden, they can reach out to charities and to their doctor/therapist, however, what is the moral code here?’

Michael argued there should be more research into suicide in the elderly, explaining: ‘We do keep people alive – but with longevity of life comes pain, chronic pain, disability, and also wealth aspects – can we live on a pension? Can we live on the good nature of our friends and family? It’s very complex. 

‘There’s a huge body of research in geriatric care but what happens in theory and scholastic circles isn’t what happens in the practical streets of our world.’

He added: ‘If someone is fearful of a friend or family member making a suicide pact, I advise they reach out to get solid advice from a professional rather than try to take on this by themselves.’

Should I Stay or Should I Go follows a nurse and GP in the NHS, Kay and Cyril Wilkinson, who have treated numerous patients eroded by ageing and illnesses. 

Cyril says he has seen patients in Britain’s aging population  becoming ‘grotesque’, adding: ‘We’re not living for longer. We’re dying for longer!’

The author previously previously wrote the bestselling novel We Need To Talk About Kevin – where a woman’s son becomes a mass murderer – which was later turned into a film

And while in their fifties, Kay’s father dies in a state of ruinous dementia who is described as battling a ‘degradation.’

She remains unable to remember anything but her father as ‘naked below the waist, purple with rage, and covered in faeces.’

The couple are determined to avoid the same grim fate and conclude that once they’ve both crossed that threshold on Kay’s 80th birthday, they’ll kill themselves.


Dementia is an umbrella term used to describe a range of progressive neurological disorders, that is, conditions affecting the brain.

There are many different types of dementia, of which Alzheimer’s disease is the most common.

Some people may have a combination of types of dementia.

Regardless of which type is diagnosed, each person will experience their dementia in their own unique way.

Dementia is a global concern but it is most often seen in wealthier countries, where people are likely to live into very old age.


The Alzheimer’s Society reports there are more than 850,000 people living with dementia in the UK today, of which more than 500,000 have Alzheimer’s.

It is estimated that the number of people living with dementia in the UK by 2025 will rise to over 1 million.

In the US, it’s estimated there are 5.5 million Alzheimer’s sufferers. A similar percentage rise is expected in the coming years.

As a person’s age increases, so does the risk of them developing dementia.

Rates of diagnosis are improving but many people with dementia are thought to still be undiagnosed.


Currently there is no cure for dementia.

But new drugs can slow down its progression and the earlier it is spotted the more effective treatments are.

Source: Dementia UK 

In chapter one, Shriver writes: ‘Everyone looks at what happens to old people and vows that it will never happen to them… Somehow they’ll do something so their ageing will proceed with dignity.’ 

The novel moves forward to Kay’s 80th birthday, before forking off to explore the different outcomes from the couple’s decision. 

In the UK, assisted suicide is illegal with anyone helping or encouraging someone to take their own life facing up to 14 years in prison in England and Wales. 

It’s far from the first time that Lionel has tackled a difficult topic with her work. 

She previously wrote the bestselling novel We Need To Talk About Kevin – where a woman’s son becomes a mass murderer – which was later turned into a film.

The 61-year-old who was born in North Carolina, but now lives in the UK, is also known for her forthright views.

In 2018, Lionel claimed that the negotiating of a sexual encounter has become so tedious she’d rather play Scrabble. 

And two years earlier, she hit the headlines when she said that the NHS should not fund fertility treatment as it’s not a human right to become a parent.   

During a private meeting last month, MP Matt Hancock told the All Party Parliamentary Group for Choice that he hopes the data on Britons with terminal conditions who have killed themselves will provide further information for a discussion on legalising doctor-assisted suicide across the nation, reports The Telegraph. 

Mr Hancock told MPs and peers that he had asked the statistician ‘to consider what should be published in terms of statistics that can inform the debate in this country.’

He also said that he wants the figures to ‘shed more light on the data of those at a time of their choosing’.  

Mr Hancock reportedly explained that he was initially against assisted suicide, but was left impacted after speaking to Sir Paul Cosford, who served as Public Health England’s medical director and died last month after a four-year battle with cancer.

He added: ‘I think it is important that public debate is informed by the best statistics.’ 

It follows nearly 50 senior doctors calling for an inquiry into the ban on assisted dying in Britain last year.

The move came just days after New Zealand voted to make assisted dying legal for terminally ill people. 

Other countries passing similar laws include Switzerland, Belgium, Canada, Colombia, Luxembourg, Holland and parts of the US and Australia. 

John Jules Leonidas Andre Faleur, 94, took his life two years after he survived a suicide pact with his French wife of 70 years, Nicole. He was found dead at his Denbighshire home in Wales earlier this year

A survey from last October also found that 50 per cent of British doctors believe there should be a change in the law to allow helping patients to die. 

It found half supported the change to allow the prescription of life-ending drugs. 

The results could pave the way for the UK’s largest doctors’ union to drop its long-standing opposition to assisted dying – its position since 2006.

Around four years ago the British Medical Association rejected a motion to adopt a more neutral position on the issue.

But the recent survey of its members found just 39 per cent are personally opposed to a change in the law, with 11 per cent undecided.

However, when it came to being prepared to actively participate in prescribing drugs which would lead to someone’s death, just 36 per cent said they would be willing, compared with 45 per cent who wouldn’t.

Is assisted suicide illegal in Britain? 

Under the Suicide Act 1961, anyone helping or encouraging someone to take their own life in England or Wales can be prosecuted and jailed for up to 14 years if found guilty of an offence.

Section two of the act states that a person commits an offence if they carry out an act capable of encouraging or assisting the suicide or attempted suicide of another person, and the act was intended to encourage or assist suicide or an attempt at suicide.

In 2015 MPs including former prime minister David Cameron rejected a Bill to legalise assisted dying.

Opposition to changing the law has come from faith groups, campaigners who say disabled people may feel pressured to end their lives and campaigners who fear assisted dying would become a business.


The union said the results of the survey of almost 29,000 medics and students will not determine BMA policy but will be discussed in a debate at its annual meeting next year. 

Over the last few years there have been several cases of apparent suicide pacts between elderly couples.

Last year, Welsh businessman John Jules Leonidas Andre Faleur, 94, was found dead at his Denbighshire home, having survived a suicide pact with his French sweetheart wife of 70 years two years earlier. 

In October, the inquest at Ruthin County Hall was told how the pensioner, who suffered with pancreatic cancer had entered a suicide pact with his wife, Nicole, in 2017. 

Both survived but Mrs Faleur passed away a few days later after taking an overdose. 

Her husband, John, who was also her carer, went on to make a full recovery. 

In the two years that followed, relatives said his mood appeared to be improving before he began having chronic back problems.

Mr Faleur had previously expressed suicidal thoughts and said he would end his life if it ‘became unsurvivable’. 

He was diagnosed with a crushed vertebrae and fell out of bed, telling friend and neighbour, Ann Jones he felt weak and had no energy.

The retired company director of Mold Road, Ruthin, was in too much pain to attend a family meal which had been planned for his 94th birthday on February 1, but said he had been looking forward to celebrating at a later date and hearing his son, Patrick play the violin.

But on February 23 last year, when Ms Jones let herself into the property, she found Mr Faleur dead in bed, having removed his wedding ring, watch and Careline button. 

Mr Meadows is pictured here in January 1976 aged 41 with Paula, left, as he and his family got set to compete in the  World Orienteering Championships

Retired Concorde pilot Tony Meadows (pictured) and his wife Paula were found dead at their home in Bucklebury, Berkshire 

And in 2019, the Queen’s former pilot and the first captain to fly Concorde from London to New York was found dead alongside his wife in a suspected murder-suicide.  

Tony Meadows, 84, and his wife Paula, 83, were found at their £800,000 home in leafy Bucklebury, Berkshire – less than three miles from the £5m home of the Duchess of Cambridge’s parents. 

Residents told MailOnline Mr Meadows was ‘fit as a flea’ and ‘devoted’ to his wife of 60 years, who had dementia. 

They said Mrs Meadows depended on her husband, who acted as her carer. 

The couple’s former daughter-in-law Katherine Meadows confirmed the news, telling MailOnline it was a ‘very difficult time for the family’. 

For confidential support, call the Samaritans on 116123 or visit a local Samaritans branch. See samaritans.org for details. 

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