Abstract

Recent decades have seen increasing survival gains in advanced developing countries, largely concentrated in the last stretch of life. However, the lengthening of lifespan has also had as a side effect the increase in periods spent under the burden of pain or discomfort considered by many to be unsustainable. In the context of these changes, a number of actions/inactions that limit or may limit lifespan are becoming increasingly common. Demography and quantitative sociology can provide a relevant contribution to the measurement of the extent of different end-of-life interventions, to the examination of differences in time, space, and among different social groups, and to the analysis of the behaviors and attitudes of different stakeholders (the sufferers, their relatives, health care personnel, and public opinion). This article focuses mainly on two aspects: medical practices that-without directly inducing death-can limit life span, and assisted death, that is, death directly induced by medical interventions. For assisted deaths we also consider connections with suicide implemented without involving others, specifically asking whether the increase in assisted deaths has led to a reduction in suicides. Finally, taking a more narrowly demographic approach throughout the paper, we ask whether the spread of all these endLa demografia del fine-vita 43 of-life practices leads to and may in the future lead to statistically significant slowdowns in the increase in survival