Medical illness is an important part of the motivation for suicide--a significant factor in about 50% of suicides in patients over the age of 50 years and 70% of suicides in patients over the age of 70 years. Depression, anxiety, and ambivalence about dying characterize both medical patients who attempt suicide and those who request assisted suicide. When the physical and psychological sources of the desperation that underlies requests for assisted suicide are addressed, the desire for death diminishes and patients are usually grateful for the time remaining to them. Improved psychiatric and medical care for those who are terminally ill offer significant possibilities for suicide prevention.