Suicide methods

A suicide method is any means by which someone purposely kills himself/herself. Methods that have been used to commit suicide include:

Bleeding

Exsanguination is a method of death which is caused by blood loss. It is usually the result of damage inflicted on arteries. The carotid, radial, ulnar or femoral arteries would be targeted.

Cutting wrists

This may damage the tendons, ulnar and median nerves which control the muscles of the hand, which can result in temporary or permanent reduction in sensory and motor abilities.

Cutting the carotid artery

Cutting through the throat is one method of exsanguination. Damage is inflicted to the carotid artery which carries blood to the brain, and it takes no longer than a few minutes to lose enough blood for death to occur, although death could also be caused by blood clogging the trachea. People who do this often cut the recurrent laryngeal nerve, the nerve that goes up to the voicebox and larynx, and lose their voices.

It was also practiced as a ritual suicide method in Japan, by noble women for the same purposes as seppuku was used by men.

Burning (self-immolation)

Main article: Self-immolation

Self-immolation is the act of setting oneself on fire; an accelerant such as gasoline is frequently used to hasten death.

There are many documented cases of this method as a public and often spectacular method of protest, particularly but not exclusively within or against repressive regimes. Thích Quảng Ðức, a Buddhist monk, burned himself alive in 1963 in protest against the oppression of Buddhism by the administration of Vietnamese Prime Minister Ngô Đình Diệm. The BBC has reported that there have been a significant number of cases among Afghan women.

Burning to death can take several minutes to several hours, making this a painful way to expire. Death may result from smoke inhalation, shock, charred lung tissue or, after a period of days, systemic failure. A person who survives self-immolation may still suffer extensive burns.

Drowning

Suicide by drowning is the act of deliberately submerging oneself in water or other liquid and staying there long enough to prevent breathing and deprive the brain of oxygen. Genuine cases of drowning are determined by whether the victim's lungs are filled with water. As with other deaths by suffocation, if the drowning is stopped before death, oxygen deprivation can cause brain damage.

Drug overdosing

Suicide by pharmaceuticals ("overdosing") is a method which involves taking medication in doses of several times greater than the indicated levels, or in a combination which will enhance each drug's effect. Due to the unpredictability of dosing requirements, death is uncertain, and an attempt may leave a person alive but with severe organ damage. Many drug overdose patients go into a coma; only three to five minutes without oxygen can do permanent damage to the brain - memory is destroyed and the ability to read and speak is reduced. Drugs taken orally may also be vomited back out before being absorbed.

Painkiller overdoses are among the most common due to easy availability of over-the-counter substances.

Aspirin, a commonly used drug for suicides, is an acid, and burns the gastrointestinal tract, can burn out parts of the nervous system, can make people deaf or develop a ringing in their ear that doesn't go away.

The pain reliever Acetaminophen, sold as Tylenol, causes the painful death of an hepatic coma. It can also cause the liver to become diseased and if this happens the results can be similar to those of hepatitis: jaundice, itchy skin, depression, long-term listlessness, inability to eat much. People often sleep off the initial sickness caused by taking Tylenol, but, the liver is destroyed, and they start to feel sick again, pass into a deep coma and die.

Swallowing lye, Drano, oven cleaner, and other household caustics is supposedly the most painful way in which to die from a drug overdose. It seeems that very few people that ingest caustics die, and if they do die, it's days, weeks or even months later, of infection. Caustics scar the mouth and tongue, puncture holes in the esophagus, burn the chest from the inside and block the gastrointestinal tract with scar tissue. Even the process of treating the inner burns is painful; surgeons drop an endoscope, or fiber-optic camera, down the person's throat, unavoidably scraping against the raw nerves there, to see what the damage is. Repairing an inner burn can take fifteen to twenty years worth of surgical operations plus fluid therapy and antibiotics to keep infections from growing. Swallowing can be painful for the rest of the person's life, and survivors of such attempts have to be fed intravenously for years afterwards.

Psychiatric drugs have lots of side-effects- dilated pupils, dry mouth, feverishness, speeded-up heartrate, slowed-down digestive muscles, breakdowns in coordination, rolling eyes, and overdosing can increase these in any part of the body. The hand muscles can contract violently after a phenothiazine overdose, leaving the fingers permanently warped. Tardive dyskinesia, a Parkinson's Disease-like condition, can be accelerated by an overdose. The most common permanent damage from overdose is brain damage, caused by seizures and fibrillation.

Sleeping pills and mood pills- the sedative hypnotics- barbiturates like Seconal, mild tranquilizer like Valium are used quite commonly for suicides. Typically, a sedative overdose will do nothing more than put you to sleep for a day or two and leave you with a bad hangover and a case of the slows when you wake up. But like many other overdoses, sedatives are often taken with alcohol, which makes people nauseous. Anyone who vomits when they're passed out risks sucking some of the vomit into their lungs, which is called aspiration. Vomit contains enzymes from the stomach that destroy tissue, and those go to work on the lung walls. It also contains a rich broth of food, perfect for pneumonia bugs to grow in. People can also drown in vomit; which keeps air from getting to the brain, which once again causes brain damage. An aspirating patient goes into intensive care; a device called a bronchoscope is used to look into their lungs and pull out whatever pieces of vomit it can.

Overdosing may also be performed by mixing medications in a cocktail with one another or with alcohol or illegal drugs. This method may leave confusion over whether the death was a suicide or accidental.

Electrocuting

Suicide by electrocution involves using a lethal electric shock to kill oneself. A high enough voltage can overcome the high resistance of the skin and pass a sizable current through the trunk. A large alternating current through the body can seriously disrupt nerve signals and can cause the heart to go into fibrillation.

Hanging

Main article: Hanging

Suicide by hanging.

The traditional death penalty of hanging by gallows consists of a rope tied to some fixed object (i.e. the gallows), with one end tied into a hangman's noose and put around the neck. The person falls through the release of a trap door (or jumps, in the case of suicide) from a height, and death is instantaneous due to breaking of the neck. If the neck is not broken, asphyxiation due to the obstructed trachea ultimately leads to death. Many people who try to hang themselves strangle themselves instead, and don't always die; they get brain damage from lack of oxygen

Jumping

Jumping from a great height can shatter organs and tissues. If a person jumps from a tall bridge into water, the person may die by impact rather than by drowning. Such jumpings off the Golden Gate Bridge, of which there have been 1,300 between 1937 and 2006, were depicted in the documentary film The Bridge.

The 68.6 metre plunge from the bridge has proven to be fatal in 98% of cases. The jumper would hit the water at 120 km/h (or about 77 mph). Most die of internal bleeding due to broken ribs which pierce the heart, lungs, liver or spleen. Survivors, who would have hit the water feet-first, would often have had their femurs shattered.

Poisoning

Suicide can be committed by using fast-acting poisons, or substances which are known for their high levels of toxicity to humans. For example, the people of Jonestown, in northwestern Guyana, all died when the leader of a religious sect organised a mass suicide by drinking a cocktail of diazepam and cyanide in 1978.

Suicide by cop

Main article: Suicide by cop

The term "suicide by cop" is used to describe a situation in which an individual behaves in a manner intended to provoke an armed law enforcement officer into use of lethal force against him.

Seppuku

Main article: Seppuku

Seppuku (colloquially "harakiri") is a Japanese ritual method of suicide, practiced mostly in the medieval era, though some isolated cases appear in modern times. For example, Yukio Mishima committed seppuku in 1970 after a failed coup d'etat intended to restore full power to the Japanese Emperor.

Unlike other methods of suicide, this was regarded as a way of preserving one's honour. The ritual is part of bushido, the code of the Samurai.

Dressed ceremonially, with his sword placed in front of him and sometimes seated on special cloth, the warrior would prepare for death by writing a death poem. With a selected attendant (kaishakunin, his second) standing by, he would open his kimono, take up his wakizashi (short sword), fan, or a tanto (knife) and plunge it into his abdomen, making first a left-to-right cut and then a second slightly upward stroke. On the second stroke, the kaishakunin would perform daki-kubi, when the warrior is all but decapitated, leaving a slight band of flesh attaching the head to the body.

Shooting

Methods of suicide among persons aged 15-19. The use of a firearm is the leading method in the United States.

This method involves using a firearm to cause a fatal injury to oneself. It is used more frequently in countries where firearms are easier to obtain, and is the leading method in the United States. It is debatable, however, if that increases the number of suicides in general. It might be that it just increases the number of people choosing this method. In countries where firearms are harder to obtain, this method is sometimes still used, especially by people who use firearms in their work (e.g., soldiers or police).

Brain or heart damage kills a person very quickly; however, the gun must be powerful enough if suicide attempts using this method are to succeed. Mortality also depends on where the shot is aimed, usually the side of forehead (temple) or in the mouth (both ways ultimately aimed at the brain). In some cases the heart is chosen as a target, but it is harder to aim correctly. Being shot in other parts of the anatomy may not result in death or lethal damage.

There are many cases of brain damage and severe physical trauma that do not result in loss of life. One can shoot oneself in the head and miss the brain but merely blow out an eye or part of your jaw. If you die, the death is usually drawn-out and painful. People can live eight hours with a hole in their head the size of a half dollar. If you shoot yourself in the temple, the primitive parts of your brain that control breathing will go on for a long time, from minutes to hours. Or they may not be shut off at all. One survivor was partially paralyzed on his left side, and can't speak, walk, or feed himself. It's as if he had a major stroke. He hit the part of the brain that controls motor function.

Some studies have shown that in Western nations, men tend to use this method of suicide more often than women, which has been cited as one potential reason for the higher suicide success rate among men. Though most men shoot themselves in the head, women tend to shoot themselves in the heart.

See also multiple gunshot suicide.

Carbon monoxide poisoning

A particular type of asphyxia is via inhalation of high levels of carbon monoxide.

Death usually occurs through hypoxia. In most cases carbon monoxide (CO) is used for this, as it is easily available as a product of combustion; for example, it can be released by cars and some types of heaters where there has been incomplete combustion.

Carbon monoxide is a colorless and odorless gas, so its presence cannot be detected. It is harmful to the human organism as the CO molecules attach themselves irreversibly to hemoglobin in the blood, displacing oxygen molecules and progressively lowering the body's oxygenation, eventually resulting in death.

In the past, before air-quality regulations and catalytic converters, suicide by carbon monoxide poisoning would be achieved by running a car's engine in a closed space such as a garage, or by redirecting a running car's exhaust back inside the cabin with a hose. However, the incidence of suicide by carbon monoxide poisoning through burning fossil fuel or charcoal (charcoal-burning suicide) within a confined space appears to have risen.

In cases where levels of carbon monoxide are not high enough to induce asphyxia, secondary poisoning may result in death.

Suicide attack

Main article: Suicide attack

A suicide attack is an attack in which the attacker (attacker being either an individual or a group) intends to kill others and intends to die in the process of doing so. In a suicide attack in the strict sense the attacker dies by the attack itself, for example in an explosion or crash caused by the attacker. The term is sometimes loosely applied to an incident in which the intention of the attacker is not clear though he is almost sure to die by the defense or retaliation of the attacked party.

Such attacks are typically motivated by religious or political ideologies and have been carried out using numerous methods. For example, attackers might attach explosives directly to their bodies before detonating themselves close to their target, or they may use car bombs or other machinery to cause maximum damage (e.g. Japanese kamikaze pilots during World War II). Some sources refer to this as a "homicide attack", to emphasize the idea that killing other people is usually the primary purpose of such an attack. However, this usage is ambiguous since the word "homicide" already refers to unlawful killing and the key aspect of a suicide attack that distinguishes it from other forms of homicide is the death of the perpetrator.

Islamist extremist terrorists have engaged in suicide attacks numerous times in the Arab-Israeli conflict, and also against the West at other times. Perpetrators believe that the gains to others, or to a religious, political or moral cause, outweigh their personal loss and/or that they will be rewarded in the afterlife.

The September 11, 2001 attacks by Al-Qaeda using civilian aircraft on the World Trade Center and The Pentagon are examples of suicide attacks.

Assisted suicide and Euthanasia

Dignitas (see "external links" below for website and more information), is a Swiss assisted suicide group that helps those with incurable physical and mental illnesses to die with the aid of doctors and nurses. It was founded in 1998 by the Swiss lawyer, Ludwig Minelli. Swiss laws on assisted suicide hold that a person who assists in an assisted suicide can only be prosecuted if they are motivated by self-interest.

Dignitas not only helps those with incurable physical illnesses such as cancer to commit suicide, but, now also helps those with incurable mental illnesses, provided that they are of sound judgment and submit an in-depth medical report prepared by a psychiatrist, that establishes the patients condition as fulfilling the specifications of the Federal (Supreme) Court of Switzerland, that state that “It cannot be denied that an incurable, long-lasting, severe mental impairment similar to a somatic one can create a suffering out of which a patient would find his/her life in the long run not worth living anymore. Based on more recent ethical, juridical and medical statements, a possible prescription of Sodium-Pentobarbital is not necessarily contra-indicated and thus no longer generally a violation of medical duty of care. However, utmost restraint needs to be exercised: It has to be distinguished between the wish to die that is expression of a curable psychic distortion and which calls for treatment, and the wish to die that bases on a self-determined, carefully considered and lasting decision of a lucid person ("balance suicide") which possibly needs to be respected. If the wish to die bases on an autonomous, the general situation comprising decision, under certain circumstances even mentally ill may be prescribed Sodium-Pentobarbital and thus be granted help to commit suicide." "Whether the prerequisites for this are given cannot be judged on separated from medical – especially psychiatric – special knowledge and proves to be difficult in practice; therefore, the appropriate assessment requires the presentation of a special in-depth psychiatric opinion."

See also

• Euthanasia
• Self harm
• Suicide crisis
• Suicide intervention
• Suicide prevention
• American Foundation for Suicide Prevention

External links

• "How-to" Euthanasia Books, Annotated Bibliography - list of books on suicide methods by Derek Humphry, author of Final Exit

• [1], [2]

(Dignitas a Swiss assisted suicide group that assists people with physical and mental illnesses).