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Suicide methods

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Suicide
Social aspects
Crisis
Types and methods
Epidemiology
History
In warfare
Related phenomena
By country
Organizations

A suicide method is any means by which a person purposely kills himself or herself. Examples of methods that have been used to commit suicide are listed below. Though individuals with suicidal feelings may consider these methods, most eventually do not act on them.[1]

Suicide methods can be classified according to two modes of interrupting life processes: physical or chemical. Physical modes of interruption typically act by incapacitating the respiratory system or the central nervous system, usually by destruction of one or more key components. Chemical modes focus on interrupting biologically significant processes such as inhibition of cellular respiration or reduction of diffusion capacity. Chemical methods of suicide produce latent evidence of action, while physical methods provide direct evidence.

Shooting

Suicides by firearm in the United States, by gender and age, 1999–2005. Data from the CDC.

Shooting oneself with a pistol, rifle or shotgun is one of the most common means of suicide for men in societies where firearms are widely available.[2] Within nations with strict firearms control laws, it is generally confined to policemen and soldiers as a suicide method.[3] Studies show that "while gun levels influence the choice of suicide method, they have no effect on the number of people who die in suicides."[4] However, a counter-argument is that a suicide attempt made with a gun is more likely to be successful than one made by another method.[5] Suicides accounted for 55% of U.S. firearm deaths in 2005.[6] A counter-counter-argument is that other factors, such as living alone and using illicit drugs, have even more of a correlation to suicide.[7]

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 may be targeted.

Cutting wrists

This entails cutting through the wrists with the aim of tearing open the radial artery and 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 ability.[8]

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; since there are two internal carotid arteries, both must be cut. Death could also be caused by blood entering the trachea, which may then be aspirated, causing obstruction of the bronchioles. People who use this method often sever the recurrent laryngeal nerve, which controls the larynx, and lose their voice.

It was also practiced as a ritual suicide method in Japan called jigai, by noble women for the same purposes as seppuku was used by men.[citation needed]

Drowning

A homeless girl contemplates drowning herself.

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. Due to the body's natural tendency to come up for air, drowning attempts often involve a heavy object, to circumvent this reflex. If the drowning is stopped before death, oxygen deprivation can cause brain damage.

Suffocation

Suicide by suffocation is the act of inhibiting one's ability to breathe or to limit the oxygen uptake while breathing, which causes asphyxia. This may involve a plastic bag tightly sealed over the head, or confinement in an enclosed space without oxygen. These attempts usually involve using depressants to make the user pass out before oxygen deprivation which prevents any escape instinct or panic. The method common in terminally ill or sincere "want-to-die" candidates is to use a gas, such as nitrogen or helium[citation needed]. Helium is freely available to inflate party balloons. It is odorless and acts painless and quick. The person loses consciousness after a few gasps and death will occur within minutes. While it is advocated to fill a plastic bag with the helium and let it slide over the head, people with understandable reservation using a plastic bag can also use an anaesthesia mask to inhale the helium. This last statement about using a mask is doubtful, says Derek Humphry of the Euthanasia Research & Guidance Organization (ERGO). Right to die groups with huge experience of helium deaths have found that either the mask does not fit the face, or blows off the face from the force of the helium gas injection. A plastic bag secured at the neck,with the helium piped in, has been found to be the only sound way in hundreds of cases. Coma comes in seconds, death in a few minutes, so the unpleasantness of the plastic bag is fleeting. (See 'Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide For The Dying' 3rd edition. Dell, NY)

Electrocution

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 sizeable current through the body. A large alternating current through the body can seriously disrupt nerve signals and can cause the heart to go into fibrillation.

Explosives

Suicide by explosives involves setting off high explosives (HE) in close proximity to the body. A sufficient quantity of high explosives would cause death instantaneously by destroying the body so thoroughly that life would end instantly - indeed, before the nervous system could register the explosion. Shattered organs, broken bones and internal bleeding from the blast wave would be likely causes of death where insufficient HE was used. The use of low-powered or home-made explosives would be likely to cause severe burns rather than immediate death.[citation needed]

When explosives are detonated with the intent of also harming others in close proximity it is commonly known as a suicide bombing.

Hanging

Main article: Hanging

Hanging is the prevalent means of suicide in pre-industrial societies and is still more common in rural rather than urban areas.[9]

Suicide by hanging.

The traditional death penalty of hanging by gallows consists of a rope tied to a fixed object (i.e. the gallows), with one end tied into a hangman's noose and placed around the neck. The person falls through the release of a trap door (or leaps from a height, in the case of suicide), and death is instantaneous due to breaking of the neck.

Vehicular impact

Jumping in front of a fast-moving vehicle, especially a large one, such as a truck or train, can prove fatal. A classic example of suicide involves one tying oneself to railroad tracks in order to be run over by an oncoming train. This may be traumatizing to the driver of the vehicle. Failure would likely result in massive body damage including fractures, brain damage, organ bruising, or long-term to permanent disability.[citation needed]

Jumping in front of an underground train is a common form of suicide in London.[citation needed] Where a deep drainage pit is present, this halves the likelihood of fatality.[citation needed] Separation of the passengers from the track by means of a partition with sliding-doors is being introduced in some stations but this is expensive.[10]

Car "accidents"

Some car accidents are in fact suicides. This especially applies to single-occupant, single-vehicle accidents. "The automobile lends itself admirably to attempts at self-destruction because of the frequency of its use, the generally accepted inherent hazards of driving, and the fact that it offers the individual an opportunity to imperil or end his life without consciously confronting himself with his suicidal intent"[11].

The real percentage of suicides among car accidents is not reliably known; studies by suicide researchers tell that "vehicular fatalities that are suicides vary from 1.6% to 5%". [12]. Some suicides are misclassified as accidents because suicide must be proven. "It is noteworthy that even when suicide is strongly suspected but a suicide note is not found, the case will be classified 'accident.'"[12]

Some researchers believe that suicides disguised as traffic accidents are far more prevalent than previously thought. One large-scale community survey among suicidal persons provided the following numbers: "Of those who reported planning a suicide, 14.8% (19.1% of male planners and 11.8% of female planners) had conceived to have a motor vehicle “accident”... Of all attempters, 8.3% (13.3% of male attempters) had previously attempted via motor vehicle collision."[13]

Jumping

The impact from jumping off a great enough 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 jumping off the Golden Gate Bridge, of which there have been 1,300 incidents between 1937 and 2006, were depicted in the documentary film The Bridge.

The 70 m (225 ft) plunge from the Golden Gate Bridge has proven to be fatal in 98% of cases. The jumper would hit the water at 120 km/h (about 75 mph).[14] Most die of internal bleeding due to broken ribs which pierce the heart, lungs, liver or spleen. Survivors, who generally have hit the water feet-first, have often had their femurs shattered.[15]

Authorities have tried to prevent jumping suicides by building fences or other barriers in potential areas, such as high towers and bridges. In some areas authorities have also installed telephones which link directly to suicide prevention hot lines.[16]

See also: Defenestration

, a term that is applied specifically to falling from a window opening.

Poisoning

For more information on the historical use of poison for suicide, see History of poison.

Suicide can be committed by using fast-acting poisons, or substances which are known for their high levels of toxicity to humans. For example, most of the people of Jonestown, in northwestern Guyana, died when the leader of a religious sect organised a mass suicide by drinking a cocktail of diazepam and cyanide in 1978.[17] Sufficient doses of some plants like the belladonna family, castor beans, and others, are also toxic.

Drug overdosing

Suicide by pharmaceuticals ("overdosing") is a method which involves taking medication in doses greater than the indicated levels, or in a combination which will enhance each drug's effect. Reliability of this method highly depends on chosen drugs. Average fatality rate for overdoses in the US is estimated to be 1.8% [18].

Assisted suicide group Dignitas reported that there was no single failure among 840 cases, where an overdose of a former sleeping pill active agent Nembutal was used[19]. While barbiturate (like Seconal or Nembutal) are considered a safe option for suicide, it is becoming increasingly difficult to acquire these drugs. Today they are only available as a dilution and are used by veterinarians to kill animals.

However, a typical drug overdose uses random prescription and over-the-counter substances. In this case death is uncertain, and an attempt may leave a person alive but with severe organ damage, which may prove eventually fatal itself. Drugs taken orally may also be vomited back out before being absorbed. Considering the very high doses needed, vomiting or falling asleep before taking enough of the active agent might be a serious hurdle.

Analgesic overdose attempts are among the most common[20] due to easy availability of over-the-counter substances. 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, especially when alcohol or other judgment-impairing substances are also involved and no suicide note was left behind.

Carbon monoxide poisoning

Main article: Carbon monoxide poisoning

A particular type of poisoning involves inhalation of high levels of carbon monoxide. Death usually occurs through hypoxia. In most cases carbon monoxide (CO) is used because it is easily available as a product of incomplete combustion; for example it may be released by cars and some types of heaters.

Carbon monoxide is a colorless and odorless gas, so its presence cannot be detected by sight or smell. It is harmful to humans since the CO molecules attach themselves 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 often 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. Motor car exhaust may have contained up to 25% carbon monoxide. However, catalytic converters can eliminate over 99% of carbon monoxide produced.[21]

The incidence of suicide by carbon monoxide poisoning through burning charcoal, such as a barbecue in a sealed room, appears to have risen. This has been referred by some as "death by hibachi".[22]

Detergent-related suicide involves mixing household chemicals to produce hydrogen sulfide or other poisonous gasses.[23]

Self-immolation

Self-immolation usually refers to suicide by fire. It has been used as a protest tactic, most famously by Thich Quang Duc in 1963 to protest the South Vietnamese government; and by Malachi Ritscher in 2006 to protest the United States' involvement in the Iraq war. The Latin root of 'immolate' means 'sacrifice', and is not restricted to the use of fire, though common media usage uses the term self-immolation to refer to suicide by fire.

Seppuku

Main article: Seppuku

Seppuku (colloquially "harakiri") is a Japanese ritual method of suicide, practised 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 honor. 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, so as to not let the head fall off the body and roll on the floor/ground; which was considered dishonorable in feudal Japan.

Apocarteresis (suicide by starvation)

Main article: Starvation

Starvation has been used by Hindu, Jain and Buddhist monks as a ritual method of suicide.

Beheading

A device capable of beheading the user (a guillotine for instance) can be used for suicidal purposes.[24][25] Results of the cutting action of the device depend mainly on what nerves and blood veins the device cuts. The more arteries supplying blood to the brain are cut, the sooner the death comes. Cutting nerves which transfer control signals for vital body functions, like breathing, is also irrecoverable and lethal.[citation needed]

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 (Columbine, Virginia Tech.) 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 defence or retaliation of the attacked party. This can also be referred to as murder/suicide.

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).

Islamic extremist terrorists have engaged in suicide attacks numerous times in the Arab-Israeli conflict, and also against the West at other times. Perpetrators believe 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.

Additionally, teenage students (most often in the United States of America and recently in Finland) have committed several notable suicide attacks in recent years, in the form of school shooting massacres. Often, these suicide attacks involve guns or homemade bombs brought into high schools or college campuses. After the attack, the perpetrator will commit suicide before being captured by police.

Indirect suicide

Indirect suicide is the act of setting out on an obviously fatal course without directly committing the act upon oneself. Indirect suicide is differentiated from legally defined suicide by the fact that the actor does not pull the figurative (or literal) trigger. Examples of indirect suicide include a soldier enlisting in the army with the express intention and expectation of getting killed in combat. Another example would be provoking an armed officer into using lethal force against them. This is generally called "suicide by cop".

Further reading

References

  1. ^ Gliatto, Michael F. (1999). "Evaluation and Treatment of Patients with Suicidal Ideation". American Family Physician. 59 (6). Retrieved 2008-03-14. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  2. ^ http://www.who.int/violence_injury_prevention/violence/global_campaign/en/chap7.pdf
  3. ^ http://www.who.int/violence_injury_prevention/violence/global_campaign/en/chap7.pdf
  4. ^ http://www.guncite.com/gun_control_gcgvsuic.html
  5. ^ http://www.dailyherald.com/story/?id=220920
  6. ^ http://www.cnn.com/2008/US/06/30/guns.suicides.ap/
  7. ^ http://www.reason.com/news/show/30225.html
  8. ^ Bukhari, AJ (2004 Oct). "Spaghetti wrist: management and outcome". J Coll Physicians Surg Pak. 14 ((10)): 608–11. PMID 15456551. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)
  9. ^ Ronald W. Maris, Alan L. Berman, Morton M. Silverman, Bruce Michael Bongar (2000). Comprehensive Textbook of Suicidology. Guildford Press. p. 96. ISBN 157230541X.{{cite book}}: CS1 maint: multiple names: authors list (link)
  10. ^ J Coats, D P Walter (9 October 1999), Effect of station design on death in the London Underground: observational study, PMID 10514158
  11. ^ Selzer, M. L., & Payne, C. E. (1992). Automobile accidents, suicide, and unconscious motivation. American Journal of Psychiatry, 119, p 239
  12. ^ a b Accident or suicide? Single-vehicle car accidents and the intent hypothesis. Adolescence, Summer, 1995 by Dennis L. Peck, Kenneth Warner
  13. ^ [http://www.informaworld.com/smpp/content~content=a781411904~db=all~jumptype=rss Suicidal Behavior by Motor Vehicle Collision. Dominique Murray, Diego de Leo. Traffic Injury Prevention, Volume 8, Issue 3 September 2007 , pages 244 - 247"
  14. ^ "Could you jump off a tall building or bridge and survive the fall?". The Straight Dope. Retrieved 2008-04-12.
  15. ^ "The bridge of suicide", Catherine Philip, The Times, February 28, 2007.
  16. ^ http://en.wikipedia.org/wiki/Image:Suicidemessageggb01252006.JPG
  17. ^ Ministry of Terror - The Jonestown Cult Massacre, Elissayelle Haney, Infoplease, 2006.
  18. ^ Stone, Geo. Suicide and Attempted Suicide: Methods and Consequences. New York: Carroll & Graf, 2001. ISBN 0-7867-0940-5, p. 230
  19. ^ Wenn Sie das trinken, gibt es kein Zurück Tagesspiegel.de Retrieved 2008-04-12
  20. ^ Brock, Anita (6th). "Trends in suicide by method in England and Wales, 1979 to 2001". Health Statistics Quarterly. 20: 7–18. ISSN 1465-1645. Retrieved 2007-06-25. {{cite journal}}: Check date values in: |date= and |year= / |date= mismatch (help); Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  21. ^ Vossberg B, Skolnick J. (1999). "The role of catalytic converters in automobile carbon monoxide poisoning: a case report". Chest. 115 (2): 580–1. doi:10.1378/chest.115.2.580. PMID 10027464.
  22. ^ Media influence on suicide: Media's role is double edged, British Medical Journal (326:498), Chan et al., 2003.
  23. ^ Japanese girl commits suicide with detergent
  24. ^ "Guillotine death was suicide". BBC News. 2003-04-24. Retrieved 2008-01-25.
  25. ^ "Police Find Man's Body, Guillotine In Wooded Area". ClickOnDetroit. 2007-09-13. Retrieved 2008-01-25. {{cite news}}: External link in |publisher= (help)
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