Page semi-protected

Suicide methods

From Wikipedia, the free encyclopedia
Jump to navigation Jump to search

Manet's painting of a suicide by gunshot

A suicide method is any means by which a person chooses to end their life. Suicide attempts do not always result in death, and a nonfatal suicide attempt can leave the person with serious physical injuries, long-term health problems, and brain damage.[1]

Worldwide, three suicide methods predominate with the pattern varying in different countries. These are hanging, poisoning by pesticides, and firearms.[2] Other common methods are jumping from a height, drug overdoses, and drowning.[3][4]

Suicides are often impulse decisions that may be preventable by removing the means.[5] Making common suicide methods less accessible leads to an overall reduction in the number of suicides.[6][7] Some ways to do this include restricting access to pesticides, firearms, and known-used drugs. Other important measures are the introduction of policies that address the misuse of alcohol and the treatment of mental disorders.[8] Gun-control measures in a number of countries have seen a reduction in suicides, and other gun-related deaths.[9]

Purpose of studying suicide methods

The study of suicide methods aims to identify those commonly used, and the groups at risk of suicide; making methods less accessible may be useful in suicide prevention.[6][5][10] Limiting the availability of means such as pesticides and firearms is recommended by a World Health Report on suicide and its prevention. The early identification of mental disorders and substance abuse disorders, follow-up care for those who have attempted suicide, and responsible reporting by the media are all seen to be key in reducing the number of deaths by suicide.[11] National suicide prevention strategies are also advocated using a comprehensive and coordinated response to suicide prevention. This needs to include the registration and monitoring of suicides and attempted suicide, breaking figures down by age, sex, and method.[11]

Such information allows public health resources to focus on the problems that are relevant in a particular place, or for a given population or subpopulation.[12] For instance, if firearms are used in a significant number of suicides in one place, then public health policies there could focus on gun safety, such as keeping guns locked away, and the key inaccessible to at-risk family members. If young people are found to be at increased risk of suicide by overdosing on particular medications, then an alternative class of medication may be prescribed instead, a safety plan and monitoring of medication can be put in place, and parents can be educated about how to prevent the hoarding of medication for a future suicide attempt.[10]

Media reporting of suicide methods

Media reporting of the methods used in suicides is "strongly discouraged" by the World Health Organization, government health agencies, universities, and the Associated Press among others.[13] Detailed descriptions of suicides contribute to copycat suicides (suicide contagion).[14] Writing for the New Yorker about celebrity suicides, Andrew Solomon wrote that "You who are reading this are at statistically increased risk of suicide right now."[15]

Media reporting guidelines also apply to "online content including citizen-generated media coverage". The Recommendations for Reporting on Suicide include linking to resources such as the National Suicide Prevention Lifeline to reduce the risk of suicide contagion.[16]

Method restriction

Method restriction, also called lethal means reduction, is an effective way to reduce the number of suicide deaths in the short and medium term.[17]

Method substitution is the process of choosing a different suicide method when the first-choice method is inaccessible.[5] Method substitution has been measured over the course of decades, so when a common method is restricted for example by making domestic gas less toxic, overall suicide rates may be suppressed for many years.[5] If the first-choice suicide method is inaccessible, a method substitution may be made which may be less lethal, tending to result in fewer fatal suicide attempts.[5]

List of methods

Suffocation

Suffocation, as a classification of suicide method, includes strangulation and hanging.[18][19]

Suicide by suffocation involves restricting breathing or the amount of oxygen taken in, causing asphyxia and eventually hypoxia. This may involve the use of a plastic suicide bag.[20] It is not possible to die simply by holding the breath, since a reflex causes the respiratory muscles to contract, forcing an in-breath, and the re-establishment of a normal breathing rhythm.[21] Therefore inhaling an inert gas such as helium, nitrogen, and argon, or a toxic gas such as carbon monoxide, is used to bring about unconsciousness.[22][23]

Suicide by strangulation is self-strangulation that may involve the partial suspension of the body rather than the full suspension used in hanging. Self-strangulation involves tightening a ligature around the neck. This compresses the carotid arteries, preventing the supply of oxygen to the brain, resulting in unconsciousness and death.

Hanging

Giotto's Desperatio, depicting suicide by hanging

Hanging is a common method of suicide.[19][18] Hanging involves the use of a ligature such as a rope or cord attached to an anchor point with the other end used to form a noose placed around the neck. The cause of death will either be due to strangulation or a broken neck. About half of attempted suicides by hanging result in death.[4] People who favor this method are usually unaware that it is often a "slow, painful, and messy method that needed technical knowledge".[24]

Hanging is the prevalent means of suicide in impoverished pre-industrial societies, and is more common in rural areas than in urban areas.[25] It is also a common means of suicide in situations where other materials are not readily available, such as in prisons.

Hanging was the most common method in traditional Chinese culture,[26] as it was believed that the rage involved in such a death permitted the person's spirit to haunt and torment survivors.[27][28] In the Chinese culture, suicide by hanging was used as an act of revenge by women[29] and of defiance by powerless officials, who used it as a "final, but unequivocal, way of standing still against and above oppressive authorities".[26] Chinese people would often approach the act ceremonially, including the use of proper attire.[26]

Poisoning

Suicide by poisoning, also called self-poisoning, is usually classed as a drug overdose when drugs such as painkillers or recreational drugs are used. The use of pesticides to self-poison is the most common method used in some countries. Inhalation of poisonous gases such as carbon monoxide may also be a cause of death by suicide. Fast-acting poison such as cyanide is also used. Many other natural substances have high levels of toxicity, including belladonna, castor beans, and Jatropha curcas.[30] Poisoning through the means of toxic plants is usually slower and is relatively painful.[31] The mass suicide of members of a cult led by Jim Jones in 1978 resulted from drinking a cocktail of diazepam and cyanide ("Drinking the Kool-Aid").[32]

Pesticide

Share of suicide deaths from pesticide poisoning[33]

Worldwide, around 30% of suicides are from pesticide poisonings.[34] The use of this method, however, varies markedly in different areas of the world, from 0.9% in Europe to just under 50% in the Pacific region.[33] In the US, pesticide poisoning is used in about 12 suicides per year.[35]

Poisoning by farm chemicals is very common among women in rural China, and is regarded as a major social problem in the country.[36] Method restriction has been an effective way to reduce suicide by poisoning in many countries. In Finland, limiting access to parathion in the 1960s resulted in a rapid decline in both poisoning-related suicides and total suicide deaths for several years, and a slower decline in subsequent years.[37] In Sri Lanka, both suicide by pesticide and total suicides declined after first toxicity class I and later class II endosulfan were banned.[38] In Korea, banning paraquat reduced the total number of suicides.[37]

Drug overdose

A drug overdose involves taking a dose of a drug that exceeds safe levels. In the UK (England and Wales) until 2013 a drug overdose was the most common suicide method in females when this was then overtaken by the method of hanging.[39] In 2019 in males the percentage is 16%. However self-poisoning accounts for the highest number of suicide attempts. Overdose attempts using painkillers are among the most common, due to their easy availability over-the-counter.[40] Paracetamol is the most widely used analgesic worldwide and is commonly used in overdose.[41] Paracetamol poisoning is a common cause of acute liver failure.[42][41] In the United States drug overdoses represents about 60% of suicide attempts and 14% of deaths.[4] The risk of death in overdose is about 2%.[4] In the United States most deaths due to drug overdose are related to opioids.[43] In 2018 only 7.2% of drug overdoses were suicides with another 5.2% undetermined.[44] Barbiturate overdoses have also long been used for suicide.

Overdose may also take place when 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 is left behind.

An overdose is often the expressed preferred method of dignified dying among members of right-to-die organizations. A poll among members of Exit International suggested that 89% would prefer to take a pill, rather than use a plastic exit bag, a CO generator, or use "slow euthanasia".[45] Death by helium inhalation is the more common method preferred in practice, largely owing to its reliability.[46] Dutch right-to-die society WOZZ proposed several safe alternatives to barbiturates for use in euthanasia.[47]

Carbon monoxide

A particular type of poisoning involves the inhalation of high levels of carbon monoxide (CO). Death usually occurs through hypoxia. In most cases carbon monoxide is used because it is easily available as a product of incomplete combustion. A nonfatal attempt can result in memory loss and other symptoms.[48][49][50]

Carbon monoxide is a colorless and odorless gas, so its presence cannot be detected by sight or smell. It acts by binding preferentially to the hemoglobin in the bloodstream, displacing oxygen molecules and progressively deoxygenating the blood, eventually resulting in the failure of cellular respiration and death. Carbon monoxide is extremely dangerous to bystanders and people who may discover the body, so "Right to Die" advocates like Philip Nitschke recommend the use of safer alternatives like nitrogen, for example in his EXIT euthanasia device.[51]

Before air quality regulations and catalytic converters, suicide by carbon monoxide poisoning was often 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 found on all modern automobiles eliminate over 99% of carbon monoxide produced.[52] As a further complication, the amount of unburned gasoline in emissions can make exhaust unbearable to breathe well before a person loses consciousness.

Charcoal-burning suicide induces death from carbon monoxide poisoning. Originally used in Hong Kong, this has been a growing practice in Japan,[53] where small charcoal-burning heaters (hibachi) or stoves (shichirin) are used in a sealed room. By 2001 this method accounted for 25% of deaths from suicide.[54] It has become the second most common suicide method in Hong Kong and is a growing trend in other countries.[53] Nonfatal attempts can result in severe brain damage due to cerebral anoxia.

Other toxins

Detergent-related suicide involves mixing household chemicals to produce hydrogen sulfide or other poisonous gases.[55] The suicide rates by domestic gas fell from 1960 to 1980, as changes were made to the formula to make it less lethal.[5][56]

At the end of the 19th century in Britain, there were more suicides from carbolic acid than from any other poison since there was no restriction on its sale. Braxton Hicks and other coroners called for its sale to be prohibited.[57][58]

Several creatures, such as spiders, snakes, and scorpions, produce venom that can easily and quickly kill a person. These substances can be used to conduct suicide. For example, Cleopatra supposedly had an asp bite her when she heard of Marc Antony's death.[59]

Firearm

Comparison of gun-related suicide rates to non-gun-related suicide rates in high-income OECD countries, 2010, countries in graph ordered by total suicides. The US was the only OECD country in which gun suicide rates exceeded non-gun suicide rates.[60]
Suicide rate by firearm[61]

In the United States suicide by firearm is the most lethal method of suicide resulting in 90% of suicide fatalities,[4] and is thus the leading cause of death by suicide as of 2017.[62] Worldwide, firearm prevalence in suicides varies widely, depending on the acceptance and availability of firearms in a culture. The use of firearms in suicides ranges from less than 10% in Australia[63] to 50.5% in the U.S., where it is the most common method of suicide.[64]

Generally, the bullet will be aimed at point-blank range. Surviving a self-inflicted gunshot may result in severe chronic pain as well as reduced cognitive abilities and motor function, subdural hematoma, foreign bodies in the head, pneumocephalus and cerebrospinal fluid leaks. For temporal bone directed bullets, temporal lobe abscess, meningitis, aphasia, hemianopsia, and hemiplegia are common late intracranial complications. As many as 50% of people who survive gunshot wounds directed at the temporal bone suffer facial nerve damage, usually due to a severed nerve.[65]

Gun control

Reducing access to guns at a population level decreases the risk of suicide by firearms.[66] Fewer people die from suicide overall in places with stricter laws regulating the use, purchase, and trading of firearms.[67][68] Suicide risk goes up when firearms are more available.[69][70][71]

Gun control is a primary method of reducing suicide by people who live in a home with guns. Prevention measures include simple actions such as locking all firearms in a gun safe or installing gun locks.[72] Some stores that sell guns provide temporary storage as a service; in other cases, a trusted friend or family member will offer to store the guns until the crisis has passed.[73][72] When a person is going through a crisis, red flag laws in some places allow family members to petition the courts to have firearms temporarily removed and stored elsewhere.

More firearms are involved in suicide than are involved in homicides in the United States. A 1999 study of California and gun mortality found that a person is more likely to die by suicide if they have purchased a firearm, with a measurable increase of suicide by firearm beginning at most a week after the purchase and continuing for six years or more.[74]

The United States has both the highest number of suicides and firearms in circulation in a developed country and when gun ownership rises so too does suicide involving the use of a firearm.[75][76] A 2004 report by the National Academy of Sciences found an association between estimated household firearm ownership and gun suicide rates,[77][78] though a study by two Harvard researchers did not find a statistically significant association between household firearms and gun suicide rates,[79] except in the suicides of children aged 5–14.[79] Another study found that gun prevalence rates were positively associated with suicide rates among people aged 15 to 24, and 65 to 84, but not among those aged 25 to 64.[80] Case-control studies conducted in the United States have consistently shown an association between guns in the home and increased suicide risk,[81] especially for loaded guns in the home.[82] Numerous ecological and time series studies have also shown a positive association between gun ownership rates and suicide rates.[83][84][85] This association tends to only exist for firearm-related and overall suicides, not for non-firearm suicides.[84][86][87][88] A 2013 review found that studies consistently found a relationship between gun ownership and gun-related suicides, with few exceptions.[89] A 2016 study found a positive association between gun ownership and both gun-related and overall suicides among men, but not among women; gun ownership was only strongly associated with gun-related suicides among women.[90] During the 1980s and early 1990s, there was a strong upward trend in adolescent suicides with a gun,[91] as well as a sharp overall increase in suicides among those age 75 and over.[92] A 2014 systematic review and meta-analysis found that access to firearms was associated with a higher risk of suicide.[93]

A 2006 study found an accelerated decline in firearm-related suicides in Australia after the introduction of nationwide gun control. The same study found no evidence of substitution to other methods.[94] Multiple studies in Canada found that gun suicides declined after gun control, but methods like hanging rose leading to no change in the overall rates.[95][96][97] Similarly, a study conducted in New Zealand found that gun suicides declined after more legislation, but overall suicide rates did not change.[98] A case-control study in New Zealand found that household gun ownership was associated with gun suicides, but not overall suicide.[99] The authors attributed this finding to the highly stringent firearm storage laws and very low prevalence of handgun ownership in New Zealand. A Canadian study found that gun ownership by province was not correlated to provincial overall suicide rates.[100] A 2020 study also found no significant correlations between provincial firearm ownership and overall provincial suicide rates.[101]

Jumping from height

As a suicide prevention initiative, signs on the Golden Gate Bridge promote special telephones that connect to a crisis hotline, as well as a 24/7 crisis text line.

Jumping from a dangerous location, such as from a high window, balcony, or roof, or from a cliff, dam, or bridge is an often used suicide method in some countries. Many countries have noted suicide bridges such as the Nanjing Yangtze River Bridge (China), and the Golden Gate Bridge (US). Other well known suicide sites for jumping from include the Eiffel Tower (France), and Niagara Falls (Canada).[102] Nonfatal attempts in these situations can have severe consequences including paralysis, organ damage, and broken bones.[103]

In the United States, jumping is among the least common methods of suicide (less than 2% of all reported suicides in 2005).[104] However, in a 75-year period to 2012, there had been around 1,400 suicides at the Golden Gate Bridge. In New Zealand secure fencing at the Grafton Bridge has resulted in zero suicides.[105]

In Hong Kong, jumping is the most common method of suicide, accounting for 52.1% of all reported suicide cases in 2006 and similar rates for the years prior to that.[3] The Centre for Suicide Research and Prevention of the University of Hong Kong believes that it may be due to the abundance of easily accessible high-rise buildings in Hong Kong.[106]

Less common methods

Wounding

Self-inflicting a wound with a sharp instrument as a suicide method is usually to the wrists but can also be to the throat (or belly in harakiri). This is a relatively common method to the wrists, and the ready availability of knives is a noted factor.[107] A fatal self-inflicted wound to the wrist is termed a deep wrist injury, and is often preceded by several tentative surface-breaking attempts known as hesitation wounds, indicating indecision or a self-harm tactic.[108] For every suicide by wrist cutting, there are many more nonfatal attempts, so that the number of actual deaths using this method is very low.[109]

Wounds from suicide attempts involve the non-dominant hand; with damage often done to the median nerve, ulnar nerve, radial artery, palmaris longus muscle, and flexor carpi radialis muscle.[110][108] Such injuries can severely affect the function of the hand, and the inability caused to carry out work or interests increases the risk of further attempts.[108]

Drowning

A homeless girl contemplates drowning herself

Suicide by drowning is the act of deliberately submerging oneself in water or other liquid to prevent breathing. It accounts for less than 2% of all suicides in the United States.[104] Of those who attempt suicide by drowning in the US, about half die.[4]

Fasting and dehydration

A classification has been made of Voluntary Stopping Eating and Drinking (VSED) which is often resorted to in terminal illness.[111][112] This includes fasting and dehydration, and has also been referred to as autoeuthanasia.[113]

Fasting to death has been used by Hindu, Buddhist, and Jain ascetics and householders, as a ritual method of suicide known as Prayopavesa in Hinduism; Sokushinbutsu historically in Buddhism, and as Sallekhana in Jainism.[114][115][116] Cathars also fasted to death after receiving the consolamentum sacrament, in order to die while in a morally perfect state.[117] This method of death is also associated with the political protest of the hunger strike such as the 1981 Irish Hunger Strike in which ten prisoners died.

The explorer Thor Heyerdahl refused to eat or take medication for the last month of his life, after he was diagnosed with cancer.[118]

Death from dehydration can take from several days to a few weeks. This means that unlike many other suicide methods, it cannot be accomplished impulsively. Those who die by terminal dehydration typically lapse into unconsciousness before death, and may also experience delirium and deranged serum sodium.[119]

Terminal dehydration has been described as having substantial advantages over physician-assisted suicide with respect to self-determination, access, professional integrity, and social implications. Specifically, a patient has a right to refuse treatment and it would be a personal assault for someone to force water on a patient, but such is not the case if a doctor merely refuses to provide lethal medication.[120] But it also has distinctive drawbacks as a humane means of voluntary death.[121] One survey of hospice nurses found that nearly twice as many had cared for patients who chose voluntary refusal of food and fluids to hasten death as had cared for patients who chose physician-assisted suicide.[122] They also rated fasting and dehydration as causing less suffering and pain and being more peaceful than physician-assisted suicide.[123][112] Other sources, however, have noted very painful side effects of dehydration, including seizures, skin cracking and bleeding, blindness, nausea, vomiting, cramping and severe headaches.[124]

By transportation

Another suicide method is to lie down, or throw oneself, in the path of a fast moving vehicle, either on the road or onto railway tracks. Sometimes a car may be driven onto the railway tracks.[125] Nonfatal attempts may result in profound injuries, such as multiple bone fractures, amputations, concussion and severe mental and physical handicapping.[126]

Rail and metro
Lime on rails after a suicide in Mainz-Laubenheim
Members of the New York City Police Department Emergency Service Unit investigate a subway suicide on the Lexington Avenue – 53rd Street subway platform

On railway tracks above ground, somebody may simply lie down or stand on the tracks, as the speed of an approaching train prevents its easy stopping. This type of suicide may cause trauma for the train driver.[105]

Jumping in front of an oncoming subway train has a 59% death rate, lower than the 90% death rate for rail-related suicides. This is most likely because trains traveling on open tracks travel relatively quickly, whereas trains arriving at a subway station are decelerating to stop and board passengers.

Europe

Data gathered to 2014 showed that there were 3,000 suicides and 800 trespass related accidents on the European railways each year.[105] In the Netherlands, as many as 10% of all suicides are rail-related.[127] In Belgium where rail service is frequently interrupted due to a high level of suicide by rail, families are expected to cover the substantial cost of rail network standstill.[128]

Japan

Trains on Japanese railroads cause a large number of suicides every year. Suicide by train is seen as something of a social problem, especially in the larger cities such as Tokyo or Nagoya, because it disrupts train schedules and if one occurs during the morning rush-hour, causes numerous commuters to arrive late for work. However, suicide by train persists despite a common policy among life insurance companies to deny payment to the beneficiary in the event of suicide by train (payment is usually made in the event of most other forms of suicide). Suicides involving the high-speed bullet-train, or Shinkansen are extremely rare, as the tracks are usually inaccessible to the public (i.e. elevated and/or protected by tall fences with barbed wire) and legislation mandates additional fines against the family and next-of-kin of the person who died by suicide.[129] As in Belgium, family members of the person who died by suicide may be expected to cover the cost of rail disruption, which can be significantly extensive. It has been argued this prevents possible suicide, as the person who is considering suicide would want to spare the family not only the trauma of a lost family member but also being sued in court; however there is insufficient evidence to support this assertion.[130]

North America

The Federal Railroad Administration, in the U.S., reports that there are 300 to 500 suicides by train per year.[131] They also reported that those suicides on railway rights-of-ways were by people who tended to live near railroad tracks, were less likely to have access to firearms, and were significantly compromised by both severe mental disorder and substance abuse.[132]

Reducing rail-related suicides
A sign at a railroad crossing in the Netherlands promoting a suicide crisis line (113)

Railway-related suicides are rarely impulsive, and this view has led to research on behaviour analysis using CCTV at known hotspots.[133] Some behaviour patterns are implicated such as station-hopping, platform switching, standing away from others, letting a number of trains go by, and standing close to where trains enter. Surveillance cameras are viewable by railway staff.[133] Media reporting has been linked to increased rail suicide attempts.[133]

Public access to rail tracks may be restricted by the erection of fences. Fencing on both sides of the rail lines are carried out. Other preventive measures are landscaping to create tree and bush hedging as a natural fencing, and the installation of prohibitive signage. Fencing and landscaping have shown significant reductions in suicide attempts, and signage a lesser reduction. Sometimes vegetation along the tracks can obscure the view of the train driver and the removal of this is also advocated.[105]

The installation of platform screen doors in many stations and countries has significantly decreased the numbers of suicides, notably in Hong Kong. In Japan the use of calming blue lights on station platforms is estimated to have resulted in an 84 per cent reduction in suicide attempts.[105]

On the London Underground the presence of a platform drainage pit has been shown to halve the number of deaths from suicide attempts.[105]

Uncommon methods

Disease

There have been documented cases of gay men deliberately trying to contract a disease such as HIV/AIDS as a means of suicide.[134][135][136]

Electrocution

Suicide by electrocution involves using a lethal electric shock, and is a rarely used method.[137] This causes arrhythmias of the heart, meaning that the heart does not contract in synchrony between the different chambers, essentially causing elimination of blood flow. Furthermore, depending on the current, burns may also occur. In his opinion outlawing the electric chair as a method of execution, Justice William M. Connolly of the Nebraska Supreme Court stated that "electrocution inflicts intense pain and agonizing suffering", adding that it is “unnecessarily cruel in its purposeless infliction of physical violence and mutilation of the prisoner’s body.”[138] Contact with 20 mA of current can result in death.[139]

Car crashes

Some suicides are the result of intentional car crashes. This especially applies to single-occupant, single-vehicle accidents;[140] although head-on collisions with heavier vehicles are becoming more common[141] as road traffic safety measures like traffic barriers and impact attenuators limit damage potential from traditional targets like trees, boulders, and bridge abutments. Even single vehicle collisions may affect other road users; for example, a car that brakes abruptly or swerves to avoid a suicidal pedestrian may collide with something else on the road, and the driver could be harmed.

The real percentage of suicides among car accident fatalities is not reliably known as they may be under-reported as accident causes are often unknown. A study in Europe suggests that more than 2 per cent of crashes result from suicides.[142]

Some researchers believe that suicides disguised as traffic accidents are far more prevalent than previously thought. One large-scale community survey in Australia among suicidal people 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."[143]

Fire

Self-immolation is suicide usually by fire. This method of suicide is rare due to its being long and painful. If the attempt is intervened severe burns, and scar tissue will prevail with subsequent emotional impact. It has been used as a protest tactic, by Thích Quảng Đức in 1963 to protest the South Vietnam's anti-Buddhist policies; by Malachi Ritscher in 2006 to protest the United States' involvement in the Iraq War; and by Mohamed Bouazizi in 2011 in Tunisia which gave rise to the Tunisian Revolution.[citation needed]; and historically as a ritual known as sati where a Hindu widow would immolate herself in her husband's funeral pyre.[144]

Indirect suicide

Indirect suicide is the act of setting out on an obviously fatal course without directly carrying out 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 intention and expectation of being killed in combat, or someone could be provoking an armed law enforcement officer into using lethal force against them. The latter is generally called "suicide by cop".

Evidence exists for numerous examples of suicide by capital crime in colonial Australia. Convicts seeking to escape their brutal treatment would murder another individual. This was felt necessary due to a religious taboo against direct suicide. A person completing suicide was believed to be destined for hell, whereas a person committing murder could be absolved of their sins before execution. In its most extreme form, groups of prisoners on the extremely brutal penal colony of Norfolk Island would form suicide lotteries. Prisoners would draw straws with one prisoner murdering another. The remaining participants would witness the crime, and would be sent away to Sydney, as capital trials could not be held on Norfolk Island, thus earning a break from the Island. There is uncertainty as to the extent of suicide lotteries. While surviving contemporary accounts claim that the practice was common, such claims are probably exaggerated.[145]

Animal attacks

Some people have chosen to indirectly bring about their death by suicide by being attacked by predatory animals. In some cases, the person has been killed; for example, a few people have been killed and eaten by crocodiles.[146][147]

Ritual suicide

Ritual suicide is performed in a prescribed way, usually involving fasting, and often as part of a religious or cultural practice. Seppuku also known as harakiri is a historical ritual suicide method involving inflicting a severe wound to the belly, that is still occasionally practiced. For example, Yukio Mishima died by seppuku in 1970 after a failed coup d'état intended to restore full power to the Japanese emperor.[148] The ritual was seen as a means of preserving one's honor, and is part of bushido, a code of the samurai.

Volcano jumping

Jumping into a volcanic crater is a rare method of suicide. Mount Mihara in Japan became a notorious suicide site in 1933 following a reported story of a young person's suicide there. Over 1,200 copycat suicides followed in the ensuing two years, prompting the erection of a high protective fence surrounding the crater. This fence was replaced with a higher fence, topped with barbed wire, after another 619 people jumped in 1936.[149][150][151]

Aircraft

Between 1983 and 2003, 36 pilots died by suicide by aircraft in the United States.[152] There have been suicide attacks by aircraft, including Japanese Kamikaze attacks in the Second World War, and the terrorist initiated September 11 attacks in 2001. On 24 March 2015, a Germanwings co-pilot deliberately crashed Germanwings Flight 9525 into the French Alps to kill himself, killing 150 people with him.[153][154]

Suicide by pilot has also been proposed as a potential cause for the disappearance and following destruction of Malaysian Airlines Flight 370 in 2014,[155] with supporting evidence being found in a flight simulator application used by the flight's pilot.[156]

Skydiving

There have been several documented cases of suicide by skydiving, by deliberately failing to open a parachute, or removing it during freefall.[157][158] Expert skydiver and former 22 SAS Soldier Charles (Nish) Bruce QGM died by suicide following eight years of mental illness and periods under section by leaping from a private Cessna 172 at 5000 feet over Fyfield, Oxfordshire without a parachute whilst on a flight home from Spain.[159][160]

See also

References

  1. ^ "Preventing Suicide |Violence Prevention|Injury Center|CDC". www.cdc.gov. 11 September 2019. Retrieved 2 October 2019.
  2. ^ "Suicide: one person dies every 40 seconds". www.who.int.
  3. ^ a b "Method Used in Completed Suicide". HKJC Centre for Suicide Research and Prevention, University of Hong Kong. 2006. Archived from the original on 10 September 2009. Retrieved 10 September 2009.
  4. ^ a b c d e f Conner, Andrew; Azrael, Deborah; Miller, Matthew (3 December 2019). "Suicide Case-Fatality Rates in the United States, 2007 to 2014". Annals of Internal Medicine. 171 (12): 885–895. doi:10.7326/M19-1324. PMID 31791066. S2CID 208611916.
  5. ^ a b c d e f Turecki, Gustavo; Brent, David A. (19 March 2016). "Suicide and suicidal behaviour". Lancet. 387 (10024): 1227–39. doi:10.1016/S0140-6736(15)00234-2. ISSN 0140-6736. PMC 5319859. PMID 26385066.
  6. ^ a b Yip, Paul S. F.; Caine, Eric; Yousuf, Saman; Chang, Shu-Sen; Wu, Kevin Chien-Chang; Chen, Ying-Yeh (23 June 2012). "Means restriction for suicide prevention". Lancet. 379 (9834): 2393–99. doi:10.1016/S0140-6736(12)60521-2. ISSN 1474-547X. PMC 6191653. PMID 22726520.
  7. ^ "Worrying trends in U.S. suicide rates".
  8. ^ "Suicide". www.who.int. Retrieved 5 September 2020.
  9. ^ Santaella-Tenorio, J; Cerdá, M; Villaveces, A; Galea, S (2016). "What Do We Know About the Association Between Firearm Legislation and Firearm-Related Injuries?". Epidemiologic Reviews. 38 (1): 140–57. doi:10.1093/epirev/mxv012. PMC 6283012. PMID 26905895.
  10. ^ a b Berk, Michele (12 March 2019). Evidence-Based Treatment Approaches for Suicidal Adolescents: Translating Science Into Practice. American Psychiatric Pub. p. 309. ISBN 978-1-61537-163-1.
  11. ^ a b "WHO | First WHO report on suicide prevention calls for coordinated action to reduce suicides worldwide". WHO. Retrieved 12 September 2020.
  12. ^ "Campaign materials – handouts". www.who.int. Retrieved 5 September 2020.
  13. ^ Carmichael, Victoria; Whitley, Rob (9 May 2019). "Media coverage of Robin Williams' suicide in the United States: A contributor to contagion?". PLOS ONE. 14 (5): e0216543. doi:10.1371/journal.pone.0216543. PMC 6508639. PMID 31071144. Retrieved 25 February 2021.
  14. ^ "Reporting on Suicide: Recommendations for the Media". American Foundation for Suicide Prevention. Archived from the original on 31 October 2004. Retrieved 25 February 2021.
  15. ^ Solomon, Andrew (9 June 2018). "Anthony Bourdain, Kate Spade, and the Preventable Tragedies of Suicide". New Yorker. Retrieved 25 February 2021.
  16. ^ "Online Media". Reporting on Suicide. Archived from the original on 10 January 2021. Retrieved 25 February 2021.
  17. ^ Yip, PS; Caine, E; Yousuf, S; Chang, SS; Wu, KC; Chen, YY (23 June 2012). "Means restriction for suicide prevention". Lancet. 379 (9834): 2393–9. doi:10.1016/S0140-6736(12)60521-2. PMC 6191653. PMID 22726520.
  18. ^ a b "QuickStats: Age-Adjusted Suicide Rates for Females and Males, by Method – National Vital Statistics System, United States, 2000 and 2014". MMWR. Morbidity and Mortality Weekly Report. 65 (19): 503. 2016. doi:10.15585/mmwr.mm6519a7. PMID 27197046.
  19. ^ a b "Suicides in the UK". www.ons.gov.uk – Office for National Statistics.
  20. ^ "Nitschke's suicide machine slammed". www.abc.net.au. 17 December 2008.
  21. ^ Kurzban, Robert (7 February 2011). "Why Can't You Hold Your Breath Until You're Dead?". Web. Retrieved 23 August 2013.
  22. ^ "Deaths Involving the Inadvertent Connection of Air-line Respirators to Inert Gas Supplies".
  23. ^ Goldstein M (December 2008). "Carbon monoxide poisoning". Journal of Emergency Nursing. 34 (6): 538–42. doi:10.1016/j.jen.2007.11.014. PMID 19022078.
  24. ^ Park, Subin; Ahn, Myung Hee; Lee, Ahrong; Hong, Jin Pyo (4 June 2014). "Associations between changes in the pattern of suicide methods and rates in Korea, the US, and Finland". International Journal of Mental Health Systems. 8: 22. doi:10.1186/1752-4458-8-22. ISSN 1752-4458. PMC 4062645. PMID 24949083.
  25. ^ Ronald W. Maris; Alan L. Berman; Morton M. Silverman; Bruce Michael Bongar (2000). Comprehensive Textbook of Suicidology. Guildford Press. p. 96. ISBN 978-1-57230-541-0.
  26. ^ a b c Lee, Sing; et al. (2003), "Suicide as Resistance in Chinese Society", Chinese Society: Change, Conflict and Resistance, Abingdon: Routledge, p. 297, ISBN 9780415301701.
  27. ^ Lee, Jonathan H.X.; et al. (2011), Encyclopedia of Asian American Folklore and Folklife, ABC-CLIO, p. 11, ISBN 9780313350672.
  28. ^ Lee, Evelyn (1997), Working with Asian Americans: A Guide for Clinicians, Guilford Press, p. 59, ISBN 9781572305700.
  29. ^ Bourne, P G (August 1973). "Suicide among Chinese in San Francisco". American Journal of Public Health. 63 (8): 744–50. doi:10.2105/AJPH.63.8.744. PMC 1775294. PMID 4719540.
  30. ^ "Poisoning drugs". Forums.yellowworld.org. Archived from the original on 26 November 2011. Retrieved 15 January 2012.
  31. ^ "Poisoning methods". Ctrl-c.liu.se. Retrieved 15 January 2012.
  32. ^ Ministry of Terror – The Jonestown Cult Massacre, Elissayelle Haney, Infoplease, 2006.
  33. ^ a b "Share of suicide deaths from pesticide poisoning". Our World in Data. Retrieved 4 March 2020.
  34. ^ Bertolote, J. M.; Fleischmann, A.; Eddleston, M.; Gunnell, D. (September 2006). "Deaths from pesticide poisoning: a global response". The British Journal of Psychiatry. 189 (3): 201–03. doi:10.1192/bjp.bp.105.020834. PMC 2493385. PMID 16946353. Retrieved 30 September 2020.
  35. ^ "Underlying Cause of Death, 1999–2018 Request". wonder.cdc.gov. Retrieved 7 March 2020.
  36. ^ Griffiths, Daniel (4 June 2007). "Rural China's suicide problem". BBC News. Retrieved 20 March 2010.
  37. ^ a b Kim, Jinyong; Shin, Sang Do; Jeong, Seungmin; Suh, Gil Joon; Kwak, Young Ho (2 November 2017). "Effect of prohibiting the use of Paraquat on pesticide-associated mortality". BMC Public Health. 17 (1): 858. doi:10.1186/s12889-017-4832-4. ISSN 1471-2458. PMC 5667494. PMID 29096617.
  38. ^ Hvistendahl, M. (2013). "In Rural Asia, Locking Up Poisons to Prevent Suicides". Science. 341 (6147): 738–39. Bibcode:2013Sci...341..738H. doi:10.1126/science.341.6147.738. PMID 23950528.
  39. ^ "Suicides in England and Wales – Office for National Statistics". www.ons.gov.uk.
  40. ^ Brock, Anita; Sini Dominy; Clare Griffiths (6 November 2003). "Trends in suicide by method in England and Wales, 1979 to 2001". Health Statistics Quarterly. 20: 7–18. ISSN 1465-1645. Retrieved 25 June 2007.
  41. ^ a b Chiew, AL; Gluud, C; Brok, J; Buckley, NA (23 February 2018). "Interventions for paracetamol (acetaminophen) overdose". The Cochrane Database of Systematic Reviews. 2: CD003328. doi:10.1002/14651858.CD003328.pub3. PMC 6491303. PMID 29473717.
  42. ^ Aminoshariae, A; Khan, A (May 2015). "Acetaminophen: old drug, new issues". Journal of Endodontics. 41 (5): 588–93. doi:10.1016/j.joen.2015.01.024. PMID 25732401.
  43. ^ "Drug Overdose Deaths | Drug Overdose | CDC Injury Center". www.cdc.gov. 30 August 2019. Retrieved 3 December 2019.
  44. ^ "Products – Data Briefs – Number 356". www.cdc.gov. 27 July 2020. Retrieved 30 September 2020.
  45. ^ Philip Nitschke. The Peaceful Pill Handbook. Exit International US, 2007. ISBN 0-9788788-2-5, p. 33
  46. ^ Howard M, Hall M, Jeffrey D et al., "Suicide by Asphyxiation due to Helium Inhalation, Am J Forensic Med Pathol 2010; accessed 12 May 2014
  47. ^ Guide to a Humane Self-Chosen Death by Dr. Pieter Admiraal et al. WOZZ Foundation www.wozz.nl, Delft, The Netherlands. ISBN 90-78581-01-8.
  48. ^ Docker, C (2013). Five Last Acts – The Exit Path. p. 368.[ISBN missing]
  49. ^ Hay, Phillipa J; Denson, Linley A; van Hoof, Miranda; Blumenfeld, Natalia (August 2002). "The neuropsychiatry of carbon monoxide poisoning in attempted suicide". Journal of Psychosomatic Research. 53 (2): 699–708. doi:10.1016/S0022-3999(02)00424-5. PMID 12169344.
  50. ^ Carbon monoxide poisoning: Four kinds of survivors "Archived copy". Archived from the original on 12 May 2014. Retrieved 12 May 2014.CS1 maint: archived copy as title (link), accessed 12 May 2014
  51. ^ Nitschke, Philip (2007). The peaceful pill handbook (New rev. international ed.). Waterford, MI: Exit International US. ISBN 978-0978878825.
  52. ^ Vossberg B, Skolnick J (1999). "The role of catalytic converters in automobile carbon monoxide poisoning: a case report". Chest. 115 (2): 580–81. doi:10.1378/chest.115.2.580. PMID 10027464. S2CID 34394596.
  53. ^ a b "Taking the easy way out?". South China Morning Post. 9 January 2005. Retrieved 6 September 2020.
  54. ^ Howe, A. (2003). "Media influence on suicide". BMJ. 326 (7387): 498. doi:10.1136/bmj.326.7387.498. PMC 1125377. PMID 12609951.
  55. ^ "Japanese girl commits suicide with detergent". Archived from the original on 29 April 2008.
  56. ^ Lester, D. (March 1990). "Changes in the methods used for suicide in 16 countries from 1960 to 1980". Acta Psychiatrica Scandinavica. 81 (3): 260–61. doi:10.1111/j.1600-0447.1990.tb06492.x. PMID 2343750. S2CID 28751662.
  57. ^ "Mr. A. Braxton Hicks held an inquiry at Battersea". Times [London, England]. The Times Digital Archive. 25 September 1894. p. 10.
  58. ^ "Suicides By Poison". The British Medical Journal. 1 (1693): 1238. 1893. JSTOR 20224772.
  59. ^ See:
    • Strabo, Geographica, Book 17, Chapter 1, paragraph 10: Octavian "forced Antony to put himself to death and Cleopatra to come into his power alive; but a little later she too put herself to death secretly, while in prison, by the bite of an asp or (for two accounts are given) by applying a poisonous ointment" …
    • Sextus Propertius, Elegies, Book 3, number 11: … "I saw your [Cleopatra's] arms bitten by the sacred asps, and your limbs draw sleep in by a secret path." … Available on-line at: Poetry in Translation
    • Horace, Odes, Book 1, Ode 37: … "And she [Cleopatra] dared to gaze at her fallen kingdom / with a calm face, and touch the poisonous asps / with courage, so that she might drink down / their dark venom, to the depths of her heart," … Available on-line at: Poetry in Translation
    • Virgil, Aeneid, Book 8, lines 696–697: … "The queen in the centre signals to her columns with the native sistrum, not yet turning to look at the twin snakes at her back." … Available on-line at: Poetry in Translation
  60. ^ Grinshteyn, Erin; Hemenway, David (March 2016). "Violent Death Rates: The US Compared with Other High-income OECD Countries, 2010". The American Journal of Medicine. 129 (3): 266–73. doi:10.1016/j.amjmed.2015.10.025. PMID 26551975.
  61. ^ "Suicide rate by firearm". Our World in Data. Retrieved 4 March 2020.
  62. ^ "NIMH » Suicide". www.nimh.nih.gov. Retrieved 3 December 2019.
  63. ^ "A review of suicide statistics in Australia". Government of Australia.
  64. ^ McIntosh, JL; Drapeau, CW (28 November 2012). "U.S.A. Suicide: 2010 Official Final Data" (PDF). suicidology.org. American Association of Suicidology. Archived from the original (PDF) on 28 June 2014. Retrieved 25 February 2014.
  65. ^ Backous, Douglas (5 August 1993). "Temporal Bone Gunshot Wounds: Evaluation and Management". Baylor College of Medicine. Archived from the original on 17 May 2008.
  66. ^ Mann, JJ; Michel, CA (1 October 2016). "Prevention of Firearm Suicide in the United States: What Works and What Is Possible". The American Journal of Psychiatry. 173 (10): 969–79. doi:10.1176/appi.ajp.2016.16010069. PMID 27444796.
  67. ^ Anestis, Michael D.; Khazem, Lauren R.; Law, Keyne C.; Houtsma, Claire; LeTard, Rachel; Moberg, Fallon; Martin, Rachel (October 2015). "The Association Between State Laws Regulating Handgun Ownership and Statewide Suicide Rates". American Journal of Public Health. 105 (10): 2059–67. doi:10.2105/AJPH.2014.302465. PMC 4566551. PMID 25880944.
  68. ^ Conner, Kenneth R; Zhong, Yueying (November 2003). "State firearm laws and rates of suicide in men and women". American Journal of Preventive Medicine. 25 (4): 320–24. doi:10.1016/S0749-3797(03)00212-5. PMID 14580634.
  69. ^ Westefeld, John S.; Gann, Lianne C.; Lustgarten, Samuel D.; Yeates, Kevin J. (2016). "Relationships between firearm availability and suicide: The role of psychology". Professional Psychology: Research and Practice. 47 (4): 271–77. doi:10.1037/pro0000089.
  70. ^ Anglemyer, Andrew; Horvath, Tara; Rutherford, George (21 January 2014). "The Accessibility of Firearms and Risk for Suicide and Homicide Victimization Among Household Members". Annals of Internal Medicine. 160 (2): 101–10. doi:10.7326/M13-1301. PMID 24592495. S2CID 4509567.
  71. ^ Miller, M.; Swanson, S. A.; Azrael, D. (13 January 2016). "Are We Missing Something Pertinent? A Bias Analysis of Unmeasured Confounding in the Firearm-Suicide Literature". Epidemiologic Reviews. 38 (1): 62–9. doi:10.1093/epirev/mxv011. PMID 26769723.
  72. ^ a b Rabin, Roni Caryn (17 November 2020). "'How Did We Not Know?' Gun Owners Confront a Suicide Epidemic". The New York Times. ISSN 0362-4331. Retrieved 22 November 2020.
  73. ^ Pierpoint, Lauren A; Tung, Gregory J; Brooks-Russell, Ashley; Brandspigel, Sara; Betz, Marian; Runyan, Carol W (September 2019). "Gun retailers as storage partners for suicide prevention: what barriers need to be overcome?". Injury Prevention. 25 (Suppl 1): i5–i8. doi:10.1136/injuryprev-2017-042700. ISSN 1353-8047. PMC 6081260. PMID 29436398.
  74. ^ Lewiecki, E. Michael; Miller, Sara A. (January 2013). "Suicide, Guns, and Public Policy". American Journal of Public Health. 103 (1): 27–31. doi:10.2105/AJPH.2012.300964. PMC 3518361. PMID 23153127.
  75. ^ "Guns and suicide: A fatal link". Harvard T.H. Chan School of Public Health. 15 May 2008. Retrieved 7 May 2020.
  76. ^ Studdert, David M.; Zhang, Yifan; Swanson, Sonja A.; Prince, Lea; Rodden, Jonathan A.; Holsinger, Erin; Spittal, Matthew; Wintemute, Garen; Miller, Matthew (2020). "Handgun Ownership and Suicide in California". The New England Journal of Medicine. 382 (23): 2220–29. doi:10.1056/NEJMsa1916744. PMID 32492303.
  77. ^ Committee on Law and Justice (2004). "Executive Summary". Firearms and Violence: A Critical Review. National Academy of Science. doi:10.17226/10881. ISBN 978-0-309-09124-4.
  78. ^ Kellermann, A.L.; Rivara, F.P.; Somes, G.; Francisco, Jerry; et al. (1992). "Suicide in the home in relation to gun ownership". New England Journal of Medicine. 327 (7): 467–72. doi:10.1056/NEJM199208133270705. PMID 1308093. S2CID 35031090.
  79. ^ a b Miller, Matthew; Hemenway, David (2001). Firearm Prevalence and the Risk of Suicide: A Review. Harvard Health Policy Review. p. 2. One study found a statistically significant relationship between estimated gun ownership levels and suicide rate across 14 developed nations (e.g. where survey data on gun ownership levels were available), but the association lost its statistical significance when additional countries were included.
  80. ^ Birckmayer, Johanna; Hemenway, David (September 2001). "Suicide and Firearm Prevalence: Are Youth Disproportionately Affected?". Suicide and Life-Threatening Behavior. 31 (3): 303–10. doi:10.1521/suli.31.3.303.24243. PMID 11577914.
  81. ^ Miller, Matthew; Hemenway, David (March 1999). "The relationship between firearms and suicide". Aggression and Violent Behavior. 4 (1): 59–75. doi:10.1016/S1359-1789(97)00057-8.
  82. ^ Brent, D. A.; Bridge, J. (1 May 2003). "Firearms Availability and Suicide: Evidence, Interventions, and Future Directions". American Behavioral Scientist. 46 (9): 1192–1210. doi:10.1177/0002764202250662. S2CID 72451364.
  83. ^ Briggs, Justin Thomas; Tabarrok, Alexander (March 2014). "Firearms and suicides in US states". International Review of Law and Economics. 37: 180–88. CiteSeerX 10.1.1.453.3579. doi:10.1016/j.irle.2013.10.004.
  84. ^ a b Miller, Matthew; Warren, Molly; Hemenway, David; Azrael, Deborah (April 2015). "Firearms and suicide in US cities". Injury Prevention. 21 (e1): e116–e119. doi:10.1136/injuryprev-2013-040969. PMID 24302479. S2CID 3275417.
  85. ^ Miller, M.; Barber, C.; White, R. A.; Azrael, D. (23 August 2013). "Firearms and Suicide in the United States: Is Risk Independent of Underlying Suicidal Behavior?". American Journal of Epidemiology. 178 (6): 946–55. doi:10.1093/aje/kwt197. PMID 23975641.
  86. ^ Miller, M (1 June 2006). "The association between changes in household firearm ownership and rates of suicide in the United States, 1981–2002". Injury Prevention. 12 (3): 178–82. doi:10.1136/ip.2005.010850. PMC 2563517. PMID 16751449.
  87. ^ Miller, Matthew; Lippmann, Steven J.; Azrael, Deborah; Hemenway, David (April 2007). "Household Firearm Ownership and Rates of Suicide Across the 50 United States". The Journal of Trauma: Injury, Infection, and Critical Care. 62 (4): 1029–35. doi:10.1097/01.ta.0000198214.24056.40. PMID 17426563.
  88. ^ Anestis, MD; Houtsma, C (13 March 2017). "The Association Between Gun Ownership and Statewide Overall Suicide Rates". Suicide and Life-Threatening Behavior. 48 (2): 204–17. doi:10.1111/sltb.12346. PMID 28294383. S2CID 4756779.
  89. ^ Stroebe, Wolfgang (November 2013). "Firearm possession and violent death: A critical review". Aggression and Violent Behavior. 18 (6): 709–21. doi:10.1016/j.avb.2013.07.025. hdl:10419/214553.
  90. ^ Siegel, Michael; Rothman, Emily F. (July 2016). "Firearm Ownership and Suicide Rates Among US Men and Women, 1981–2013". American Journal of Public Health. 106 (7): 1316–22. doi:10.2105/AJPH.2016.303182. PMC 4984734. PMID 27196643.
  91. ^ Cook, Philip J.; Ludwig, Jens (2000). "Chapter 2". Gun Violence: The Real Costs. Oxford University Press. ISBN 978-0-19-513793-4.
  92. ^ Ikeda, Robin M.; Gorwitz, Rachel; James, Stephen P.; Powell, Kenneth E.; Mercy, James A. (1997). Fatal Firearm Injuries in the United States, 1962–1994: Violence Surveillance Summary Series, No. 3. National Center for Injury and Prevention Control.
  93. ^ Anglemyer, A; Horvath, T; Rutherford, G (21 January 2014). "The accessibility of firearms and risk for suicide and homicide victimization among household members: a systematic review and meta-analysis". Annals of Internal Medicine. 160 (2): 101–10. doi:10.7326/M13-1301. PMID 24592495. S2CID 4509567.
  94. ^ Chapman, S; Alpers, P; Agho, K; Jones, M (1 December 2006). "Australia's 1996 gun law reforms: faster falls in firearm deaths, firearm suicides, and a decade without mass shootings". Injury Prevention. 12 (6): 365–372. doi:10.1136/ip.2006.013714. PMC 2704353. PMID 17170183.
  95. ^ Caron, Jean (October 2004). "Gun Control and Suicide: Possible Impact of Canadian Legislation to Ensure Safe Storage of Firearms". Archives of Suicide Research. 8 (4): 361–74. doi:10.1080/13811110490476752. PMID 16081402. S2CID 35131214.
  96. ^ Caron, Jean; Julien, Marie; Huang, Jean Hua (April 2008). "Changes in Suicide Methods in Quebec between 1987 and 2000: The Possible Impact of Bill C-17 Requiring Safe Storage of Firearms". Suicide and Life-Threatening Behavior. 38 (2): 195–208. doi:10.1521/suli.2008.38.2.195. PMID 18444777.
  97. ^ Cheung, AH; Dewa, CS (2005). "Current trends in youth suicide and firearms regulations". Canadian Journal of Public Health. 96 (2): 131–35. doi:10.1007/BF03403676. PMC 6975744. PMID 15850034.
  98. ^ Beautrais, A. L.; Fergusson, D. M.; Horwood, L. J. (26 June 2016). "Firearms Legislation and Reductions in Firearm-Related Suicide Deaths in New Zealand". Australian & New Zealand Journal of Psychiatry. 40 (3): 253–59. doi:10.1080/j.1440-1614.2006.01782.x. PMID 16476153. S2CID 208623661.
  99. ^ Beautrais, Annette L.; Joyce, Peter R.; Mulder, Roger T. (26 June 2016). "Access to Firearms and the Risk of Suicide: A Case Control Study". Australian & New Zealand Journal of Psychiatry. 30 (6): 741–748. doi:10.3109/00048679609065040. PMID 9034462. S2CID 9805679.
  100. ^ "Firearms, Accidental Deaths, Suicides and Violent Crime: An Updated Review of the Literature with Special Reference to the Canadian Situation". 10 March 1999.
  101. ^ Langmann, C. (2020). "Effect of firearms legislation on suicide and homicide in Canada from 1981 to 2016". PLOS ONE. 15 (6): e0234457. doi:10.1371/journal.pone.0234457. PMC 7302582. PMID 32555647.
  102. ^ ""Jumping" and Suicide Prevention". Centre for Suicide Prevention.
  103. ^ Koopman, John (2 November 2005). "LETHAL BEAUTY / No easy death: Suicide by bridge is gruesome, and death is almost certain. The fourth in a seven-part series on the Golden Gate Bridge barrier debate". San Francisco Chronicle. Retrieved 3 June 2014.
  104. ^ a b "WISQARS Leading Causes of Death Reports". Retrieved 6 July 2009.
  105. ^ a b c d e f Havârneanu, GM; Burkhardt, JM; Paran, F (August 2015). "A systematic review of the literature on safety measures to prevent railway suicides and trespassing accidents". Accident Analysis and Prevention. 81: 30–50. doi:10.1016/j.aap.2015.04.012. PMID 25939134.
  106. ^ "遭家人責罵:掛住上網媾女唔讀書 成績跌出三甲 中四生跳樓亡". Apple Daily. 9 August 2009. Retrieved 10 September 2009.
  107. ^ Pounder, Derrick. "Lecture Notes in Forensic Medicine" (PDF). p. 6. Archived from the original (PDF) on 14 June 2011. Retrieved 16 April 2011.
  108. ^ a b c Kisch, T; Matzkeit, N; Waldmann (May 2019). "The Reason Matters: Deep Wrist Injury Patterns Differ with Intentionality (Accident versus Suicide Attempt)". Plastic and Reconstructive Surgery. Global Open. 7 (5): e2139. doi:10.1097/GOX.0000000000002139. PMC 6571333. PMID 31333923.
  109. ^ Baker, Susan P.; O'Neill, Brian; Ginsburg, Marvin J.; Li, Guohua (1991). The Injury Fact Book. Oxford University Press. p. 65. ISBN 978-0-19-974870-9.
  110. ^ Bukhari, AJ; Saleem, M; Bhutta, AR; Khan, AZ; Abid, KJ (October 2004). "Spaghetti wrist: management and outcome". Journal of the College of Physicians and Surgeons Pakistan. 14 (10): 608–11. doi:10.2004/JCPSP.608611 (inactive 18 January 2021). PMID 15456551.CS1 maint: DOI inactive as of January 2021 (link)
  111. ^ Gruenewald, DA (September 2018). "Voluntarily Stopping Eating and Drinking: A Practical Approach for Long-Term Care Facilities". Journal of Palliative Medicine. 21 (9): 1214–20. doi:10.1089/jpm.2018.0100. PMID 29870302.
  112. ^ a b Pope, Thaddeus Mason; Anderson, Lindsey E. (7 October 2010). "Voluntarily Stopping Eating and Drinking: A Legal Treatment Option at the End of Life". SSRN 1689049. Cite journal requires |journal= (help)
  113. ^ Sheldon, T (21 June 2008). "Dutch doctors publish guide to "careful suicide"". BMJ (Clinical Research Ed.). 336 (7658): 1394–95. doi:10.1136/bmj.a362. PMC 2432148. PMID 18566058.
  114. ^ Docker C, The Art and Science of Fasting in: Smith C, Docker C, Hofsess J, Dunn B, Beyond Final Exit 1995
  115. ^ Sundara, A. "Nishidhi Stones and the ritual of Sallekhana" (PDF). International School for Jain Studies. Archived from the original (PDF) on 28 February 2018. Retrieved 21 April 2017.
  116. ^ "Hinduism – Euthanasia and Suicide". BBC. 25 August 2009.
  117. ^ Greer, John Michael (2003). The New Encyclopedia of the Occult. ISBN 978-1567183368. Retrieved 4 February 2014 – via Google Books.
  118. ^ Radford, Tim (19 April 2002). "Thor Heyerdahl dies at 87". The Guardian. London. Retrieved 6 July 2009.
  119. ^ Baumrucker, Steven (5 September 2016). "Science, hospice, and terminal dehydration". American Journal of Hospice and Palliative Medicine. 16 (3): 502–03. doi:10.1177/104990919901600302. PMID 10661057. S2CID 44883936.
  120. ^ Bernat, James L. (27 December 1993). "Patient Refusal of Hydration and Nutrition". Archives of Internal Medicine. 153 (24): 2723–28. doi:10.1001/archinte.1993.00410240021003. PMID 8257247. S2CID 36848946.
  121. ^ Miller, Franklin G.; Meier, Diane E. (2004). "Voluntary Death: A Comparison of Terminal Dehydration and Physician-Assisted Suicide". Annals of Internal Medicine. 128 (7): 559–62. doi:10.7326/0003-4819-128-7-199804010-00007. PMID 9518401. S2CID 34734585.
  122. ^ Jacobs, Sandra (24 July 2003). "Death by Voluntary Dehydration – What the Caregivers Say". New England Journal of Medicine. 349 (4): 325–26. doi:10.1056/NEJMp038115. PMID 12878738.
  123. ^ Arehart-Treichel, Joan (16 January 2004). "Terminally Ill Choose Fasting Over M.D.-Assisted Suicide". Psychiatric News. 39 (2): 15–51. doi:10.1176/pn.39.2.0015.
  124. ^ Smith, Wesley J. (12 November 2003). "A 'Painless' Death?". The Weekly Standard.
  125. ^ Hilkevitch, Jon (4 July 2004). "When death rides the rails". Chicago Tribune. Archived from the original on 20 December 2012. Retrieved 29 March 2009.
  126. ^ Ricardo Alonso-Zaldivar (26 January 2005). "Suicide by Train Is a Growing Concern". Los Angeles Times.
  127. ^ Netherlands, Statistics. "Suicide death rate up to 1,647". www.cbs.nl.
  128. ^ "Les suicides coûtent 2 millions à la SNCB qui tente de se faire rembourser auprès des familles". sudinfo.be.
  129. ^ French, Howard W. (6 June 2000). "Kunitachi City Journal; Japanese Trains Try to Shed a Gruesome Appeal". The New York Times. ISSN 0362-4331. Retrieved 14 January 2017.
  130. ^ New, Ultra Super. "Blood on the tracks: Who pays for deadly railway accidents? | Yen for Living".
  131. ^ Noah Bierman (9 February 2010). "Striving to prevent suicide by train". Boston.com. Boston Globe.
  132. ^ Martino, Michael et al. (2013). Defining Characteristics of Intentional Fatalities on Railway Rights-of-Way in the United States, 2007–2010. Washington, D.C.: U.S. Department of Transportation, Federal Railroad Administration.
  133. ^ a b c Mishara, BL; Bardon, C (15 March 2016). "Systematic review of research on railway and urban transit system suicides". Journal of Affective Disorders. 193: 215–26. doi:10.1016/j.jad.2015.12.042. PMID 26773913.
  134. ^ Frances, Richard J.; Wikstrom, Thomas; Alcena, Valiere (1985). "Contracting AIDS as a means of committing suicide". The American Journal of Psychiatry. 142 (5): 656. doi:10.1176/ajp.142.5.656b. PMID 3985206.
  135. ^ Flavin, Daniel K.; Franklin, John E.; Frances, Richard J. (1986). "The acquired immune deficiency syndrome (AIDS) and suicidal behavior in alcohol-dependent homosexual men". The American Journal of Psychiatry. 143 (11): 1440–42. doi:10.1176/ajp.143.11.1440. PMID 3777237. S2CID 21218263.
  136. ^ Ronald W. Maris; Alan L. Berman; Morton M. Silverman; Bruce M. Bongar (2000). Comprehensive textbook of suicidology. Guilford Press. p. 161. ISBN 978-1-57230-541-0.
  137. ^ Marc, B; Baudry, F; Douceron, H; Ghaith, A; Wepierre, JL; Garnier, M (January 2000). "Suicide by electrocution with low-voltage current". Journal of Forensic Sciences. 45 (1): 216–22. doi:10.1520/JFS14665J. PMID 10641944.
  138. ^ Liptak, Adam (9 February 2008). "Electrocution Is Banned in Last State to Rely on It". The New York Times. Retrieved 24 May 2010.
  139. ^ Fish, RM; Geddes, LA (12 October 2009). "Conduction of electrical current to and through the human body: a review". ePlasty. 9: e44. PMC 2763825. PMID 19907637.
  140. ^ Selzer, M. L.; Payne, C. E. (1992). "Automobile accidents, suicide, and unconscious motivation". American Journal of Psychiatry. 119 (3): 237–40 [239]. doi:10.1176/ajp.119.3.237. PMID 13910542. S2CID 46631419.
  141. ^ Evans, Leonard. "Driver behavior". Science Serving Society. Retrieved 23 September 2020.
  142. ^ Pompili, M; Serafini, G; Innamorati, M; et al. (30 November 2012). "Car accidents as a method of suicide: a comprehensive overview". Forensic Science International. 223 (1–3): 1–9. doi:10.1016/j.forsciint.2012.04.012. PMID 22576104.
  143. ^ Murray, D.; de Leo, D. (September 2007). "Suicidal behavior by motor vehicle collision". Traffic Inj Prev. 8 (3): 244–47. doi:10.1080/15389580701329351. PMID 17710713. S2CID 30149719.
  144. ^ Sophie Gilmartin (1997), The Sati, the Bride, and the Widow: Sacrificial Woman in the Nineteenth Century, Victorian Literature and Culture, Cambridge University Press, Vol. 25, No. 1, p. 141, Quote: "Suttee, or sati, is the obsolete Hindu practice in which a widow burns herself upon her husband's funeral pyre..."
  145. ^ Hughes, Robert (1988). The Fatal Shore, The Epic Story of Australia's Founding (first ed.). Vintage Books.
  146. ^ "Thai woman eaten by crocodiles". news.bbc.co.uk. 11 August 2002.
  147. ^ "Thai woman in crocodile pit suicide". BBC News. 16 September 2014.
  148. ^ Nathan, John. Mishima: A biography, Little Brown and Company: Boston/Toronto, 1974.
  149. ^ Cedric A. Mims (1998). When we die. Robinson. p. 40. ISBN 978-1-85487-529-7.
  150. ^ Edward Robb Ellis; George N. Allen (1961). Traitor within: our suicide problem. Doubleday. p. 98.
  151. ^ "Jumpers". The New Yorker. 13 October 2003.
  152. ^ Bills, Corey B.; Grabowski, Jurek George; Li, Guohua (2005). "Suicide by Aircraft: A Comparative Analysis". Aviation, Space, and Environmental Medicine. 76 (8): 715–19. PMID 16110685.
  153. ^ Clark, Nicola; Bilefsky, Dan (26 March 2015). "Germanwings Co-Pilot Deliberately Crashed Airbus Jet, French Prosecutor Says". The New York Times. Retrieved 26 March 2015.
  154. ^ "Germanwings Flight 4U9525: Co-pilot put plane into descent, prosecutor says". CBC News. 26 March 2015. Retrieved 26 March 2015.
  155. ^ Wescott, Richard (16 April 2015). "Flight MH370: Could it have been suicide?". BBC News. BBC News. Retrieved 20 June 2017.
  156. ^ Pells, Rachael (23 July 2016). "MH370 pilot flew 'suicide route' on a simulator 'closely matching' his final flight". The Independent. The Independent. Retrieved 20 June 2017.
  157. ^ W.G. Eckert; W.S. Reals (1978). "Air disaster investigation". Legal Medicine Annual: 57–70. PMID 756947.
  158. ^ David Dolinak; Evan W. Matshes; Emma O. Lew (2005). Forensic pathology: principles and practice. Academic Press. p. 293. ISBN 978-0-12-219951-6.
  159. ^ Allison, Rebecca (20 June 2002). "Depressed pilot leapt to death". The Guardian. ISSN 0261-3077. Retrieved 14 January 2017.
  160. ^ "SAS soldier dies in plane plunge". CNN. 10 January 2002. Retrieved 14 January 2017.

Further reading

External links