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One of our contributors wrote:

I for one, were horrified to learn of how many different ways there were to commit suicide. They need to know that there is help and advice out there and that there are people who do care and that they can turn to. If anyone out there is considering suicide then please seek help. Don't feel ashamed or embarrassed admitting that you have a problem, we all need someone to lean on at times, it's part of being human. I felt as though i was in this black hole that i couldn't get out of, but i am living proof that there is light at the end of the tunnel. Seeing a psycologist that i trust and can relate to has helped me tremendously, medication can only do so much, off loading some of the pain by talking to a proffessional, someone who will sympathise and understand, is far the best treatment for me. No matter how dark and bleak things look now, there are always other routes to take, suicide is not the answer.
User:Tess01. See the discussion page for more

Please bear this in mind if reading this page in distress.

If you are suicidal you should seek help immediately from your nearest health professional or you may find some of the Hotline services listed here helpful depending on where you live.



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.

BleedingEdit

Main article: Bleeding
See also: Self mutilation

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. Death may occur directly as a result of the desanguination of the body or via hypovolemia, wherein the blood volume in the circulatory system becomes too low and results in the body shutting down.

Cutting wristsEdit

This method attempts to self-inflict a class IV haemorrhage by traumatic bleeding. Standard emergency bleeding control applies for pre-hospital treatment -- i.e. elevation and direct pressure; application of tourniquets should be reserved for professionals if used at all.

DrowningEdit

File:Street Girl's End.jpg
Main article: 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. If the drowning is stopped before death, oxygen deprivation can cause brain damage.

Drowning is among the least common methods (typically less than 2% of all reported suicides in the United States for 2005) [2]

SuffocationEdit

Suicide by suffocation is the act of inhibiting one's ability to breathe or to limit the oxygen uptake while breathing, which causes asphyxia (by all methods excluding drowning). Inert gasses, such as helium, argon and nitrogen, are sometimes used, because breathing inert gas causes loss of consciousness and death without ever experiencing air hunger.

ElectrocutionEdit

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.

JumpingEdit

Many people have committed suicide by jumping or falling from high altitudes (eg from a cliff, dam, bridge, ...) Also, many people have committed suicide by defenestration whereby they throw themselves out of a high window.

Jumping is among the least common methods (typically less than 2% of all reported suicides in the United States for 2005) [3]

FirearmsEdit

A common suicide method is to use a firearm. Some research shows an association between household firearm ownership and gun suicide rates,[4][5] while other research indicates no such association between firearm ownership and gun suicide rates.[6]During the 1980s and early 1990s, there was a strong upward trend in adolescent suicides with a gun,[7] as well as a sharp overall increase in a suicides among those age 75 and over.[8] In the United States, firearms remain the most common method of suicide, accounting for 53.7% of all suicides committed during 2003.[9] Unlike in the U.S., suicide rates of suicides committed with guns in countries where firearms are uncommon are similarly uncommon, with other methods typically being used to commit suicides.

Research also indicates no association vis-à-vis safe-storage laws of guns that are owned, and gun suicide rates, and studies that attempt to link gun ownership to likely victimology often fail to account for the presence of guns owned by other people.[10][11] Researchers have shown that safe-storage laws do not appear to affect gun suicide rates or juvenile accidental gun death.[10][11]

HangingEdit

Main article: Hanging

Hanging is the prevalent means of suicide in pre-industrial societies and is more common in rural rather than urban areas.[12]


Vehicular impactEdit

Jumping, lying or standing in front of a fast-moving vehicle, especially a large one, such as a truck, can prove fatal.

RailEdit

Suidide involving trains is a significant problem in some jurisdictions.

This may be traumatizing to the driver of the train and may result in them suffering PTSD requiring treatment. Suicide by being hit by a train has a 10% survival rate. Not dying following impact of the vehicle could result in massive body damage including amputations, fractures, brain damage, organ bruising, and disability.

In some European countries with highly developed rail networks and very strict gun-control laws, such as Germany and Sweden, railway-related suicide is considered a social problem, and extensive research has been carried out into this type of suicide. According to these studies, most suicides occur in densely populated areas, but away from train stations and terminal points. Wooded areas, curves and tunnels are especially plagued. Most suicides occur at evening or night time, with reduced visibility for the driver.

Studies have shown that people who commit suicide in this manner usually stay at or around the suicide location for an extended period of time before the actual suicide. Unlike suicides in the underground, they rarely or never jump in front of the train, but rather stand or lie on the tracks, waiting for the arrival of the train. As the trains usually keep high speeds, at around 80 km/h for regular trains and around 200 km/h or more for high speed trains, the driver is usually unable to bring the train to a halt before hitting the suicide candidate. Drivers are often traumatized and suffer from post-traumatic stress disorder.

In Germany 10% of all suicides occur in this manner. Germany is the country where railway related suicides account for the largest share of overall suicides. Railway related suicides are also common in Britain and Japan.

Methods to reduce the number of rail-related suicides include video surveillance of stretches where suicides frequently occur, often with direct links to the local police or surveillance companies. This enables the police or guards to be on the scene within minutes after the trespassing was noted. Public access to the tracks is also made more difficult by erecting fences. Trees and bushes are cut down around the tracks in order to increase driver visibility.

SubwayEdit

Jumping in front of an oncoming subway train has a 67% survival rate, much higher than the 10% survival rate for rail-related suicides. Jumping in front of an underground train is a comparatively common form of suicide in many larger cities, such as London.

Different methods have been used in order to decrease the number of suicide attempts in the underground: a deep drainage pit halves the likelihood of fatality. 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.[13]

Traffic collisions Edit

Some car accidents are in fact suicides. This especially applies to single-occupant, single-vehicle accidents. "The automobile lends itself 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"[14].

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%". [15] 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.'"[15]

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."[16]

PoisoningEdit

Suicide can be committed by using fast-acting poisons (eg HCN), or substances which are known for their high levels of toxicity to humans. Poisoning is more common amongst occupational groups who have access to chemicals such as farmers. Poisioning by farm chemicals is common among females in the Chinese countryside, and is regarded as a major social problem in the country.

Drug overdosingEdit

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 depends on chosen drugs and additional measures like use of antiemetics to preventing vomiting. Average fatality rate for overdoses in the US is estimated to be 1.8% only[17]. At the same time, assisted suicide group Dignitas reported no single failure among 840 cases (fatality rate 100%), where an overdose of a former sleeping pill active agent Nembutal was used in combination with antiemetic drug[18].

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 euthanize animals. Dutch right to die society WOZZ proposed several safe alternatives to barbiturates for use in euthanasia.[19]

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.

Drug overdose as a method is more prevelent amongst occupational groups that have access to the drugs, such as doctors and dentists.

Carbon monoxide poisoningEdit

Main article: Carbon monoxide poisoning

A particular type of poisoning involves inhalation of high levels of carbon monoxide. Death usually occurs through hypoxia. 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.

VenomEdit

Several insects such as spiders, snakes, scorpions, etc., carry venoms that can easily and quickly kill a person. Evidence that any particular death is due to suicide is problematic so reliable estimates of the prevalence of this method are hard to come by

ImmolationEdit

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 immolation to refer to suicide by fire.

SeppukuEdit

Main article: Seppuku

Seppuku (colloquially harakiri "belly slitting") 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 the novelist 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.


Apocarteresis (suicide by starvation)Edit

Main article: Starvation

Starvation has been used by Hindu, Jain and Buddhist monks as a ritual method of suicide. Albigensians or Cathars also fasted after receiving the 'consolamentum' sacrament, in order to die while in a morally perfect state.

A hunger strike may ultimately lead to death.

Terminal dehydrationEdit

Main article: Terminal dehydration

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.[21][22] But it also has distinctive drawbacks as a humane means of voluntary death.[23] One survey of hospice nurses in Oregon (where physician-assisted suicide is legal) 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.[24] They also rated fasting and dehydration as causing less suffering and pain and being more peaceful than physician-assisted suicide.[25] There can be a fine line between terminal sedation that results in death by dehydration and euthanasia.[26]

Studies have shown that for terminally ill patients who choose to die, deaths by terminal dehydration are generally peaceful, and not associated with suffering, when supplemented with adequate pain medication.[27][28][29][30][31][32] All ages may feel sudden head rushes, dizziness, and loss of appetite, as well.


See alsoEdit

Further readingEdit


ReferencesEdit

  1. Gliatto, Michael F., Rai, Anil K. (March 1999). Evaluation and Treatment of Patients with Suicidal Ideation. American Family Physician 59 (6).
  2. WISQARS leading death reporting
  3. WISQARS leading death reporting
  4. Committee on Law and Justice (2004). "Executive Summary" Firearms and Violence: A Critical Review, National Academy of Science.
  5. Kellermann, A.L., F.P. Rivara, G. Somes, et al. (1992). Suicide in the home in relation to gun ownership. New England Journal of Medicine 327: pp. 467–472.
  6. Miller, Matthew and Hemenway, David (2001). Firearm Prevalence and the Risk of Suicide: A Review, Harvard Health Policy Review. "One study found a statistically significant relationship between 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."
  7. Cook, Philip J., Jens Ludwig (2000). "Chapter 2" Gun Violence: The Real Costs, Oxford University Press.
  8. Ikeda, Robin M., Rachel Gorwitz, Stephen P. James, Kenneth E. Powell, James A. Mercy (1997). Fatal Firearm Injuries in the United States, 1962-1994: Violence Surveillance Summary Series, No. 3, National Center for Injury and Prevention Control.
  9. U.S.A. Suicide: 2000 Official Final Data. American Association of Suicidology.
  10. 10.0 10.1 Kleck, Gary (2004). Measures of Gun Ownership Levels of Macro-Level Crime and Violence Research. Journal of Research in Crime and Delinquency 41: pp. 3–36. Template:NCJ.
  11. 11.0 11.1 Lott, John, John E. Whitley (2001). Safe-Storage Gun Laws: Accidental Deaths, Suicides, and Crime. Journal of Law and Economics 44(2): pp. 659–689.
  12. Ronald W. Maris, Alan L. Berman, Morton M. Silverman, Bruce Michael Bongar (2000). Comprehensive Textbook of Suicidology, Guildford Press.
  13. J Coats, D P Walter (9 October 1999), Effect of station design on death in the London Underground: observational study, PMID 10514158, http://bmj.bmjjournals.com/cgi/content/full/319/7215/957 
  14. Selzer, M. L., & Payne, C. E. (1992). Automobile accidents, suicide, and unconscious motivation. American Journal of Psychiatry, 119, p 239
  15. 15.0 15.1 Accident or suicide? Single-vehicle car accidents and the intent hypothesis. Adolescence, Summer, 1995 by Dennis L. Peck, Kenneth Warner
  16. Suicidal Behavior by Motor Vehicle Collision. Dominique Murray, Diego de Leo. Traffic Injury Prevention, Volume 8, Issue 3 September 2007 , pages 244 - 247"
  17. Stone, Geo. Suicide and Attempted Suicide: Methods and Consequences. New York: Carroll & Graf, 2001. ISBN 0-7867-0940-5, p. 230
  18. Wenn Sie das trinken, gibt es kein Zurück Tagesspiegel.de Retrieved 2008-04-12
  19. Guide to a Humane Self-Chosen Death by Dr. Pieter Admiraal et al. WOZZ Foundation www.wozz.nl, Delft, The Netherlands. ISBN 9078581018.
  20. Brock, Anita, Sini Dominy, Clare Griffiths (6th). Trends in suicide by method in England and Wales, 1979 to 2001. Health Statistics Quarterly 20: 7–18.
  21. James L. Bernat, MD; Bernard Gert, PhD; R. Peter Mogielnicki, MD (27 December 1993), "Patient Refusal of Hydration and Nutrition", Archives of Internal Medicine (Archives of Internal Medicine) 153 (24): 2723–8, doi:10.1001/archinte.1993.00410240021003, PMID 8257247, http://archinte.highwire.org/cgi/content/summary/153/24/2723. 
  22. Thaddeus M. Pope; Lindsey Anderson (2011), "Voluntarily Stopping Eating and Drinking: A Legal Treatment Option at the End of Life", Widener Law Review (Widener Law Review) 17 (2): 363–428, http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1689049 
  23. Miller, Franklin G. and Meier, Diane E. (2004), "Voluntary Death: A Comparison of Terminal Dehydration and Physician-Assisted Suicide", Annals of internal medicine (Annals of Internal Medicine) 128 (7): 559–62, PMID 9518401, http://www.annals.org/content/128/7/559.abstract. 
  24. Jacobs, Sandra (July 24, 2003), "Death by Voluntary Dehydration — What the Caregivers Say", The New England Journal of Medicine (New England Journal of Medicine) 349 (4): 325–6, doi:10.1056/NEJMp038115, PMID 12878738, http://nejm.highwire.org/cgi/content/extract/349/4/325. 
  25. Arehart-Treichel, Joan (January 16, 2004), "Terminally Ill Choose Fasting Over M.D.-Assisted Suicide", Psychiatric News (American Psychiatric Association) 39 (2): 15 
  26. The Supreme Court and Physician-Assisted Suicide — Rejecting Assisted Suicide but Embracing Euthanasia, 337:1236-1239, New England Journal of Medicine, October 23, 1997, http://nejm.highwire.org/cgi/content/extract/337/17/1236 
  27. Ganzini L, Goy ER, Miller LL, Harvath TA, Jackson A, Delorit MA (July 2003), "Nurses' experiences with hospice patients who refuse food and fluids to hasten death", The New England Journal of Medicine 349 (4): 359–65, doi:10.1056/NEJMsa035086, PMID 12878744, http://content.nejm.org/cgi/pmidlookup?view=short&pmid=12878744&promo=ONFLNS19. 
  28. McAulay D (2001), "Dehydration in the terminally ill patient", Nursing Standard 16 (4): 33–7, PMID 11977821. 
  29. Van der Riet P, Brooks D, Ashby M (November 2006), "Nutrition and hydration at the end of life: pilot study of a palliative care experience", Journal of Law and Medicine 14 (2): 182–98, PMID 17153524. 
  30. Miller FG, Meier DE (April 1998), "Voluntary death: a comparison of terminal dehydration and physician-assisted suicide", Annals of Internal Medicine 128 (7): 559–62, PMID 9518401, http://www.annals.org/cgi/pmidlookup?view=long&pmid=9518401. 
  31. Printz LA (April 1992), "Terminal dehydration, a compassionate treatment", Archives of Internal Medicine 152 (4): 697–700, doi:10.1001/archinte.152.4.697, PMID 1373053, http://archinte.ama-assn.org/cgi/pmidlookup?view=long&pmid=1373053. 
  32. Sullivan RJ (April 1993), "Accepting death without artificial nutrition or hydration", Journal of General Internal Medicine 8 (4): 220–4, doi:10.1007/BF02599271, PMID 8515334. 

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