Suicide

Suicide (from Latin sui caedere, to kill oneself) is the act of willfully ending one's own life. Suicide is sometimes used as a noun for one who has committed or attempted the act.

The terminology and its implications
Suicide is frequently highly stigmatized, and those experiencing suicidal ideation struggle to be heard and understood. Suicidal ideation frequently results from the experience of pain outweighing the individual's coping strategies and resources for dealing with that pain.

Suicide is viewed in highly varying ways among the cultures, religions, legal and social systems of the world. It is considered a sin or immoral act in many religions, and a crime in some jurisdictions. On the other hand, some cultures have viewed it as an honorable way to exit certain shameful or hopeless situations. Persons attempting or dying by suicide sometimes leave a suicide note.

According to stricter definitions of suicide, to be considered suicide, the death of the person who commits suicide must be the central component and only intention of the act, not just a certain consequence; hence, suicide bombing is considered a kind of bombing rather than a kind of suicide, and martyrdom usually escapes religious or legal proscription. Generally, there are only legal consequences when there is death and proof of intent. However, not all follow this narrower definition. Certainly, a suicide bomber knows that death will be part of the outcome of his or her actions.

It should be noted that by the stricter definition, acts of suicide are only committed by human beings and most likely by dolphins as well; no other healthy organisms capable of reproducing that are currently known of except for those mentioned terminate their own life with the central intention being their own death.

If you are in suicidal crisis, call a crisis line and talk to someone about it. In the United States, you can call 1-800-273-TALK to reach a trained counselor near you.

Medical views on suicide
Medicine views suicide as a mental health issue. Severe suicidal thoughts are considered a medical emergency. Mental health practitioners consistently advise suicidal people to seek help. This is especially true if the means (weapons, drugs, or other methods) are available, or if a detailed plan is in place. Suicidal patients in mental hospitals may be temporarily bound, placed in padded rooms, or incapacitated with drugs to limit access to means of suicide.

Suicide as a form of defiance and protest
Heroic suicide, for the greater good of others, is often celebrated. For instance, Gandhi went on a hunger strike to prevent fighting between Hindus and Muslims, and although they stopped before he died, he might have killed himself if they hadn't. For this, he earned the respect of many.

In the 1960s, Buddhist monks, most notably Thích Quảng Ðức, in South Vietnam gained Western praise in their protests against President Ngô Đình Diệm by burning themselves to death. Similar events were reported in eastern Europe, such as Jan Palach following the Soviet invasion of Czechoslovakia. In wars, there have been numerous reports of combatants performing suicidal acts in order to save other soldiers. Not everybody would count all these actions as suicides, as the person's death was clearly not the primary purpose. Opponents argue that these people would probably achieve a comparable result by spending the rest of their lives in active struggle.

Arguments for suicide and euthanasia
There are arguments in favor of allowing an individual to choose between life and suicide. This view sees suicide as a valid option and a human right. This line rejects the widespread belief that suicide is always or usually irrational, saying instead that it is a genuine, albeit severe, solution to real problems – a line of last resort that can legitimately be taken when the alternative is considered worse. No being should be made to suffer unnecessarily, and suicide provides an escape from suffering in certain circumstances, such as incurable disease and old age.

In the past, the Japanese were often ordered to commit seppuku, a form of ritual disembowelment suicide, by their superiors, and were expected to do so as a matter of honor, in an instance where they committed a greater dishonor to their family. They may also have done it as a matter of free choice, also for the sake of honor, and it was considered better than being taken prisoner.

A few rare groups say that people should kill themselves for the greater good. For example, the Church of Euthanasia says that people should kill themselves in order to reduce mankind's stress on the environment.

Epidemiology


It is probable that the incidence of suicide is widely under-reported due to both religious and social pressures, and possibly completely unreported in some areas. Many theories have been developed to explain the causes of suicide with no strong consensus with one. Nevertheless, from the known suicides, certain trends are apparent: for example, in the Western world, males die much more often than females by suicide, while females attempt suicide more often. Suicide rates in various nations have followed significant patterns over time, and it's often possible to anticipate suicides based on a person's social, economic, and psychological condition. The radical view would be that in the countries with the extremely high rate this may reflect the psychological problems of the whole society rather than the problems of that particular individual. However, there is insufficient data to adequately compare suicide rates among nations.

Combination of homicide and suicide
Since crime just prior to suicide is often perceived as being without consequences, it's not uncommon to combine homicide with suicide. Motivations range from wishing to be with one's family in an expected afterlife to avoiding punishment to killing others as part of a suicide pact.

Attempted suicide and parasuicide
Many suicidal people participate in suicidal activities which do not result in death. These activities fall under the designation attempted suicide or parasuicide. Generally, those with a history of such attempts are almost 23 times more likely to eventually end their own lives than those without.

Sometimes, a person will make actions resembling suicide attempts while not being fully committed, or in a deliberate attempt to have others notice. This is called a suicidal gesture (also known as a "cry for help"). Prototypical methods might be a non-lethal method of self-harm that leaves obvious signs of the attempt, or simply a lethal action at a time when the person considers it likely that they will be rescued or prevented from fully carrying it out.

On the other hand, a person who genuinely wishes to die may fail, due to lack of knowledge about what they are doing; unwillingness to try methods that may end in permanent damage if they fail or harm to others; or an unanticipated rescue, among other reasons. This is referred to as a suicidal attempt.

Distinguishing between a suicidal attempt and a suicidal gesture may be difficult. Intent and motivation are not always fully discernable since so many people in a suicidal state are genuinely conflicted over whether they wish to end their lives. One approach, assuming that a sufficiently strong intent will ensure success, considers all near-suicides to be suicidal gestures. This however does not explain why so many people who fail at suicide end up with severe injuries, often permanent, which are most likely undesirable to those who are making a suicidal gesture. Another possibility is those wishing merely to make a suicidal gesture may end up accidentally killing themselves, perhaps by underestimating the lethality of the method chosen or by overestimating the possibility of external intervention by others. Suicide-like acts should generally be treated as seriously as possible since if there is an insufficiently strong reaction from loved ones from a suicidal gesture, this may motivate future, more committed attempts.

In the technical literature the use of the terms parasuicide, or deliberate self-harm (DSH) are preferred – both of these terms avoid the question of the intent of the action.

Those who self-harm are, as a group, quite different from those who attempt to die from suicide. It is of utmost importance to note that self-harm is not a suicide attempt and should never be construed as such. There is a non-causal correlation between self-harm and suicide; individuals who suffer from depression or other mental health issues are also more likely to choose suicide. DSH is far more common than suicide, and the majority of DSH participants are females aged under 35. They are usually not physically ill and while psychological factors are highly significant, they are rarely clinically ill and severe depression is uncommon. Social issues are key – DSH is most common among those living in overcrowded conditions, in conflict with their families, with disrupted childhoods and history of drinking, criminal behavior, and violence. Individuals under these stresses become anxious and depressed and then, usually in reaction to a single particular crisis, they attempt to harm themselves. The motivation may be a desire for relief from emotional pain or to communicate feelings, although the motivation will often be complex and confused. DSH may also result from an inner conflict between the desire to end life and the desire to continue living. See the article on self-harm for an in depth discussion.

Distinction between suicide and attempted suicide
An important distinction has also been made (see Erwin Stengel, 'Suicide and Attempted Suicide') between those who kill themselves and did not mean to, and those who did not kill themselves but did mean to. Thus a 'Suicide' (noun) may either succeed or fail in his/her goal (ie. succeed in killing himself/herself or not) and an 'Attempted Suicide' (noun) may either succeed or fail in his/her goal (e.g., succeed in 'making a cry for help' or fail and, in doing so, probably die).

This distinction, if correctly drawn, can have important ramifications for the treatment of people who are suicidal.

Suicide in literature
Suicide has been used as a dramatic plot element in a number of literary works, such as The Sorrows of Young Werther, Madame Bovary, Anna Karenina, Umberto D, The Awakening, Romeo and Juliet, Death of a Salesman, Groundhog Day, and Survivor. Robert E. Howard wrote several poems, including The Tempter, about suicide. In The Picture of Dorian Gray, the main protagonist inadvertently committed suicide when he stabbed a portrait of himself.

Documents and periodicals

 * Frederick, C. J. Trends in Mental Health: Self-destructive Behavior Among Younger Age Groups. Rockville, MD: National Institute on Drug Abuse. 1976. ED 132 782.
 * Lipsitz, J. S. MAKING IT THE HARD WAY: ADOLESCENTS IN THE 1980S. Testimony presented to the Crisis Intervention Task Force of the House Select Committee on Children, Youth, and Families. 1983. ED 248 002.
 * McBrien, R. J. "Are You Thinking of Killing Yourself? Confronting Suicidal Thoughts." SCHOOL COUNSELOR 31 (1983): 75–82.
 * Ray, L. Y. "Adolescent Suicide." PERSONNEL AND GUIDANCE JOURNAL 62 (1983): 131–35.
 * Rosenkrantz, A. L. "A Note on Adolescent Suicide: Incidence, Dynamics and Some Suggestions for Treatment." ADOLESCENCE 13 (l978): 209–14.
 * Sheppard, Gordon, "HA! A Self-Murder Mystery". (2003) (Fiction) Documentary novel based on the suicide of Québec Novelist Hubert Aquin and other notable suicides in literary history.
 * Suicide Among School Age Youth . Albany, NY: The State Education Department of the University of the State of New York, 1984. ED 253 819.
 * SUICIDE AND ATTEMPTED SUICIDE IN YOUNG PEOPLE. REPORT ON A CONFERENCE. Geneva, Switzerland: World Health Organization, 1974. ED 162 204.
 * TEENAGERS IN CRISIS: ISSUES AND PROGRAMS. HEARING BEFORE THE SELECT COMMITTEE ON CHILDREN, YOUTH, AND FAMILIES. HOUSE OF REPRESENTATIVES NINETY-EIGHTH CONGRESS, FIRST SESSION. Washington, DC: Congress of the U. S., October, 1983. ED 248 445.
 * Smith, R. M. ADOLESCENT SUICIDE AND INTERVENTION IN PERSPECTIVE. Paper presented at the annual meeting of the National Council on Family Relations, Boston, MA, August, 1979. ED 184 017.

Nonfiction books

 * Bongar, B. The Suicidal Patient: Clinical and Legal Standards of Care . Washington, D.C.: APA. 2002. ISBN 1557987610
 * Stone, Geo: Suicide and Attempted Suicide. New York: Carroll & Graf, 2001. ISBN 0-7867-0940-5
 * Stone, Geo: Suicide and Attempted Suicide. New York: Carroll & Graf, 2001. ISBN 0-7867-0940-5

Fiction books

 * Sheppard, Gordon, "HA! A Self-Murder Mystery". (2003) (Fiction) Documentary novel based on the suicide of Québec Novelist Hubert Aquin and other notable suicides in literary history.

Crisis Lines
If you are in suicidal crisis, call a crisis line and talk to someone about it. In the United States, you can call 1-800-273-TALK or 1-800-SUICIDE to reach a trained counselor near you.
 * 1-800-273-TALK National Suicide Prevention Lifeline
 * Suicide Prevention Center Los Angeles Serving Southern California
 * Suicide Hotlines Listing of suicide prevention lines in the United States and around the world. Look here to find a crisis line near you.

Support groups

 * Samaritans (UK)
 * #alt.suicide.bus.stop – think about suicide differently. A support group for the suicidal, by the suicidal.
 * Befrienders International (or in other languages)
 * The Suicide Forum, an international support forum for those in crisis
 * SuicideTalk.com Suicide forums
 * Open Directory Project: Support groups for those who are suicidal or in despair

Other links

 * Understanding and Helping the Suicidal Person
 * Website of Geo Stone, author of "Suicide and Attempted Suicide" (see above)
 * Suicide as a Moral Alternative
 * "Suicide" in the Stanford Encyclopedia of Philosophy
 * 169 Manually selected Suicide Resources
 * Befrienders.org - links statistics for various countries and age groups.
 * American Association of Suicidology - statistics and general information
 * Recommended readings on selected topics in suicide prevention
 * Choose Life (Scotland)
 * Anti-suicide page from metanoia.org
 * The Debate: a pro-choice FAQ
 * Teenage Suicide: Identification, Intervention and Prevention
 * Suicide and the Exceptional Child
 * Suicide and Sudden Loss: Crisis Management in the Schools
 * American Foundation for Suicide Prevention – media reporting guidelines.
 * Ethical and legal considerations in suicide and its prevention
 * Lithuania's Suicide Epidemic
 * Teen suicide prevention
 * Suicide Promotion (Internet) – United Kingdom Parliamentary debate, 25th January 2005
 * Suicide - Frequently Asked Questions
 * Our Right to Suicide - Article
 * Suicide & the Self(PDF)

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