Suicide

Un article de Vev.

Modèle:Otheruses Modèle:Suicide

Suicide (Latin sui caedere, to kill oneself) is the act of intentionally terminating one's own life. Suicide occurs for a number of reasons such as depression, substance abuse, shame, avoiding pain, financial difficulties or other undesirable situations.<ref> Merriam-Webster OnLine

. Retrieved on 2007-07-21. </ref>

Views on suicide have been influenced by cultural views on existential themes such as religion, honor, and the meaning of life. Most Western and Asian religions—the Abrahamic religions, Buddhism, Hinduism—consider suicide a dishonorable act; in the West it was regarded as a serious crime and offense against God due to religious belief in the sanctity of life. Japanese views on honor and religion led to seppuku being respected as a means to atone for mistakes or failure during the samurai era; Japanese suicides rates remain some of the developed world's highest. In the 20th century suicide in the form of self-immolation has been used as a form of protest, and in the form of kamikaze and suicide bombing as a military or terrorist tactic.

Medically assisted suicide (euthanasia, or the right to die) is a controversial ethical issue involving people who are terminally ill, in extreme pain, and/or have minimal quality of life through illness. Self-sacrifice for others is not usually considered suicide, as the goal is not to kill oneself but to save another.

The predominant view of modern medicine is that suicide is a mental health concern, associated with psychological factors such as the difficulty of coping with depression, inescapable suffering or fear, or other mental disorders and pressures. Suicide is sometimes interpreted in this framework as a "cry for help" and attention, or to express despair and the wish to escape, rather than a genuine intent to die.<ref> WHO Europe - Suicide Prevention

. World Health Organization 
 
 (2005-01-15)
   

. Retrieved on 2007-12-11. </ref> Most suicides (for various reasons) do not succeed on a first attempt; those who later gain a history of repetitions are significantly more at risk of eventual completion.<ref>Modèle:Cite journal</ref>

Nearly a million people worldwide die by suicide annually.<ref>CIS: UN Body Takes On Rising Suicide Rates</ref> There are an estimated 10 to 20 million attempted suicides every year.<ref>Modèle:Web cite</ref> Elderly males have the highest suicide rate, although rates for young adults have been increasing in recent years.<ref> How can suicide be prevented?

 (2005-09-09)
   

. Retrieved on 2007-04-13. </ref>

Sommaire 1 Suicidal phenomena 1.1 Suicidal ideation 1.2 Parasuicide 1.3 Suicidal gestures and attempts 1.4 Suicide crisis 1.5 Suicide note 2 Related phenomena 2.1 Para-suicidality 2.2 Fake suicide 2.3 Euthanasia 2.4 Murder-suicide 2.5 Suicide attack 2.6 Self-harm 3 Suicide methods 4 Reasons for suicide 4.1 Causes of suicide 4.2 Suicide and mental illness 4.3 Epidemiology 4.4 Other reasons 4.4.1 Suicide as a form of defiance and protest 4.4.2 Judicial suicide 4.4.3 Military suicide 4.4.4 Ritual suicide 4.4.5 Dutiful suicide 4.4.5.1 Examples 5 Impact of suicide 5.1 Economic impact 6 Views on suicide 6.1 Medical 6.2 Criminal 6.3 Cultural 6.4 Religious 6.5 Debate over suicide 7 See also 7.1 Lists 8 Footnotes 9 Further reading 9.1 Documents and periodicals 9.2 Nonfiction books 10 External links 10.1 General information 10.2 Suicide prevention 10.3 Views on suicide 10.4 Support groups 10.5 Support groups for survivors

Suicidal phenomena

Suicidal ideation

Main article: Suicidal ideation

Suicidal ideation is a medical term for thoughts about suicide, which may range from vague or unformed urges to meticulously detailed plans and posthumous instructions. The condition requires professional intervention to determine its extent, including the presence of a suicide plan and the patient's means to commit suicide. Severe suicidal ideation is a medical emergency requiring immediate treatment.<ref>Gliatto MF, Rai AK Evaluation and Treatment of Patients with Suicidal Ideation, American Family Physician, March 15, 1999</ref>

Parasuicide

Main article: Parasuicide

Many suicidal people engage in suicidal activities that do not result in death. These activities fall under the clinical designation of parasuicide. Those with a history of such attempts are almost 23 times more likely to eventually commit suicide than those who don't participate in such activities.<ref>Modèle:Cite journal</ref>

Suicidal gestures and attempts

Sometimes, a person will make actions resembling suicide attempts while not being fully committed. This is called a suicidal gesture. 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 he/she 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 he fails or harms others, or an unanticipated rescue, among other reasons. There is a conflict, whereby a genuinely suicidal person can be desperate enough to want to kill themselves but at the same time, too afraid to go through with the extreme measures that are needed to guarantee success. There is also a difference in genders, with men tending to try extremely dangerous, physical methods as opposed to women who tend to use methods such as overdosing etc. which is less frightening but less successful. It may be incorrect to state that a person who survived an overdose was issuing a 'cry for help' when in reality it was a suicide attempt that simply failed. This highlights a basic fact that it is not easy to kill oneself in a way that is not traumatic or painful, hence the phenomenon of assisted suicides. This is referred to as a suicide attempt.

Distinguishing between a suicide attempt and a suicidal gesture may be difficult. Intent and motivation are not always fully discernible 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 suicide 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. (See: self-harming.) 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, because if there is an insufficiently strong reaction from loved ones from a suicidal gesture, this may motivate future and ultimately 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 actions.

Suicide crisis

Main article: Suicide crisis

A suicide being attempted, or a situation in which a person is seriously contemplating suicide or has strong suicidal thoughts, is considered by public safety authorities to be a medical emergency requiring suicide intervention.

Suicide note

Main article: Suicide note

A written message left by someone who attempts, or indeed dies by, suicide is known as a suicide note. The practice is fairly common, occurring in approximately one out of three suicides in the United States.[1] Motivations for leaving a note range from seeking closure with loved ones, to exacting revenge against others by blaming them for the decision. It may also contain a few sentences apologizing to those they may have left. Most suicide notes are hand-written, and also often left with a few personal possessions.

Related phenomena

Para-suicidality

Para-suicidality is a psychiatric term that refers to a suicidal gesture that is a marker for histrionic behavior, or even overt attention seeking. Para-suicidality is typically associated with Borderline personality disorder, psychotic depression, and/or mania.

Fake suicide

Main article: Pseudocide

People sometimes fake suicide, usually in order to escape legal, financial, or relationship difficulties and start a new life. In order to explain the absence of a body, it is common to fake suicide by drowning. The term pseudocide covers not only fake suicide, but other fake deaths too (primarily fake murder). There have been numerous cases of celebrity suicides that have been challenged as possible homicides. Among the most famous were the 1962 drug overdose death of Marilyn Monroe, the 1994 shooting of Kurt Cobain, the 2007 death of Anna Nicole Smith, as well as the 1949 death of James Forrestal.<ref>Zogby Poll. </ref>

Euthanasia

Main article: Euthanasia

Individuals who wish to end their own life may enlist the assistance of another person to achieve death, e.g. by a deadly poison. The other person, usually a family member or physician, may help carry out the act if the individual lacks the physical capacity to do so even with the supplied means. According to different moral views, this may not be considered a form of suicide. The assistant may think of it as acting in behalf of the individual, perhaps to end suffering, while opponents regard it as akin to murder. Assisted suicide is a contentious moral and political issue in many countries.

Murder-suicide

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The motivation for the murder in murder-suicide can be purely criminal in nature or be perceived by the perpetrator as an act of care for loved ones in the context of severe depression. The severely depressed person may see the world as a terrible place and can feel that they are helping those they care about by removing them from it. Thoughts like this are generally regarded as a medical emergency requiring suicide intervention.

Since crime just prior to suicide is often perceived as being without consequences, it is not uncommon for suicide to be linked with homicide. Motivations may range from guilt to evading punishment, insanity, part of a suicide pact, or exacting revenge on those whom they feel are responsible.

A famous example of murder-suicide is the alleged double murder-suicide of professional wrestler Chris Benoit, who was found hanged in his home along with the bodies of his wife and son.

Suicide attack

Main article: Suicide attack

A suicide attack is when an attacker perpetrates an act of violence against others, typically to achieve a military or political goal, that foreseeably results in his or her own death as well. Suicide bombings have been prominent in the news in recent years. Other historical examples include the assassination of Tsar Alexander II and the kamikaze attacks by Japanese air pilots during the Second World War.

Self-harm

Main article: Self-harm

Self-harm is not a suicide attempt; however, initially self-injury was classified as a suicide attempt. There is a non-causal correlation between self-harm and suicide; both are most commonly a joint effect of depression.

Suicide methods

Main article: Suicide methods

In countries where firearms are readily available, many suicides involve the use of firearms. Over 55% of suicides that occurred in the United States in 2001 were by firearm.<ref> U.S. Suicide Statistics (2001)

. Retrieved on 2007-04-13. </ref> Asphyxiation methods (including hanging) and toxification (poisoning and overdose) are fairly common as well. Each comprised about 20% of suicides in the US during the same time period. Other methods of suicide include blunt force trauma (jumping from a building or bridge, or stepping in front of a train, for example), exsanguination or bloodletting (slitting one's wrist or throat), intentional drowning, self-immolation, electrocution, car collision and intentional starvation. The documentary film The Bridge tells the story of 24 people who committed suicide and their families' responses. All the suicides took place at San Francisco's Golden Gate Bridge.

Reasons for suicide

Causes of suicide

Suicide poses a conundrum to sociobiologists: Why would one choose to eliminate oneself from the gene pool? Sociobiologists debate the ultimate adaptive advantage of suicidality, though it is thought that altruistic behavior evolves to increase the survivability of one's kin. While at a proximate level of animal behaviour, no single factor has gained acceptance as a universal cause of suicide. Depression, however, is a common phenomenon amongst those who die by suicide.

Other factors that may be related are as follows (note that this is not meant as a comprehensive list, but rather as a summary of notable causes):

• Suffering (e.g. physical or emotional agony that is not correctable)
• Stress (e.g. grief after the death of a loved one)
• Crime (e.g. escaping judicial punishment and the dehumanisation and boredom of incarceration; self-punishment due to guilt)
• Mental illness (e.g. depression, bipolar disorder, schizophrenia, anxiety disorders, anorexia nervosa, bulimia nervosa or post traumatic stress disorder)
• Catastrophic injury (e.g. paralysis, disfigurement, loss of limb)
• Adverse environment (e.g. sexual abuse, domestic abuse, poverty, homelessness, bullying, social isolation, discrimination)
• Financial loss (e.g. loss of job/assets, debts)
• Self sacrifice reasons (e.g. a soldier throwing his body on a grenade) (this is not considered suicide by some because the individual does not have the goal of ending his or her life per se, but rather shielding others from harm at the possible risk of losing their own life)
• Accidental suicide (e.g. while playing Russian roulette or Overdose)
• Unresolved or unresolvable sexual issues (e.g. sexism, sexual orientation,<ref> Suicide and suicide prevention among gays and lesbians

. Retrieved on 2007-04-13. </ref> gender dysphoria, unrequited love, aftermath of a break up, involuntary celibacy, acquiring an incurable sexually transmitted infection (HIV, herpes, HPV))

• To avoid shame or dishonour (e.g. the Bushido ideal, under which a disgraced samurai could regain his honor by performing seppuku)
• Terrorism can also be a motive for suicide, especially when related to religion (e.g. suicide bombings)
• Extreme nationalism (e.g. the Kamikaze, Selbstopfer, and Kaiten suicide weapons)
• Philosophical belief that life has no inherent value (e.g. absurdism, pessimism, nihilism)
• Religious cults (e.g. Heaven's Gate and Peoples Temple)
• Loneliness especially when prolonged.

Suicide and mental illness

Modèle:Sect-stub Studies show a high incidence of psychiatric disorders in suicide victims at the time of their death with the total figure ranging from 98%<ref name= "BetoloteJM2004">Bertolote JM, Fleischmann A, De Leo D, Wasserman D. (2004) Psychiatric diagnoses and suicide: revisiting the evidence. Crisis., 25(4):147-55. PMID 15580849</ref> to 87.3%<ref name= "Arsenault-LapierreG2004"> Arsenault-Lapierre G, Kim C, Turecki G. (2004) Psychiatric diagnoses in 3275 suicides: a meta-analysis. BMC Psychiatry, Nov 4;4:37. PMID 15527502</ref> with mood disorders and substance abuse being the two most common. In schizophrenia suicide can be triggered by either the depression that is common with this disorder, or in response to command auditory hallucinations. Suicide among people suffering from bipolar disorder is often an impulse, which is due to the sufferer's extreme mood swings (one of the main symptoms of bipolar disorder). Severe depression is considered a terminal illness due to the likelihood of suicide when left untreated.<ref> Shuster, JL.(2000) Can depression be a terminal illness? Journal of Palliative Medicine. Winter;3(4):493-5. </ref>

Epidemiology

Main article: Epidemiology and methodology of suicide

According to official statistics, about a million people die by suicide annually, more than those murdered or killed in war.<ref> Suicide prevention

. WHO Sites: Mental Health
. World Health Organization 
 
   (February 16, 2006)
     
   
 

. Retrieved on 2006-04-11. </ref> As of 2001 in the USA, suicides outnumber homicides by 3 to 2 and deaths from AIDS by 2 to 1.<ref> Teen Suicide Statistics

. Adolescent Teenage Suicide Prevention
. FamilyFirstAid.org 
 
   (2001)
     
   
 

. Retrieved on 2006-04-11. </ref>

Gender and suicide: In the Western world, males die much more often than females by suicide, while females attempt suicide more often; this has been true for at least a century.<ref>1920 World Book, Volume 9, page 5618</ref> Some medical professionals believe this is due to the fact that males are more likely to end their life through violent means (guns, knives, hanging, etc.), while women primarily overdose on medications or use other methods which may be less likely to result in death; again, this has been the case for at least a century.<ref>1920 World Book, Volume 9, page 5618</ref>

Others ascribe the difference to inherent differences in male/female psychology. Greater social stigma against male depression and a lack of social networks of support and help with depression is often identified as a key reason for men's disproportionately higher level of suicides, since suicide as a "cry for help" is not seen as an equally viable option by men. Typically males die from suicide 3 to 4 times as often as females, and not unusually 5 or more times as often.

Excess male mortality from suicide is also evident from data from non-western countries. In 1979–81, 74 territories reported one or more cases of suicides. Two of these reported equal rates for both sexes: Seychelles and Kenya. Three territories reported female rates exceeding male rates: Papua New Guinea, Macau, French Guiana. The remaining 69 territories had male suicide rates greater than female suicide rates.<ref>Lester, Patterns, Table 3.3, pp. 31-33</ref>

Barraclough found that the female rates of those aged 5–14 equaled or exceeded the male rates only in 14 countries, mainly in South America and Asia.<ref>Barraclough,B M. Sex ratio of juvenile suicide. Journal of the American Academy of Child & Adolescent Psychiatry, 1987, 26, 434-435.</ref>

Suicides per 100,000 people per year:<ref>Table of WHO suicide rates by gender as of December 2005.</ref><ref>WHO country reports and charts for suicide rates retrieved June 6, 2006.</ref>

Rank	Country	Year	Males	Females	Total
1.	Lithuania	2005	68.1	12.9	38.6
2.	Belarus	2003	63.3	10.3	35.1
3.	Russia	2004	61.6	10.7	34.3
4.	Kazakhstan	2003	51.0	8.9	29.2
5.	Slovenia	2003	45.0	12.0	28.1
6.	Hungary	2003	44.9	12.0	27.7
7.	Latvia	2004	42.9	8.5	24.3
8.	Japan	2004	35.6	12.8	24.0
9.	Ukraine	2004	43.0	7.3	23.8
10.	Sri Lanka	1996	NA	NA	21.6

National suicide rates sometimes tend to be stable. For example, the 1975 rates for Australia, Denmark, England, France, Norway, and Switzerland, were within 3.0 per 100,000 of population from the 1875 rates.<ref>Australian Bureau of Statistics, 1983; Lester, Patterns, 1996, p. 21</ref> The rates in 1910–14 and in 1960 differed less than 2.5 per 100,000 of the population in Australia, Belgium, Denmark, England and Wales, Ireland, Japan, New Zealand, Norway, Scotland, South Africa, Spain, Sweden, and the Netherlands.<ref>Lester, Patterns, 1996, p. 22</ref>

There are considerable differences between national suicide rates. Findings from two studies showed a range from 0 to more than 40 suicides per 100,000 of population.<ref>La Vecchia, C., Lucchini, F., & Levi, F. (1994) Worldwide trends in suicide mortality, 1955-1989. Acta Psychiatrica Scandinavica, 90, 53-64.; Lester, Patterns, 1996, pp. 28-30.</ref>

National suicide rates, apparently universally, show a long-term upward trend. This trend has been well-documented in European countries.<ref>Lester, Patterns, 1996, p. 2.</ref> The trend for national suicide rates to rise slowly over time might be an indirect result of the gradual reduction in deaths from other causes, i.e. falling death rates from causes other than suicide uncover a previously hidden predisposition towards suicide.<ref>Baldessarini, R. J., & Jamison, K. R. (1999) Effects of medical interventions on suicidal behavior. Journal of Clinical Psychiatry, 60 (Suppl. 2), 117-122.</ref><ref>Khan, A., Warner, H. A., & Brown, W. A. (2000) Symptom reduction and suicide risk in patients treated with placebo in antidepressant clinical trials. Archives of General Psychiatry, 57, 311-317.</ref> There may also be an explanation in the reduced stigma attached to survivors as suicide is no longer a crime or a sin. This may allow coroners to record more suicides as such and so increase stats.

Ethnic groups and suicide: In the USA, Asian-Americans are more likely to die by suicide than any other ethnic group. Caucasians die by suicide more often than African Americans do. This is true for both genders. Non-Hispanic Caucasians are nearly 2.5 times more likely to kill themselves than are African Americans or Hispanics.<ref>Modèle:PDFlink</ref>

Age and suicide: In the USA, males over 70 die by suicide more often than younger males. There is no such trend for females. Older non-Hispanic Caucasian men are much more likely to kill themselves than older men or women of any other group, which contributes to the relatively high suicide rate among Caucasians.

Season and suicide: People die by suicide more often during spring and summer. The idea that suicide is more common during the winter holidays (including Christmas in the northern hemisphere) is a common misconception.<ref name="Christmas">"

   Questions About Suicide 
     
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  , 2006
 
 . </ref> There is also potential risk of suicide in some people experiencing Seasonal affective disorder.

Other reasons

Suicide as a form of defiance and protest

Heroic suicide, for the greater good of others, is often celebrated. For instance, Mahatma Gandhi went on a hunger strike to prevent fighting between Hindus and Muslims, and, although he was stopped before dying, it appeared he would have willingly succumbed to starvation. This attracted attention to Gandhi's cause, and generated a great deal of respect for him as a spiritual leader. In the 1960s, Buddhist monks, most notably Thích Quảng Đức, in South Vietnam drew Western attention to their protests against President Ngô Đình Diệm by burning themselves to death. Also in the 1960s, Quaker Norman Morrison committed suicide by self-immolation to protest the United States involvement in the Vietnam War. Similar events were reported during the Cold War in eastern Europe, such as the deaths of Ryszard Siwiec and later of Jan Palach and Jan Zajíc following the Soviet invasion of Czechoslovakia, or Romas Kalanta's self-immolation in the main street of Kaunas, Lithuania in 1972. More recently, in 2006, an American anti-war activist, Malachi Ritscher, died by suicide by self-immolation as a protest against the Iraq war. In Ireland there exists a long tradition of hunger strike to the death against British rule, predominantly in Northern Ireland during the infamous 1981 hunger strikes, led by Bobby Sands, which resulted in 10 deaths. The period caused international outrage as shown, for example, by the Indian parliament standing for two minutes of silence or, more bemusingly, the Iranian government renaming the street in Tehran on which the British Embassy stands to "Bobby Sands Street", named after the first hunger-striker to die in 1981. Before the Republic of Ireland got its independence there were also examples of hunger striking, such as Terence McSwiney in Cork. Critics may see such suicides as counter-productive, arguing that these people would probably achieve a comparable or greater result by spending the rest of their lives in active struggle. This is a contentious issue, especially when one considers that the Northern Ireland hunger strikers who died trying to obtain certain prisoners rights (e.g. POW status, right to wear own clothes, right not to have to work, etc.) actually had nearly all their requests eventually granted in the years after the spate of 1981 hunger strikes happened.

Judicial suicide

Sometimes a person who has committed a crime will commit suicide to avoid prosecution and disgrace:

• Colonel Alfred Redl was presented with the evidence of his espionage and shot himself to avoid a trial.
• In The Unpleasantness at the Bellona Club, Lord Peter Wimsey presents Dr. Penberthy with evidence proving that he is a murderer, then leaves him in a room with a loaded gun. A shot rings out, and the club members rush in to find the dead doctor, along with a signed confession.

Military suicide

Modèle:See also

In the desperate final days of World War II, many Japanese pilots volunteered for kamikaze missions in an attempt to forestall defeat for the Empire. In Nazi Germany, many soldiers and government officials (including Adolf Hitler and many in his inner circle) killed themselves rather than surrender to Allied forces; Luftwaffe squadrons were formed to smash into American B-17s during daylight bombing missions, in order to delay the highly-probable Allied victory, although in this case, inspiration was primarily the Soviet and Polish taran ramming attacks, and death of the pilot was not a desired outcome. The degree to which such a pilot was engaging in a heroic, selfless action or whether they faced immense social pressure is a matter of historical debate. The Japanese also built one-man "human torpedo" suicide submarines.

However, suicide has been fairly common in warfare throughout history. Soldiers and civilians committed suicide to avoid capture and slavery (including the wave of German and Japanese suicides in the last days of World War II). Commanders committed suicide rather than accept defeat. Spies and officers have often committed suicide to avoid revealing secrets under interrogation and/or torture. Behaviour that could be seen as suicidal occurred often in battle, for instance a soldier falling on a grenade to save his comrades. Other examples include soldiers under cannon fire at the Battle of Waterloo who took fatal hits rather than duck and place their comrades in harm's way.Modèle:Verify source The Charge of the Light Brigade in the Crimean War, Pickett's Charge at Gettysburg in the American Civil War , and the charge of the French cavalry at the Battle of Sedan in the Franco-Prussian War were assaults that continued even after it was obvious to participants that the attacks were unlikely to succeed and would probably be fatal to most of the attackers. Japanese infantrymen usually fought to the last man, launched "banzai" suicide charges, and suicided during the Pacific island battles in World War II. In Saipan and Okinawa, civilians joined in the suicides. Suicidal attacks by pilots were common in the 20th century: the attack by U.S. torpedo planes at the Battle of Midway was very similar to kamikaze.

Ritual suicide

Ritual suicide is the act of suicide motivated by a religious, spiritual, or traditional ritual.

An extreme interpretation of Hindu custom historically practiced, mostly in the 2nd millennium, was self-immolation by a widow as an assurance that she will be with her husband for the next life. This, however, is extreme, and is looked down upon by other Hindus in most cases. Other rituals of self-immolation or self-starvation were used by Hindu, Jain and Buddhist monks for religious or philosophical purposes, or as a form of extreme non-violent protest. In China, some groups would practice suicide for similar reasons. In Japan, rituals of suicide like seppuku were practised.

Dutiful suicide

Dutiful suicide is an act, or attempted act, of fatal self-violence at one's own hands done in the belief that it will secure a greater good, rather than to escape harsh or impossible conditions. It can be voluntary, to relieve some dishonor or punishment, or imposed by threats of death or reprisals on one's family or reputation (a kind of murder by remote control). It can be culturally traditional or generally abhorred; it can be heavily ritualized as in seppuku or purely functional. Dutiful suicide can be distinguished from a kamikaze or suicide bomb attack, in which a fighter consumes his own life in delivering a weapon to the enemy. Perhaps the most famous example of dutiful suicide is a soldier in a foxhole throwing his body on a live grenade to save the lives of his comrades.

Examples

• Disgraced Roman patricians were sometimes allowed to commit suicide to spare themselves a trial and penalties against their families.
• Erwin Rommel, found to have foreknowledge of the German attempt on Hitler's life, was threatened with public trial, execution and reprisals on his family unless he killed himself, which he did.
• According to the Bible, King Saul committed suicide at a losing battle against the Philistines.^{[citation needed]}

Impact of suicide

It is estimated that an average of six people are suicide "survivors" for each suicide that occurs in the United States.<ref>http://www.suicidology.org/displaycommon.cfm?an=6</ref> In the context of suicide, the word survivors refers to the family and friends of the person who has died by suicide; this figure therefore does not represent the total number of people who may be affected. For example, the suicide of a child may leave the school and their entire community left to make sense of the act.

As with any death, family and friends of a suicide victim feel grief associated with loss. These suicide survivors are often overwhelmed with psychological trauma as well, depending on many factors associated with the event. This trauma can leave survivors feeling guilty, angry, remorseful, helpless, and confused. It can be especially difficult for survivors because many of their questions as to why the victim felt the need to take his or her own life are left unanswered. Moreover, survivors often feel that they have failed or that they should have intervened in some way. Given these complex sets of emotions associated with a loved one's suicide, survivors usually find it difficult to discuss the death with others, causing them to feel isolated from their own network of family and friends and often making them reluctant to form new relationships as well.<ref>http://www.faqs.org/faqs/suicide/info/</ref>

"Survivor groups" can offer counseling and help bring many of the issues associated with suicide out into the open. They can also help survivors reach out to their own friends and family who may be feeling similarly and thus begin the healing process. In addition, counseling services and therapy can provide invaluable support to the bereaved. Some such groups can be found online, providing a forum for discussion amongst survivors of suicide (see Support Groups for Survivors section below).

Economic impact

Deaths and injuries from suicidal behavior represent $25 billion each year in direct costs, including health care services, funeral services, autopsies and investigations, and indirect costs like lost productivity.<ref> Preventing suicide

. Retrieved on 2007-04-13. </ref><ref> The Cost of Suicide Mortality in New Brunswick, 1996

 (1996)
   

. Retrieved on 2007-04-13. </ref>

These costs may be counterbalanced by economic gains. Expenditure on those who would have continued living is reduced, including pensions, social security, health care services for those with brain disorders ("mentally ill"),<ref>Yang B, Lester D. Recalculating the economic cost of suicide. Death studies, 2007 Apr;31(4):351-61</ref> as well as other normal budgetary expenditure per head of living population.

Views on suicide

Medical

Main article: Suicide intervention

Modern medicine treats suicide as a mental health issue. Overwhelming or persistent suicidal thoughts are considered a medical emergency. Medical professionals advise that people who have expressed plans to kill themselves be encouraged to seek medical attention immediately. This is especially relevant if the means (weapons, drugs, or other methods) are available, or if the patient has crafted a detailed plan for executing the suicide. Medical personnel frequently receive special training to look for suicidal signs in patients. Individuals suffering from depression are considered a high-risk group for suicidal behavior. Suicide hotlines are widely available for people seeking help.^{[citation needed]} However, the negative and often too clinical reception that many suicidal people receive after relating their feelings to health professionals (e.g. threats of institutionalization, increased dosages of medication, the social stigma) may cause patients to remain more guarded about their mental health history or suicidal urges and ideation.

In the United States, individuals who express the intent to harm themselves are automatically determined to lack the present mental capacity to refuse treatment, and can be transported to the emergency department against their will. An emergency physician will determine whether inpatient care at a mental health care facility is warranted. This is sometimes referred to as being "committed". A court hearing may be held to determine the patient's competence.

Criminal

Main article: Legal views of suicide

In some jurisdictions, an act or failed act of suicide is considered to be a crime. More commonly, a surviving party member who assisted in the suicide attempt will face criminal charges.

In Brazil, if the help is directed to a minor, the penalty is applied in its double and not considered as homicide. In Italy and Canada, instigating another to suicide is also a criminal offense. In Singapore, assisting in the suicide of a mentally handicapped person is a capital offense. In India, abetting suicide of a minor or a mentally challenged person can result in a possible death penalty, otherwise a maximum 10 years prison term. [2]

Cultural

Main article: Cultural views of suicide

In the Warring States Period and the Edo period of Japan, samurai who disgraced their honor chose to end their own lives by seppuku, a method in which the samurai takes a sword and slices into his abdomen, causing a fatal injury. The cut is usually performed diagonally from the top corner of the samurai's writing hand, and has long been considered an honorable form of death (even when done to punish dishonor). Though such a wound would be fatal, seppuku was not always technically suicide, as the samurai's assistant (the kaishaku) would usually stand by to cut short any suffering by quickly administering a fatal cut to the back of the neck (just short of decapitation), sometimes as soon as the first tiny incision into the abdomen was made.

Religious

Main article: Religious views of suicide

In most forms of Christianity, suicide is considered a sin, based mainly on the writings of influential Christian thinkers of the Middle Ages, such as St. Augustine and St. Thomas Aquinas. Their arguments center around the commandment "Thou shalt not kill" (made applicable under the New Covenant by Jesus in Matthew 19:18), as well as the idea that life is a gift given by God which should not be spurned, and that suicide is against the "natural order" and thus interferes with God's master plan for the world.[3][4] However, it is believed that mental illness or grave fear of suffering diminishes the responsibility of the one completing suicide.[5] Suicide was not considered a sin under the Byzantine Christian code of Justinian, for instance.[6][7]

Judaism focuses on the importance of valuing this life, and as such, suicide is tantamount to denying God's goodness in the world. Despite this, under extreme circumstances when there has seemed no choice but to either be killed or forced to betray their religion, Jews have committed individual suicide or mass suicide (see Masada, First French persecution of the Jews, and York Castle for examples) and as a grim reminder there is even a prayer in the Jewish liturgy for "when the knife is at the throat", for those dying "to sanctify God's Name". (See: Martyrdom). These acts have received mixed responses by Jewish authorities, regarded both as examples of heroic martyrdom, whilst others state that it was wrong for them to take their own lives in anticipation of martyrdom.<ref>{{web cite |url=http://www.religionfacts.com/euthanasia/judaism.htm |title=Euthanasia and Judaism: Jewish Views of Euthanasia and Suicide |accessdate=2007-12-16 |publisher=ReligionFacts.com</ref>

Suicide is not allowed in the religion of Islam; however, martyring oneself for Allah (during combat) is not the same as completing suicide. Suicide by Muslim standards is traditionally seen as a sign of disbelief in God.[8] The use of suicide bombing is therefore a controversial one in Islam. Groups like Hamas consider it necessary—for instance, in the struggle against occupation.

In Hinduism, suicide is frowned upon and is considered equally sinful as murdering another. Hindu Scriptures state that one who commits suicide will become part of the spirit world, wandering earth, for a set period of time. The ghost can feel hunger and thirst, but can not eat or drink.

Debate over suicide

Main article: Philosophical views of suicide

Some see suicide as a legitimate matter of personal choice and a human right (colloquially known as the right to die movement), and maintain that no one should be forced to suffer against their will, particularly from conditions such as incurable disease, mental illness, and old age that have no possibility of improvement. Proponents of this view reject the belief that suicide is always irrational, arguing instead that it can be a valid last resort for those enduring major pain or trauma. This perspective is most popular in continental Europe,[9] where euthanasia and other such topics are commonly discussed in parliament, although it has a good deal of support in the United States as well.

A narrower segment of this group considers suicide something between a grave but condonable choice in some circumstances and a sacrosanct right for anyone (even a young and healthy person) who believes they have rationally and conscientiously come to the decision to end their own lives. Notable supporters of this school of thought include German pessimist philosopher Arthur Schopenhauer,[10] and Scottish empiricist David Hume.[11] Adherents of this view often advocate the abrogation of statutes that restrict the liberties of people known to be suicidal, such as laws permitting their involuntary commitment to mental hospitals. Critics may argue that suicidal impulses are often products of mental illness rather than rational self-interest, and that because of the gravity and irreversibility of the decision to take one's life it is more prudent for society to err on the side of caution and at least delay the suicidal act.

See also

Footnotes

Further reading

Documents and periodicals

• Butler, Sara M. "Cultures of Suicide?: Suicide Verdicts ad the 'Community' in Thirteenth- and Fourteenth-Century England," The Historian 69.3 (Fall, 2007): 427-449.
• 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 (l97Image:Cool.gif: 209–14.
• 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 1-55798-761-0
• Durkheim, Emile. Suicide, (1897), The Free Press reprint 1997, ISBN 0684836327
• Modèle:Cite book
• Keogh, Abel Room for Two Cedar Fort, 2007 ISBN 1-599-55062-8
• Humphry, Derek. Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying. Dell. 1997.
• Maguire, Maureen, Uncomfortably Numb. A Prison Requiem. Luath Press 2001. ISBN 1-84282-001-X (A factual documentation of suicide in prison)
• O'Connor, R., & Sheehy, N.P. Understanding Suicidal Behaviour. BPS Blackwell. 2000. ISBN 1854332902
• Paterson, Craig. Assisted Suicide and Euthanasia. Ashgate, 2008. ISBN 0 7546 5746 9
• Paul, Sam. Why I Committed Suicide. New York: iUniverse, Inc., 2004. ISBN 0-59532-695-1
• Stillion, Judith M. and McDowell, Eugene E. Suicide Across the LifeSpan: Premature Exits. New York: Routledge, 1996. ISBN 1-56032-304-3
• Stone, Geo. Suicide and Attempted Suicide: Methods and Consequences. New York: Carroll & Graf, 2001. ISBN 0-7867-0940-5

External links

Modèle:Wiktionary Modèle:Wikiquote Modèle:External links

General information

• Medline Plus - suicide and suicidal behavior
• cbel.com/suicide/ - directory of information on suicide
• American Association of Suicidology - statistics and general information
• Online Education on Suicide Prevention for Professionals - list of courses for medical professionals

Suicide prevention

• stampoutsuicide.org.uk
• ChooseLife,Choose Life is a 10 year plan aimed at reducing suicides in Scotland by 20% by 2013, Looking at ways of preventing Suicide using ASIST,SafeTALK and SuicideTALK
• ReachOut! Website for young people going through tough times
• Kristin Brooks Hope Center
• Youth America Hotline
• Preventing Suicide The National Journal
• resources for graduate students who are depressed and or suicidal
• American Foundation for Suicide Prevention
• metanoia.org/suicide - suicide prevention page
• "Understanding and Helping the Suicidal Person" - information on suicide prevention
• The Fred Fund : suicide support, resources, online stories, memorials and interaction
• TeenSuicide.us - teenage suicide prevention information
• Suicide Prevention Help - A Friendship Letter and Web directory of helpful suicide prevention resources from around the world.
• suicide.com self-help website for suicidal persons written by a recovered suicidal person
• A Time to Live.com Free on-line abridged version of "A Time to Live: Surviving Suicidal Thoughts" - a suicide prevention resource

Views on suicide

• Exit International is the pro-choice voluntary euthanasia/ assisted suicide organisation founded by Dr Philip Nitschke
• The Eclipse: A Memoir of Suicide - a detailed examination of suicide's underlying philosophical beliefs and its impact on survivors
• "The Murder of Oneself" - ethical and legal considerations in suicide and its prevention
• The Debate: a pro-choice FAQ
• "Suicide as a Moral Alternative" - discussion on the morality of suicide, including arguments for and against
• "Suicide" in the Stanford Encyclopedia of Philosophy
• Suicide & Euthanasia - a Biblical Perspective - discussion of suicide from a biblical perspective
• * Suicide Promotion (Internet) - United Kingdom Parliamentary debate - debate by politicians on suicide, 25 January 2005

Support groups

• [Support Groups Catégorie Health/Mental_Health/Disorders/Suicide/Support_Groups/] de l’annuaire dmoz.
• Samaritans (UK & Ireland) - 24-hour support help, United Kingdom & Ireland
• Befrienders Worldwide Worldwide Suicide Prevention help
• #alt.suicide.bus.stop (ASBS) - a support group for the suicidal, by the suicidal
• Maytree Respite Centre - A refuge for people in a suicidal crisis. They welcome referrals or self-referrals
• Ghetto - Japanese suicide webcommune(webmaster:yudetamago)

Support groups for survivors

• American Association of Suicidology - Referrals to local self help groups for survivors of suicide across the United States
• Heartbeat - Mutual support for those who have lost loved ones to suicide
• SOLES - Survivors of Law Enforcement Suicide
• International Friends and Families of Suicide - Online support for survivors internationally
• Parents of Suicide - Support via chatrooms and email for those who have lost sons or daughters to suicide

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