Suicide

Suicide, derived from Latin , is "the act of taking one's own life". Attempted suicide, or non-fatal suicidal behavior, amounts to self-injury with at least some desire to end one's life that does not result in death. Assisted suicide occurs when one individual helps another bring about their own death indirectly by providing either advice or the means to the end. Euthanasia, more specifically voluntary euthanasia, is where another person takes a more active role in bringing about a person's death. In a murder–suicide (or homicide–suicide), the individual aims at taking the lives of others at the same time. A special case of this is extended suicide, where the murder is motivated by seeing the murdered persons as an extension of their self. Suicide in which the reason is that the person feels that they are not part of society is known as egoistic suicide. The Centre for Suicide Prevention in Canada found that the normal verb in scholarly research and journalism for the act of suicide was commit, and argued for destigmatizing terminology related to suicide; in 2011, they published an article calling for changing the language used around suicide entitled "Suicide and language: Why we shouldn't use the 'C' word". The American Psychological Association lists "committed suicide" as a term to avoid because it "frame[s] suicide as a crime." Some advocacy groups recommend using the terms took his/her own life, died by suicide, or killed him/herself instead of committed suicide. The Associated Press Stylebook recommends avoiding "committed suicide" except in direct quotes from authorities. The Guardian and Observer style guides deprecate the use of "committed", as does CNN. Opponents of commit argue that it implies that suicide is criminal, sinful, or morally wrong. Suicide may involve more than one method or result in unintended secondary trauma, such as in the case of complex and complicated suicides. Complex suicides involve the use of more than one method either simultaneously or successively; a rare type that may be further decomposed into secondary (i.e., a succeeding method spontaneously used after the principal is perceived to have failed to prevent pain or suffering) or primary (i.e., a succeeding method initiated after the principal is perceived to have failed) types. Complicated suicide describes a poorly understood process that results in secondary unintentional trauma as a result of using a single method. == Pathophysiology ==

There is no known unifying underlying pathophysiology for suicide; and indirectly associated through its role in major depression, post-traumatic stress disorder, schizophrenia and obsessive–compulsive disorder. Post-mortem studies have found reduced levels of BDNF in the hippocampus and prefrontal cortex, in those with and without psychiatric conditions. Serotonin, a brain neurotransmitter, is believed to be low in those who die by suicide. This is partly based on evidence of increased levels of 5-HT2A receptors found after death. Other evidence includes reduced levels of a breakdown product of serotonin, 5-hydroxyindoleacetic acid, in the cerebral spinal fluid. However, direct evidence is hard to obtain. == Risk factors ==

{{Bar box|title=Precipitating circumstances in the US, 2017|titlebar=#DDD|left1=Categories|right2=Percentage|width=500px|bars= Factors that affect the risk of suicide include mental disorders, drug misuse, psychological states, cultural, family and social situations, genetics, experiences of trauma or loss, and nihilism. For example, suicide rates have been found to be greater in households with firearms than those without them. Research examining 3,018 US counties found that "the distribution of suicide rates across US states corresponded to variations in [social determinants of health] cluster distribution in each state." Socio-economic problems such as unemployment, poverty, homelessness, and discrimination may trigger suicidal thoughts. Suicide might be rarer in societies with high social cohesion and moral objections against suicide. Suicides may also occur as a local cluster of cases. Most research does not distinguish between risk factors that lead to thinking about suicide and risk factors that lead to suicide attempts. Risks for suicide attempt, rather than just thoughts of suicide, include a high pain tolerance and a reduced fear of death. Autism Autistic individuals, on average, face more mental health and social challenges than non-autistic individuals, including higher rates of anxiety, depression, and social isolation. They attempt and consider suicide more frequently than the general population. Autistic people are about three times as likely as non-autistic people to attempt suicide. Suicide is a leading cause of early death for autistic people without co-occurring learning disabilities. Environmental exposures Some environmental exposures, including air pollution, intense sunlight, sunlight duration, hot weather, and high altitude, are associated with suicide. There is a possible association between short-term PM10 exposure and suicide. These factors might affect certain high-risk individuals more than others. but an increase in rates during spring and summer, which might be related to exposure to sunshine. Genetics might influence rates of suicide. A family history of suicide, especially in the mother, affects children more than adolescents or adults. Media 's The Sorrows of Young Werther, the title character kills himself due to a love triangle involving Charlotte (pictured at his grave). Some admirers of the story were triggered into copycat suicide, known as the "Werther effect". The media, including the Internet, plays an important role. For example, about 15–40% of people leave a suicide note, and media are discouraged from reporting the contents of that message. When detailed descriptions of how to kill oneself by a specific means are portrayed, this method of suicide can be imitated in vulnerable people. In a bid to reduce the adverse effect of media portrayals concerning suicide report, one of the effective methods is to educate journalists on how to report suicide news in a manner that might reduce that possibility of imitation and encourage those at risk to seek for help. When journalists follow certain reporting guidelines the risk of suicides can be decreased. It appears that while news media has a significant effect, that of the entertainment media is equivocal. It is unclear if searching for information about suicide on the Internet relates to the risk of suicide. The opposite of the Werther effect is the proposed "Papageno effect", in which coverage of effective coping mechanisms may have a protective effect. The term is based upon a character in Mozart's opera The Magic Flute—fearing the loss of a loved one, he had planned to kill himself until his friends helped him out. As a consequence, fictional portrayals of suicide, showing alternative consequences or negative consequences, might have a preventive effect, for instance fiction might normalize mental health problems and encourage help-seeking. Medical conditions There is an association between suicidality and physical health problems such as traumatic brain injury, cancer, chronic fatigue syndrome, kidney failure (requiring hemodialysis), HIV, and systemic lupus erythematosus. Sleep disturbances, such as insomnia and sleep apnea, are risk factors for depression and suicide. In some instances, the sleep disturbances may be a risk factor independent of depression. A number of other medical conditions may present with symptoms similar to mood disorders, including hypothyroidism, Alzheimer's, brain tumors, systemic lupus erythematosus, and adverse effects from a number of medications (such as beta blockers and steroids). Of those who have been hospitalized for suicidal behavior, the lifetime risk of suicide is 8.6%. Comparatively, non-suicidal people hospitalized for affective disorders have a 4% lifetime risk of suicide. Other conditions implicated include schizophrenia (14%), personality disorders (8%), obsessive–compulsive disorder, and post-traumatic stress disorder. About 5% of people with schizophrenia die of suicide. Eating disorders are another high risk condition. Among approximately 80% of suicides, the individual has seen a physician within the year before their death, Approximately 25–40% of those who died by suicide had contact with mental health services in the prior year. Antidepressants of the SSRI class appear to increase the frequency of suicide among children and young persons. Lithium significantly reduces the risk of suicide in people with mood disorders. Occupational factors Certain occupations carry an elevated risk of self-harm and suicide, such as military careers. Research in several countries has found that the rate of suicide among former armed forces personnel in particular, and young veterans especially, Previous attempts A 2002 review of about 90 suicide related studies concluded that the risk of suicide following a previous attempt or self-harm is hundreds of times larger than in the general population. Later, a 2017 study estimated that individuals with a history of suicide attempts are approximately 25 times more likely to die by suicide compared to the general population. These findings makes a suicide attempt one of the strongest predictors of eventual suicide. attempted suicide before. The likelihood of dying by suicide after the subsequent attempt depends on the means used, the age of the person and their gender. Time passed since the last attempt also plays a critical role. The first and the second year have the highest risk of suicide. A poor ability to solve problems, the loss of abilities one used to have, and poor impulse control also play a role. In older adults, the perception of being a burden to others is important. Those who have never married are also at greater risk. and hypothalamic–pituitary–adrenal axis. Social isolation and the lack of social support has been associated with an increased risk of suicide. with heightened relative poverty compared to those around a person increasing suicide risk. Over 200,000 farmers in India have died by suicide since 1997, partly due to issues of debt. In China, suicide is three times as likely in rural regions as urban ones, partly, it is believed, due to financial difficulties in this area of the country. Being religious may reduce one's risk of suicide while beliefs that suicide is noble may increase it. This has been attributed to the negative stance many religions take against suicide and to the greater connectedness religion may give. Rational suicide pilots in May 1945 Rational suicide is the reasoned taking of one's own life. However, some consider suicide as never being rational. They are supported by the legal arguments for a right to die. An example of this is an elder ending their life to leave greater amounts of food for the younger people in the community. Some suicide bombers are motivated by a desire to obtain martyrdoms or are religiously motivated. Murder–suicide is an act of homicide followed within a week by suicide of the person who carried out the act. Mass suicides are often performed under social pressure where members give up autonomy to a leader (see Notable cases below). Mass suicides can take place with as few as two people, often referred to as a suicide pact. In extenuating situations where continuing to live would be intolerable, some people use suicide as a means of escape. Some inmates in Nazi concentration camps are known to have killed themselves during the Holocaust by deliberately touching the electrified fences. Self-harm Non-suicidal self-harm is common with 18% of people engaging in self-harm over the course of their life. Acts of self-harm are not usually suicide attempts and most who self-harm are not at high risk of suicide. Some who self-harm, however, do still end their life by suicide, and risk for self-harm and suicide may overlap. Sexual and gender variance LGBTQ individuals face significantly higher risk of suicide and self-harm than straight and cisgender individuals. Internalized queerphobia, family rejection, anti-LGBTQ legislation, as well as minority stressors in the form of discrimination, abuse, bullying, and violence are among the main risk factors for suicide in LGBTQ individuals. Supportive environments, inclusive legislation, boosted self-esteem, and access to gender-affirming healthcare for trans individuals are among the main protective factors. Both chronic substance misuse as well as acute intoxication are associated. When combined with personal grief, such as bereavement, the risk is further increased. with alcoholism present in between 15% and 61% of cases. About 2.2–3.4% of those who have been treated for alcoholism at some point in their life die by suicide. In adolescents who misuse alcohol, neurological and psychological dysfunctions may contribute to the increased risk of suicide. The misuse of cocaine and methamphetamine has a high correlation with suicide. In those who use cocaine, the risk is greatest during the withdrawal phase. Those who used inhalants are also at significant risk with around 20% attempting suicide at some point and more than 65% considering it. There is little evidence as to why this association exists; however, it has been hypothesized that those who are predisposed to smoking are also predisposed to suicide, that smoking causes health problems which subsequently make people want to end their life, and that smoking affects brain chemistry causing a propensity for suicide. and adults. A history of childhood sexual abuse and time spent in foster care are also risk factors. Sexual abuse is believed to contribute to approximately 20% of the overall risk. Problem gambling is associated with increased suicidal ideation and attempts compared to the general population. Between 12 and 24% of pathological gamblers attempt suicide. Other factors that increase the risk in problem gamblers include concomitant mental illness, alcohol, and drug misuse. Infection by the parasite Toxoplasma gondii, more commonly known as toxoplasmosis, has been linked with suicide risk. One explanation states that this is caused by altered neurotransmitter activity due to the immunological response. Dutch research by Lin Zhang focuses on the role of P2RX7 and the apoptosis of microglia in suicidal ideation. == Prevention ==

Suicide prevention is a term used for the collective efforts to reduce the incidence of suicide through preventive measures. Protective factors for suicide include support, and access to therapy. Reasons for not doing so include low perceived need, and wanting to deal with the problem alone. Other measures include reducing access to charcoal (for burning) and adding barriers on bridges and subway platforms. In young adults who have recently thought about suicide, cognitive behavioral therapy appears to improve outcomes. In people who have attempted suicide, following up on them might prevent repeat attempts. Although crisis hotlines are common, there is little evidence to support or refute their effectiveness. Diet About 50% of people who die of suicide have a mood disorder such as major depression. Sleep and diet may play a role in depression (major depressive disorder), and interventions in these areas may be an effective add-on to conventional methods. Vitamin B2, B6 and B12 deficiency may cause depression in females. Risk of depression may be reduced with a healthy diet "high in fruits, vegetables, nuts, and legumes; moderate amounts of poultry, eggs, and dairy products; and only occasional red meat". A balanced diet and the consumption of lots of water is essential for mental health. Consuming oily fish may also help as they contain omega-3 fats. Consuming too much refined carbohydrates (e.g., snack foods) may increase the risk of depression symptoms. The mechanism on how diet improves or worsens mental health is still not fully understood. Blood glucose levels alterations, inflammation, or effects on the gut microbiome have been suggested. Screening those who come to the emergency departments with injuries from self-harm have been shown to help identify suicide ideation and suicide intention. Psychometric tests such as the Beck Depression Inventory or the Geriatric Depression Scale for older people are being used. As there is a high rate of people who test positive via these tools that are not at risk of suicide, there are concerns that screening may significantly increase mental health care resource utilization. Assessing those at high risk, though, is recommended for. Some clinicians get patients to sign suicide prevention contracts where they agree to not harm themselves if released. Psychotherapy There is tentative evidence that certain types of psychotherapy, particularly dialectical behaviour therapy and cognitive behavioural therapy, reduce suicidality, though there currently exists no expert consensus on how these interventions should be applied to maximize positive outcomes (in large part due to the heterogeneity of suicide patients). In older persons, however, they may decrease the risk. It is effective at lowering the risk of suicide in those with bipolar disorder and major depression to nearly the same levels as that of the general population. It is thought to exert this effect by treating the underlying mood disorder and through a reduction in impulsivity and aggressiveness. Lithium in the water supply is correlated with lower overall suicide rates, especially among men. In addition to lower rates of suicide, areas with high concentrations of lithium in the water supply have lower rates of homicide, rape, drug arrests, and other crimes. Other Clozapine may decrease the thoughts of suicide in some people with schizophrenia. Most systematic reviews suggest that ketamine shows short-term efficacy in reducing suicidality with generally mild side effects, but the evidence is largely low quality and its long-term efficacy remains unclear. In the United States, health professionals are legally required to take reasonable steps to try to prevent suicide. Caring letters to his patient The "Caring Letters" model of suicide prevention involved mailing short letters that expressed the researchers' interest in the recipients without pressuring them to take any action. The intervention reduced deaths by suicide, as proven through a randomized controlled trial. The technique involves letters sent from a researcher who had spoken at length with the recipient during a suicidal crisis. The typewritten form letters were brief – sometimes as short as two sentences – personally signed by the researcher, and expressed interest in the recipient without making any demands. They were initially sent monthly, eventually decreasing in frequency to quarterly letters; if the recipient wrote back, then an additional personal letter was mailed. Caring letters are inexpensive and either the only, or one of very few, approaches to suicide prevention that has been scientifically proven to work during the first years after a suicide attempt that resulted in hospitalization. == Methods ==

The leading method of suicide varies among countries. The leading methods in different regions include hanging, pesticide poisoning, and firearms. These differences are believed to be in part due to availability of the different methods. Worldwide, 30% of suicides are estimated to occur from pesticide poisoning, most of which occur in the developing world. It is also common in Latin America due to the ease of access within the farming populations. Many are unplanned and occur during an acute period of ambivalence. In Japan, self-disembowelment known as seppuku (harakiri) still occurs; Jumping to one's death is common in both Hong Kong and Singapore at 50% and 80% respectively. In the United States, 50% of suicides involve the use of firearms, with this method being more common in men (56%) than women (31%). The next most common cause was hanging in males (28%) and self-poisoning in females (31%). Together, hanging and poisoning constituted about 42% of U.S. suicides (). == Epidemiology ==

Approximately 1.4% of people die by suicide, a mortality rate of 11.6 per 100,000 persons per year. It was ranked as the 10th leading cause of death in the United States in 2016 with about 45,000 cases that year. Rates have increased in the United States in the last few years, In the United States, about 650,000 people are seen in emergency departments yearly due to attempting suicide. Greenland, Lithuania, Japan, and Hungary have the highest rates of suicide. File:Share of deaths from suicide, OWID.svg|Share of deaths from suicide, 2017 An unofficial report estimated 5,000 suicides in Iran in 2022. Sex and gender Globally , death by suicide occurs about 1.8 times more often in males than females. In the Western world, males die three to four times more often by means of suicide than do females. Researchers have attributed the difference between suicide and attempted suicide among the sexes to males using more lethal means to end their lives. However, separating intentional suicide attempts from non-suicidal self-harm is not currently done in places like the United States when gathering statistics at the national level. China has one of the highest female suicide rates in the world and is the only country where it is higher than that of men (ratio of 0.9). In the Eastern Mediterranean, suicide rates are nearly equivalent between males and females. Among transgender persons, rates of attempted suicide are about 40% compared to a general population rate of 5%. This is believed to in part be due to social stigmatisation. Age In many countries, the rate of suicide is highest in the middle-aged or elderly. Suicidality is rare in children, but increases during the transition to adolescence. In the United States, the suicide death rate is greatest in Caucasian men older than 80 years, even though younger people more frequently attempt suicide. and in young males is second only to accidental death. In young males in the developed world, it is the cause of nearly 30% of mortality. In the developing world rates are similar, but it makes up a smaller proportion of overall deaths due to higher rates of death from other types of trauma. In South-East Asia, in contrast to other areas of the world, deaths from suicide occur at a greater rate in young females than elderly females. == History ==

killing himself and his wife, Roman copy after the Hellenistic original, Palazzo Massimo alle Terme In ancient Athens, a person who died by suicide without the approval of the state was denied the honors of a normal burial. The person would be buried alone, on the outskirts of the city, without a headstone or marker. It was also common for the hand to be cut off the body and buried separately - the hand (and the instrument used) being considered the perpetrator. However, it was deemed to be an acceptable method to deal with military defeat. Aristotle condemned all forms of suicide while Plato was ambivalent. Suicide was not limited to men: a Livonian priest named Johann recorded that in 1205, fifty Lithuanian women hanged themselves after learning that their husbands, who had joined a raid led by Duke Žvelgaitis, had been killed, believing they would reunite with them in the afterlife. Archaeological evidence, such as double graves among the Balts and other Indo-European peoples, may reflect similar beliefs, possibly including ritual widow suicide. Defeated warriors also often chose death over captivity or enslavement, most famously in 1336 at Pilėnai Castle, where defenders reportedly killed their families and themselves rather than surrender to the Teutonic Knights. , depicting the suicide of Seneca the Younger in Ancient Rome Suicide came to be regarded as a sin in Christian Europe and was condemned at the Council of Arles (452) as the work of the Devil. In the Middle Ages, the Church had drawn-out discussions as to when the desire for martyrdom was suicidal, as in the case of martyrs of Córdoba. Despite these disputes and occasional official rulings, Catholic doctrine was not entirely settled on the subject of suicide until the later 17th century. A criminal ordinance issued by Louis XIV of France in 1670 was extremely severe, even for the times: the dead person's body was drawn through the streets, face down, and then hung or thrown on a garbage heap. Additionally, all of the person's property was confiscated. Attitudes towards suicide slowly began to shift during the Renaissance. John Donne's work Biathanatos contained one of the first modern defences of suicide, bringing proof from the conduct of Biblical figures, such as Jesus, Samson and Saul, and presenting arguments on grounds of reason and nature to sanction suicide in certain circumstances. The secularization of society that began during the Enlightenment questioned traditional religious attitudes (such as Christian views on suicide) toward suicide and brought a more modern perspective to the issue. David Hume denied that suicide was a crime as it affected no one and was potentially to the advantage of the individual. In his 1777 Essays on Suicide and the Immortality of the Soul he rhetorically asked, "Why should I prolong a miserable existence, because of some frivolous advantage which the public may perhaps receive from me?" A shift in public opinion at large can also be discerned; The Times in 1786 initiated a spirited debate on the motion "Is suicide an act of courage?". By the 19th century, the act of suicide had shifted from being viewed as caused by sin to being caused by insanity in Europe. In 1882, the deceased were permitted daylight burial in England and by the middle of the 20th century, suicide had become legal in much of the Western world. The term suicide first emerged shortly before 1700 to replace expressions on self-death which were often characterized as a form of self-murder in the West. == Society and culture ==

Legislation knife prepared for seppuku'' (abdomen-cutting) about to perform seppuku Suicide is a crime in some parts of the world. No country in Europe currently considers suicide or attempted suicide to be a crime. However, it was in most Western European countries from the Middle Ages until at least the 19th century. If such protocol is not followed, it is an offence punishable by law. In Germany, active euthanasia is illegal and anyone present during suicide may be prosecuted for failure to render aid in an emergency. Switzerland has taken steps to legalize assisted suicide for the chronically mentally ill. The high court in Lausanne, Switzerland, in a 2006 ruling, granted an anonymous individual with longstanding psychiatric difficulties the right to end his own life. England and Wales decriminalized suicide via the Suicide Act 1961 and the Republic of Ireland in 1993. In the United States, suicide is not illegal, but may be associated with penalties for those who attempt it. In Oregon, people with terminal diseases may request medications to help end their lives. Canadians who have attempted suicide may be barred from entering the United States. U.S. laws allow border guards to deny access to people who have a mental illness, including those with previous suicide attempts. In Australia, suicide is not a crime, however it is a crime to counsel, incite, or aid and abet another in attempting to die by suicide, and the law explicitly allows any person to use "such force as may reasonably be necessary" to prevent another from taking their own life. The Northern Territory of Australia briefly had legal physician-assisted suicide from 1996 to 1997. In India, suicide was illegal until 2014, and surviving family members used to face legal difficulties. It remains a criminal offense in most Muslim-majority nations. Proponents of decriminalisation argue that suicide legislation may deter people from seeking help, and may even strengthen the resolve of would-be suicides to end their lives to avoid prosecution. The first reading of a bill to repeal Section 309 of the Penal Code was tabled in Parliament in April 2023, bringing Malaysia one step closer towards decriminalising attempted suicide. Suicide became a trending crisis in North Korea in 2023; a secret order criminalized suicide as treason against the socialist state. Religious views Christianity Most forms of Christianity consider suicide sinful, based mainly on the writings of influential Christian thinkers of the Middle Ages, such as St. Augustine and St. Thomas Aquinas, but suicide was not considered a sin under the Byzantine Christian code of Justinian, for instance. In Catholic and Orthodox doctrine, suicide is considered to be murder, violating the commandment "Thou shalt not kill," and historically neither church would even hold a burial service for a member that died by suicide, deeming it an act that condemned the person to hell, since they died in a state of mortal sin. The basic idea being 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. However, according to the Catechism of the Catholic Church, it is believed that mental illness or grave fear of suffering diminishes the responsibility of the one committing suicide. Judaism 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, there are several accounts of Jews having died by suicide, either individually or in groups (see Holocaust, 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 by some as examples of heroic martyrdom, while others state that it was wrong for them to take their own lives in anticipation of martyrdom. Islam Islam religious views condemn suicide In Islamic countries, suicide is often stigmatized; However, Hinduism accepts a man's right to end one's life through the non-violent practice of fasting to death, termed Prayopavesa; but Prayopavesa is strictly restricted to people who have no desire or ambition left, and no responsibilities remaining in this life. Ainu Within the Ainu religion, someone who dies by suicide is believed to become a ghost (tukap) who would haunt the living, to come to fulfillment from which they were excluded during life. Also, someone who insults another so they kill themselves is regarded as co-responsible for their death. According to Norbert Richard Adami, this ethic exists due to the case that solidarity within the community is much more important to Ainu culture than it is to the Western world. Arguments as to acceptability of suicide in moral or social terms range from the position that the act is inherently immoral and unacceptable under any circumstances, to a regard for suicide as a sacrosanct right of anyone who believes they have rationally and conscientiously come to the decision to end their own lives, even if they are young and healthy. Opponents to suicide include philosophers such as Augustine of Hippo, Thomas Aquinas, and, arguably, John Stuart Mill – Mill's focus on the importance of liberty and autonomy meant that he rejected choices which would prevent a person from making future autonomous decisions. Others view suicide as a legitimate matter of personal choice. Supporters of this position maintain that no one should be forced to suffer against their will, particularly from conditions such as incurable disease, mental illness, and old age, with no possibility of improvement. They 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. A stronger stance would argue that people should be allowed to autonomously choose to die regardless of whether they are suffering. Notable supporters of this school of thought include Scottish empiricist David Hume, Adverse attitudes Society may have negative attitudes towards suicide, which can lead to suicidal people experiencing discrimination, stigmatization, exclusion, pathologization, and incarceration. They may be hospitalized or drugged without their consent, have difficulties in finding jobs or housing, and have their parental rights revoked. Suicide is not seen as a positive human right or a logical decision given circumstances. Suicidal people are not seen as having potentially valuable messages to convey. Advocacy , the palette, pistol, and note lying on the floor suggest that the event has just taken place; an artist has taken his own life. Advocacy of suicide has occurred in many cultures and subcultures. The Japanese military during World War II encouraged and glorified kamikaze attacks, which were suicide attacks by military aviators from the Empire of Japan against Allied naval vessels in the closing stages of the Pacific Theater of World War II. Japanese society as a whole has been described as "suicide-tolerant" (see Suicide in Japan). Internet searches for information on suicide return webpages that, in a 2008 study, about 50% of the time provide information on suicide methods. A similar study found that 11% of sites encouraged suicide attempts.