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Suicide methods

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

Purpose of study
The study of suicide methods aims to identify those commonly used, and the groups at risk of suicide; making methods less accessible may be useful in suicide prevention. Limiting the availability of means such as pesticides and firearms is recommended by a World Health Report on suicide and its prevention. The early identification of mental disorders and substance abuse disorders, follow-up care for those who have attempted suicide, and responsible reporting by the media are all seen to be key in reducing the number of deaths by suicide. National suicide prevention strategies are also advocated using a comprehensive and coordinated response to suicide prevention. This needs to include the registration and monitoring of suicides and attempted suicide, breaking figures down by age, sex, and method. For instance, if firearms are used in a significant number of suicides in one place, then public health policies there could focus on gun safety, such as keeping guns locked away, and the key inaccessible to at-risk family members. If young people are found to be at increased risk of suicide by overdosing on particular medications, then an alternative class of medication may be prescribed instead, a safety plan and monitoring of medication can be put in place, and parents can be educated about how to prevent the hoarding of medication for a future suicide attempt. == Media reporting ==
Media reporting
, such as this number for North America. Media reporting of the methods used in any given suicide is "strongly discouraged" by the World Health Organization, government health agencies, universities, and the Associated Press among others. Detailed descriptions of suicides or the personal characteristics of the person who died contribute to copycat suicides (suicide contagion). In one study, changes in how news outlets reported suicide reduced suicides by a particular method. Media reporting guidelines also apply to "online content including citizen-generated media coverage". The Recommendations for Reporting on Suicide, created by journalists, suicide prevention groups, and internet safety non-profit organizations, encourage linking to resources such as a list of suicide crisis lines and information about risk factors for suicide, and reporting on suicide as a multi-faceted, treatable health issue. == Method restriction ==
Method restriction
Method restriction, also called lethal means reduction, is an effective way to reduce the number of suicide deaths in the short and medium term. According to Danuta Wasserman, professor in psychiatry and suicidology at Karolinska Institute, choosing not to restrict access to suicide methods is unethical. Method restriction is effective and prevents suicides. It has the largest effect on overall suicide rates when the method being restricted is common and no direct substitution is available.'''' If the method being restricted is uncommon, or if a substitute is readily available, then it may be effective in individual cases but not produce a large-scale reduction in the number of deaths in a country. Method substitution is the process of choosing a different suicide method when the first-choice method is inaccessible. In many cases, when the first-choice method is restricted, the person does not attempt to find a substitute. Method substitution has been measured over the course of decades, so when a common method is restricted (for example, by making domestic gas less toxic), overall suicide rates may be suppressed for many years. If the first-choice suicide method is inaccessible, a method substitution may be made which may be less lethal, tending to result in fewer fatal suicide attempts. In an example of the curb cut effect, changes unrelated to suicide have also functioned as suicide method restrictions. Examples of this include changes to align train doors with platforms, switching from coal gas to natural gas in homes, and gun control laws, all of which have reduced suicides despite being intended for a different purpose. ==List==
List
Suffocation Suffocation, as a classification of suicide method, includes strangulation and hanging. Suicide by suffocation involves restricting breathing or the amount of oxygen taken in, causing asphyxia and eventually hypoxia. It is not possible to die simply by holding the breath, since a reflex causes the respiratory muscles to contract, forcing an in-breath, and the re-establishment of a normal breathing rhythm. Therefore, inhaling an inert gas such as helium or nitrogen, or a toxic gas such as carbon monoxide, is used to bring about unconsciousness. Certain devices such as exit bags are designed to be used with this method, and provide a way for the carbon dioxide to passively escape, which prevents the panic, sense of suffocation and struggling before unconsciousness, known as the hypercapnic alarm response caused by the presence of high carbon dioxide concentrations in the blood. , organizations supporting a right to die promoted death by helium inhalation, although most cases using this method in the US were people with psychiatric conditions. Hanging by Giotto, depicting suicide by hanging Hanging is a common method of suicide. Hanging is the prevalent means of suicide in impoverished pre-industrial societies, and is more common in rural areas than in urban areas. Hanging was the most common method in traditional Chinese culture, In the Chinese culture, suicide by hanging was used as an act of revenge by women and of defiance by powerless officials, who used it as a "final, but unequivocal, way of standing still against and above oppressive authorities". Drowning girl contemplating drowning herself Suicide by drowning is the act of deliberately submerging oneself in water or other liquid to prevent breathing. It accounts for less than 2% of all suicides in the United States. People with dementia and schizophrenia have a higher risk of dying by drowning. Of those who attempt suicide by drowning in the US, about half die. About 2% to 3% of suicides by drowning involve driving a vehicle into a body of water. Poisoning Suicide by poisoning, also called self-poisoning, is usually classed as a drug overdose when drugs such as painkillers or recreational drugs are used. The use of pesticides to self-poison is the most common method used in some countries. , worldwide, around 30% of suicides were from pesticide poisonings. It was the leading suicide method in developing countries, with about half of suicide deaths in India involving poisoning, and most of those involving pesticides. Method restriction is an effective way to reduce suicide by pesticide poisoning. In the UK (England and Wales) until 2013, a drug overdose was the most common suicide method in women. In 2019 the percentage was 16% in males. Self-poisoning accounts for the highest number of non-fatal suicide attempts. In the United States about 60% of suicide attempts and 14% of suicide deaths involve drug overdoses. A particular type of poisoning involves the inhalation of high levels of carbon monoxide (CO). Death usually occurs through hypoxia. A nonfatal attempt can result in memory loss and other symptoms. Firearm (The Suicide'') by Édouard Manet, depicting suicide by firearm In the United States, suicide by firearm is the most lethal method of suicide, resulting in a fatality 90% of the time, Worldwide, firearm prevalence in suicides varies widely, depending on the acceptance and availability of firearms in a culture. The use of firearms in suicides ranges from less than 10% in Australia, to 50.5% in the U.S., where it is the most common method of suicide. Reducing access to guns at a population level decreases the risk of suicide by firearms. Fewer people die from suicide overall in places with stricter laws regulating the use, purchase, and trading of firearms. Jumping Jumping is the most common method of suicide in Hong Kong, accounting for 52.1% of all reported suicide cases in 2006 and similar rates for the years before that. The Centre for Suicide Research and Prevention of the University of Hong Kong believes that it may be due to the abundance of easily accessible high-rise buildings in Hong Kong. In the United States, jumping is among the least common methods of suicide (less than 2% of all reported suicides in 2005). Jumping deaths are often impulsive, and one study of the Golden Gate Bridge demonstrated that more than 90% of people interrupted in a suicide attempt ultimately died by natural or accidental causes, with only 6% dying in a subsequent suicide attempt. Similarly, in New Zealand, secure fencing at the Grafton Bridge substantially reduced the rate of suicides. Chest-high barriers are more effective than waist-high barriers because they require more time and effort to climb over. Other method-specific prevention actions include making staff members visible in high-risk areas, using closed-circuit television cameras to identify people in inappropriate places or behaving abnormally (e.g., lingering in a place that people normally spend little time in), and installing awnings and soft-looking landscaping, which deters suicide attempts by making the place look ineffective. For every suicide by wrist cutting, there are many more nonfatal attempts, so that the number of actual deaths using this method is very low. Wounds from suicide attempts involve the non-dominant hand, with damage often done to the median nerve, ulnar nerve, radial artery, palmaris longus muscle, and flexor carpi radialis muscle. Starvation and dehydration A classification has been made of Voluntarily Stopping Eating and Drinking (VSED) which is often resorted to by those with a terminal illness. It has been used by assisted dying activists, such as Wendy Mitchell, as a means of death in places where assisted suicide is not available. Starvation Fasting to death has been used by Hindu, Buddhist, and Jain ascetics and householders, as a ritual method of suicide known as "prayopavesa" in Hinduism, Vatakkiruttal in Tamil tradition, "sokushinbutsu" historically in Buddhism, and as "sallekhana" in Jainism. Cathars also fasted to death after receiving the consolamentum sacrament, in order to die while in a morally perfect state. The method is also used in passive senicide and associated with the political protest of the hunger strike such as the 1981 Irish hunger strike in which ten prisoners died. Dehydration Death from dehydration can take from several days to a few weeks. This means that unlike many other suicide methods, it cannot be accomplished impulsively. Those who die by terminal dehydration typically lapse into unconsciousness before death, and may also experience delirium and deranged serum sodium. Terminal dehydration has been described as having substantial advantages over physician-assisted suicide with respect to self-determination, access, professional integrity, and social implications. Specifically, a patient has a right to refuse treatment and it would be a personal assault for someone to force water on a patient, but such is not the case if a doctor merely refuses to provide lethal medication. But it also has distinctive drawbacks as a humane means of voluntary death. One survey of hospice nurses found that nearly twice as many had cared for patients who chose voluntary refusal of food and fluids to hasten death as had cared for patients who chose physician-assisted suicide. They also rated fasting and dehydration as causing less suffering and pain and being more peaceful than physician-assisted suicide. Other sources note very painful side effects of dehydration, including seizures, skin cracking and bleeding, blindness, nausea, vomiting, cramping and severe headaches. Collision with or of a vehicle Another suicide method is to lie down, or throw oneself, in the path of a fast-moving vehicle, either on the road or onto railway tracks. Nonfatal attempts may result in profound injuries, such as multiple bone fractures, amputations, concussion and severe mental and physical handicapping. Road Some people use intentional car crashes as a suicide method. This especially applies to single-occupant, single-vehicle wrecks, Even single-vehicle collisions may harm other road users; for example, a driver who brakes abruptly or swerves to avoid a suicidal person may collide with something else on the road, resulting in harm to the driver or others. Both the innocent driver and bystanders may be traumatized by the experience, even if everyone survives. Being victimized by a suicidal pedestrian is recognized as an occupational hazard for professional drivers, especially if they operate heavy vehicles. The pilot was usually flying alone at the time, and was using alcohol or drugs about half the time. In the rare case of a pilot engaging in murder–suicide, the number of innocent people is sometimes very high. On 24 March 2015, a Germanwings co-pilot deliberately crashed Germanwings Flight 9525 into the French Alps to kill himself, killing 149 people with him. Suicide by pilot has also been proposed as a potential cause for the disappearance and following destruction of Malaysian Airlines Flight 370 in 2014, with supporting evidence being found in a flight simulator application used by the flight's pilot. Disease There have been documented cases of gay men deliberately trying to contract a disease such as HIV/AIDS as a means of suicide. Electrocution Suicide by electrocution involves using a lethal electric shock, and is a rarely used method. This causes arrhythmias of the heart, meaning that the heart does not contract in synchrony between the different chambers, essentially causing elimination of blood flow. Furthermore, depending on the current, burns may also occur. Fire Self-immolation is suicide usually by fire. This method of suicide is rare due to it being long and painful. If the attempt is intervened, severe burns and scar tissue will prevail with subsequent emotional impact. It has been used as a protest tactic, by Thích Quảng Đức in 1963 to protest the South Vietnam's anti-Buddhist policies; by Malachi Ritscher in 2006 to protest the United States' involvement in the Iraq War; by Mohamed Bouazizi in 2011 in Tunisia which gave rise to the Tunisian Revolution; by Aaron Bushnell in 2024 to protest the United States' support for Israel in the Israel–Hamas war; and historically as a ritual known as sati where a Hindu widow would immolate herself in her husband's funeral pyre. Hypothermia Hypothermia is a rare method of suicide. Between 1991 and 2014 in the United States, there were eight cases in the scientific literature, and they usually involved some other factor like drugs. Assisted suicide Indirect Indirect suicide is the act of setting out on an obviously fatal course without directly carrying out the act upon oneself. Indirect suicide is differentiated from legally defined suicide by the fact that the person does not directly cause the action meant to kill them, but rather expects and allows the action to happen to them. Examples of indirect suicide include a soldier enlisting in the army with the intention and expectation of being killed in combat, or provoking an armed law enforcement officer into using lethal force against them. The latter is generally called "suicide by cop". Evidence exists for suicide by capital crime in colonial Australia. Convicts seeking to escape their brutal treatment would murder another individual. This was felt necessary due to a religious taboo against direct suicide. A person committing suicide was believed to be destined for hell, whereas a person committing murder could be absolved of their sins before execution. In its most extreme form, groups of prisoners on the extremely brutal penal colony of Norfolk Island would form suicide lotteries. Prisoners would draw straws with one prisoner murdering another. The remaining participants would witness the crime, and would be sent away to Sydney, as capital trials could not be held on Norfolk Island, thus earning a break from the Island. There is uncertainty as to the extent of suicide lotteries. While surviving contemporary accounts claim that the practice was common, such claims are probably exaggerated. Rituals Ritual suicide is performed in a specifically prescribed way, often as part of a cultural or religious practice. Suicide by hanging was traditionally practiced in China and the Sinosphere as a means of ensuring that one's ghost would be able to haunt and torment the powerful but unjust. Self-immolation was practiced similarly in India and spread with Dharmic religions. Some forms of suicide involve or are understood as martyrdom and are undertaken ritualistically. Sallekhana is the practice of ritualized starvation following Jain practices. Romans who considered themselves dishonored would "fall on their sword", ritualistically transfixing themselves on their swords; the similar medieval Japanese practice became known as seppuku or harakiri for samurai. Female ritual suicide (incorrectly referred to in some English sources as jigai) was carried out in Japan by wives of samurai who had committed seppuku or otherwise brought dishonour. ==See also==
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