Suicide methods
[4][3][11] Limiting the availability of means such as pesticides and firearms is recommended by a World Health Report on suicide and its prevention.
[18] Method restriction, also called lethal means reduction, is an effective way to reduce the number of suicide deaths in the short and medium term.
At the individual level, method restriction can be as simple as asking a trusted friend or family member to store firearms until the crisis has passed.
[20][21] According to Danuta Wasserman, professor in psychiatry and suicidology at Karolinska Institute, choosing not to restrict access to suicide methods is unethical.
[16] 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.
[25][26] 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.
[27] As of 2010[update], 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.
[23][22] Hanging involves the use of a ligature such as a rope or cord attached to an anchor point with the other end used to form a noose placed around the neck.
[31] Hanging was the most common method in traditional Chinese culture,[32] as it was believed that the rage involved in such a death permitted the person's spirit to haunt and torment survivors.
[33][34] In the Chinese culture, suicide by hanging was used as an act of revenge by women[35] and of defiance by powerless officials, who used it as a "final, but unequivocal, way of standing still against and above oppressive authorities".
[45] The overall case fatality rate for suicide attempts using pesticide is about 10–20%;[46] the risk of death increases if the person is also drunk at the time.
It acts by binding preferentially to the hemoglobin in the bloodstream, displacing oxygen molecules and progressively deoxygenating the blood, eventually resulting in the failure of cellular respiration and death.
Carbon monoxide is extremely dangerous to bystanders and people who may discover the body; right-to-die advocate Philip Nitschke has therefore recommended against this method.
[62] As a further complication, the amount of unburned gasoline in emissions can make exhaust unbearable to breathe well before a person loses consciousness.
Originally used in Hong Kong, it spread to Japan,[63] where small charcoal-burning heaters (hibachi) or stoves (shichirin) have been used in a sealed room.
Stoves of this era required one to manually ignite a pilot light with a match; without the combustion the gas cloud would spread unimpeded.
Surviving a self-inflicted gunshot may result in severe chronic pain as well as reduced cognitive abilities and motor function, subdural hematoma, foreign bodies in the head, pneumocephalus and cerebrospinal fluid leaks.
[20][21] When a person is going through a crisis, red flag laws in some places allow family members to petition the courts to have firearms temporarily removed and stored elsewhere.
[119][117] Such injuries can severely affect the function of the hand, and the inability caused to carry out work or interests increases the risk of further attempts.
While reserved for samurai in their code of honour, a feminine counterpart of female ritual suicide also exists (sometimes incorrectly referred to in western understanding as jigai), which involves cutting the jugular vein.
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; Sokushinbutsu historically in Buddhism; and as Sallekhana in Jainism.
Those who die by terminal dehydration typically lapse into unconsciousness before death, and may also experience delirium and deranged serum sodium.
[130] Terminal dehydration has been described as having substantial advantages over physician-assisted suicide with respect to self-determination, access, professional integrity, and social implications.
[134][124] Other sources note very painful side effects of dehydration, including seizures, skin cracking and bleeding, blindness, nausea, vomiting, cramping and severe headaches.
Nonfatal attempts may result in profound injuries, such as multiple bone fractures, amputations, concussion and severe mental and physical handicapping.
[38] People who attempt vehicular suicide or murder–suicides tend to be adult men who recently experienced a stressful event.
Train drivers in particular, effectively forced into being accomplices to the suicide they witness, often suffer post-traumatic stress disorder that has adversely affected their personal lives and careers.
[citation needed] 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.
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.
Female ritual suicide (incorrectly referred to in some English sources as jigai)[158] was carried out in Japan by wives of samurai who had committed seppuku or otherwise brought dishonour.
