Suicide and Attempted Suicide: Methods and Consequences [Hardcover]

Geo Stone (Author)

Book Description

Publication Date: February 1999

Each year in the United States 30,000 people kill themselves. Each year, too, almost half a million survive suicide attempts. Of these, 19,000 are permanently disabled. Only about one in fifteen attempts is actually fatal. Most who attempt suicide do not want to die.

Yet many people who do not intend to kill themselves nevertheless do. They are ignorant of the likelihood that their "gesture" will succeed. Some expect rescuers to save them. Few understand how dangerous their chosen method is, or the consequences of its failure.

The purposes of this book are to decrease the ignorance that leads to terrible unintended consequences; to help identify the would-be suicides, such as teenagers, who can be successfully helped; and to better understand why people attempt to end their lives.

In the absence of knowledge about suicide methods -- and, importantly, about alternatives to suicide -- people act in desperation and ignorance. The methods people use, all too often, leave them neither dead nor able to recover, but maimed and Permanently injured. That is the reality.

Geo Stone also discusses the following subjects:

- The psychological makeup of suicidal people

- The ways to prevent suicide

- The comfort care and hospice care available for those who disable themselves

- Medical systems available for the terminally ill

- The issues surrounding assisted suicide

Editorial Reviews

From Kirkus Reviews

This is essentially a guide on how to commit suicide, or alternatively, stage a ``safe'' suicidal gesture. Stone (who has studied pharmacology at George Washington University Medical School and the National Institutes of Health) offers little backgroundpersonal, occupational, educational, familial, religious, or otherwisewhich might help readers absorb this work into some kind of useful discussion. Stone does set out his basic premises: first, that it is each person's right to make decisions concerning his own death, and second, that most decisions to commit suicide are due to temporary problems and are therefore tragic mistakes.'' Stone goes on, in a pragmatic, almost cold-blooded, tone to set out an immense amount of information on suicide and attempted suicide. He delineates four groups of people who attempt to kill themselves: rational people facing an insoluble problem, usually fatal illness; those acting on impulse, temporarily miserableand often drunk; those who are irrational due to depression, schizophrenia, or alcoholism; and those who are making a desperate bid for attention or help. Stone also looks at issues around terminal illness and euthanasia. In Part II, he explains the following methods of killing oneself: asphyxia, cutting and stabbing, drowning, drugs, chemicals, poisons, electrocution, gunshot, strangulation, hypothermia, and jumping. He includes explicit instructions on how to go about each method, and what the likely physiological damage will be if the attempt fails. Difficult as all this is to take in, there is moreinformation on how to make a relatively safe suicidal gesture will certainly confound readers, as will descriptions of autopsy results and asides on the strange and various ways people hurt themselves. The technical information here is accurate. But to approach such a stunningly painful, morally loaded, politically hot subject constructively, we need more than information. We need to know who our guide is, how he has come to this place, how and why his view was formed. -- Copyright ©1999, Kirkus Associates, LP. All rights reserved.

From the Author

I place suicide attempters in one of four groups: (1) Rational people facing an insoluble problem, generally a fatal or debilitating illness; (2) Impulsive people, frequently young, truly but temporarily miserable, sometimes drunk, who wouldn't even consider suicide six months later; (3) Irrational people, often chronically alcoholic, schizophrenic, or depressed; (4) People trying to make a safe gesture as a "cry for help" or to get someone's attention.

The first group---and most of us will eventually be in it---has, in my view, the right to decide the time, place, and manner of their death. It is clear that a competent person who really wants to kill him- or herself can almost always do so. However, seriously ill or physically impaired people often have both the greatest interest in, and least ability to carry out, suicide. I believe that they ought to have medical help to die peacefully and without pain if they so choose; but this, while sometimes surreptitiously done, cannot at present be relied on.

Many of us have known people who have suffered long, agonizing deaths because they became too ill to kill themselves and their physicians were unwilling to act on their request. I will not mince words by calling it "euthanasia" or "self-deliverance": if you're terminally ill, I hope to provide you with information that will help you determine the best way to kill yourself, if that's your well-considered decision.

What about the young and impulsive, particularly teenagers? At the moment, they seem to have the worst of all worlds, where: (1) lethal and not-so-lethal suicide methods are readily available; (2) neither they, their parents, nor their teachers are likely to know how dangerous particular methods are; (3) personal ("Are you thinking about...?) or practical ("How would you go about...?) discussion of suicide is largely taboo.

While many schools now teach about AIDS and its transmission, many more teenagers will attempt or commit suicide next year than will become HIV-infected. The ignorance, stigma, and fear about suicide would decrease if that topic were added to the curriculum and treated honestly.

What of "irrational" people? They too face a lack of information on suicide methods. Will they sit down and read a book before acting and will they choose more (or less) lethal methods as a result? No one knows. The most relevant data show that in the year after the publication of an earlier suicide-methods book, "Final Exit" there was a small increase in the number of people using the book's recommended methods (from 3477 to 3751), but a small decrease in the overall number of suicides (from 30,906 to 30,810). This is consistent with the notion that "Final Exit" merely shifted the method used by about one percent of suicides; but it can't resolve the possibility that the overall number of suicides would have decreased without the "recommended methods" increase.

As for the fourth group, those trying to carry out a "safe" suicidal gesture, the information in this book can only be beneficial.

A case will be made that people shouldn't commit suicide and that, therefore, a manual telling them how to go about it is pernicious. This is like one of the arguments against sex education: "If they know how, they'll do it." Well, they do it anyway. Thirty thousand suicide deaths a year in the U.S. should make this clear. In the absence of knowledge about suicide methods---and the consequences of failed attempts---people will continue to act in desperation and ignorance, as they have throughout recorded history, with gun, rope, blade, poison, and anything else available. That is the reality. And the methods people use all too often leave them neither dead nor fully recovered, but maimed and permanently injured: paralyzed from jumps, brain-damaged from gunshots, comatose from drugs.

But for anyone considering suicide (or even "safe" suicidal gestures; nothing is 100 percent reliable), I urge you to try every alternative first---and then try them again. These include a variety of anti-depressant drug therapies, various flavors of psychotherapy, electroshock, and "reality therapy"---helping people worse off than you. Each of these will work for some; no single solution will work for everyone. That's why it's vital not to give up if one or two or three don't do much to decrease your pain. How do you know that suicide is the best solution if you haven't tried everything else first? You can always kill yourself later.

See all Editorial Reviews

Product Details

• Hardcover: 480 pages
• Publisher: Carroll & Graf Pub (February 1999)
• Language: English
• ISBN-10: 0786704926
• ISBN-13: 978-0786704927
• Product Dimensions: 9.4 x 6.6 x 1.4 inches
• Shipping Weight: 1.7 pounds
• Average Customer Review: 3.8 out of 5 stars  See all reviews (22 customer reviews)
• Amazon Best Sellers Rank: #921,692 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

86 of 88 people found the following review helpful:

4.0 out of 5 stars Not the best book on suicide, but the best on suicide method, March 24, 2000

By A Customer

This review is from: Suicide and Attempted Suicide: Methods and Consequences (Hardcover)

(...)this is a book about which it's hard to be neutral. If you think that suicide is always wrong, a sin, or a crime, you won't like it: the book provides lots of "how-to" information that can be used to commit suicide. But at the same time there is an anti-suicide thread running through the text---time and again, the author suggests delay, alternatives, and medical treatment, so the in-your-face pro-suicide crowd (small, but vocal) won't be happy either. Further, the author's website contains, among other things, lots of grisly photos that seem intended to discourage suicide.

Unlike Gaul, the book is divided into two parts. The first half is an overview of suicide, covering history, causes of suicide (considered through sociology, psychiatry, and biology), American and Dutch end-of-life medical practices, and a few related areas. Compressed into a little over a hundred pages, this broad coverage is not terribly detailed but functions well as a summary and is both interesting and well done.

The second half describes, with sometimes weirdly-fascinating factoids, what is known about suicide methods (the "how-to" part) and their medical consequences (the "why-you-probably-shouldn't-try-them" part). If you're interested in suicide methods, this is the best source of information available. If you're not, there's far more information here than you want to know. Trust me.

The book's layout is poor. References are in the back organized by chapter, but pages in the text don't have chapter headers, so it's easy to lose your place, whilst flipping back and forth. Footnotes are at the end of each chapter instead of at the bottom of the page, another annoying practise, and there are a surprising number of typso. <g>

In sum, if you want to know why people kill themselves, there are better sources. If you want to know how, this is your book.

55 of 55 people found the following review helpful:

5.0 out of 5 stars The most thorough book on the subject. . ., March 6, 1999

By A Customer

This review is from: Suicide and Attempted Suicide: Methods and Consequences (Hardcover)

This is the definitive book on the subject, exhaustively researched, and yet quite readable...

As I read this book, I was struck that this is not so much about suicide, as about self-determination (...). I began reading this out of a sense of professional obligation, but quickly found the book surprisingly interesting. There is a wealth of detail presented, with the solid and sobering information relieved by the often wickedly amusing (albeit occasionally warped) footnotes.

While the "how to" sections are quite graphic, the reader can readily find areas of interest through the clear chapter subheadings, and thereby skip those that might be either too gory or too technical. But the detail presented is here out of necessity-for how else can the individual make an informed decision?

This book clearly does not advocate suicide. It provides individuals with the information to make a better decision about their future. For example, if someone wishes to make a gesture, it gives them guidance about appropriate choices that will not leave them off in an even worse state.

As a physician, I was a bit put off by the author's criticism of docs. I think he underestimates the chilling effect the threat of professional criticism and repercussions has. Of course, there is also the effect fear of more serious legal action (eg charges of murder) has on the willingness of physicians to be more active in this area. This extends to efforts in the area of pain relief (such as by providing adequate doses of morphine) which are often inappropriately criticized as excessive. Also, as he notes, docs have been very poorly educated regarding pain control.

I highly recommend this thorough reference work, the most definitive work I have seen on this controversial subject. It is far more than a "how to" manual. It is both a reference book, as well as a thoughtful resource, providing objective information, historical information, and perspective on this difficult topic.

66 of 69 people found the following review helpful:

4.0 out of 5 stars If you want information about suicide methods, this is it., February 21, 1999

By A Customer

This review is from: Suicide and Attempted Suicide: Methods and Consequences (Hardcover)

This is an odd, idiosyncratic, fascinating, uneven, irritating, and important book: there's nothing out there like it. "Suicide and Attempted Suicide" is primarily a study of suicide methods---how people try to kill themselves (or, more often, try to get attention or help). It reads as if it were written by more than one author, or over an extended period of time: the tone bounces unpredictably from didactic to ironic to funny (be sure to read the chapter endnotes!).

The first half of the book touches on a wide range of suicide topics: history of suicide, the legal situation, treatment options, terminal illness, philosophical issues, euthanasia and assisted suicide. The information is interesting and well enough presented, but tries to cover too much ground in too few pages. A reader unfamiliar with this material will find it a reasonable, though patchy, introduction that can be followed up from the author's well-chosen "suggested reading" list.

The heart of the book is the second half, where it discusses suicide methods and their consequences in clinical detail. This treatment will surely be controversial, since the author provides "how to" (and "how not to") information that can be used either to commit suicide or to carry out a suicidal gesture.

I've seen only one other book that takes a similar approach, Derek Humphry's "Final Exit" to which this book will inevitably be compared. "Suicide and Attempted Suicide" is the far more comprehensive and detailed work, which is both its strength and its weakness. There is no better---in fact no other---book that discusses the variety of suicide methods in any significant depth. However the large amount of information comes at a cost: a suicidal reader may have a hard time extracting the data he wants from the mass of data he doesn't need. Similarly, the casual reader will probably find the quantity and details of evidence overwhelming.

The writing style is rather pedestrian, which doesn't detract much from a book of this sort, but occasionally slips into "medicalese" which does. On the other hand there are quite a few interesting and informative asides and digressions. These range from early Christian theological disputes, to minimizing heat loss in marine mammals, to the words of Jim Jones (remember Jonestown?) at an anti-suicide rally in San Francisco.

Given the sometimes-gory descriptions, the absence of photos and drawings is a bit surprising. However the author says in a "note to the reader" that these will be available on his website.

Overall, flaws and all, I highly recommend this book for anyone who has seriously considered suicide, or is presently contemplating it. With more reservations---the first half has too little detail, the second half too much---I would recommend it for general readers as well.