Suicide and Attempted Suicide (Paperback)

There's no nonsense here. You won't be talked down to or patronized. It's accurate and precise information written by a doctor who has studied each method. This makes it an important and interesting book because there is very little accurate information on this subject available. Dr. Stone is clear to point out that there are many misconceptions about suicide methods in the general public. And if you're going to play with fire, don't you think you it is wise to know what you're doing?

Just like any cookbook the author does not make tangential remarks about why he made this book. But there is an underlying message of personal responsibility here that can be gleaned from the book's introduction and Dr. Stone's dark humor.

Part One of the book describes suicide in broad terms, speaking of the different kinds of people who in the past had made successful or unsuccessful attempts. And there's a clear warning that due to lack of information some people who didn't really want to die, end up making the tragic mistake of using a method that is much more lethal than intended. The reverse warning is also here: That for those who wanted to die, and took action without clear thought often results in waking up in an Emergency Room with a damaged body or a slow and painful death.

Personally, I am more familiar with genuinely wanting to die rather than using a suicide attempt as a gesture for attention. When I read this book, I was depressed and specifically purchased the book for the "recipes" in Part Two. I was amazed to discover how many choices you have, even when your goal is the same. As I continued to read, I realized that these methods would always be there, waiting for me, tucked away like a fire extinguisher. Despite the great pain that you might be feeling, I realized that there is no need to rush things. I could execute one of these methods, and ensure my death, at any time I chose.

What I'm about to say might sound strange to you initially, but this feeling of certainty and control over your own destiny is something that I hadn't felt before. So, now, as I finished reading, and put it back on the shelf, I wondered what things in life existed to which I had not properly been introduced. If there were so many ways to die, could there be even more ways to live? I believe this feeling of control and certainty that I now felt is what kept the book on the shelf and me in the game. I hope that if you purchase this book, you will experience a similar feeling.

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.

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.