DISCOVERING SUICIDE DISCOVERING SUICIDE Studies in the Social Organization of Sudden Death

J. Maxwell Atkinson

~ MACMIllAN © J. Maxwell Atkinson 1978

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First published 1978 by MACMILLAN PRESS LTD Houndmills, Basingstoke, Hampshire RG21 2XS and London Companies and representatives throughout the world

ISBN 978-0-333-34553-5 ISBN 978-1-349-06606-3 (eBook) DOI 10.1007/978-1-349-06606-3

A catalogue record for this book is available from the British Library.

10 9 8 7 6 5 4 3 02 01 00 99 98 97 96 95 To the memory of my father Contents

Tables and Figures viii

Preface to the Paperback Edition ix

Preface xii

Acknowledgements xvi

PART I: SUICIDE AND SOCIOLOGY

1 Background and Introduction in the Research 3

3 Suicide Research and Data Derived from Official Sources 33

4 Alternative Sociological Approaches to Suicide Research 68

PART II : SUICIDE AND THE SOCIAL ORGANIZATION OF SUDDEN DEATH

5 Registering Sudden Deaths: Official Definitions and Procedures 87

6 Some Relevant Factors in Imputing Suicide 110

7 Common-Sense Theorizing about Suicide 148

8 Ethnomethodology and the Problem of Categorization 175

Notes 198

Select Bibliography 212

lnde~ 221 'Tables and Figures

Table 2.3.1 Summary statement of central assumptions and criti- cisms of positivism 20 Table 4.2.1 Three stages in the processes leading to suicides being recorded as such 69 Table 5.3.1. Official Certification procedures used by coroners in England and Wales and the numbers processed in 1969 101 Table 5.3.2 Verdicts available to coroners, together with the numbers returned in 1969 102 Table 7.2.1 Sex, age and marital status of seventy accidents and seventy suicides 152 Table 7.2.2. Types of evidence present in cases resulting in verdicts of suicide and accidental death 154 Table 7.2.3. 'Positive' and 'negative' evidence presented and verdicts 155

Figure 5.1.1. Schematic representation of different types of definitions of suicide 88 Figure 5.3.1. Extract from pathologist's report form 97 Figure 5.3.2. Schematic representation of the death registration process in England and Wales 99 Figure 6.6.1. A dynamic model of the transmission of shared definitions of suicide through a social system 145 Preface to the Paperback Edition

One reason for reprinting this book in paperback is that some of my work on suicide is now used as a teaching aid in various courses where students are exposed to Durkheim's classic treatise on the subject. In some respects, of course, it is quite gratifying to find oneself being listed, even as 'secondary reading', along with one ofthe more famous founding fathers of sociology. But it is also somewhat unnerving to think that relative newcomers to the discipline may be having to familiarise them­ selves with the products of one's first serious attempts to do research. This is particularly so given my strong suspicion that the most commonly cited reference may not be this book at all , but is more probably an article which appeared several years before the present project was com ­ pleted ('Societal Reactions to Suicide: The Role ofCoroners' Definitions, in S. Cohen (Ed .), 1971, pp. 165-91). That the trailer may be more widely known than the main film might not matter were it not for the fact that the ending was subsequently revised . I therefore have mis­ givings about the thought of being cited as representing a position to which I no longer fully subscribe. and which I sought to modify and clarify when writing the present book. If nothing else. then, I hope that this paperback edition will make it easier for those who found some interest in the earlier paper to compare it with the extended version included here as Chapter 6. and to note the criticisms of it which con ­ tinue into Chapter 7. A related reason for making the book more readily available is that it has evidently also found favour in some quarters as a reasonably ac­ cessible statement of the problems and issues associated with the emer­ gence of ethnomethodology. Here again I have certain reservations. particularly if it is seen as being representative of research in ethno­ methodology and conversation analysis as it is currently practised. And, as I have noted in a more recently formulated view of works like the present one, they are also open to other interpretations with which their authors may disagree:

Ethnomethodological studies of official categorisation procedures are sometimes regarded as being merely negative critiques of the way sociologists have traditionally used officially derived data for research purposes. They are also sometimes read as recommendations to the x Discovering Suicide effect that previous methodological procedures should be reformed or improved, so thar.in future 'more careful' or 'more accurate' studies could be based on the analysis of official statistics. These are not, however, the implications that ethnomethodologists take from their work on official categorisations. Rather they see them as confirma­ tions of the promise of treating methods of reasoning, hitherto taken for granted, as the topic for inquiry, and of the essentially unin­ teresting and un-newsworthy character of professional research that merely relies on them as an unexplicated resource. Accordingly, traditional approaches to the social and behavioural sciences are viewed as interesting only in so far as they, like the analyses by coroners and others, testify to the methodic ways in which human beings are readily able to construct plausible descriptions of social action and social order. Thus, if the production of ambitious and plausible-sounding theories (whether of crime, suicide, or society as a whole) is such an easily and routinely accomplishable task, then to adopt the construction of such theories as a professional enterprise hardly seems enough of a challenge to justify a specialised discipline such as sociology. But what does emerge as being much more of a challenge is the attempt to identify and explicate the workings of the methodic ways in which members collaborate to produce sense, facticity and orderliness (Atkinson, 1981, p. 216).

A range of empirical investigations have now been .conducted in response to this challenge, and readers curious to learn more about the directions taken in such work are recommended to refer to some of the research reports that have become available since this book was first 'published (e.g, Schenkein, 1978; Sociology, 1978; Psathas, 1979; Atkinson and Drew, 1979; Sociological Inquiry, 1980; Goodwin, 1981; Atkinson and Heritage, 1983). Taken together, these and other studies conducted within the framework established by Harold Garfinkel and Harvey Sacks represent an expanding research literature on the organi­ sation of naturally occurring social interaction. It is being produced by researchers who share a common commitment to the investigation of previously unexplored levels oforderliness in human conduct, and to the view that the viability of any approach to research, including their own, should in the long run be judged in terms of its capacity to generate original discoveries that can be made openly available for public scrutiny and evaluation. The fact that such work has developed and diversified in ways that could not have been foreseen when the present book was written is in my view an extremely promising sign . For if the directions it has taken could have been accurately anticipated in advance of research being done, there might then have been grounds for doubting its claims to be ex­ ploring new and previously uncharted territory. But such developments also mean that readers looking to this book for a short cut to the frontiers Preface to the Paperback Edition xi are likely to be disappointed, and should certainly not expect to be taken more than part of the way there. I hope nonetheless that it may help to illustrate and clarify some ofthe issues in response to which ethnomethodology first emerged. The con­ tinuing relevance of these for debates about alternative approaches to sociology has not substantially diminished over the past several years, and seems unlikely to do so until there is a more widespread willingness to question the extraordinarily influential claim contained in the opening paragraph of Durkheim's Suicide - namely that social science can and should proceed without paying serious attention to the ways in which phenomena like suicide are understood and analysed in everyday conversation. Research in ethnomethodology and conversation analysis starts from exactly the opposite position, and the present study seeks to elaborate on some of the reasons for so doing.

May 1982 MAXWELL ATKINSON

REFERENCES

ATKINSON, 1- M. (1981) 'Ethnomethodological Approaches to Socio­ Legal Studies'. In Podgorecki, A., and Whelan, C. J. (Eds.). Socio­ logical Approaches to Law. London: Croom Helm: 201-23. ATKINSON, J. M., DREW, P. (1979) Order in Court : The Organisa­ tion of Verbal Interaction inJudicial Settings. London: Macmillan. ATKINSON, J. M. and HERITAGE, J. (1983) Structures of Social Action: Studies in Conversation Analysis. Cambridge: Cambridge University Press. GOODWIN, C. (1981) Conversational Organization: Interaction between Speakers and Hearers . New York: Academic Press. PSATHAS, G., (Ed .) (1979) Everyday Language: Studies in Ethno­ methodology. New York: Irvington. SCHENKEIN, J., (Ed .) (1978) Studies in the Organization of Con­ versational Interaction. New York: Academic Press. Sociological Inquiry. (1980) Special Issue on 'Language and Social Interaction'. Volume 50, Numbers 3-4. Sociology. (1978) Special Issue on 'Langu age and Practical Reasoning'. Volume 12, Number 1. Preface

The research reported in this book was originally written up as a thesis for a Ph.D. in Sociology at the University of Essex. Other research and teaching committments meant that it always had to be done as part­ time.venture, which is one reason why it took about seven years to com­ plete. Another is that the work was started in the late 1960s at a time when the theoretical and methodological turmoils which have characterized the last decade of sociology were beginning to have widespread influence in Britain. The emergent debates posed new and difficult challenges for empirically oriented researchers so that, having begun with an almost total lack of awareness that there might be serious problems with traditional positivist research procedures, I developed during the present work a commitment first to symbolic in­ teractionism and second to ethnomethodology. While such changes in orientation clearly involve taking theoretical writings seriously, I started with and retained a certain scepticism about the kind of abstract sociological theorizing which abounds with criticisms and suggestions about empirical research without showing any sign of being based on attempts to resolve the problems at first hand. I like to think, therefore, that the transition from positivism through interactionism to ethnomethodology described in this book was influenced at least as much by the attempts to explore theoretical ideas in empirical settings as by reading about the competing theories themselves. To this extent, then, it can be read as a chronicle of one empirical researcher's attempts to come to terms with the theoretical developments which were taking place in the discipline while the research was being done. There is another sense in which the book may be seen as a reflection of (or perhaps a reaction against) contemporary developments in professional sociology. For it is arguable that the dominant British response to the availability of competing paradigms has been to talk about them rather than to try working within them. Such a trend was probably inevitable given the way academic life in Britain is structured and the rapid growth of sociology during the late 1960s. Compared with, for example, the situation in American universities, there is much less scope for British academics to get the amount of time away from teaching that is needed to engage in extensive empirical work . This Preface xiii may not matter too much as far as survey research is concerned, as the time-consuming work of data collection and analysis can be con­ veniently passed on to assistants and other agencies, but the kinds of unstructured observational studies called for by some perspectives are much less amenable to such delegation. In selecting examples of em­ pirical studies to illustrate different approaches for their students, therefore, teachers have to rely heavily on the work of others, so that the ever-present and sometimes only option as far as their own research output is concerned is to tidy up lecture notes for publication as synthe­ sizing texts . This temptation, furthermore, was added to greatly by the demand for textbooks that was created by the massive expansion of sociology in British higher education. The point of these remarks is to prepare the way for a confession that the present book was originally conceived of as two separate studies. The first was to have been a literature review/personal essay on the sociology of suicide, and the second an empirical thesis/monograph. The beginnings of the former project have survived in Chapter 2 of the present volume, which was intended to provide a version of what it is about suicide that sociologists have found interesting. Having got that far, however, I found I could no longer distinguish satisfactorily between the two enterprises, as my views on the suicide literature were so closely bound up with a very particular empirical problem which un­ derpinned so much of the research on suicide by sociologists and others, namely the status of the data used in testing hypotheses. Indeed, it was not until I had redefined the project as a single and more limited one that I was able to continue writing beyond Chapter 2 and, while it was originally prepared with the literature review project in mind, it has nevertheless been retained more or less intact. For one thing, it provides some kind of a warrant for not giving too much atten­ tion to the issues which sociological researchers into suicide are nor­ mally expected to attend to (e.g, anomie; the dispute between sociological and psychological modes of explanation; etc.). And more generally my hope is that the discussion of 'The Suicide Problem in Sociology' will give student and non-sociological readers some clarifica­ tion of the character of sociologists' interest in suicide. My main regret about the book is that the journey through the perspectives does not extend further than it does into the final one, so that it may be open to the complaint that it is no more than yet another programmatic statement on behalf of ethnomethodology. Against this , however, I would note first that some of the analyses, which were done even before the final transition, were carried out (albeit unwittingly) in a style which is just about recognizable as ethnomethodology of the pre-conversational analysis era. Second, I would like to think that it both differs from and complements more abstract programmatic writings by describing an empirical route to ethnomethodology which has not previously been documented in detail. Thus, I have tried to XlV Preface elaborate as clearly as I am able how the empirical research not only was guided by interpretations of the competing perspectives, but also prompted reassessments and new commitments. A9d a possible lesson in all this may be that attempts to work nalvely within a particular paradigm can be just as convincing and satisfying a way of discovering strengths and weaknesses as purely theoretical exegesis. Finally, to the extent that the research was heavily influenced by the interactionist literature on the sociology of deviance, the direction taken as a way forward from labelling theory contrasts markedly with the dominant post-interactionist tendencies, particularly in Britain, which have been quick to dismiss ethnomethodology in favour of a variety of macro-structural-radical alternatives. In this particular area, then, there is arguably a special case even for abstracted programmatics which give voice to a dissenting view, and this work will hopefully make a small contribution towards redressing the balance away from the new conventional wisdoms about deviance. The slow pace of the work, coupled with the fact that it was done in three universities, has meant that I have discussed various parts of it with more people than is perhaps usual in ventures of this sort . Those who have encouraged me will mostly know who they are and ifthey are not aware of my gratitude to them, I thank them now. Of those deser­ ving special mention, Terence Morris did me a great service by spark­ ing off the initial interest in official statistics in a seminar at the London School of Economics. Alasdair MacIntyre, my supervisor for the first couple of years or so, then gave me the opportunity to pursue it by hir­ ing me as his research assistant and, had he not taken my ill-formulated ideas seriously, the research would almost certainly never have got ofT the ground. For this and the ongoing stimulation which is a feature of regular encounters with him I shall always be grateful. During the tran­ sition to interactionism, Dorothy Smith was a constant source of help and encouragement and, after her departure from Essex to North America, similar sub-cultural support was provided by the regular con­ tact with friends at meetings of the National Deviancy Conference, and particularly with Phil Strong, Mike Hepworth and Margaret Voysey. The transition to ethnomethodology was greatly eased by Rod Watson, to whom my debts of gratitude cannot readily be documented.The final stage of writing up the research coincided with Harold Garfinkel's stay at Manchester as Simon Visiting Professor and, without his sym­ pathetic encouragement, I might well have scrapped the whole project on the grounds that the kind of work I was doing had been superseded by the emergence of conversational analysis within ethnomethodology. Of those who read and commented on the book when it was still a thesis , I am particularly grateful to Colin Bell, Stan Cohen, Gordon Horobin, Jeff Coulter and John Heritage for being encouraging about publication, even though not all of them agreed with the general thrust of the argument. Preface xv

The empirical materials could not have been gathered without the help and co-operation of coroners, policemen and others who must re­ main anonymous. My gratitude to them and my high regard for their competence as theorizers will hopefully be evident in what follows. One who can be mentioned is Dr Charles Clark who, as Essex County Coroner, played an important part in initiating suicide research at his local university by offering to make his records available for researchers there. I took advantage of his offer and also of his willingness to talk more generally about his work, and for this I am very grateful. I must also record my thanks to the University of Lancaster for gran­ ting me a term's study leave which enabled me to get on with some of the fieldwork and writing. Parts of my research were also made possible by the award of Social Science Research Council Grant HR 1496/1 'Community Reactions to Deviance'. I am also grateful to Penny Anson and Margaret Whittall for surviving the task of typing so morbid a manuscript. Without the constant support and encouragement of my wife the project would certainly never have been completed and, in ad­ dition to the things wives are normally commended for in prefaces, I am particularly thankful to mine for not being a sociologist. Her lay member's scepticism about the discipline has continually kept me on my toes.

MAXWELL ATKINSON Acknowledgements

Some of the material in Chapter 3 was originally published in 'Status Integration, Suicide and Pseudo-Science', in Sociology, 7 (1973) pp . 251­ 64. Some of that in Chapter 4 first appeared in 'On the Sociology of Suicide', in Sociological Review, 16 (1968) pp. 83-92, and was also reprinted in A. Giddens (Ed.), The Sociology of Suicide (London, Frank Cass, 1971). Pans of Chapters 5 and 6 were previously include in 'Societal Reactions to Deviance: The Role of Coroners' Definitions', in S. Cohen (Ed.) , Images of Deviance (Harmondswonh, Penguin Books, 1971) pp. 165-91. Some of the interview data quoted in Chapter 5, 6 and 7 were derived from a programme prepared for the Open University's course 'Sociological Perspectives' (BBC. Radio 3). I am indebted to all these sources for permission to reprint the materials in question .