From the scanning team: “Suicide and Attempted Suicide” by Geo Stone is one of the best books written on the topic. Unfortunately, the book is out of print; prices for used copies start at $150 and go up to $500 (see amazon). That’s why we decided to provide a digital version of the book. Updated links http://www.suicidemethods.net/ - Geo Stone has published large part of this book on his site. The site has an extensive links collection. alt.suicide.holiday (ASH) – the oldest community and discussion site, listed in wikipedia http://www.suicideforum.com/ - moderated site, no methods discussion allowed http://www.finalexit.org/ Final Exit http://www.exitinternational.net/ Exit International, Australian right-to-die organization http://www.dignitas.ch/ Dignitas, Swiss assisted suicide organization helping people from other countries Wikipedia has lots of information, see for example: http://en.wikipedia.org/wiki/Suicide (“See Also” chapter includes links to other sites) If you like the book, please support the author by buying it when it becomes available again! ebooks on the internet You need to have emule from http://www.emule-project.net/ installed to open the download links. Ebooks are also available on http://www.mininova.org If you like any of the books, please buy it from the author to support him ! (download) Peaceful Pill Handbook by Dr. Philip Nitschke Official site: http://www.peacefulpillhandbook.com/ (download) Final Exit 3rd ed by Derek Humphy Official site: http://finalexit.org/ (download) In Würde Sterben (Final Exit in German) SUICIDE AND ATTEMPTED SUICIDE METHODS AND CONSEQUENCES Geo Stone Carroll & Graf Publishers, Inc. New York A NOTE TO THE READER: There is some material you should be aware of that is not presented in this book (I) Grisly photographs showing the results of suicide attempts; (2) detailed information about specific drugs: dosage, overdose, and toxic effects. Both of these will be available at my website (under construction), as are links to other suicide-related sites of all persuasions. There will also be an oppor­ tunity to make suggestions and corrections to the text there. Please do: all of us are smarter than any of us. Attempting suicide is not a game or sport. This book was written to enlight­ en its readers on the general subject of suicide. Beyond the dissemination of general historical and statistical information, this book provides information that might save the lives of those who attempt suicide, as a means of seeking help, but who do not actually intend to end their lives. This book also provides information that might ease the physical pain of those who have made the decision to end their lives. This book is absolutely not intended to encourage anyone to attempt or to commit suicide. Copyright © 1999 by Geo Stone All rights reserved First Carroll 8c Graf edition 1999 Carroll 8c Graf Publishers, Inc. 19 West 21st Street New York, NY 10010-6805 Library of Congress Cataloging-in-Publication Data is available. ISBN: 0-7867-0492-6 Manufactured in the United States of America Leslie-gun; Laurie-drugs; Mike-drugs; Jessica-jump Acknowledgments "There is no new thing under the sun."—Ecclesiastes, I, 2; XII. I owe large debts to the works of Margaret P. Battin, George Howe Colt, Herbert Hendin, and Cyril Poison. I am very grateful to them and others who have contributed to the mass of suicide literature. I've also had assistance from Sarah Fallon, Peter Goodman, John Hofsess, Ted Miller, Sam Rosenfeld, the helpful reference librarians at the National Library of Medicine, George Washington University, and the Library of Congress, and, especially, Virgina Singer. CONTENTS INTRODUCTION 1 PART I: BACKGROUND 1. A Brief Overview of Suicide 9 2. History of Suicide 15 3. Three Ways to Study Suicide 22 4. Why People Attempt Suicide 30 5. Youth Suicide 39 6. Suicide in the Elderly and Other Groups 45 7. Some Frequently Asked Questions About Suicide 51 8. Is Suicide Appropriate? Is Intervention Appropriate? Who Decides? 69 9. Assisted Suicide in Terminal Illness 76 10. The Medical System in Terminal Illness 90 11. Pain Control and Hospice Care 94 12. Advance Directives: Living Will, Power of Attorney for Medical Decisions, and Do Not Resuscitate Orders 103 13. Some Practical Issues in Assisted Suicide 120 14. Euthanasia in the Netherlands 128 15. Euthanasia and Assisted Suicide in the United States 134 PART II: SUICIDE METHODS 16. How Dangerous Are Various Methods of Suicide? 147 17. Asphyxia 157 18. Cutting and Stabbing 185 ix x • Contents 19. Drowning 207 20. Drugs, Chemicals, and Poisons 224 21. Electrocution 265 22. Gunshot Wounds 285 23. Hanging and Strangulation 322 24. Hypothermia 357 25. Jumping 376 APPENDIX References 403 INDEX 459 SUICIDE AND ATTEMPTED SUICIDE INTRODUCTION Razors pain you; Rivers are damp; Acids stain you; And drugs cause cramp; Guns aren't lawful; Nooses give; Gas smells awful; You might as well live. —Dorothy Parker; "Resume," 1926 This book describes, in sometimes-gory detail: (1) methods people use to commit suicide; (2) the medical consequences of suicide attempts; (3) how to carry out a safe suicidal gesture; (4) how to commit suicide as nontrau- matically as possible.3 You may find parts of it disturbing. But the conse­ quences of ignorance are more disturbing: botched suicides, accidental deaths and maimed survivors, slow and painful deaths. Every eighteen minutes someone in the United States kills himself.b A few are younger than ten years old; others over ninety. Between 7.5 and 16 per­ cent take more than a day to die.1 An estimated 300,000 to 600,000 survive suicide attempts, but suffer varying degrees of injury; 19,000 are permanently disabled each year.2 Only about one in ten or twenty suicide attempts is fatal. Given the easy I 2 • Geo Stone availability of highly lethal methods, the conclusion must be that most peo­ ple who attempt suicide don't want to die. Yet, many people who didn't in­ tend to die succeed in killing themselves. Most lack knowledge of drugs and may unknowingly take a lethal overdose; some expect rescuers to save them. Others, who are really trying to die, live through their attempts. Many sur­ vive five-story jumps or head-in-the-oven gassing. Few have an accurate idea of how dangerous their chosen method is or of the consequences should their attempt fail. Throughout this book, I try to provide evidence of the medical effects of each suicide method so that you can make more realistic decisions if you're thinking of suicide. For the same reason I also cite the sources of my infor­ mation so that you can look at the original data unfiltered through my in­ terpretations, biases, or errors. Statistics, though informative, diminish the impact and reality of death. While this book is filled with figures and abstractions, behind each of these numbers is a real person, with a history, personality, and pain that is both particular to the individual and common to us all. These are not just num­ bers; these are our friends, and neighbors, and families, and selves. I include some of their words to give a sense of the quality of their lives, and the thinking that led to their choice of suicide. For example, listen to Karen, age sixteen, describe the situation that brought on her suicide attempt: I was really upset and depressed. My life just seemed to be in total chaos. My boyfriend just dumped me flat, and he said he loved the other girl and didn't love me at all. My parents and I also just got into another fight again about some really dumb things, so I just went into my room and closed the door. There was this bottle of sleeping pills my mother was using, and I had them with me. I sat and stared at it for a long time, weighing out the good and the bad things in my life. The bad things came out ahead. I poured some of the pills in my hand, and figured ten or fifteen ought to be enough to do it. Those pills... they all looked so innocent and peaceful, like they couldn't do much to hurt anyone. Well, I put them in my mouth and held them there for a long time, wondering if I should or shouldn't. I took a glass of water and swallowed. At first nothing Suicide and Attempted Suicide • 3 happened, and then they all hit me at once. The room started to blur and spin, small sounds were going on in my head. The last thing I remembered was trying to move and not being able to. I woke up in the hospital. They were pumping out my stomach—one of the worst things you can have done to you. My mother came into the room, and she apologized for the fight we had.3 The material here is intended both for those who want a quick and rela­ tively painless death, and for those who want to carry out a suicidal gesture as safely and noninjuriously as possible. If it convinces some potential sui­ cides to seek other solutions—suicide should be an absolutely last resort and mistakes may leave you crippled—so much the better. But the fact re­ mains: there is no way to limit this knowledge to those whose aims we agree with. To make my premises explicit: (1) Decisions concerning your death should be, ultimately, yours to make; (2) most—but not all—decisions to commit suicide are due to temporary problems and are therefore tragic mistakes.