Suicide
suicide (from Latin: suicidium) is the act by which a person intentionally causes death. psychological suffering and despair derived from or attributable to vital circumstances such as financial difficulties, problems in interpersonal relationships, painful illnesses, loneliness or psychological harassment. These can lead to a psychiatric pathology and be classified as mental disorders such as depression, bipolar disorder, schizophrenia, borderline personality disorder, alcoholism or drug use. The most "important" known indicator and individual risk factor is a history of a failed suicide attempt.
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Suicide methods vary by country and are partly related to their availability. The most common are hanging, poisoning with pesticides and handling firearms. Suicide was the cause of death for 817,000 people globally in 2016, an increase from 712,000 deaths for this reason in 1990. As a result, suicide is the ninth leading cause of death globally, rising to the second among young people between the ages of 10 and 29. It is more common in men than in women; the former are three to four times more likely to commit suicide than the latter. It is estimated that there are ten to twenty million suicide attempts each year, which when not fatal can lead to long-term injury and disability. For their part, unsuccessful attempts are more common in young men and women in general.
To prevent suicide, it is effective to address the causes and circumstances through psychotherapy. Some limiting measures for the immediate moment and prior to the suicidal act are limiting access to methods –such as firearms, drugs and poisons–, or substance abuse. It is considered that an appropriate coverage of the issue by the media limits the attempts. An approach directed towards the roots and causes of suicide implies, among other ways, working with the improvement of economic conditions. Although telephone help lines are common, there is no evidence on their effectiveness. Currently, they are in use. Several computational linguistics studies are underway that work with algorithms to detect patterns in the language of the person planning suicide.
The view of suicide is influenced by issues such as religion, honor and the meaning of life. Traditionally the Abrahamic religions consider it a sin, due to their belief in the sanctity of life. During the samurai era in Japan, harakiri was respected as a way to make up for failure or as a form of protest. The Hindu ritual called sati, prohibited in the British Raj, involved the immolation of the widow on the funeral pyre of her recently deceased husband, either voluntarily or under pressure from family or society.
Although in several countries suicide or its attempt are considered a crime, in most Western nations they are not punishable. During the 20th and 21st centuries, suicide by immolation was sometimes used as a protest, while suicide attacks, such as kamikaze, have been used as a military and terrorist technique.
Definitions
Suicide is the "act of deliberately taking one's own life." While attempted suicide—also called non-fatal suicidal behavior—is self-injury carried out with the intent to die that is nonetheless unsuccessful. in the death of the individual. For its part, assisted suicide consists of the help that a person provides to another who wishes to end their life, either with the knowledge or the means to do so. In contrast, in euthanasia the person who helps another to end their life plays a more active role, for example by not initiating or stopping medical treatment. Suicidal ideation involves thoughts about committing suicide "with varying degrees of intensity and elaboration" and "homicide followed by suicide" represents the suicide of an individual within a maximum period of twenty-four hours after murdering one or more persons.
Suicide field
The interdisciplinary field that studies the various aspects related to suicidal behaviors. Understanding that suicidal behavior has a multi-causal origin and that it requires interdisciplinary and intersectoral interventions. This interdisciplinary field is oriented towards the development of scientific, theoretical, methodological and ethical knowledge in relation to promotion, prevention, care and assistance, post-vention, research, education, training and state policies for intervention in the suicide process and/or in suicidal behavior disorder.
Risk factors
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Completed suicide is usually the consequence of the sum of various determinant, precipitating or predisposing factors of a social, cultural and biological nature.
The specific causes of suicide are difficult to assess, among other reasons, because only between 15 and 40% of cases have a suicide note.
Suffering from an underlying mental disorder (such as depressive disorder, bipolar disorder, schizophrenia, autism spectrum disorder, borderline personality disorder, eating disorders, among others), having suffered head injuries, or being a carrier of Various genetic factors are elements associated with a greater suicidal risk. Regarding the genetic factor, in Brent and Melhem (2008) it is indicated that it could be responsible for between 38 and 55% of suicidal behaviors.
Structural conditions and socioeconomic problems such as poverty, violence, unemployment, migration, substance abuse, homelessness, discrimination, social stigma, etc. facilitate the synergy of the different factors that influence suicide. In this way, it is frequent that mental disorders and substance abuse coexist (dual pathology) that incline to suicide. These disorders and addictions appear in turn associated with histories of child abuse or financially difficult family situations. The presence of a family history is also a risk factor.
At the individual level, the most important factors are a history of self-injurious behavior or suicidal attempts.
The availability of means increases the risk, with higher suicide rates being found in homes with firearms. War veterans are, in part, at greater risk of committing suicide due to the elevated incidence of mental disorders, such as post-traumatic stress disorder, and war-related physical health problems. Police forces are also a group affected by high suicide rates.
Currently, according to various investigations carried out in the clinical care of patients with suicidal behavior disorder, the term suicidal process is coined. This consists of a succession of phases that are chained, having different transit times and levels of severity. This process is built on the plot of the subject's vital history, where three questions guide his thinking: how, when and where. The phases named above begin with the difficulty of solving everyday life problems and often end with completed suicide. These phases are:
- accumulation of unsolved problems
- accumulation of conflicts
- crisis
- negative thoughts
- suicidal ideation
- crisis for attempted suicide
- suicide
From observing that the suicidal act is not in itself a completed, reduced event, but that it goes through different phases, it is possible to understand that it is possible to intervene in each one of them based on preventive, diagnostic, clinical and post-ventive.
Risk factors for suicide can be divided into two groups:
- Modable risk factors.- These relate to social, psychological and psychopathological factors that can be potentially clinically modified.
- Unchangeable risk factors.- They are associated with the subject himself or the social group to which he belongs, characterized by his maintenance in time and because his change is alien to the clinical.
Mental Illnesses
It has been estimated that, at the time of suicide —including suicide attempts—, in more than 90% of cases there was the presence of some mental illness; of these, 27% had significant problems with alcohol or drugs. In those patients admitted to psychiatric units, the lifetime risk of committing suicide is approximately 8.6%. According to Chehil and Kutcher (2012), half of the people who died for this reason could have suffered from major depressive disorder. This and other mood disorders, such as bipolar disorder, can increase the risk of suicide up to twenty times. Schizophrenia, personality disorders, and post-traumatic stress disorder are also related conditions. About 5 % of individuals with schizophrenia die by suicide. Eating disorders are also a risk factor.
However, Bostwick et al. (2016) point out that prior attempts are considered the most "robust" indicator of subsequent suicide. About 20% of suicide bombers have previously attempted to kill themselves; of them, 1% committed suicide after one year and 5% after ten. On the other hand, it is common for self-injurious practices to lack suicidal motives and, for the most part, do not represent a suicide risk. However, some of those who commit suicide do commit suicide. Also, approximately 80% of suicides went to see a doctor in the year before their death; 45% did so in the month before. A study by Ahmedani et al. (2014) found that, of a total of 5,894 deaths by suicide, 83% received some medical attention in the previous year and approximately 45% were diagnosed with some mental illness.
Drug abuse
Substance abuse is the second most common risk factor. Both chronic abuse and acute intoxication are associated. The risk increases when combined with personal problems, such as bereavement. On the other hand, substance abuse is associated with some mental disorders.
Most people are under the influence of sedative drugs (such as alcohol or benzodiazepines) at the time of committing suicide; alcoholism is present in between 15 and 61% of cases. countries with higher rates of alcohol use and higher density of bars have higher suicide rates. Between 2.2 and 3.4% of people treated for alcoholism die by suicide. Commonly, alcoholics who attempt suicide are male, older and have previously attempted suicide. Between 3 and 35% of deaths from heroin use are suicides. In adolescents with alcohol abuse, neurological and psychological dysfunctions may contribute to increased risk.
Cocaine and methamphetamine abuse are highly correlated with suicide. In people who use cocaine the risk is greatest during the withdrawal phase. In those who use inhalants there is also a significant risk; 20% of people attempt suicide at some point, and more than 65% have considered it. Additionally, tobacco use also carries some risk of suicide. However, there is little evidence as to why this happens; it has been conjectured that those with a predisposition to smoke are also predisposed to suicide, that smoking causes health problems that subsequently lead people to end their lives, and that smoking affects brain chemistry, causing suicidality. For its part, marijuana (by itself) does not appear to increase risk.
Gambling
Compared to the general population, gambling addicts have higher suicidal ideation and a higher number of suicide attempts. Between 12 and 24% of pathological gamblers have attempted to end their life. For gamblers, the suicide rate is three times higher compared to the general population. Other factors that increase risk in gamblers are mental illness and substance abuse.
Medical Conditions
There is an association between suicidality and health problems such as chronic pain, head injury, cancer, kidney failure (requiring hemodialysis), AIDS, and systemic lupus erythematosus. Cancer diagnosis doubles the subsequent risk of suicide. In Japan, health problems are recorded as the main reason for suicide.
Recent research has established close relationships between neuroinflammation and various factors of mild systemic inflammation associated with metabolic diseases as modulators of suicidal behavior.
On the other hand, sleep disorders such as insomnia or sleep apnea are also risk factors for depression and suicide. In some cases, sleep disorders may be an independent risk factor for depression. Other medical conditions may present with symptoms similar to mood disorders, including hyperthyroidism, Alzheimer's, brain tumors, lupus erythematosus systemic and adverse effects of certain drugs (such as beta blockers and steroids).
Psychosocial factors
Certain psychological states can increase the risk of suicide, such as ideas of worthlessness and hopelessness, anhedonia, depression, and anxiety. Poor problem-solving ability, loss of previously held abilities, and poor impulse control also play a role.. In older adults, the perception of being a burden to other people is important. Suicide resulting from a "poor integration into society" is called "selfish suicide".
Impulsive type personality traits are widely associated with suicide, hyperreactivity to stress that generates negative or adverse emotional situations in people's lives, such as: mourning or the loss of a family member or friend, a job or social isolation (such as living alone) increase the risk of suicide. Likewise, people who have never been married are at greater risk. Conversely, being religious may reduce it. This has been attributed to many religions' negative perceptions of suicide and the interplay that religion can provide.
Some people choose suicide to escape situations such as bullying or prejudice. A history of childhood sexual abuse and foster care are also risk factors. Sexual abuse is thought to contribute to about 20% of the total risk. From an evolutionary point of view, one explanation of suicide is that it helps inclusive biological fitness, which occurs if the suicide is a person who cannot have more children, therefore, by committing suicide, avoid stealing necessary resources from your relatives. One objection to this theory is that deaths of healthy adolescents do not help inclusive fitness.
Poverty is also related. Increasing relative poverty, compared to the people around the individual, increases risk. Nearly 200,000 farmers in India have committed suicide since 1997 due, in part, to to financial problems. In China, suicide is three times higher in rural regions. It is believed to be partially due to the economic difficulties in these areas of the country. The reduction in poverty seems to confirm the importance of this factor and its relationship with the number of suicides. A $1 increase in the minimum wage in the United States could have prevented 27,000 suicides, which could be 57,000 if the increase were $2, according to a report in the Journal of Epidemiology & Community Health.
Some studies correlate economic crises with an increase in suicide deaths. One study found that each point increase in unemployment is associated with a 0.79% increase in suicide rates in people under the age of 65. According to the World Health Organization, mental health problems, intake Excessive drinking and suicide increase during economic downturns. Suicide is more common in areas of high socioeconomic deprivation, social fragmentation and unemployment, so social protection is essential to alleviate the appearance of mental problems during economic crises. According to data from European countries, unemployment does not increase suicide rates if annual spending on social welfare programs is greater than $190 per person.However, there are also studies that maintain that the risk of suicide among unemployed people is between two and three times greater.
Another psychosocial factor that increases the risk of suicide is loneliness, a widespread problem in modern societies. This circumstance frequently occurs in older people as well as in separated or divorced people. The latter actually present a greater risk of suicide than those who are married, particularly in the case of men. Among these, the suicide rate is 2.4 times that of married men, and they are up to eight times more likely to take their own lives than divorced women. However, no statistical difference has been found between married women and women. divorced. On the other hand, being single or widowed does not appear to have a significant effect on suicide risk.
But these are not the only factors. Employment can lead people to end their lives. According to a study, it reveals that the professions with the highest risk of suicide in Spain are Police Agents and Doctors. In fact, in 2021 alone, 34 agents took their own lives, of which 17 belonged to the National Police and 17 to the Civil Guard. In addition, it should be noted that during the coronavirus pandemic the job suicide rate rose by 3.3%.
Media
The media, such as the Internet, are major risk factors. The way suicide is portrayed, with prominent and repetitive high-volume coverage glorifying and idealizing it, has a negative effect. perform detailed descriptions of a suicide method, the use of this method may increase in the population.
This triggers the so-called Werther effect, which takes its name from the protagonist of the novel The Sorrows of Young Werther by Johann Wolfgang von Goethe, whose suicide was emulated by several admirers of the book. risk is higher in adolescents, who may tend to idealize death.
The opposite effect, the proposed Papageno effect, in which coverage of effective coping strategies can have preventive effects, is based on the name of the character from Wolfgang Amadeus Mozart's The Magic Flute, who, fearing the loss of a loved one, plans to commit suicide until he is helped by his friends. When the media follows the recommended guidelines, the risk of suicide may decrease. However, gaining industry support can be difficult, especially in the long term.
Social networks
In some cases, users of social media platforms may experience social pressure to commit suicide, idolize those who have committed suicide, and agree to suicide pacts. For example, in 2008, a Japanese forum shared information about the possibility of committing suicide with hydrogen sulfide. Soon after, 220 people attempted suicide in this way, of which 208 were successful. For their part, Biddle et al. (2008), carried out a systematic search for twelve terms related to suicide, such as «suicide», «suicide methods», «how to commit suicide?» and «the best methods of suicide», to analyze the results. They found that pro-suicide sites and chat rooms where general topics related to suicide were discussed within the first results obtained.
In 2013, the Blue Whale game appeared in Russia, consisting of 50 challenges, the latter being suicide. By 2016, 130 deaths were reported by young people related to the game in Russia and it spread to other countries Latinos like Brazil, Mexico and Colombia.
Rationalization
Rational suicide is suicide "coldly decided by a person who receives adequate palliative care and moral support for their illness". The act of deliberately causing one's death for the benefit of other people is called "altruistic suicide".. An example is the suicide of an older person in order to leave more food for younger people in the community. In some Eskimo cultures, suicide is seen as an act of respect, courage, or good sense.
On the other hand, a suicide attack is a political action in which one or more attackers carry out a violent attack against other individuals with the understanding that the result will be their own death. Some are motivated by the desire to become martyrs. Likewise, kamikaze missions are carried out as a duty to a higher cause or a moral obligation. Homicide-suicide is the act in which a homicide is succeeded in less than a week by the suicide of the homicidal.
Commonly, collective suicide is carried out under social pressure in communities where members cede their autonomy to a leader. For its part, when two people agree to take their own lives at the same time it is called a "suicide pact". In situations In grueling conditions, where going on with life becomes intolerable, some people turn to suicide as a method of escape. Some Nazi concentration camp inmates committed suicide by touching electrified fences.
Methods
The most common methods of suicide vary by country. However, among the most commonly used are hanging, pesticide poisoning, and shooting with a firearm. Differences in methods are believed to be due, in part, to their availability. A review of 56 countries found found that hanging was the most widely used method, accounting for 53% of suicides in men and 39% in women.
Globally, 30% of suicides are carried out by means of pesticides. However, the use of this method varies markedly from 4% in Europe to more than 50% in the Pacific. It is also commonly used in Latin America, due to easy access to pesticides in agricultural populations. Drug overdose is the reason for approximately two-thirds of suicides in women and one-third in men. Many are unplanned and occur during periods of ambivalence.
Similarly, the mortality rate varies by method: firearm 80-90%, drowning 65-80%, hanging 60-85%, exhaust pipe 40-60%, jumping 35-60%, burning coal 40-50%, pesticides 6-75% and drug overdose 1.5-4%. The methods most used for attempted suicide and for successful suicide are also different; about 85% of suicide attempts in the developed world are made by overdose.
In China, the most common method is pesticide poisoning. In Japan, although harakiri is still practiced, the most common method is hanging, as in Switzerland. Jumping from a height is common in Hong Kong and Singapore, involved in 50 and 80% of suicides, respectively. In the United States, 57% of suicides involve a firearm, a method slightly more common in men than in women, followed by hanging in men and poisoning in women.
Another method of suicide is to cut the forearms. Sometimes they are carried out with the aim of self-harm, although if the bleeding is intense, it can cause death. In the case of a nonfatal suicide attempt, the person may injure the tendons or the ulnar and median nerves that innervate the muscles of the hand, which may result in a temporary or permanent reduction in sensory and motor capabilities of the hand. person, or in chronic pain when nociceptive nerve fibers are affected. In suicide attempts by drowning, death usually occurs due to cerebral hypoxia caused by obstruction of the common carotid artery, neck rupture, or airway blockage. As the level of carbon dioxide in the blood of the person rises, the central nervous system sends an involuntary signal to the respiratory muscles to contract, and the person breathes in water. Death usually occurs when the oxygen level becomes too low to support brain cells. Suicide by electrocution involves the use of an electric shock that causes heart arrhythmias by dramatically affecting blood flow.
Pathophysiology
There is no unifying pathophysiology of depression or suicide. However, it is believed to result from the interaction of socioenvironmental, psychiatric, and behavioral factors. Low levels of brain-derived neurotrophic factor (BDNF or BDNF in English) are directly associated with suicide and indirectly associated with major depressive disorder, post-traumatic stress disorder, schizophrenia, and obsessive-compulsive disorder. Low levels of FNDC have been found in various autopsies in the hippocampus and prefrontal cortex. in people with and without psychiatric conditions. Suicides are thought to have low serotonin levels, which is based, in part, on the autopsy finding of increased levels of 5-HT2A receptors. Other evidence also have found reduced levels of 5-hydroxyindolacetic acid in cerebrospinal fluid. However, direct evidence is difficult to gather. T epigenetics are also believed to play a role in determining suicide risk.
There are currently various theoretical models that explain the presence of suicidal behavior.
- Integrative model "Motivational-volitive of suicidal behavior.
- Prognostic models for suicide.
- Model "Stress - Diathesis".
- Model of cellular inflammation in suicide.
Prevention
Suicide prevention encompasses collective efforts to reduce the incidence of suicide through preventive measures. One way to reduce risk is to limit access to certain methods, such as firearms and poisons. Other measures include: reducing access to charcoal and barriers on bridges and subway platforms. treatment of addictions, such as alcohol or drugs, diseases, such as depression, and people with previous suicide attempts. Reducing access to alcohol has been proposed as a preventive strategy (as well as reducing the number of bars). Although hotlines are common, there is little evidence to support or refute their effectiveness. In young adults with suicidal thoughts, cognitive behavioral therapy may help improve outcomes. Economic development through its ability of reducing poverty may be able to reduce suicide rates. Measures that increase social connectedness, especially in older men, may also be effective. World Day for Prevention Suicide Prevention is celebrated every September 10 with the support of the International Association for Suicide Prevention and the World Health Organization.
Mental disorders
Various treatments can reduce the risk in people with mental health problems. Patients at increased risk of suicide may be admitted, voluntarily or involuntarily, to a psychiatric unit. Personal belongings that could be used for self-harm are commonly removed. Some doctors have patients sign a "no suicide contract", through which they agree not to harm themselves if they are discharged. However, there is no evidence to show a significant effect of this practice. If the person is not at high risk, outpatient psychiatric treatment may be carried out. Likewise, short-term hospitalizations have not been confirmed to be more effective than community help in people with borderline personality disorder (BPD), who are chronically suicidal.
There is tentative evidence that psychotherapy, specifically dialectical behavior therapy, reduces suicidality in adolescents and in people with BPD. It may also be helpful in reducing suicide attempts in high-risk adults. however, no evidence has been found to show a decrease in completed suicides. There is controversy surrounding the benefits versus harms of antidepressants. In young people, antidepressants such as SSRIs appear to increase the risk of suicide by 25 over 1,000 to 40 out of 1,000. In contrast, in adults they may reduce risk. Lithium may be effective in reducing risk in people with bipolar disorder and clinical depression to levels similar to those in the general population. Clozapine can reduce suicidal thoughts in some patients with schizophrenia.
Legislation
Different countries have created legal mechanisms to improve conditions when dealing with suicide risk factors, as well as implement prevention programs led by institutions such as the World Health Organization or the Pan American Health Organization.
Argentina
In Argentina, from the Presidency of the Nation, the Ministry of Health and the Ministry of Social Development, have generated an instrument for Suicide Prevention in the Communication Media. National for the Province of Jujuy, Dr. Mario Fiad.
The National Suicide Prevention Law, has number 27,130 and was published in the Official Gazette on April 8, 2015, passing through both chambers of legislators unanimously approved.
Since the promulgation of the National Suicide Prevention Law, the Suicide Prevention, Attention and Post-vention Program - LIFE COACHES, focuses on disseminating the Law in the Provinces and Municipalities that make up the Republic, this work is going achieving adhesions and projects with the intention of adding each jurisdiction to the National Law.
Places of help
Many health centers, public or private, have psychological or psychiatric care units prepared to provide support and treatment to people with suicidal ideas or other psycho-emotional disorders. For emergency care, there are also telephone lines in various countries, either publicly owned or supported by non-governmental organizations, aimed at helping people in a crisis situation or with suicidal thoughts. In Spain there is, among others, the one known as Telephone of Hope, and more recently under public ownership, the telephone 024.
In Argentina there is the Suicide Prevention, Attention and Post-vention Program, an interdisciplinary team that carries out prevention, assistance, post-vention, training and research actions.
Epidemiology
Approximately 0.5 to 1.4% of people die by suicide, a death rate of 11.6 per 100,000 people each year. In 2013, suicide was the cause of death for 842,000 people, compared with the 712,000 who died for this reason in 1990. Primarily in the developed world, suicide rates have increased by 60% between the 1960s and 2012. Globally, between 2008 and 2009, suicide it was the tenth leading cause of death. For every completed suicide there are between 10 and 40 attempts.
Rates per 100,000 population in 2012 were: Australia 10.6, Canada 9.8, China 7.8, India 21.1, UK 6.2, US 12.1, and South Korea 28.9. In 2009, it was the tenth leading cause of death in the United States, with approximately 36,000 cases per year and 650,000 hospital admissions for attempted suicide. Guyana, South Korea, Sri Lanka, and Lithuania have the highest rates in the world. Countries with the highest absolute numbers are China and India, with about half of all. In China, suicide is the fifth leading cause of death. In Latin America, the highest rates are in El Salvador (13.6), Bolivia, and Chile (12.2), Uruguay (12.1), Cuba (11.4) and Argentina (10.3).
Gender
In the Western world, men die by suicide four times more than women, although women attempt it four times more than men. This can be attributed to men using more lethal methods. The difference is even more pronounced in people aged 65 and over, where ten times as many men commit suicide for every woman. In Asian countries, the suicide ratio between men and women is 2:1, or even even. A special case is that of China, which has one of the highest female suicide rates in the world and is the only one where it is higher than that of men.
In the eastern Mediterranean, suicide rates are nearly equal between the genders. The highest rate of female suicide is in South Korea (22 per 100,000 population). Partly due to stigma and As a result of the depression, people who identify as a gender other than the one they were assigned at birth are at high risk of suicide.
Age
In many countries, suicide rates are highest in the middle and senior years. However, the absolute number of suicides is highest in those between the ages of 15 and 29, given the number of people in this age group of age. In the United States, the rate is higher in Caucasian men over the age of 80, although younger people attempt it more frequently. It is the second most common cause of death in adolescents. In young men in the In the developed world, suicide accounts for approximately 30% of deaths. Rates in developed countries are similar, but it constitutes a small proportion of total deaths because other types of injuries have higher mortality rates. In contrast Compared to other areas of the world, in Southeast Asia, suicide deaths are more common in younger women than in older women.
History
In most ancient Greek city-states, suicide was criminalized. In ancient Athens, people who committed suicide without state approval could not receive normal burial honors. The suicide was buried unattended on the outskirts of the city, without a tombstone or marker. However, suicide was considered a way to maintain honor or avoid humiliation. In ancient Rome, although it was initially permitted and considered for centuries as an honorable way out of shameful or unfortunate situations, later, due to its practice among slaves, it was judged as a crime against the State due to its economic costs. In Christian Europe it came to be esteemed as a sin and was condemned at the Council of Arles in 452 as a work of Satan, in addition suicides were excommunicated. In France in 1670 a criminal ordinance was promulgated in relation to suicide: the corpse of the suicide had to be dragged through the streets, upside down, and then thrown or hung from a pile of rubbish. Also, the deceased's belongings were confiscated.
In the interpretive compendium of common law Comments on the Laws of England (1765-1769) by William Blackstone, it is explained that suicide was a crime equivalent to murder, considered one of the most serious crimes. serious. It constituted a particular type of crime called Felo de se, and was not decriminalized until the 1961 suicide law was passed.
During the Renaissance, the attitude against suicide began to change. John Donne's Biathanatos contained the first modern defenses of suicide. In his work, Donne suggests that suicide "is not contrary to the laws of nature, reason, or God." He also points out the lack of condemnation of Biblical figures to suicide and even presents some circumstances in which "reason recommends suicide."
The secularization of society began during the Enlightenment, which challenged traditional religious attitudes against suicide and presented a more modern perspective on the issue. David Hume denied that suicide was a crime since it did not affect anyone and was potentially for the benefit of the individual. In his Essays on Suicide and the Immortality of the Soul of 1777, Hume asserts that “A man who withdraws from life does no harm to society; all he does is stop producing good for him. And if this is an offense, he is certainly of the most modest kind ».
By the 19th century, suicide in Europe went from being considered caused by sin to being caused by madness. On the other hand, he became the target of satirical comments, such as that of The Mikado, a Gilbert and Sullivan musical, which ironized the idea of executing someone who had committed suicide. In 1879, English law began to distinguish between suicide and homicide, although suicide resulted in loss of inheritance rights. In 1882, England allowed the suicide bomber to receive burial during daylight hours. And by mid-century XX, suicide was decriminalized in most Western countries.
From the Americas, a new aspect was provided in the suicidological field, the first specific legislation that refers to suicide and that proposes public policy actions and expansion of rights for people who are going through this problem and their families, this is the Law National Suicide Prevention 27130
Society and culture
Legislation
In the vast majority of Western countries, suicide is not a crime. However, in some Muslim countries, it is still considered a crime. Although in Australia suicide is not a crime, inciting suicide is punishable, advise or assist the suicide of another person. In addition, the use of "as much force as is necessary" to prevent the suicide from being completed is explicitly allowed. Between 1996 and 1997, physician-assisted suicide was legal in the Northern Territory.
At present, no European country penalizes suicide or its attempt. In England and Wales suicide was decriminalized through the Suicide Act 1961, while the Republic of Ireland did so in 1993. In India, suicide was illegal and the family of the suicide bomber could face legal problems. However In 2014, the Government of India repealed that law. In Germany, active euthanasia is illegal and anyone present at the time of suicide can be prosecuted for failure to help.
For its part, Switzerland legalized assisted suicide in chronically mentally ill patients. The Lausanne Supreme Court, in a 2006 ruling, guaranteed the right of a person with a long history of psychiatric difficulties to end their life. In the United States, suicide is not illegal but can carry penalties for individuals to attempt. Assisted suicide is legal in Washington state for the terminally ill. In Oregon, terminally ill patients can request medication to end their life. Canadians who have attempted suicide can be barred from attempting suicide. access to the United States. US law allows border guards to deny access to the mentally ill and people with previous suicide attempts.
Latin America and Spain
In Spain and Latin America, suicide is not a crime, but its facilitation or instigation by third parties is punishable. Article 143 of the Spanish Penal Code states that "anyone who induces the suicide of another will be punished with a prison sentence of four to eight years".
For its part, Bolivia considers mercy killing illegal. Article 257 of its Penal Code states that "a prison sentence of one to three years will be imposed, if pious motives were decisive for the homicide [...]". Likewise, in Colombia it is punishable by two to six years imprisonment for those who "induce another to commit suicide" or "provide effective help to carry it out", while "when the inducement or help is aimed at putting an end to intense suffering" the sentence is reduced to one or two years. In Costa Rica, El Salvador, Paraguay and Peru, homicide for pious motives is also penalized. In contrast, article 37 of the Penal Code of Uruguay highlights that, in cases of pious homicide, "judges have the power to exonerate from punishment of the person with an honorable record, the perpetrator of a homicide, carried out out of pity motives, through repeated pleas from the victim". Likewise, although in Mexico active euthanasia and instigating or facilitating suicide are illegal, since 2008 terminal patients refusing medication or medical treatments that seek to keep you alive —passive euthanasia—
Religion
In Christianity, suicide is considered a sin, largely due to the writings of influential medieval thinkers such as Augustine of Hippo and Thomas Aquinas. However, suicide was not considered a sin in the Corpus iuris civilis. life is a gift from God that should not be despised and that suicide goes against the "natural order" and therefore interferes with God's master plan for the world. Mental illness or fear of suffering is believed to it reduces the responsibility of the suicide. However, a large number of suicides by followers of God are not condemned in the Bible. In those passages, suicide does not seem to be considered a serious sin. Suicide was not yet considered a sin according to the Christian code. Justinian's Byzantine.
For Judaism, life is also sacred and condemns the fact of shortening life. For this religion, suicide is a criminal act, even suicides are considered homicides, and a serious crime, since it implies « denying that life is a divine gift" and because "it constitutes a defiance of God's will". Likewise, Islamic morality is against suicide. The Qur'an forbids it by stating that "you shall not kill or destroy yourself". For its part, the Hadith adds that individual suicide is illegal and a sin. There is also a stigma associated with suicide in Islamic countries.
In Hinduism, suicide is generally prohibited, as it "disrupts the synchronization of the cycle of death and rebirth." However, Hinduism accepts the right of people to end their lives by fasting, called Prayopavesa, which is not considered suicide since it is a non-violent and natural practice and accepted only under certain circumstances. Satí, the self-immolation carried out by widows, was a common practice in Hindu society during the Middle Ages.
In Mayan religion, suicide was considered an extremely honorable way of dying, on a par with human sacrificial victims, warriors fallen in battle, women still in childbirth, or priests. According to the Mayans, suicides did not go to a place of condemnation, but to a paradise where they received their protection and happiness.
Within the Ainu religion, it is believed that someone who dies by suicide becomes a Ghost (tukap) that would haunt the living.
In general, the pagan world, both Roman and Greek, had a relaxed attitude towards suicide.
In Buddhism, it is recognized that an individual's past acts greatly influence what they experience in the present; present acts, in turn, become the background influence for future experiences (the Karma doctrine common to Hinduism). Intentional actions of mind, body, or speech have a reaction. This reaction, or repercussion, is the cause of the conditions and differences one encounters in life.
Buddhism teaches that all people experience substantial suffering (Duḥkha), in which suffering originates primarily from past negative actions (karma), or may result as a natural process of the cycle of birth and death (Samsara).. Other reasons for the prevalence of suffering concern the concepts of impermanence and illusion (Maya (illusion)). Since everything is in a constant state of impermanence or flux, individuals experience dissatisfaction with fleeting events in life. To get out of samsara, Buddhism advocates the Noble Eightfold Path and does not advocate suicide. However, Buddhism does not condemn suicide without exception, instead noting that the reasons for suicide are often negative and thus counteract the path to enlightenment.
In Wicca, as in many other neopagan religions, there is no general consensus on suicide. Some view suicide as a violation of the sanctity of life and a violation of the most fundamental of Wiccan laws, Rede. However, because Wicca believes in Reincarnation rather than permanent rewards or punishments, many believe that suicide bombers are reborn (like everyone else) to endure the same circumstances in each subsequent life until the ability to cope is developed. circumstances.
Philosophy
The French writer and philosopher Albert Camus argues in The Myth of Sisyphus that suicide is surrendering to the absurdity of life, being the only truly serious philosophical problem.
Various questions have been raised around the philosophy of suicide, including what constitutes suicide, whether suicide can be a rational choice, and the moral permissibility of suicide. Arguments regarding the acceptability of suicide in moral and social terms They range from positions that consider it inherently immoral and unacceptable under all circumstances, to others that consider it a right of anyone who believes that they have rationally and conscientiously made the decision to end life, even if they are young and healthy.
Opponents of suicide include Augustine of Hippo, Thomas Aquinas, Immanuel Kant, and, arguably, John Stuart Mill—Mill's focus on the importance of freedom and autonomy implies his rejection of decisions by which prevent people from making future autonomous decisions. Other philosophers view suicide as a legitimate matter of personal decision. Those who support these positions maintain that no one should be forced to suffer, particularly from conditions such as incurable or mental illness and old age. Furthermore, they reject the belief that suicide is always irrational, arguing that it can be a valid last resort for those facing lasting pain or trauma. A stronger position would argue that people should be allowed to choose, autonomously, die regardless of whether they are suffering. Among those who support this position are David Hume and Jacob Appel. Some currents of pessimistic and antinatalist philosophy tend towards the moral justification of suicide. However, Sarah Perry argues that "it is the suicidal person who should justify his refusal to live, rather than require the community to justify forcing him to live".
Literature
In universal literature, the theme of suicide has been recurrent since almost the beginning of the first ancient texts. Sophocles, in ancient Greece, already spoke about him in his tragedies Oedipus the King and Ajax. In Oedipus the King, Jocasta hangs herself with her own hair while in Ajax, Ajax himself falls on Hector's sword.
The famous English playwright, William Shakespeare, immortalized the theme of suicide in his universal dramas such as Othello or Romeo and Juliet, where the two lovers have a tragic destiny due to to their impossible love and decide to end their lives. In the words of Romeo himself: "Life is my torture and death will be my rest." In addition, the same author inquires philosophically about the subject of suicide in the tragedy Hamlet, where the Prince Hamlet himself maintains in his famous soliloquy "To be or not to be", in the first scene of the third act, a reflection on his own suicide after the discovery of his father's murder by his uncle.
In Spanish literature, the tragicomedy La Celestina ends with the suicide of Melibea after seeing her lover Calisto die. Similarly in Don Álvaro o la fuerza del sino after the murder of the character Leonor, the protagonist Don Álvaro falls into madness and commits suicide by throwing himself off a cliff. The theme of suicide was common in the nineteenth-century currents of literary romanticism and realism, present in works such as Frankenstein, Anna Karenina, Madame Bovary, etc.
In Victorian England, Scottish author Robert Louis Stevenson wrote the detective story The Suicide Club, from his collection of short stories, The New Arabian Nights, where the author raised a secret society whose members decide to join it to commit suicide.
Music
In the rock music industry, suicide is common among artists, especially singers, who have achieved dominant status within the world of musical entertainment. Suicide in these cases has been induced by pressures inherent in the music industry itself or by drug abuse.
Some of the most famous cases were, for example, the suicide of Kurt Cobain, leader, singer and guitarist of the American grunge rock group Nirvana, who was found died in his home apparently from a shot to the head - despite the fact that there are still controversies about the real nature of his death - Another of the most representative cases was the suicide of Ian Curtis, the singer and leader of the Manchester group, Joy Division. The Stretford singer suffered from epilepsy for some years of his life and had severe seizures related to it during some of his concerts, which led to seizures while singing for which he quickly became famous. Curtis put an end to his life by hanging from the clothesline in his house at the age of 23. Rozz Williams, singer of the death rock band Christian Death, also hanged himself at his West Hollywood home at age 34 for problems of all kinds, especially related to his frustrations.
Other famous suicide singers and musicians were Jim Morrison of The Doors, Janis Joplin, Brian Jones of The Rolling Stones, Jimi Hendrix who, together with the aforementioned Cobain, formed the so-called Club of 27, musical artists who died at the age of 27 years. In 2017, Linkin Park singer Chester Bennington hanged himself at his home in Palos Verdes, California at the age of 41. Another famous artist who committed suicide was Avicii.
Cinema
The film industry often portrays the subject of suicide from multiple points of view. As in Dead Poets Society, a film directed by Peter Weir in 1989, the main protagonist of the story, Neil Perry, decides to commit suicide because of the iron and intransigent paternal upbringing that prevents him from achieving his dream of Being an actor, in Hard Candy —directed by David Slade in 2005— the male lead commits his own induced suicide after meeting a girl much younger than him who threatens him with something very torrid about his past. In Sofia Coppola's The Virgin Suicides from 1999, one of her sisters commits suicide during puberty. In crime films it is common to focus suicides after ingesting narcotic substances, for example, in Lethal Weapon directed by Richard Donner in 1987, where the girl who opens the case, Amanda Hunsaker, rushes down the balcony of a gigantic skyscraper after taking drugs.
On the other hand, there are numerous cases of suicide among the guild of creators of the entertainment industry. The actor Robin Williams committed suicide in 2014 after suffering a neural disease. The actress Romy Schneider, famous for playing the Empress Elizabeth of Bavaria —better known as Sissi— also committed suicide in 1982 after having lost his eldest son. Director Tony Scott committed suicide in circumstances that are not yet fully clarified, since while the coroner ruled out cancer, his brother Ridley Scott assured that he had been fighting this disease for years.
Sociology
The French sociologist Émile Durkheim in his work Le suicide (1897), points out that suicides are individual phenomena that essentially respond to social causes. This act is defined as “every case of death that results, directly or indirectly, from an act, positive or negative; performed by the victim herself, knowing she must produce this result". For Durkheim, suicide "is the result of the strength or weakness of society's control over the individual".
Durkheim defines four types of suicide:
- Suicide altruist: "ordered by society, due to its culture, norms and customs." The person lacks another “honorable choice”, so that continuing to live would be a “ignominia”. It is given in individuals "integrated in the group but with a lack of individualization".
- Selfish suicide: the individual has few ties to society; "They are people who live alone, have no family or social group or institution to relate to." It practically lacks social demands. It is given in individuals "not strongly integrated into their social group".
- Anatomical suicide: caused by a "repentant rupture" in the relationship between the person and society, for example, in the face of the loss of "dear ones, property, prestige". That is, it occurs in individuals with a "distorted integration with the group".
- Fatalist suicide: "when excessive regulation exists, it ends up crushing individuals."
According to Rodríguez Pulido et al. (1990), the most relevant conclusions of Durkheim's work are: that the individual commits suicide because the society to which he belongs has lost its cohesion and that the Religion "exercises a prophylactic action on suicide because it constitutes a society." In contrast, critics of his work have noted: that social reality is not independent of individual realities, that there is a tendency to "draw conclusions through conceptual analysis to prove things," and that "[Durkheim] adjusted" the data statistics and theoretical ideas to "prove the validity of his general proposition".
Defense
Some cultures and subcultures have advocated suicide. The Japanese military, during World War II, encouraged and glorified kamikaze attacks, the suicide attacks carried out by Imperial airmen against Allied shipping. Japanese society has been described as "suicide tolerant". When searching the Internet for information related to suicide, between 11 and 30% of web pages can encourage suicide and provide methods to do so. Many people make suicide pacts online, either with existing friends or with people they recently met in chat rooms or on forums. However, the Internet can help prevent suicides by providing a social group to isolated people.
Places
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Some landmarks have become known for their high levels of suicide attempts. These include: London Underground, Nusle Bridge in Prague, Cape Beachy in Eastbourne, Prince Edward Viaduct in Toronto, Tequendama Falls in Colombia, The Gap in Sydney, Niagara Falls, Golden Gate Bridge in San Francisco, the Nanking Bridge over the Yangtze River, a rock known as the Happy Stone in Valparaíso, the Metro and the Costanera Center Mall in Santiago de Chile, Mount Mihara in Izu Ōshima and the Aokigahara Forest in Japan. By 2010, the Golden Gate Bridge had over 1,300 deaths by suicide since its construction in 1937. In other places, barriers have been built to prevent suicides, for example, the Eiffel Tower in Paris, the Empire State Building in New York, the Sydney Bay Bridge or the Madrid Viaduct.
Notable cases
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During the final days of the 1944 Battle of Saipan, thousands of Japanese citizens committed suicide, some by jumping off "Banzai" or "Suicide" cliffs, fearing they were living under American occupation. Something similar happened a year later. next, on May 8, 1945; Between 700 and 1,000 inhabitants of Demmin, Germany, committed suicide before the imminent arrival of the Red Army. Also during World War II, German Field Marshal Erwin Rommel, accused of involvement in the July 20 bombing, was forced to commit suicide under the threat of a public trial (where he would be found guilty and receive the death penalty) and reprisals against his family. On November 18, 1978, 914 members of the People's Temple committed suicide after taking cyanide. The strikes 1981 famines, led by Bobby Sands, resulted in the deaths of 10 people. The cause of death was identified by the coroner as "starvation, self-imposed" rather than suicide; the cause was changed to simply "starvation" on the death certificates after protests by relatives of the deceased.
Suicide was also used as a way of denouncing the repression suffered towards the weakest (such as the self-immolation of the bonzes or Mohamed Bouazizi).
There have been cases of suicides of airplane pilots (without terrorist motivation).
Suicide in other species
Suicide in animals is self-destructive behavior on the part of an animal to intentionally end his own life, thus reminiscent of suicide in humans. Scientists have been unable to determine whether animals are able to consciously end their own lives. Although there are anecdotal reports of dogs, horses and suicide dolphins, there is little conclusive evidence. There are few scientific studies on animal suicide.
Animal suicide was used for a long time to define human suicide; during the centuryXIX animal suicide was seen as an act of abuse, madness, love or loyalty, in the same way as human suicide.[chuckles]required]