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INTRODUCTIONRazors 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 --1926This 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 suicidalgesture; (4) how to commit suicide as non-traumatically as possible.
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 You may find parts of it disturbing. But the consequences of ignorance are moredisturbing: botched suicides, accidental deaths and maimed survivors, slow and painfuldeaths,Every 18 minutes someone in the United States kills himself.
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A few are younger thanten years old; others over ninety. Between seven-and-a-half and sixteen percent takemore than a day to die.
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An estimated 300,000 to 600,000 survive suicide attempts, butsuffer varying degrees of injury. Nineteen thousand are permanently disabled eachyear.
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 Only about one in ten or twenty suicide attempts is fatal. Given the easy availability of highly-lethal methods, it seems that most suicide attempters don't want to die.Yet some people who didn't intend to die kill themselves. Many lack knowledge of drugsand may unknowingly take a lethal overdose. Some expect rescuers to save them. Others,who are really trying to die, live through their attempts. Many survive five-story jumps orhead-in-the-oven gassing. Few have an accurate idea of how dangerous their chosenmethod is, or the consequences of its failure. Throughout the book, I try to provideevidence of the medical effects of each suicide method so that you can make morerealistic decisions, whether you're thinking about killing yourself or hoping to get helpand attention. I also cite my information sources so that you can look at the original data
 
unfiltered through my interpretations, 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 the numbers is a real person, with ahistory, personality, and pain that is both particular to each and common to us all. Theyare not just numbers; these are our friends, and neighbors, and families, and selves. Iinclude some of their words to give a sense of the quality of their lives, and the thinkingthat led to their choice of suicide.Karen, sixteen:"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 anddidn't love me at all. My parents and I also just got into another fight againabout some really dumb things, so I just went into my room and closed thedoor. There was this bottle of sleeping pills my mother was using, and Ihad them with me. I sat and stared at it for a long time, weighing out thegood and the bad things in my life. The bad things came out ahead. Ipoured some of the pills in my hand, and figured ten or fifteen ought to beenough to do it. Those pills...they all looked so innocent and peaceful, likethey couldn't do much to hurt anyone. Well, I put them in my mouth andheld them there for a long time, wondering if I should or shouldn't. I took a glass of water and swallowed. At first nothing happened, and then theyall hit me at once. The room started to blur and spin, small sounds weregoing on in my head. The last thing I remembered was trying to move andnot being able to. I woke up in the hospital. They were pumping out mystomach, one of the worst things you can have done to you. My mothercame into the room, and she apologized for the fight we had."
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 The material here is intended both for those who want a quick and relatively painlessdeath, and for those who want to carry out a suicidal gesture as safely and non-injuriouslyas possible. If it convinces some potential suicides to seek other solutions---suicideshould be an absolutely last resort and mistakes may leave you crippled---so much thebetter. But the fact remains: there is no way to limit this knowledge to those whose aimswe 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 mistakes.My position comes from two principles: (1) self-determination and (2) mercy. The morefundamental, self-determination, says that each competent person may decide and act on(subject to non-interference with the rights of others) his or her own views of whatconstitutes a good life and death.In practice, I think that temporary suicide intervention is appropriate when there is otherreason to believe that someone's thinking is impaired (e.g. by depression), though boththe nature (reversible) and timecourse (brief) of the intervention should be limited.The principle of mercy holds that no one (or thing) should be made to sufferunnecessarily. This is necessarily the subordinate principle; one may choose to suffer forsome perceived higher good. While mentioned in this book, these ethical andphilosophical issues are treated in much greater detail elsewhere. (See suggestedreadings.)For those who are religiously, philosophically, or ethically opposed to suicide under anycircumstance, this publication will be of little comfort; those who believe that it is eachperson's right to decide, insofar as possible, when to die may find some answers to theirquestions and fears.* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *"Just as I shall select my ship when I am about to go on a voyage, or my house when Ipropose to take a residence, so I shall choose my death when I am about to depart fromlife. "--Seneca, Epistulae MoralesI place suicide attempters in one of four groups: (1) Rational people facing an insolubleproblem, generally a fatal or debilitating illness; (2) Impulsive people, frequently young,truly but temporarily miserable, sometimes drunk, who wouldn't even consider suicidesix months later; (3) Irrational people, often alcoholic, schizophrenic, or depressed; (4)People trying to make a safe gesture as a "cry for help" or to get someone's attention.
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