Suicide and civil commitment

The contemporary approach to suicide prevention relies primarily on involuntary commitment of the suicidal individual. While there is generally widespread acceptance of the principle of society's right, even its moral obligation, to intervene to prevent a suicide, there is much less agreement concerning the conditions under which such an action should proceed. Most of the debate centers on the widely applied commitment criteria of mental illness and dangerousness to self and others. Questions have also been raised regarding the efficacy of commitment as a preventive measure. In this paper, these controversies are placed in a broader historical context. We examine empirical evidence concerning prevailing commitment criteria and the prophylactic value of involuntary hospitalization, and discuss the appropriateness of our current approach to civil commitment in light of existing data.     

Suicide by pencil

We report an unusual suicide, committed with a common pencil. A 72-year-old male inflicted himself a penetrating thoracic wound while being hospitalized for a hip prosthesis operation. Although the patient was immediately operated, the cardiac injury appeared to be fatal. Cases of suicidal penetrating wounds of the anterior chest wall are rare and they are mostly inflicted by knives, glass fragments, or other sharp instruments. The potential danger of a pencil should be taken into consideration, especially in psychiatric hospitals and imprisonment facilities. We examined the legislation in Italy and Finland concerning the regulation of privacy in special care institutions.     

Suicide in pregnancy

The difficulty in establishing the cause of death of a pregnant woman emphasizes the necessity for the careful gathering of evidence. Especially in the case of motor accidents along lonely stretches of road involving a solitary motorist the possibility of suicide should be taken into consideration. Since a televised suicide had apparently served as model for the method of suicide, mention has been made of the "Werther effect". A literature review reveals that little has been written on the subject-suicide during pregnancy.     

自杀文化在东瀛

近年来,日本每年自杀的人数都超过3万人,而且这种现象已经持续了10年。最近几年,由于通过互联网集体自杀的事件频发,日本厚生劳动省已经开始对如何预防自杀进行研究,并将自杀人数减少20％作为目标。虽然正在制订诸如访问保健所职员的家庭、与专门医生的联合以及居民之间相互交流的网络等具体对策,     

Suicide by drowning

A study of suicidal drownings was performed by using the case files of the Office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, U.S.A., during 1980-1984. A total of 70 cases were collected and analyzed as to the age, race, sex, and cause of death of the victim, along with blood alcohol content, the drugs detected at postmortem examination, the geographic location of the terminal incident, the scene circumstances, the presence or absence of a suicide note, and the reason for the suicide. Essentially, one deals with an older white male population, although all age groups can be affected. Members of the population studied frequently died from drowning alone, rather than from additional contributory causes. Most were sober and frequently without drugs detected. Most incidents occurred at home or in a canal, with the victim just "found floating". A note was absent approximately half the time. The reason for the act was depression concerning poor health, death of a loved one, financial problems, chronic pain, or being "tired of life". A discussion ensues about the approach a forensic scientist should have concerning such cases.     

Suicide by self-immolation

In the Western world, self-incineration is a rare event compared with the Asian countries. The circumstances of death are often unusual, and differentiation from homicide is sometimes possible only after evaluating all the investigation results and findings. In many cases of self-cremation, a fire accelerant is used. In our study material at least 30% of the body surface were burned. Unaffected skin was predominantly found on the back of the body. The cases presented by us are inhomogenous as to the motive and differ from those reported in the literature with regard to gender distribution, scene, motivational situation and psychological constitution.     

Psychiatric Medication Intake in Suicide Victims: Gender Disparities and Implications for Suicide Prevention

Frequency and gender differences of psychiatric medication intake in a sample of suicide victims from the Athens Greater Area were investigated with a particular focus on the implications for suicide prevention. Data were collected from the toxicological analyses of the suicide cases of the period November 2007–October 2009. Information was available for 262 individuals, 196 men (74.8%) and 66 women (25.2%); 109 of these (41.6%) were receiving psychiatric medication(s). Women were statistically more frequently under treatment: antidepressants (32.8% vs. 11.3%, p < 0.001), antiepileptics (9.1% vs. 0.5%, p = 0.001), antipsychotics (24.2% vs. 9.2%, p = 0.003), and benzodiazepines (16.7% vs. 6.6%, p = 0.024). Campaigns aiming to bring men with psychological difficulties in contact with mental health services and to lessen the stigma of mental illness, together with better training of nonpsychiatrists into “suspecting” “male” depression, could be particularly helpful for decreasing male suicides. More thoughtful choice of psychiatric medication could possibly already prevent a number of female suicides.     

Suicide by air rifle and shotgun

We report the case of a 39-year old white male who committed suicide by shooting himself with an air rifle and a shotgun. The ballistics of air guns and rifles, with particular reference to the Sheridan air rifle, are reviewed. Only two cases of multiple firearm suicide have been reported; both involved simultaneously fired handguns. Ours is the first case, to our knowledge, of an air rifle and a shotgun used in sequence to commit suicide.     

Suicide and homicide away from home

In 1980, suicides in the United States that occurred outside the victim's home state were most often committed by young single or divorced men. Hanging was the most common means of suicide. Homicide victims who were killed outside their home state were usually male, black, divorced, young, and killed by unusual (other) means or by law-enforcement officers.     

Suicide among adolescents and young adults

A closer analysis was made of all postmortems at the Benjamin Franklin Campus of the Institute of Forensic Medicine performed on juveniles who committed suicide at the age of 20 or below in the period from 1998 to 2003. A double suicide of a young couple, who met on the Internet and agreed on the procedure to be followed up to the act itself, which took place in Berlin, is presented as a representative case. The authors emphasise that in view of the danger of emulation, the media should exercise restraint in describing concrete details especially when reporting about suicides of juveniles.     

Suicide and the war in Croatia

Analyzing data from the Institute of Forensic Medicine (IFM) in Rijeka, a total of 853 suicides were recorded in a 15 years period (1986–2000). Quantitative and qualitative features of suicides were analyzed in three intervals: pre-wartime, wartime and post-wartime. In the wartime period (1991–1995), the suicide rate increased by 20.9% in comparison with the pre-war period. In the post-wartime period, the suicide rate dropped by 26.2% in comparison with the war period. The results show a significant increase in suicide rates in the wartime. During the wartime period, a large number of suicide victims under the age of forty increased—45.3% in comparison with the pre-war period and 56.6% in comparison with the post-war period. The use of firearms as a means of committing suicide quadrupled during the war in comparison with the pre-war period. The level of alcohol intoxication of perpetrators at the moment of suicide significantly increased in the wartime period. War had a direct impact on quantitative and qualitative characteristics of suicides in Croatia.     

Suicide by band saw

Suicidal injuries caused by power tools have rarely been reported in the literature. The case of a 37-year-old white male schizophrenic patient who sustained a fatal self-inflicted neck injury from a band saw, while engaging in occupational therapy, is presented. Unusual features of this type of injury as noted at postmortem examination were the extent of the wound, the absence of hesitation injuries, and the presence of grease wipe, bone dust, and sawdust within the wound.     

Suicide with acetylsalicylic acid

The authors report on a suicide of a 41-year-old man with acetylsalicylic acid. According to his own statement the man had taken about 200 tablets of Aspirin (65 g acetylsalicylic acid) and initially showed no symptoms of intoxication. 4-5 hours after ingestion he vomited twice, but clear intoxication symptoms like convulsions and cardiac arrhythmia occurred not earlier than 11 hours after ingestion. Resuscitation by the emergency physician was not successful. The chemical-toxicological analysis (HPLC-DAD) of blood samples taken in the hospital approximately 12 h after ingestion showed salicylate in concentrations of 475 mg/L to 557 mg/L. The post-mortem concentrations of salicylate were within the lethal-toxic range, i.e. 762 mg/L in heart blood and 215 mg/L in femoral blood. All tested organs contained equally lethal salicylate levels (e.g. 503 mg/L in the liver and 251 mg/L in the brain).     

Suicide on Death Row

Despite the level of supervision of inmates on death row, their suicide rate is higher than both the male prison population in the United States and the population of males over the age of 14 in free society. This study presents suicide data for death row inmates from 1978 through 2010. For the years 1978 through 2010, suicide rates on death row were higher than that for the general population of males over the age of 15 and for state prisons for all but 2 years.