name | Suicide |
---|---|
icd10 | –| ICD9 | MedlinePlus 001554 |
emedicinesubj | article |
emedicinetopic | 288598 |
meshname | Suicide |
meshnumber | F01.145.126.980.875 }} |
Suicide (Latin suicidium, from sui caedere, "to kill oneself") is the act of a human being intentionally causing his or her own death. Suicide is often committed out of despair, or attributed to some underlying mental disorder which includes depression, bipolar disorder, schizophrenia, alcoholism and drug abuse. Pressures or misfortunes such as financial difficulties or troubles with interpersonal relationships may play a significant role.
Over one million people die by suicide every year. The World Health Organization (WHO) estimates that it is the thirteenth-leading cause of death worldwide and the National Safety Council rates it sixth in the United States. It is a leading cause of death among teenagers and adults under 35. The rate of suicide is higher in men than in women. There are an estimated 10 to 20 million non-fatal attempted suicides every year worldwide.
Views on suicide have been influenced by broader cultural views on existential themes such as religion, honor, and the meaning of life. The Abrahamic religions consider suicide an offense towards God due to religious belief in the sanctity of life. In the West it was often regarded as a serious crime. Conversely, during the samurai era in Japan, seppuku was respected as a means of atonement for failure or as a form of protest. In the 20th century, suicide in the form of self-immolation has been used as a form of protest, and in the form of kamikaze and suicide bombing as a military or terrorist tactic. Sati is a Hindu funeral practice in which the widow would immolate herself on her husband's funeral pyre, either willingly or under pressure from the family and in-laws.
Medically assisted suicide (euthanasia, or the right to die) is currently a controversial ethical issue involving people who are terminally ill, in extreme pain, or have (perceived or construed) minimal quality of life through injury or illness. Self-sacrifice for others is not always considered suicide, as the goal is not to kill oneself but to save another; however, Émile Durkheim's theory termed such acts "altruistic suicide."
The motivation for the murder in murder–suicide can be purely criminal in nature or be perceived by the perpetrator as an act of care for loved ones in the context of severe depression.
In approximately 75% of completed suicides the individuals had seen a physician within the prior year before their death, 45%-66% within the prior month. Approximately 33% - 41% of those who completed suicide had contact with mental health services in the prior year, 20% within the prior month.
Conservative estimates are, that 10% of all psychological symptoms may be due to medical reasons, with the results of one study, suggesting that about 50% of individuals with a serious mental illness have general medical conditions that are largely undiagnosed and untreated and may cause or exacerbate psychiatric symptoms (Rothbard AB,et al. 2009)
Problem gambling is often associated with increased suicidal ideation and attempts compared to the general population.
Early onset of problem gambling increases the lifetime risk of suicide. However, gambling-related suicide attempts are usually made by older people with problem gambling. Both comorbid substance use and comorbid mental disorders increase the risk of suicide in people with problem gambling.
A 2010 Australian hospital study found that 17% of suicidal patients admitted to the Alfred Hospital's emergency department were problem gamblers.
Disgraced Roman aristocrats were sometimes allowed to commit suicide to spare themselves a trial and penalties against their families. An example of this was Emperor Nero who reportedly committed forced suicide facing a revolt and execution. A more modern case is Erwin Rommel, who was found to have foreknowledge of the July 20 Plot on Hitler's life. Rommel was threatened with public trial, execution and reprisals on his family unless he killed himself, which he did.
As Germany faced inevitable defeat in mid–1945, there were unprecedented waves of suicides amongst Germans in the final weeks of the war (see Mass suicides in 1945 Nazi Germany) These included many senior figures in the regime (e.g., Adolf Hitler, Heinrich Himmler and Joseph Goebbels), as well as many ordinary people who were fearful of suffering atrocities at the hands of the advancing Red Army. The behaviour of Soviet troops also played a role, as many Germans committed suicide to avoid rape or out of shame at having been raped.
Emperor Tewodros II of Ethiopia, facing defeat at the hands of the British expeditionary force committed suicide rather than be taken captive, announcing ""It is finished! Sooner than fall into his hands I will kill myself".
According to a report by Tata Institute of Social Sciences in Mumbai, 150,000 debt-ridden farmers in India have committed suicide in the past decade.
One study found that a lack of social support, a deficit in feelings of belongingness and living alone were crucial predictors of a suicide attempt. One study found that among prison inmates, suicide was more likely among inmates who had committed a violent crime.
Whether or not exposure to suicide is a risk factor for suicide is controversial. A 1996 study was unable to find a relationship between suicides among friends, while a 1986 study found increased rates of suicide following the televisation of news stories regarding suicide.
[[File:Self-inflicted injuries world map - Death - WHO2004.svg|thumb|Deaths for self inflicted injuries per 100,000 inhabitants in 2004. ]]
Suicide is the tenth leading cause of death worldwide According to 2007 data, suicides in the U.S. outnumber homicides by nearly 2 to 1 and ranks as the 11th leading cause of death in the country, ahead of liver disease and Parkinson's. Worldwide suicide rates have increased by 60% in the past 50 years, mainly in the developing countries.
A disproportionate amount of suicides in the world occur in Asia, which is estimated to account for up to 60% of all suicides. According to the WHO, China, India and Japan may account for 40% of all world suicides.
In the U.S., the rate of suicide is increasing for the first time in a decade. The increase in the overall suicide rate between 1999 and 2005 has been due primarily to an increase in suicides among whites aged 40–64, with white middle-aged women experiencing the largest annual increase.
In the United States, individuals who express the intent to harm themselves may be automatically determined to lack the present mental capacity to refuse treatment, and can be transported to the emergency department against their will. An emergency physician will determine whether inpatient care at a mental health care facility is warranted. This is sometimes referred to as being "committed". A court hearing may be held to determine the individual's competence. In most states, a psychiatrist may hold the person for a specific time period without a judicial order. If the psychiatrist determines the person to be a threat to himself or others, the person may be admitted involuntarily to a psychiatric treatment facility. This period is usually of three days duration. After this time the person must be discharged or appear in front of a judge. As in any judicial proceeding this person has a right to legal counsel.
Switzerland has recently taken steps to legalize assisted suicide for the chronically mentally ill. The high court in Lausanne, in a 2006 ruling, granted an anonymous individual with longstanding psychiatric difficulties the right to end his own life. At least one leading American bioethicist, Jacob Appel of Brown University, has argued that the American medical community ought to condone suicide in certain individuals with mental illness.
In Brazil, if the help is directed to a minor, the penalty is applied in its double and not considered as homicide. In Italy and Canada, instigating another to suicide is also a criminal offense. In Singapore, assisting in the suicide of a mentally handicapped person is a capital offense. In India, abetting suicide of a minor or a mentally challenged person can result in a maximum 1 year prison term with a possible fine.
In Germany, the following laws apply to cases of suicide:
Judaism focuses on the importance of valuing this life, and as such, suicide is tantamount to denying God's goodness in the world. Despite this, under extreme circumstances when there has seemed no choice but to either be killed or forced to betray their religion, Jews have committed individual suicide or mass suicide (see Masada, First French persecution of the Jews, and York Castle for examples) and as a grim reminder there is even a prayer in the Jewish liturgy for "when the knife is at the throat", for those dying "to sanctify God's Name". (See: Martyrdom). These acts have received mixed responses by Jewish authorities, regarded both as examples of heroic martyrdom, whilst others state that it was wrong for them to take their own lives in anticipation of martyrdom.
Suicide is not allowed in Islam; however, martyring oneself for Allah (during combat) is not considered the same as completing suicide. Suicide in Islam is seen as a sign of disbelief in God.
In Hinduism, suicide is generally frowned upon and is considered equally sinful as murdering another in contemporary Hindu society. Hindu Scriptures state that one who commits suicide will become part of the spirit world, wandering earth until the time one would have otherwise died, had one not committed suicide. However, Hinduism accept a man's right to end one's life through the non-violent practice of fasting to death, termed Prayopavesa. But Prayopavesa is strictly restricted to people who have no desire or ambition left, and no responsibilities remaining in this life. Jainism has a similar practice named Santhara. Sati, or self-immolation by widows was prevalent in Hindu society during the Middle Ages.
A narrower segment of this group considers suicide something between a grave but condonable choice in some circumstances and a sacrosanct right for anyone (even a young and healthy person) who believes they have rationally and conscientiously come to the decision to end their own lives. Notable supporters of this school of thought include German pessimist philosopher Arthur Schopenhauer, Friedrich Nietzsche, and Scottish empiricist David Hume. Bioethicist Jacob Appel has become the leading advocate for this position in the United States. Adherents of this view often advocate the abrogation of statutes that restrict the liberties of people known to be suicidal, such as laws permitting their involuntary commitment to mental hospitals.
Pea aphids, when threatened by a ladybug, can explode themselves, scattering and protecting their brethren and sometimes even killing the lady bug. Some species of termites have soldiers that explode, covering their enemies with sticky goo. There have been anecdotal reports of dogs, horses, and dolphins committing suicide, but with little conclusive evidence. There has been little scientific study of animal suicide.
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