Suicide methods

A suicide method is any means by which a person completes suicide, purposely ending their life. Suicide by cutting might involve exsanguination, infarction, septic shock from certain ruptures such as appendicitis, or drowning from a lung contusion. Exsanguination involves reducing the volume and pressure of the blood to below critical levels by inducing massive blood loss. It is usually the result of damage inflicted on arteries. The carotid, radial, ulnar or femoral arteries may be targeted. Death may occur directly as a result of the desanguination of the body or via hypovolemia, wherein the blood volume in the circulatory system becomes too low and results in the body shutting down. Those considering a suicide attempt, or trying out the weapon to ascertain its effectiveness, may first make shallow cuts, referred to as hesitation wounds or tentative wounds in the literature. They are often non-lethal, multiple parallel cuts. Wrist cutting is sometimes practiced with the goal of self-harm and not suicide; however, if the bleeding is copious or allowed to continue unchecked, cardiac arrhythmia, followed by severe hypovolemia, shock, circulatory collapse or cardiac arrest, and death may ensue, in that order. In the case of a non-fatal suicide attempt, the person may experience injury of the tendons of the extrinsic flexor muscles, or the ulnar and median nerves which control the muscles of the hand, both of which can result in temporary or permanent reduction in the victim's sensory or motor ability or also cause chronic somatic or autonomic pain. As in any class IV hemorrhage, aggressive resuscitation is required to prevent death of the patient; standard emergency bleeding control applies for pre-hospital treatment. Death from dehydration can take from several days to a few weeks. This means that unlike many other suicide methods, it cannot be accomplished impulsively. Those who die by terminal dehydration typically lapse into unconsciousness before death, and may also experience delirium and deranged serum sodium. Discontinuation of hydration does not produce true thirst, although a sensation of dryness of the mouth often is reported as 'thirst.' The evidence this is not true thirst is extensive and shows the ill feeling is not relieved by giving fluids intravenously, but is relieved by wetting the tongue and lips and proper care of the mouth. Patients with edema tend to take longer to die of dehydration because of the excess fluid in their bodies. Terminal dehydration has been described as having substantial advantages over physician-assisted suicide with respect to self-determination, access, professional integrity, and social implications. Specifically, a patient has a right to refuse treatment and it would be a personal assault for someone to force water on a patient, but such is not the case if a doctor merely refuses to provide lethal medication. But it also has distinctive drawbacks as a humane means of voluntary death. One survey of hospice nurses found that nearly twice as many had cared for patients who chose voluntary refusal of food and fluids to hasten death as had cared for patients who chose physician-assisted suicide. They also rated fasting and dehydration as causing less suffering and pain and being more peaceful than physician-assisted suicide. Other sources, however, have noted very painful side effects of dehydration, including seizures, skin cracking and bleeding, blindness, nausea, vomiting, cramping and severe headaches. There can be a fine line between terminal sedation that results in death by dehydration and euthanasia. There have been documented cases of deliberately contracting a fatal disease such as HIV/AIDS as a means of suicide.