Suicide and Attempted Suicide – Medical, Sociological, and Statistical Perspectives
Source: Geo Stone, Suicide and Attempted Suicide: Methods and Consequences
These study notes supply the factual backbone for an essay examining the multi-faceted nature of suicide. All data are drawn directly from Geo Stone’s text.
I. Statistical Overview and the Reality of Failure
Attempt-to-fatality ratio: only one in ten to twenty suicide attempts ends in death. The great majority of attempters survive, yet many live with permanent, disabling injuries.
Annual U.S. toll: one suicide death every eighteen minutes, totaling roughly 30,000 fatalities per year.
Underreporting: official counts are understated because stigma prompts families and physicians to classify suicides as “accidents” or “natural causes,” especially in drowning and elderly-drug-overdose cases.
II. Methods – Lethality and Medical Consequences
Lethality is governed by the speed and irreversibility of the bodily damage inflicted.
Firearms: fatality rate 84.7 percent to 91.6 percent. Head wounds are the most lethal, but survivors often suffer catastrophic facial or brain injury.
Hanging: fatality rate about 78 percent. Death usually results from carotid or jugular occlusion rather than cervical fracture.
Drowning: fatality rate about 75 percent. Asphyxia occurs when the lungs fill with fluid; in 10–30 percent of cases, laryngospasm produces a “dry lung” picture.
Drug overdose: the most frequent method attempted, yet fatality ranges only from 1.2 percent to 11.8 percent. Failure often follows vomiting or the use of low-toxicity modern antidepressants.
Cutting or stabbing: the least lethal method, with a fatality rate near 5 percent. Most failures involve superficial wrist wounds that clot before fatal exsanguination.
III. Demographic and Sociological Patterns
Gender paradox: men die by suicide at roughly four times the rate of women, even though women make more attempts. The disparity arises because men tend to select firearms or hanging, whereas women more often choose drug overdose or cutting.
Racial patterns: White Americans have approximately twice the suicide rate of Black Americans. One explanatory model is the “externalization-of-blame” hypothesis: individuals who can attribute their suffering to external oppression may direct rage outward (homicide), while those lacking an external target may turn anger inward (suicide).
Occupational risk: physicians, psychiatrists, and lawyers exhibit markedly elevated suicide rates compared with the general population.
Socio-economic factors: poverty itself is not a reliable predictor of suicide. Affluent welfare states such as Sweden and Denmark sometimes post higher rates than less affluent nations such as Mexico or Greece.
IV. Psychological and Biological Drivers
Depression versus hopelessness: although severe depression carries a lifetime suicide risk of about 15 percent, hopelessness about the future is a stronger statistical predictor of an actual attempt.
Neurobiology: low central serotonin levels correlate strongly with suicidal behavior. Genetic influence is evident in twin studies; when one identical twin dies by suicide, the co-twin’s risk rises to 19 percent, compared with essentially zero for fraternal twins.
Impulsivity: many attempts are unplanned. One study found that half of adolescent attempters had contemplated suicide for less than fifteen minutes before acting.
V. End-of-Life Issues and Rational Suicide
Rational suicide: some elderly or terminally ill individuals elect suicide not because of psychiatric illness but as a deliberate response to irreversible physical decline or intractable pain.
Quality-of-life calculus: patients may conclude that their “quality of life has dropped below zero” and therefore prefer a chosen death to prolonged institutional suffering.
Advance-directive failures: living wills and durable powers of attorney often prove ineffective because physicians are unaware of them or fear malpractice suits from surviving relatives.
Physician-assisted suicide debate: opponents warn of a “slippery slope” toward state-sanctioned killing of the “defective.” Proponents frame the practice as an extension of personal autonomy and mercy.
Reading : the book challenges the claim that suicide mostly by poor and mentally sick.
Suicide is not confined to the poor or the mentally ill, as is often assumed. Geo Stone’s Suicide and Attempted Suicide: Methods and Consequences challenges this perception, noting that the suicide rate is not reliably correlated with factors such as income level, education, or the availability of health care. Instead, the data reveals a complex interplay of social, professional, and personal factors that place even the wealthy and highly educated at significant risk.
The Paradox of Wealth and Poverty
According to Stone, poverty is not a reliable predictor of suicide. National data shows that some countries with very high per-capita income and comprehensive social welfare systems, such as Sweden and Denmark, have high suicide rates, while countries with much lower economic standards, like Greece and Mexico, have particularly low rates.
Furthermore, specific economic conditions suggest that prosperity itself can be a risk factor:
- The Prosperity Paradox: In the United States, during periods of economic prosperity, the suicide rate for the elderly tends to go down, but the rate for younger adults actually goes up.
- Externalization of Blame: Stone notes that people in oppressed or poor conditions often have an outside source to blame for their misery (such as social or economic oppression), which tends to result in outward rage or homicide. Conversely, those in wealthier, more successful environments may lack an external target for blame and instead turn their anger inward, resulting in depression and suicide.
Beyond "Mental Sickness": Rational Suicide
While mental disorders like depression and schizophrenia carry a high lifetime risk of suicide, Stone emphasizes that one doesn’t need to be “crazy” or clinically ill to consider ending their life.
-Medical Pragmatism: Many individuals, particularly the elderly or terminally ill, choose suicide as a rational response to an insoluble problem, such as a debilitating illness or the prospect of a prolonged, painful death.
- Quality of Life: Some make a calculated decision that their "quality of life" has dropped below zero due to physical or mental disintegration, preferring a chosen death over a “prolonged death” in a medical institution.
Professional and Educational Risk
Stone highlights that highly educated individuals in high-status professions have especially high suicide rates. This group includes:
* Psychiatrists, physicians, and lawyers.
* Female physicians: In Switzerland, their life expectancy is ten years shorter than that of the general female population, primarily due to self-destruction.
* Loss of Status: Highly successful individuals, particularly men in competitive roles, may experience a more profound sense of loss regarding their social standing and identity as they age and face the “accumulation of losses” (health, status, friends) associated with old age.
The "High-Risk" Profile
Statistically, the highest likelihood for suicide is found in a profile that is depressed, ill, and an elderly white Protestant male. This group represents the highest statistical risk, with a rate five times the national average, highlighting that those traditionally seen as having “achieved” social and economic success are among the most vulnerable.
Examples of Famous or Prominent Individuals
Stone cites several famous and intellectually or socially prominent individuals whose suicides illustrate specific patterns, methods, or philosophical contexts:
* Sylvia Plath – poet, carbon monoxide poisoning.
* Kurt Cobain – musician, discussed in relation to contagion/copycat suicides.
* Seneca – Roman philosopher, on choosing the time and manner of death.
* Arthur Koestler – author, suicide linked to terminal illness.
* Percy Bridgman – Nobel physicist, shot himself after cancer.
* Yukiko Okada – Japanese singer, triggered a wave of copycat suicides.
* Janet Adkins – first to use Dr. Kevorkian’s suicide machine.
* Socrates – philosophical and historical context of state-mandated death.
* Judas – religious context in the New Testament.
Context of Wealth and Status
Stone notes that wealthy and highly educated individuals are often at high risk, specifically mentioning physicians, psychiatrists, and lawyers as having particularly elevated suicide rates. Furthermore, high-status men in competitive roles (such as business or sports) may experience a more profound sense of “social loss” as they age, increasing their vulnerability.
Full Source Reference
Title: Suicide and Attempted Suicide: Methods and Consequences
Author: Geo Stone
Date: First Carroll & Graf edition published in 1999
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