Suicide and Attempted Suicide: Methods and Consequences [Hardcover]

As I read this book, I was struck that this is not so much about suicide, as about self-determination (something the Kirkus reviewer apparently missed). I began reading this out of a sense of professional obligation, but quickly found the book surprisingly interesting. There is a wealth of detail presented, with the solid and sobering information relieved by the often wickedly amusing (albeit occasionally warped) footnotes.

While the "how to" sections are quite graphic, the reader can readily find areas of interest through the clear chapter subheadings, and thereby skip those that might be either too gory or too technical. But the detail presented is here out of necessity-for how else can the individual make an informed decision?

This book clearly does not advocate suicide. It provides individuals with the information to make a better decision about their future. For example, if someone wishes to make a gesture, it gives them guidance about appropriate choices that will not leave them off in an even worse state.

As a physician, I was a bit put off by the author's criticism of docs. I think he underestimates the chilling effect the threat of professional criticism and repercussions has. Of course, there is also the effect fear of more serious legal action (eg charges of murder) has on the willingness of physicians to be more active in this area. This extends to efforts in the area of pain relief (such as by providing adequate doses of morphine) which are often inappropriately criticized as excessive. Also, as he notes, docs have been very poorly educated regarding pain control.

I highly recommend this thorough reference work, the most definitive work I have seen on this controversial subject. It is far more than a "how to" manual. It is both a reference book, as well as a thoughtful resource, providing objective information, historical information, and perspective on this difficult topic.

The first half of the book touches on a wide range of suicide topics: history of suicide, the legal situation, treatment options, terminal illness, philosophical issues, euthanasia and assisted suicide. The information is interesting and well enough presented, but tries to cover too much ground in too few pages. A reader unfamiliar with this material will find it a reasonable, though patchy, introduction that can be followed up from the author's well-chosen "suggested reading" list.

The heart of the book is the second half, where it discusses suicide methods and their consequences in clinical detail. This treatment will surely be controversial, since the author provides "how to" (and "how not to") information that can be used either to commit suicide or to carry out a suicidal gesture.

I've seen only one other book that takes a similar approach, Derek Humphry's "Final Exit" to which this book will inevitably be compared. "Suicide and Attempted Suicide" is the far more comprehensive and detailed work, which is both its strength and its weakness. There is no better---in fact no other---book that discusses the variety of suicide methods in any significant depth. However the large amount of information comes at a cost: a suicidal reader may have a hard time extracting the data he wants from the mass of data he doesn't need. Similarly, the casual reader will probably find the quantity and details of evidence overwhelming.

The writing style is rather pedestrian, which doesn't detract much from a book of this sort, but occasionally slips into "medicalese" which does. On the other hand there are quite a few interesting and informative asides and digressions. These range from early Christian theological disputes, to minimizing heat loss in marine mammals, to the words of Jim Jones (remember Jonestown?) at an anti-suicide rally in San Francisco.

Given the sometimes-gory descriptions, the absence of photos and drawings is a bit surprising. However the author says in a "note to the reader" that these will be available on his website.

Overall, flaws and all, I highly recommend this book for anyone who has seriously considered suicide, or is presently contemplating it. With more reservations---the first half has too little detail, the second half too much---I would recommend it for general readers as well.