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Bleeding
Main article: Bleeding
See also: Self mutilation
Suicide by 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.

Cutting wrists
This method attempts to self-inflict a class IV haemorrhage by traumatic bleeding. The technique may be performed with a single or multiple incisions and/or lacerations at the wrist(s) with the aim of tearing open arteries and/or veins; the radial artery, ulnar artery, the cephalic vein and basilic vein are obvious candidates. The body will attempt to remedy and compensate for the problem by increased cardiac rate and vasoconstriction. The victim will experience a drop in blood pressure, increased heart rate, somatic pain and peripheral perfusion. In the case of a failed suicide attempt, the patient 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 and/or motor ability.[3] As in any class IV haemorrhage, aggressive resuscitation required to prevent death of the patient; standard emergency bleeding control applies for pre-hospital treatment, namely elevation of the wound and direct pressure. Application of tourniquets should be reserved for professionals if used at all.

Drowning

A homeless girl contemplates drowning herself.
Main article: Drowning
Suicide by drowning is the act of deliberately submerging oneself in water or other liquid and staying there long enough to prevent breathing and deprive the brain of oxygen. Due to the body's natural tendency to come up for air, drowning attempts often involve a heavy object, to circumvent this reflex. If the drowning is stopped before death, oxygen deprivation can cause brain damage.
Drowning is among the least common methods of suicide, typically accounting for less than 2% of all reported suicides in the United States. [4]

Suffocation
Suicide by suffocation is the act of inhibiting one's ability to breathe or to limit the oxygen uptake while breathing, which causes asphyxia (by all methods excluding drowning). This may involve an exit bag, a plastic bag tightly sealed over the head, or confinement in an enclosed space without oxygen. These attempts usually involve using depressants to make the user pass out before oxygen deprivation which prevents any escape instinct or panic. Inert gases, such as helium, argon and nitrogen, are sometimes used, because breathing inert gas causes loss of consciousness and death without ever experiencing air hunger.

Electrocution
Suicide by electrocution involves using a lethal electric shock to kill oneself.

Jumping
Many people have committed suicide by jumping or falling from high altitudes (e.g., from a cliff, dam, or bridge). Also, many people have committed suicide by defenestration whereby they throw themselves out of a high window.
Jumping is among the least common methods of committing suicide (typically less than 2% of all reported suicides in the United States for 2005). [4]

Firearms
A common suicide method is to use a firearm. Generally the bullet will be aimed at point-blank range often at the head or less commonly into the mouth or pointed at the chest.
Research published in the New England Journal of Medicine and the National Academy of Science found an association between household firearm ownership and gun suicide rates,[5][6] though a study by one researcher did not find a statistically significant association between household firearms and gun suicide rates,[7] except in the suicides of children aged 5–14.[7] During the 1980s and early 1990s, there was a strong upward trend in adolescent suicides with a gun,[8] as well as a sharp overall increase in a suicides among those age 75 and over.[9]
In the United States, firearms remain the most common method of suicide, accounting for 53.7% of all suicides committed during 2003.[10]
Research also indicates no association vis-à-vis safe-storage laws of guns that are owned, and gun suicide rates, and studies that attempt to link gun ownership to likely victimology often fail to account for the presence of guns owned by other people.[11][12] Researchers have shown that safe-storage laws do not appear to affect gun suicide rates or juvenile accidental gun death.[11][12]

Hanging

Suicide by hanging.
Main article: Hanging
Hanging is the prevalent means of suicide in pre-industrial societies and is more common in rural areas than in urban areas.[13]
Unlike the traditional capital punishment by hanging on gallows where the condemned falls through the release of a trap door and death is relatively quick due to breaking of the neck, a suicide victim may not have made provision for a sufficient drop and thus instead suffers a much slower death by strangulation.

Vehicular impact
Some people commit suicide by deliberately placing themselves in the path of a, usually large and fast-moving, vehicle, resulting in a fatal impact.

Rail
Some may throw themselves in directly front of an oncoming train, or drive an automobile onto the tracks and sit inside while they wait for the locomotive to smash into it. [14]. Suicide by being hit by a train has a 10% survival rate; a failed attempt typically results in severe injuries, including massive fractures, amputations, and concussion, usually leading to permanent brain damage, and physical disability.
In some European countries with highly developed rail networks and very strict gun control laws, such as Germany and Sweden, railway-related suicide is considered a social problem, and extensive research has been carried out into this type of suicide. According to these studies, most suicides occur in densely populated areas, but away from train stations and terminal points. Wooded areas, curves and tunnels are especially plagued. Most suicides occur at evening or night time when the driver's visibility is reduced, reducing the chance of a failed suicide.
People who commit suicide in this manner usually stay at or around the place for the suicide for an extended period of time before the actual suicide.[citation needed] Unlike on underground railways, in suicides involving above ground railway lines the victim will often simply stand or lie on the tracks, waiting for the arrival of the train. As the trains usually travel at high speeds (usually between 80 and 200 km/h)), the driver is usually unable to bring the train to a halt before the collision. This type of suicide may be traumatizing to the driver of the train and may lead to post-traumatic stress disorder.
In Germany, 10% of all suicides occur in this manner. Germany is the country where railway-related suicides account for the largest share of overall suicides. Railway-related suicides are also common in Britain and Japan.[citation needed]
Methods to reduce the number of rail-related suicides include CCTV surveillance of stretches where suicides frequently occur, often with direct links to the local police or surveillance companies. This enables the police or guards to be on the scene within minutes after the trespassing was noted. Public access to the tracks is also made more difficult by erecting fences. Trees and bushes are cut down around the tracks in order to increase driver visibility.

Subway
Jumping in front of an oncoming subway train has a 67% survival rate, much higher than the 10% survival rate for rail-related suicides. This is most likely because trains traveling on open tracks travel relatively quickly, whereas trains arriving at a subway station are decelerating so that they can stop and board passengers. Jumping in front of an underground train is a common form of suicide in many larger cities, such as London.[citation needed]
Different methods have been used in order to decrease the number of suicide attempts in the underground: a deep drainage pit halves the likelihood of fatality. Separation of the passengers from the track by means of a partition with sliding-doors is being introduced in some stations, but is expensive.[15]

[edit] Traffic collisions
Some car accidents are in fact suicides. This especially applies to single-occupant, single-vehicle accidents. "The automobile lends itself admirably to attempts at self-destruction because of the frequency of its use, the generally accepted inherent hazards of driving, and the fact that it offers the individual an opportunity to imperil or end his life without consciously confronting himself with his suicidal intent"[16].
The real percentage of suicides among car accidents is not reliably known; studies by suicide researchers tell that "vehicular fatalities that are suicides vary from 1.6% to 5%". [17] Some suicides are misclassified as accidents because suicide must be proven; "It is noteworthy that even when suicide is strongly suspected but a suicide note is not found, the case will be classified an 'accident.'"[17]
Some researchers believe that suicides disguised as traffic accidents are far more prevalent than previously thought. One large-scale community survey among suicidal persons provided the following numbers: "Of those who reported planning a suicide, 14.8% (19.1% of male planners and 11.8% of female planners) had conceived to have a motor vehicle “accident”... Of all attempters, 8.3% (13.3% of male attempters) had previously attempted via motor vehicle collision."[18]

[edit] Poisoning
Suicide can be committed by using fast-acting poisons, such as hydrogen cyanide, or substances which are known for their high levels of toxicity to humans.[19] For example, most of the people of Jonestown, in northwestern Guyana, died when Jim Jones, the leader of a religious sect, organized a mass suicide by drinking a cocktail of diazepam and cyanide in 1978.[20] Sufficient doses of some plants like the Belladonna family, castor beans, Jatropha curcas and others, are also toxic. Poisoning through the means of toxic plants however is usually less quick and relatively painful.[21] Poisoning by farm chemicals is very common among females in the Chinese countryside, and is regarded as a major social problem in the country.[citation needed]

[edit] Drug overdosing
Overdosing is a method of suicide which involves taking medication in doses greater than the indicated levels, or in a combination that will interact to either cause harmful effects or increase the potency of one or other of the substances.
A peaceful overdose is the preferred method of dignified dying among members of right to die societies. A poll among members of right to die society Exit International has shown that 89% would prefer to take a pill, rather than use a plastic exit bag, a CO generator or use 'slow euthanasia'.[22]
Reliability of this method highly depends on chosen drugs and additional measures like use of antiemetics to preventing vomiting. Average fatality rate for overdoses in the US is estimated to be 1.8% only[23]. At the same time, assisted suicide group Dignitas reported no single failure among 840 cases (fatality rate 100%), where an overdose of a former sleeping pill active agent Nembutal was used in combination with antiemetic drug[24].
While barbiturates (such as Seconal or Nembutal) have long been considered a safe option for suicide, they are becoming increasingly difficult for potential suicide victimes to acquire. Dutch right to die society WOZZ proposed several safe alternatives to barbiturates for use in euthanasia.[25]
However, a typical drug overdose uses random prescription and over-the-counter substances. In this case death is uncertain, and an attempt may leave a person alive but with severe organ damage, although that itself may in turn eventually prove fatal. Drugs taken orally may also be vomited back out before being absorbed. Considering the very high doses needed, vomiting or losing conciousness before taking enough of the active agent is often a major problem for people attempting this.
Analgesic overdose attempts are among the most common[26] due to easy availability of over-the-counter substances. Overdosing may also be performed by mixing medications in a cocktail with one another, or with alcohol or illegal drugs. This method may leave confusion over whether the death was a suicide or accidental, especially when alcohol or other judgment-impairing substances are also involved and no suicide note was left behind.

[edit] Carbon monoxide poisoning
Main article: Carbon monoxide poisoning
A particular type of poisoning involves inhalation of high levels of carbon monoxide. Death usually occurs through hypoxia. In most cases carbon monoxide (CO) is used because it is easily available as a product of incomplete combustion; for example it is released by cars and some types of heaters.
Carbon monoxide is a colorless and odorless gas, so its presence cannot be detected by sight or smell. It acts by binding preferentially to the hemoglobin in the victim's blood, displacing oxygen molecules and progressively deoxygenating the blood, eventually resulting in the failure of cellular respiration, and death.
In the past, before air-quality regulations and catalytic converters, suicide by carbon monoxide poisoning would often be achieved by running a car's engine in a closed space such as a garage, or by redirecting a running car's exhaust back inside the cabin with a hose. Motor car exhaust may have contained up to 25% carbon monoxide. However, catalytic converters found on all modern automobiles eliminate over 99% of carbon monoxide produced.[27] As a further complication, the amount of unburned gasoline in emissions can make exhaust unbearable to breathe well before losing consciousness.
The incidence of suicide by carbon monoxide poisoning through burning charcoal, such as a barbecue in a sealed room, appears to have risen. This has been referred to by some as "death by hibachi".[28]
Carbon monoxide is extremely dangerous to bystanders and people who may discover the body, so "Right to Die" advocates like Philip Nitschke recommend the use of safer alternatives like nitrogen, for example in his EXIT euthanasia device.

[edit] Detergent-related suicide
Detergent-related suicide involves mixing household chemicals to produce hydrogen sulfide or other poisonous gases.[29]