When we use the term “self-deliverance” or “rational suicide” we indicate suicide as a response to unbearable, unrelievable suffering (in contrast to regrettable suicides due to a temporary emotional or psychological disturbance).
Yet the history of self-deliverance shows people do make mistakes: either in the practice or the choice of methods. This can bring considerable, unnecessary suffering for the person concerned and those left behind.
In the first category of methods, helium seems to take first place. Both science and direct observation demonstrates it to be painless – if the person concerned has mastered the very basic requirements – and technically speaking almost impossible to get wrong. In the Five Last Acts / Exit Path series, we detail three other methods that involve varying levels of difficulty, and then a long chapter on methods such as refusing food and liquids, which are complex, unsuited to everyone, yet still possible for some people if enough care is taken. Since the whole objective is to reduce suffering when all other options have been exhausted (palliative care, for instance cannot relieve all suffering) it seems necessary to point out those categories that are downright unpleasant and unreliable to help to dissuade anybody from using them.
Foremost among bad methods is probably paracetamol (acetaminophen). Paracetamol remains the most common cause of acute liver failure in both the United States and the United Kingdom. The large number of suicide attempts do not result in death but a large proportion result in liver failure. This can mean long, distressing symptoms and long, painful illness while awaiting a possible liver transplant. Additionally, many people who overdose feel the ‘effects have worn off’ after a couple of days and this is exactly the time that irreversible damage can start to set in. If you are reading this and have just taken a paracetamol overdose, it is essential that you find emergency treatment immediately.
There are many drugs that can kill you: but very few that will do so reliably.
Halfway between ‘bad’ and ‘weird’ are types of suicide often connected with considerable media coverage. A high-profile death from slit wrists, drowning or (one of the latest ‘crazes’) hydrogen sulphide, frequently ignores the amount or risk of suffering involved, the many failures, or the dangers and suffering to other people. Many people falsely assume that if they swallow enough prescription medicines popularly associated with death-from-overdose that they, too, will die: whereas the truth is that most of them will simply make themselves more ill. (‘Overdose’ in popular terminology, simply means a dose that can in some cases be dangerous and cause serious symptoms or even death, not that it will in all or even most cases).
Then there is the ‘weird’ category. These appeal to people going to extreme lengths to find a difficult but sometimes workable method of ending their life. These include making your own sleeping drugs, obtaining veterinary supplies illegally from abroad, or sourcing drugs over the Internet or from third-world countries. Refusing food and drink should also come into this category. Dying by such means is possible but difficult, in spite of what people will tell you. Popular guides recommending refusal of food and liquids as the ‘best’ method of suicide, rely on idealized or clinically controlled cases – for instance in countries allowing assisted suicide – where there was ongoing medical support. It is easy to look at ‘successes’ and gloss over the horrific failures. No-one should have to suffer terribly at the end of life.
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