INDEX

AA (Alcoholics Anonymous), 62, 73–74, 103, 109, 121, 324, 522

AAS (American Association of Suicidology), 116, 118, 201, 258, 304, 309, 310, 350–51, 417, 524

Abimelech (biblical figure), 151

abortion, 144, 317

Abram, Morris, 368

accidents, 269–70, 273–74

accidie, 162

active listening, 287

Addison, Joseph, 166

Adkins, Janet, 376, 378, 379, 382, 384, 385, 399, 572n

Adler, Alfred, 188

Admiraal, Pieter, 390–91

“Admonitions of a Sage,” 129–31

adolescent depression, 41–43, 321, 322, 331

adolescent suicide, 15–126

of African Americans, 252–53

antidepressant medication and, 3, 57, 319, 321–22

attempts vs. completion of, 38–39, 95–97, 438

case histories, 15–37, 59–79, 93–94, 97–110, 121–26, 518–20

causality of, 39–58

childhood trauma and, 45, 60, 61, 252–53

clusters of, 2, 11, 39, 78–83, 85–86, 87, 92, 114–15, 116, 259

cultural influences on, 53–55, 86–92, 139, 542n–43n

depression as factor in, 41–43, 322

home location of, 95

as impulsive act, 48–49

in Japan, 139

of males vs. females, 38, 39, 97, 260, 264

mother-infant bonding issues linked with, 46–47

of Native Americans, 259, 260

parental loss and, 43–44

parents’ divorces after, 125

peer reactions to, 31–34, 36, 37, 81, 123–24, 126

prevention programs on, 2, 32, 37, 79, 111–20, 259, 260–61

psychiatric hospitalization and, 63–65, 71–72, 103–4, 105–10

rates of, 2, 3, 11, 37–39, 51, 56–57, 197, 252, 314, 539n

serotonin dysfunction in, 47–48

sexual-identity concerns and, 48, 66, 101–2, 264–66

substance abuse and, 46, 48, 62, 73–74, 93, 99–100, 101, 103–5, 106

triggering events of, 48–49

Viennese psychoanalytic panel on, 86, 188

adrenaline junkies, 275

advance directives, 371–72

adversity, responses to, 222, 256

AEA (autoerotic asphyxiation), 83

Aedesius, 152

African Americans, 234–35, 251–58, 263, 557n–58n

African Homicide and Suicide (Bohannan), 85

African tribal cultures, 131–32, 133, 135, 364

Age of Reason, The (Paine), 87

aggression, psychoanalytic theories of, 188, 189–90

aggressive behavior:

antidepressants in reduction of, 320

mass media violence coverage vs., 542n

serotonin function vs., 196

suicide as, 224–26, 239

suppression of, 245

in young male suicides, 47–48

Ahithophel (biblical figure), 152

AIDS, 38, 263–64, 270, 384, 386–87, 429

air hunger, 406

Alabama Indians, 132, 259

Alaska, high suicide rate of, 247

Albigensians, 155

alcohol abuse, 41, 46, 271–73

Alcoholics Anonymous (AA), 62, 73–74, 103, 109, 121, 324, 522

Alexander, Amy, 255, 257

Alexander, Leo, 421

Alexander III (the Great), King of Macedon, 136

Allen, Nancy, 351

Al-Queda, 186

ALS (amyotrophic lateral sclerosis), 382

altruistic suicide, 1, 186–87

Alvarez, A.:

on Donne’s suicidality, 161, 162

on family history of suicide attempts, 230, 496

on history of suicide, 85, 268

on impulsive behavior, 445

on logic of suicide, 229–30, 250

on painless methods, 234

suicide attempted by, 230

on triggering events, 49

Alzheimer’s disease:

mercy killing and, 570n

suicide of people with, 378, 575n

Amboyna, 431

Ambrose, Saint, 548n

American Association of Suicidology (AAS), 116, 118, 201, 258, 304, 309, 310, 350–51, 417, 524

American Psychiatric Association (APA), 262, 326–27, 438

Americans with Disabilities Act (1990), 389

Amish, suicide study of, 198

amygdala, 194

amyotrophic lateral sclerosis (ALS), 382

Anatomy of Melancholy, The (Burton), 162, 267–68

Anatomy of Suicide, The (Winslow), 179

anesthetics, 366, 416, 490, 574n

Angell, Marcia, 368, 427, 442

anger:

of suicidal persons, 491

of survivors, 491–92, 500, 520

animals:

bereavement behavior exhibited by, 489

euthanasia of, 366, 415, 436

Anna Karenina (Tolstoy), 353

anomic suicide, 187, 188, 255, 551n

anorexia nervosa, 273

Anthony, Saint, 153

anticonvulsant medications, 320, 564n

antidepressants, 318–23

compliance rates on, 320, 564n

development of, 3, 195, 318–20

dosage levels of, 320

efficacy of, 320–21

in Japan, 143

lethal potential of, 320

pediatric prescriptions of, 3, 57, 319, 321–22

psychotherapy vs., 318, 322–23, 439

rollback phase in use of, 320

SSRIs, 3, 143, 192, 319, 320–23, 331

suicidality allegedly induced by, 3, 57, 321–22, 539n

antiretroviral medications, 264

anxiety attacks, 490

Aokigahara-Jukai, 342, 344

APA (American Psychiatric Association), 262, 326–27, 438

Appointment with Doctor Death (Betzold), 572n

April, highest suicide rates in, 249

Arango, Victoria, 191–92, 193, 197, 200–201

Arapaho, 259

Archer, William, 444, 445

Aristotle, 146, 156, 415

Arizona, suicide rate of, 247

Arluke, Arnold, 437

Arnold, Alice, 300–301

Aronowitz, Eugene, 79

Arras, John, 445

Arroyo Seco Bridge, 342

Artaud, Antonin, 226

“Arts, The” (Hippocrates), 365

Åsberg, Marie, 195–96, 200

asceticism, 153, 154, 547n, 560n

Asimos, Chrisula, 324

assimilation, cultural, 248, 251, 256–57

assisted suicide, see euthanasia

atonement:

Hebrew scapegoat ritual of, 492

suicide as, 139, 223

Aubrey of Wystelesburg, 467

Auenbrugger, Leopold, 179

Auer (German physician), 422

Augustine, Saint, 154, 156, 203, 414

Augustus, Emperor of Rome, 365

Auschwitz, 222

Australia:

aboriginal tribes of, 275

voluntary euthanasia in, 410, 573n

Austria:

suicide attempts prosecuted in, 164

suicide rates of, 187, 246

autoerotic asphyxiation (AEA), 83

auto fatalities, 273–74, 354, 542n

autonomy, 418–19, 424, 425, 435–36

see also free will

AUTONOMY, Inc., 435

Aymara Indians, 365

Aztecs, 135

baby boomers, 432

Bacon, Francis, 366

Baechler, Jean, 277, 560n

Baganda, 131–32

balance-sheet suicide (Bilanz-Selbstmord), 417

Baldessarini, Ross, 319, 320

Baldwin, James, 253

Balogh, David, 92

Baltus, Ellen, 388

Bancroft, Anne, 305

Bannaus, 132

baptism, 152

barbiturate suicides:

access limitations on, 346–47, 392, 408

in euthanasia, 375, 376, 385, 386–87, 388, 392–93, 399, 402, 408, 410, 411

plastic-bag methods vs., 399, 408, 411

Barbusse, Henri, 270

Barnard, Christiaan, 374, 375, 571n

Barnes, Donna Holland, 557n–58n

Barnett, Isobel, 223

Barraclough, Brian, 438

Barrington, Mary Rose, 436

Barron, Bailey, 512, 513, 516

Barron, Fredi, 513, 525

Barron, Stanley, 512, 525

Bartling, William, 571n

Batavia, Andrew, 435–36

Battie, William, 178

Battin, Margaret Pabst, 419, 442, 444–45

Beachy Head, cliffs at, 341

Beaumont, Louis de, 164

Beccaria, Cesare, 172

Beck, Aaron, 43, 314, 323

Beck Scale for Suicide Ideation (SSI), 314

Beddoes, Thomas, 175

befriending, 294

behavioral psychological therapies, 314, 323

Belarus, suicide rate of, 246

Belgium, euthanasia practices legalized in, 573n

Bell Jar, The (Plath), 229

Benin, sacrificial suicides in, 135

Bentham, Jeremy, 167

Berdyaev, Nicholas, 415

Bergman, Ingmar, 518

Berman, Alan, 49, 50, 54, 543n

Berryman, John, 495

Best in Show, 523

Betzold, M., 572n

Beyle, François-Marie (Voltaire), 167, 168–69, 174, 469

Biathanatos (Donne), 161–62, 165, 267, 420

Bible, 151–52, 267, 472

Bicêtre mental institution, 180, 334

Bilanz-Selbstmord (balance-sheet suicide), 417

Bills of Mortality, 182

Billy Budd (Melville), 569n

Binding, Karl, 367

Binet-Sanglé (French physician), 444

Binstock, Robert, 433

Binswanger, Ludwig, 531

bipolar disorder (manic depression):

in children, 42, 541n

dialectical behavior therapy for, 323

failure of treatment for, 492

medications for, 64, 229, 318, 319–20, 353

substance abuse and, 272

suicidality vs., 41

black bile, 194

Black Death, 84, 187

Black Panthers, 254

Blackstone, William, 173, 468

Blair, Robert, 174

blame, 492

bleeding, medical technique of, 271

blister packaging, 347

Blumenthal, Susan, 79, 200

Bohannan, Paul, 85, 364

Boismont, Brierre de, 181, 183, 184

Boldt, Menno, 354

Bolivia, Aymara Indians of, 365

Bolton, Edmund, 267

Bolton, Iris, 475

Bonger, W. A., 562n

Booth, William, 293

borderline personality disorder, 41, 323, 351

Borneo, suicide beliefs of, 133

Bostrom, Alan, 336

Boswell, James, 173–74

Boudin, 184

Bowlby, John, 46–47, 489

Boyd, Jeffrey, 347, 348

Boys in the Band, The (Crowley), 261

Bracton, Henry de, 156

Brady Bill (1994), 56–57, 348

brain damage, 367, 369, 372

brain development, childhood trauma effects on, 45

brain studies, 47, 191–94

serotonin depletion examined in, 47, 192–93, 196–97

Brandt, Richard, 417

Breed, Warren, 255

Breitbart, William, 429

Brenner, M. Harvey, 247, 253

Brent, David, 198

Brentano, Clemens, 177

Brewer, Colin, 397, 436

bridge suicides, 238, 340–41, 342–46, 349, 353, 561n, 567n, 568n

Brodow, Richard, 32, 33, 35, 123, 125

Brokaw, Tom, 79

Broken Connection, The (Lifton), 226–27

Brown, Bertram, 307

Brown, Herbert, 357

Browne, Thomas, 268, 416

Bruller, Jean, 573n

Bruno, Saint, 155

Buber, Martin, 336–37

Bucknill, J. C., 550n

Buddhism, 135, 137, 142, 235, 323, 397

Budgell, Eustace, 166

Buie, Dan, 318, 324, 325, 328

bulimia, 273

Bunzel, B., 548n

Burma, euthanasia practices in, 364

Burning Brand, The (Pavese), 228, 555n

Burrows, George Man, 88

Burton, Robert, 162–63, 267–68

Bush, George W., 374

Bushido, 137

Butler, Robert, 437, 439

Byron, George Gordon, Lord, 87, 175, 176

Cabanis, Pierre-Jean-Georges, 178, 184

Caesar, Gaius Julius, 148

Cain, Albert, 473, 474, 498

Cain, James M., 233

Calas, Jean, 475

Calas, Marc-Antoine, 468–69, 475

California:

euthanasia ballot initiative in, 385

suicide rate of, 247

California Supreme Court, on pastoral counseling, 337

Callahan, Daniel, 420, 433

Call to the Tempted, A (Mather), 165

Cambodian culture, 132

Camus, Albert, 204

Canada:

Inuit population of, 260–61

suicide rate of, 260

cancer patients:

deaths of, 368, 377, 386, 387, 388, 447, 451–52

depression of, 429

suicides of, 418, 427, 446

Candon, Jim, 72

Canedo, Ignacio, 349–50

Cantor, Pamela, 39, 47, 50, 55–56, 81, 338–39

Capel, Richard, 567n–68n

capital punishment, 150, 276, 383, 415

Caplan, Arthur, 572n

Caputo, Arnold, 75, 78, 81

carbon monoxide poisoning, 238, 346, 354, 379, 410, 570n

Caring Friends, 407–8, 410

Carll, Elizabeth, 541n

Carrel, Alexis, 436, 577n

Carrington, Dora, 222

Carroll, James, 277–78

case histories:

Brian Hart, 59–80, 110, 122, 320, 541n

Dana Evans (fictitious name), 93–94, 97–110, 121, 130

Ishams (fictitious names), 446–52

Justin Spoonhour, 15–37, 39–40, 48, 49, 59, 79–80, 111, 122–26, 130

Lisa Courtney, 230–32, 512, 513, 517, 518–20

Merryl Maleska, 455–65, 477–87, 502–12, 513, 514–15, 516, 527–30, 535–36, 580n

Peter Newell (fictitious name), 209–20

Casper, Sally, 49

Cassidy, James, 336

Castaldo, Charles, Jr., 79

categorical imperative, 172

Catholic Church:

on passive euthanasia, 370

social community of, 186

suicide condemned by, 87, 203, 272, 275, 475

see also Christianity

Catholics, suicide rates of, 186, 246

Cato, Marcus Porcius, 2, 5, 148–49, 150, 166, 200, 268

Cavan, Ruth, 249

celibacy, 547n—48n

Celts, 134

Center for Studies of Suicide Prevention (CSSP), 304–5, 307, 308, 310, 473

Ceos, state-sponsored suicide of, 147, 159, 443

cerebrospinal fluid, serotonin depletion seen in, 193, 195–96

Charleton, Walter, 268

Charondas, 145

Chateaubriand, François-Auguste-René de, 87, 175–76

Chatterton (Vigny), 176

Chatterton, Thomas, 175

Chaucer, Geoffrey, 159, 162

chemotherapy, 433

Chesterton, G. K., 367

Chevalier, Thomas, 181

Cheyenne Indians, 259–60

Cheyne, George, 177, 178

Chicago, Ill., North Shore suicide cluster in, 80, 116

childhood:

depression in, 41–43, 321, 331

grief process in, 497–99, 581n

guilt inducement in, 245

trauma experienced in, 45, 60, 61, 252–53, 495

see also adolescent suicide

child psychology, 458, 459

child-rearing, styles of, 52, 98, 245

Children’s Hour, The (Hellman), 261

Chinese cultures, suicide practices in, 133, 135, 248

Chippewa, 259

chlorpromazine (Thorazine), 63, 318–19, 518

Christianity:

on euthanasia, 160, 370, 414–15

fundamentalist, 414–15

martyrdom in, 1, 152–54, 155, 275, 547n, 548n

Protestant, 185, 186, 246

suicide as sin in, 1, 87, 131, 132, 151, 154–57, 158, 159, 162, 163, 177, 203–4, 272, 275, 414–15, 475

on value of suffering, 154, 416

chronic illnesses, 433, 434, 438

Chu, James, 328

Chukchee, 134

Cicero, Marcus Tullius, 148–49

cirrhosis, 269, 558n

cities, suicide rates in, 249

City of God (Augustine), 154

“Civil Commitment of the Mentally Ill,” 354

civil liberties, 332, 352–57

see also right to die

Clark, Brian, 369

Clark, Jean, 512, 525

Cleanthes, 147

Clement, Mary, 434

Clement of Alexandria, Saint, 153, 267

Cleombrotus, 146

Cleomenes III, King of Sparta, 145

clergymen, psychological counseling by, 336–38

climate, 173–74, 177–78, 183–84, 249–50, 550n

Clinton, Bill, 380

Clinton, Hillary, 380

Clough, Arthur Hugh, 369

clozapine, 319

Club of Life, 414

clusters, suicides occurring in, 2, 11, 36, 37, 39, 78–92, 114–15, 341–42

Cobain, Kurt, 92

Coconut Grove, 1942 fire at, 488

COGEN, 410

cognitive behavior therapy, 314, 323

Cohen, George, 111–14, 116, 117, 118, 119

Cohen-Sandler, Roni, 50

coke gas, 346

Coleman, Diane, 435

Collins, Judy, 474

Colorado, suicide rates of, 247

Columbine High School, murder/suicides at, 2, 90, 225

comatose patients, 369–74, 416, 570n, 571n

Commentaries on the Laws of England (Blackstone), 468

Common-Sense Suicide (Portwood), 395, 434, 443, 448

Community Mental Health Centers Act (1963), 334

Compassion & Choices, 409, 410

Compassionate Friends, 521

Compassion in Dying, 386, 387, 388, 405–7, 408, 409, 410, 411, 427–28, 429

Compassion in Dying (Lee), 387

competition, pressures of, 139, 245

concentration camps, 222, 553n–54n, 570n

Congolese tribal deaths, 431

Congress, U.S., Schiavo case addressed by, 373–74

Connolly, Cyril, 472

Conolly, Matthew, 437

consumerism, 52–53

control, 43, 333, 352, 491

Conwell, Yeates, 439

Coser, Rose, 565n

Costa Rica, low suicide rate of, 246

Council of Arles (452), 154, 155

Council of Braga (563), 155, 475

Council of Orleans (533), 154–55

Council of Toledo (693), 155

countertransference, 328

country music, 244

Courtney, Lisa, 230–32, 512, 513, 517, 518–20, 522, 525, 532, 533

Courtney, Liz, 512, 515, 517–22, 532–33

Courtney, Peter, 512, 513, 517–21, 525–26, 532

Cox, Marion, 25, 29–30, 34

Crane, Hart, 11

Creeks, 259

criminal prosecution, euthanasia assistance subject to, 363, 375, 376, 382–83, 385, 389–90, 394, 396, 403–4, 572n

criminals, suicides of, 150, 222–23

crisis hotlines, 9, 37, 142, 281–90, 305, 309–11, 317, 439, 562n–63n

crossroads burials, 131, 132, 136, 167, 467, 553n

Crowley, Mart, 261

Cruzan case, 371, 372

Cry for Help, A (Giffin and Felsenthal), 47, 96, 97

CSSP (Center for Studies of Suicide Prevention), 304–5, 307, 308, 310, 473

Curphey, Theodore, 301–2

“Custome of the Ile of Cea, A” (Montaigne), 159

cutting behaviors, 271, 518–19, 520

Cynics, 151

Cyran, Saint, 163

Dahomey natives, suicide disposal of, 132

Dakotas, 133

Dante Alighieri, 156–57, 159

Danto, Bruce, 329, 351

Darkness Visible (Styron), 44, 229, 474

Darwin, Charles, 409

Daube, David, 267

Dean, James, 274

death:

of cancer patients, 368, 377, 387, 447, 451–52

children’s comprehension of, 498, 581n

classical views of, 146, 148–49, 151, 365–66

with dignity, 365, 383, 386–88, 575n

five emotional stages prior to, 488

five medical-legal modes of, 268–69, 301–2

in home vs. institution, 368, 442

life after, 130, 131, 132–33, 134, 135, 137, 152, 154, 226

magical thinking about, 49–50, 540n

as medical failure, 368, 441, 570n

medieval view of, 158

physicians’ anxieties about, 441

as public spectacle, 151

as refuge, 130, 159

Renaissance concept of, 158–59

Romantic idealization of, 175–76

technological advances in delay of, 368–75, 415, 431–32, 571n

three leading causes of, 367–68

death instinct, 189–90, 205, 269–70

Death of a Salesman (Miller), 273

death penalty, 150, 276, 383, 415

Death with Dignity Act (1994), 421

abuse concerns in, 426–31, 434, 435

Compassion in Dying assistance with, 405–7

death certificate required by, 419

deaths conducted under, 385–88

euthanasia methods of, 388–89

palliative care issues and, 441

qualification safeguards of, 385, 422, 427–30, 576n

social impact of, 431, 442

statistics on usage of, 385–86, 426–27, 434

Supreme Court ruling expected on, 4

Deer Hunter, The, 87–88

Definition of Suicide (Shneidman), 317, 338

Defoe, Daniel, 84

deinstitutionalization, 335, 336

DeLaValliere, Robbie, 33–34, 78, 87–88

DeLay, Tom, 373

Deliverance, 410

demonic possession, 154, 155, 548n

Demosthenes, 145

denial, 490, 493–94

Denmark, suicide in, 245, 246, 248, 252

Dennis, Ruth, 254, 256

dentists, suicide completed by, 235, 250, 251

dependency-loss suicides, 245

depression:

African-Americans views of, 257

alternative therapies for, 323

biological components of, 3, 47, 193, 194, 195–97, 495

of cancer patients, 429

in children and adolescents, 41–43, 321, 322, 331

circadian rhythm of, 250

disease model of, 257, 474

in elderly, 417, 418, 429, 439

electroconvulsive therapy for, 565n

euthanasia wishes vs., 418, 420, 425–26, 428, 429–30

in females vs. males, 43, 95

Freudian view of, 41, 205

genetic susceptibility to, 495

grief vs., 484, 487, 488–89

historical views of, 162

incidence of, 41

in Japanese culture, 142–43

managed-care treatments of, 331, 566n

masked, 42

medication therapy for, 3, 57, 143, 192, 195, 318, 319–23, 331, 439, 539n, 564n

misdiagnosis of, 331

as personal weakness, 257

of physicians, 251

postpartum, 225

psychic pain of, 228–32

psychotherapy in treatment of, 323–26, 439

religious condemnation of, 337

seasonal, 250

serotonin abnormalities linked to, 47, 193

situational, 42, 484

somatic treatments for, 194–95, 555n, 565n

substance abuse vs., 272

suicidality vs., 41, 42–43, 112, 318, 539n

symptoms of, 42, 112, 318

Desecration of the Corpse, The, 466–67

Des Maladies Mentales (Esquirol), 178–79

Deykin, Eva, 45

Diagnostic and Statistical Manual of Mental Disorders, 41, 262, 318

dialectical behavioral therapy, 323

Dial Hotline, 305

dialysis, 433

Dickens, Monica, 521, 522

Didi Hirsch Community Mental Health Center, 282

Dido, 145, 153, 159

disabled persons, euthanasia legalization as threat to, 367, 421, 435–36, 577n

disaster syndrome, 490

Discourse on Death, A (Tuke), 163

disease epidemics, suicides spurred by, 84

“Dispute Between a Man and His Ba, The,” 129–30

Divine Comedy (Dante), 156–57

divorce rates, 51, 125, 186, 253

Dizmang, Larry, 259

Donne, John, 161–62, 163, 165, 168, 267, 415, 420, 548n

do-not-resuscitate (DNR) policies, 372, 374, 442

dopamine, 195

Dora (Freud’s patient), 189

Dorpat, T. L., 498

Double Exit (Wickett), 395

Double Indemnity (Cain), 233

double suicides, 175, 395

of Arthur and Cynthia Koestler, 392–93, 418–19, 575n

coercion in, 404, 418–19

of elderly, 225, 404, 446, 448, 450

Japanese practice of, 139–40, 143

Douglas, Jack, 204

Dowcett, Eileen, 512

Dowcett, Philip, 512

drapetomania, 557n

dreams, of surviving family members, 483–84, 490, 493, 501, 502

“Dream Song 384” (Berryman), 495

Drowned and the Saved, The (Levi), 222

Druids, 135

Dublin, L. I., 548n

duels, 254, 269

Duglas, 184

Dunne, Edward, 491–92

Dunne-Maxim, Karen, 491–92

Durkheim, Émile, 185–88, 194, 247

on altruistic suicide, 1, 186–87

on fatalistic suicide, 255

on Japanese suicides, 142, 545n

mass media effects discounted by, 89

on protective social factors, 185, 186, 187, 245, 256, 257, 263

on risky behavior, 269

on social integration, 185, 186, 187, 204, 245

sociology established as science by, 185, 187

on status vs. suicidality, 252

on three suicide classifications of, 185–87, 263

Dutch Patients Association, 425

Dwork, Andrew, 192

Dyaks, 133

Eastern Europe, high suicide rates in, 246

eating disorders, 273

economic (thrift) suicides, 134, 166–67, 431–32, 434–35, 437, 551n

ECT (electroconvulsive therapy) (shock treatment), 194, 565n

Edgar, King of the English, 155–56

Edlin, John, 53

Edwards, Menlove, 560n

Edwards, Romaine, 563n

Edwards, Vince, 305

Egeland, Janice, 198

Ego and the Id, The (Freud), 190

egoistic suicide, 186, 263

ego splitting, 189

Egyptian civilization, ancient, 130–31, 135

Eiffel Tower, 341, 342

Eisenberg, Leon, 313, 323, 332

Eisenhower, Dwight, 244

elderly:

African-American, 252, 255–56

depression in, 417, 418, 429, 439

double suicides of, 225, 404, 446, 448, 450

euthanasia desired by, 4, 363, 395, 426, 446–52

health care costs of, 431–33, 437

health declines of, 361–64, 449–50, 452

leading causes of deaths of, 367–68

living conditions worsened for, 362–63, 437, 438

in nursing homes, 362–63

as percentage of population, 432

physician attitudes toward, 438–39

recommendations for life enhancement of, 439–40, 442–43

as social burden, 431–33, 436, 445, 448, 452

solitude of, 362–63, 438

suicides of, 147, 222, 225, 247, 249, 252, 255–56, 314, 395, 426, 437–38, 442

traditional sacrificial deaths of, 134, 186, 431, 443

electroconvulsive therapy (ECT) (shock treatment), 194, 565n

Eliot, George (Mary Ann Evans), 49

Eliot, T. S., 249

Ellison, Ralph, 254

embryonic suicide, 269

emergency rooms:

adolescent attempters treated in, 95, 316

end-of-life decisions in, 371, 372

health-care rationing in, 433

Emery, Gary, 439

Emme, Dale, 120

Emme, Dar, 120

Emme, Mike, 120

emotions, numbing of, 490

Empire State Building, 341, 342

End-of-Life Choices, 408–9

England:

antisuicide statutes in, 156, 165, 173, 203, 467, 468

crossroads burials in, 131, 132, 136, 167, 553n

euthanasia legislation in, 366–67, 394, 400

gas suicides in, 346

right-to-die movement in, 366–67, 393, 400–401, 403–4

suicide rates in, 173–74, 182, 183

English Malady, The (Cheyne), 177

Enlightenment, 167–72, 174, 177, 181, 561n

Epicurus, 146–47

Erasmus, Desiderius, 159

ERGO (Euthanasia Research and Guidance Organization), 409

Erigone, 145

Erikson, Erik, 46

Esenin, Sergei, 87

Eskimo tribes:

Canadian Inuit suicides, 260–61

traditional suicide practices of, 134, 186, 431

Esquirol, Jean-Étienne, 178–79, 180, 181

“Essay on Suicide” (Berdyaev), 415

Ethical Society Agency for Suicidal Persons, 293

Ethiopians, 431

eugenics movement, 471, 577n

Euripides, 233

Eusebius of Caesarea, 153

euthanasia:

abuse potential of, 420–37, 444–45

for animals, 366, 415, 436

autonomy concerns in, 4, 418–19, 424, 425, 435–36

British activism on, 366–67, 393, 394, 400–401, 403–4

bureaucratization of, 444–45

case history of, 446–52

in classical civilization, 365–66

criminal penalties for aid in, 363, 375, 376, 382–83, 385, 389–90, 394, 396, 403–4, 572n

of depressed persons, 418, 420, 425–26, 428, 429–30

disability community attitudes toward, 367, 421, 435–36, 577n

elderly wishes for, 4, 363, 395, 426, 446–52

etymology of, 365, 367

without explicit request, 423–25, 426

failed attempts of, 388–89, 392, 448

family assistance in, 363, 364

financial motivations of, 432–35

history of, 365–68

legalization of, 364, 366–67, 384, 385–91, 394–95, 405, 407, 410–11, 420, 423–31, 436, 442, 450, 572n–73n, 576n

literary portrayals of, 443–44

manuals on, 398–403, 409, 573n

mercy killing vs., 570n

methods of, 375–76, 377, 378, 379, 389, 392, 393–94, 397, 398–403, 408, 409–10, 411, 448, 450, 452

Nazi mass murder vs., 367, 413, 421, 422, 570n, 577n

in Netherlands, 377, 389–91, 421, 422–26, 573n

palliative care vs., 424, 441–42

passive, 369–75, 570n

physical limitations on, 363, 389, 396

physician-assisted, 366, 375, 376–91, 423–31, 441–42, 450, 571n–72n, 576n–77n

physicians’ resistance to, 388, 416–17, 428

in primitive societies, 364, 365, 431

public acceptance of, 383, 435

religious views of, 160, 370, 414–15, 416, 425

slippery-slope argument against, 420–21, 422–23

social inequality and, 434–35

as social service, 415–16, 432–33, 434, 445

statutory prohibition of, 375, 378, 382–83

suicide prevention experts on, 575n

suicide rates vs., 426

terminology developed on, 367, 419

ulterior motives of second party in, 418, 422, 424, 425, 430

voluntary, 375, 388–91

see also right to die

“Euthanasia” (Williams), 366

Euthanasia Research and Guidance Organization (ERGO), 409

Euthanasia Society of America, 436

Evans, Dana (fictitious name), 93–94, 97–110, 121, 130

Evans, James, Jr., 253–54

Evans, Mary Ann (George Eliot), 49

executioners, 250

exhibitionism, suicidal, 151, 341–42

Exit, 400–402, 403, 404

Exit Guide Program, 411–12

Faber, M. D., 160–61

Faerie Queene, The (Spenser), 160

Falret, Jean-Pierre, 179, 180, 181

family history, suicide in, 197–98, 199, 200, 470–72, 495, 554n

family life:

contemporary breakdown of, 51–53, 186

as protective factor, 45

Victorian respectability and, 471

Fanny and Alexander, 518

Farber, Maurice, 205

Farberow, Norman, 351

background of, 296

on group therapy, 324

on hospitalization, 332

on motivation of suicide, 96

psychological autopsies developed by, 301, 302

research studies of, 239, 296–97, 301, 330

suicide prevention work of, 298, 299, 300, 302, 303–4, 308

on suicidology literature, 306

Farr, William, 88

Fast, Irene, 498

fatalistic suicide, 255

Fawcett, Jan, 563n

FDA, 321

Fedden, Henry Romilly, 134, 182, 472, 547n, 561n

Federal Witness Protection Program, 223

Feltz, Arlene, 514

Ferriar, John, 366

feudalism, 155, 467

Fieger, Geoffrey, 379, 383

Field, Marshall, 295

Fieve, Ronald, 569n

films, suicide portrayed in, 87–88, 90–91, 141, 523

Final Exit (Humphry), 3, 399–400, 401, 404, 405, 409, 422, 432

Final Exit Network, 410–12

financial concerns, suicides motivated by, 166–67, 249, 293, 431–35

Finland, suicides of, 164, 246

Fishbain, David, 274

Fisher, Mark, 116

5-hydroxyindoleacetic acid (5HIAA), 195–96, 197, 200, 201

Flaubert, Gustave, 153, 176, 177, 531–32

Fletcher, Joseph, 368, 369, 375, 386, 415, 416

Florence, Italy, Duomo in, 341

Florida, high suicide rates of, 247, 249

fluoxetine (Prozac), 3, 319, 321, 322–23

Fodéré, 184

Foley, Kathleen, 429, 441

Fonda, Peter, 474

“For Black Poets Who Think of Suicide” (Knight), 255

Four Winds, 106–10

Fox, Sandra, 497, 498–99, 581n

France:

religious fanaticism in, 155, 468–69

right-to-die movement in, 402–3

Romantic movement in, 175–76

suicide penalties in, 164, 168, 172–73, 466, 467, 468

suicide rate of, 183

Franklin, Benjamin, 366

Frazer, James, 151

Frederick, Calvin, 43, 51, 239–40, 295, 418

Freedom to Die (Humphry and Clement), 434

Freeman, Walter Jackson, 251

free will, 159, 167–68, 171–72, 186, 354, 357, 418

Freud, Martha Bernays, 188

Freud, Sigmund, 86, 204, 251

on accidents, 269–70

aggression theory of, 188, 189–90

death instinct posited by, 189–90, 205, 269–70

on depression, 41, 205

euthanasia of, 389

on grief, 487, 488, 531

on self-destructive tendencies, 269–70, 276

on suicide, 133–34, 188–89, 194, 224–25, 236, 252, 325, 551n

on war, 275

Freudians, 47

Freund, Andy, 215–16, 217, 218, 219

Freund, Jane, 214–15, 216, 217–18, 219–20

Friedenthal, Richard, 87

Friendship Line, 439

Fulbecke, William, 165

Funeral, The (Erasmus), 159

Furst, Sidney, 237

Gall, Franz Joseph, 178

Gandhi, Mohandas, 415

Garbesi, Curt, 417

Gardner, Bruce, 224

Garfinkel, Barry, 44

gas, suicides by, 235, 238, 346, 354, 379, 410, 570n

geese, bereavement behavior observed in, 489

general practitioners (GPs), 331–32, 566n

“Gentle Death, A,” 405

Gerbner, George, 54

geriatric patients, 438–39

see also elderly

Germany:

Nazi regime of, 222, 293, 367, 413, 421, 422, 444, 560n, 570n, 577n

romantic movement in, 175

suicide rates of, 183, 246

ghosts, protection rituals for, 131–33, 134, 144, 155, 467

Gibbon, Edward, 547n

Gibbs, Jack, 204

Gibson, Paul, 264–65

Giffin, Mary, 96

Gilman, Charlotte Perkins, 415–16

Gilmore, Gary, 276

Giotto, 341

Giraudoux, Jean, 123

Girl, Interrupted (Kaysen), 250, 333

Girsh, Faye, 408

gisei-shi, 139

Godwin, Fanny Imlay, 241–42

Goethe, Johann Wolfgang von, 86–87, 88, 168, 175, 180

Goffman, Erving, 303

Goin, Marcia, 315

Golden Gate Bridge, 238, 340–41, 342–46, 349, 353, 567n

Good, Janet, 379–80, 572n, 577n

Good Euthanasia Guide, The (Humphry), 409, 436–37

Good Life/Good Death (Barnard), 374

Goths, 134

Gould, Madelyn, 44, 48, 542n–43n

GPs (general practitioners), 331–32, 566n

Grace Community Church of the Valley, 337

grandmothers, 256

Grateful Dead, 242

Graunt, John, 182–83

“Grave, The” (Blair), 174

Gray Panthers, 395

Great Depression, 187, 247

Greek culture:

stigma in, 467

on suicide, 144–48, 156, 159, 186, 233, 267, 365, 367, 443, 550n

Greene, Graham, 274

Greer, Ina May, 492

Gregory, Dick, 252

Gregory, G., 469, 561n

Greyhound therapy, 336

greylag geese, bereavement behaviors observed in, 489

grief, 481–501

anger connected with, 491–92, 500, 520

animal reactions of, 489

children’s experiences of, 497–99, 581n

depression vs., 484, 487, 488–89

diminution of, 531–33, 535–36

duration of, 487, 488–89, 517–18

family members’ support in, 479, 481, 482

mortality risk increased by, 487–88

physical manifestations of, 485

range of reactions to, 487, 581n

as selfish, 452

sex differences in process of, 487–88

stages of, 488

suicide risk increased by, 495

support groups on, 474, 512–17, 521–25

systematic research on, 487–89

unresolved, 489, 498

Griffiths (1823 English suicide), 131, 132

Grollman, Earl, 336–37

Grotius, Hugo, 163

group therapy, 107–8, 324, 333

Guerry, M. A., 184, 250

Guide to Self-Deliverance, A, 401, 403

Guillotin, Joseph, 173

guilt:

as child-rearing tactic, 245

of recovery from grief, 532

of surviving family members, 455, 473, 482, 483, 490–92, 495, 504–5, 516, 520, 532

Guislain, Joseph, 180

gun ownership, 54, 56–57, 220, 234, 235, 347–49, 568n, 569n

Guyana, collective suicides in, 85, 90, 186, 413, 567n

Hackethal, Julius, 397

Halley’s comet, 84

Hamilton, Donald, 43

Hamilton, Gregory, 434

Hamlet (Shakespeare), 114, 161, 165, 167, 267

handguns, restrictions on, 347–49

hanging, 237–38, 347, 504

hara-kiri, 137

Hardwig, John, 432

Hardy, Thomas, 240

Harlan, Kevin, 79

Harris, Abraham, 165

Harris, Harold, 419

Harris, Karl, 284–85

Harrison, Barbara Grizzuti, 575n

Harrison’s Principles of Internal Medicine, 440

Hart, Brian, 59–80, 110, 122, 320, 541n

Hart, Gary, 276

Hart, Mary, 59–60, 61–64, 66, 67–68, 70, 71–72, 73, 74–77, 78, 122

Hart, Patrick, 59–60, 62, 63, 64, 67–68, 70, 71–72, 73–77, 78, 122

Hartley, Mariette, 115, 474

Hastings Center Report, 432

Hawaii, assisted-suicide legislation effort in, 427

health care:

end-of-life expenditures in, 431–33, 437

family members’ wishes on, 372–73, 571n

rationing of, 433, 434

self-determination rights in, 370, 371–72, 571n

suicides of professionals in, 235, 250, 251, 327

health care proxy, 371

health insurance:

access to, 257, 564n

on chronic illnesses, 433

for inpatient psychiatric treatment, 71, 334

for managed care, 565n–66n

health maintenance organizations (HMOs) (managed care), 3, 331, 332, 374, 433, 565n–66n

heart disease, 368, 432–33

Heggen, Thomas, 298

Heilig, Sam, 299, 301, 524

Heliogabalus, Emperor of Rome, 555n

helium, in plastic-bag suicide technique, 408, 411

Hellman, Lillian, 261

help, cry for, 284, 297, 313

Hemenway, David, 348

Hemingway, Ernest, 114, 277, 495

Hemingway, Leicester, 495

Hemlock Society, 4, 364, 379

Caring Friends assistance services of, 407–8

establishment of, 394–95, 411

euthanasia legalization goal of, 394–95, 404, 405, 407, 410

leadership of, 395, 404

literature published by, 3, 395, 398–400, 401, 405, 447–48

membership of, 395, 396–97, 447, 448

name and logo changes of, 408–9

national conferences held by, 397, 413, 420, 436, 437, 446, 575n

opponents of, 413–14

progressive levels of assistance offered by, 396, 407–8, 422

public education efforts of, 395

Hendin, Herbert, 351

on African-American suicide, 234–35, 252–53, 256

on ambivalence of suicides, 353

on civil liberties vs. suicide prevention, 353

on elderly, 438, 439

on end-of-life medical care, 441, 442

on euthanasia, 424, 425, 426, 429, 441, 442, 575n

on psychiatric hospitalization, 332, 333

psychiatric practice of, 323, 329

on psychoanalysis, 323

psychosocial perspective described by, 245–46

on risk management, 565n

Scandinavian suicide studied by, 245

on suicide methods, 234–35, 237

on suicide notes, 240

on suicide prevention, 316, 439

Henry, Andrew, 204

Henry, Patrick, 356

Hepburn, Katharine, 400

Herbert, Clarence, 570n–71n

Herodotus, 135, 145, 431

heroism, 275

Hey, Richard, 171, 469

Hidatsa, 132–33

Hildreth, Harold, 298

Hillman, James, 227, 230, 356

Hinduism, 136, 186, 365, 414

Hippocrates, 194, 250, 365

Hippocratic oath, 368

Hiroshima, Japan, survivors of atomic bombing of, 490, 497

Hispanic Americans, 258–59

Hitler, Adolf, 222, 367, 414, 432

HIV/AIDS, 38, 263–64, 270, 384, 386–87, 429

HMOs (health maintenance organizations) (managed care), 3, 331, 332, 374, 433, 565n–66n

Hoche, Alfred, 367, 417

Holcroft, Thomas, 174

holidays:

for family members of suicides, 505–6, 513, 516, 525

suicide rates on, 249

Holy Stone, 443

home, deaths at, 95, 368, 442

homeless population, 335

Homer, 144

homicide, see murder

homosexuality, 3, 48, 66, 101–2, 261–66, 558n

hopelessness, 43, 54, 253–54, 323

Horace, 148–49

horror comic books, 87

hospice care, 406, 407, 411, 421, 426, 428, 433, 434, 437, 442, 451

hospitals:

end-of-life care in, 338–39, 371–72, 440–41

see also psychiatric hospitalization

Hottentots, 431

House of Representatives, U.S., Schiavo case in, 373

Housman, A. E., 226

Houston, Michaele, 406

How to Die with Dignity (Mair), 401, 402

How to Stop Killing Yourself (Steincrohn), 277

How We Die (Nuland), 417

Hudgens, Richard, 348–49

Hufeland (Goethe physician), 180

human rights, 332, 352–57

see also right to die

Hume, David, 169–70, 172, 415

Humphry, Derek, 407, 432

assisted-suicide network organized by, 410–12

background of, 393

first marriage of, 393–94

on health care inadequacies, 433, 434, 440

Hemlock Society established by, 394–96, 398, 404, 409, 575n

on legalization of euthanasia, 394–95, 396, 409, 410–11

on potential abuses of euthanasia, 422

protests against, 413, 414

as public figure, 394, 409, 413, 442, 447

second marriage of, 394, 404, 574n

suicide literature written by, 394, 398, 399–400, 409, 422, 434, 436

Humphry, Jean, 393–94, 396

Hungary, high suicide rate of, 246

Hunter, Kim, 305

Huxley, Aldous, 275

Huxley, Julian, 366

I Accuse, 421

“I Counsel You Beware” (Housman), 226

Iga, Mamoru, 546n

Iglulik tribe, 134

Ignatius, Saint, 153

imipramine, 195

immigration, 248, 256

immitation, role of in suicide, see clusters

impulsive behavior, 47, 48–49, 196, 275, 320, 353

India, suicide practices in, 132, 133, 135, 136, 186, 235, 365

indirect suicide, see self-destructive behaviors

industrialization, 185, 222, 246

insanity, see mental illness; psychiatric disorders; psychiatric hospitalization

Institute for Studies of Destructive Behaviors, 282

insulin coma therapy, 194

International Association for Suicide Prevention, 303

Internet suicides, 143

Inuit culture, 260–61

Invisible Man (Ellison), 254

involuntary commitment, 352, 354–55

ipecac, 117–18

iproniazid, 195

Iraq, U.S. invasion of, 247

Iroquois, 132–33

Isham, Fred (fictitious name), 446–52

Isham, Holly (fictitious name), 446–52

Islam, 246

Isocrates, 145

Is the Homosexual My Neighbor? 263

“I Thought People Like That Killed Themselves” (Rofes), 261

Jackson, David, 418

Jackson, Jesse, 373

Jacobs, Douglas, 96, 308, 314

Jakuts, 132

James, William, 301

Jamison, Kay Redfield, 38, 95, 335–36, 581n

Janus, Margo, 379

Japan:

current suicide rate of, 246

depression in, 142–43

elderly in, 438

Hiroshima bomb survivors in, 490, 497

history of suicide practices in, 137–43, 186, 235, 268, 546n

kamikaze pilots of, 1, 139, 186, 225

post-surrender suicides in, 84, 138–39

suicide categories of, 139, 223, 225

suicide settings in, 143, 341–43, 567n

Jean’s Way (Humphry), 394, 448

Jefferson, Thomas, 173, 550n

Jesus Christ, 152, 153, 416

Jewish law, burial criteria in, 202

Jews:

collective suicides of, 84, 186

Nazi mass murder of, 367, 570n

suicide rates of, 246

Jim in Bold, 265

Joan of Arc, Saint, 155

Job (biblical figure), 152

Jocasta, 144

John Chrysostom, Saint, 154

John Paul II, Pope, 370–71

Johnson, Lancelot, 468

Jones, Jim, 2, 84, 567n

Jonestown, Guyana, mass suicide at, 84, 90, 186, 413, 567n

Journal of the Plague Year, A (Defoe), 84

Joyce, James, 471

Judas Iscariot, 152, 155

Jude the Obscure (Hardy), 240

Jukai, forest of, 342, 344

Julius Caesar (Shakespeare), 123

Jungian psychology, 356

junshi, 139

Justifiable Euthanasia (Admiraal), 390

Justinian I (the Great), Byzantine Emperor, 150

jyoshi shinju, 139–40, 143

Kaiser Permanente, 430

Kalafat, John, 120

Kalasardo, Beverly, 287, 288

Kalmuck Tartars, 431

kamikaze, 1, 139, 186, 225

Kamisar, Yale, 422

Kammerer, Paul, 223

kangen-shi, 139

Kant, Immanuel, 172

Kanwar, Roop, 136

Karens, 364

kashitsu-shi, 139, 223

Kass, Leon, 418, 430

Kastenbaum, Robert, 438

Kaysen, Susanna, 250, 333

Keagan, Kelly, 79

Keats, John, 175, 399

Kehoe, Nancy, 337–38, 355

Kelly, David, 223

Kennedy, Foster, 436

Kenyan tribes, suicide ethics of, 364

Keown, John, 424–25

Kernberg, Otto, 351

Kerouac, Jack, 272

Kevorkian, Flora, 378

Kevorkian, Jack “Dr. Death,” 3, 376–83, 421, 435

assistants of, 378, 379–80, 572n, 577n

background of, 376, 377

finances of, 380

Hemlock Society approached by, 396

notoriety of, 380, 383, 412, 442

obitoria conceived by, 377, 444

personality of, 381

physical appearance of, 376

prosecutions against, 378, 379, 382–83, 435

recreational activities of, 380–81, 383, 572n

screening process used by, 378, 379, 380, 381–82

suicide machine constructed by, 377, 378

suicides enabled by, 378–79, 382, 384, 385, 389, 399, 411, 571n–72n

Kierkegaard, Søren, 227

Kiev, Ari, 329, 330, 332, 351

King Lear (Shakespeare), 96

Kinnell, David (fictitious name), 242–43

Kirk, Alton, 257, 258

Klagsbrun, Samuel, 43, 49, 81, 117

Kleist, Heinrich von, 175

Klugman, David, 301, 302, 311

Knight, Etheridge, 255

Knock, Matthew, 225

Koestenbaum, Peter, 357

Koestler, Arthur, 392–93, 401, 418–19, 575n

Koestler, Cynthia, 392–93, 418–19, 575n

Kohn, Mel, 386

kokoro no kaze, 142–43

Koop, C. Everett, 421–22

Koppel, Ted, 339

Koresh, David, 2

Kornhaber, Eugene, 60, 63, 70, 71, 74, 75, 76

Kraai, John, 571n

Kramer, Sandri, 286–87

Kubie, Lawrence, 224, 227

Kübler-Ross, Elisabeth, 488

Kunitz, Stanley, 494

Kushner, Howard, 248

Laborit, Henri, 318

labor pains, 574n

Lamartine, Alphonse-Marie-Louis de Prat de, 87, 176

Lamm, Richard, 431–32

Landers, Ann, 81, 336

landmarks, suicides at, 143, 238, 340–46, 349, 353, 561n, 567n

Larue, Gerald, 395, 414

LASPC, see Los Angeles Suicide Prevention Center

Last Wish (Rollin), 375

Laws (Plato), 146

Lay My Burden Down (Poussaint and Alexander), 255, 257

lebensunwertes Leben (life unworthy of life), 367

Lee, Barbara Coombs, 387, 428

leeches, 555n

Lemberg Volunteer Rescue Society, 561n

Lester, David, 307

lethal injections, 375, 384, 389, 391, 410, 573n

lethality, 301, 314

Let Me Die Before I Wake (Humphry), 398, 401, 422, 447–48

Leukakas, 144–45

Levi, Primo, 222

Levin, Jack, 437

Levine, Stephen, 397

Levinson, A. J., 445

Libanius, 147

life, quality of, 364, 368–69, 450

Life Crisis Services, 439

life expectancy, 367, 433

life insurance claims, 419, 475

Lifes Preservative Against Self-Killing (Sym), 163–64, 269

life-support systems, 369–75, 415, 416, 571n

life unworthy of life (lebensunwertes Leben), 367, 421, 570n

Lifton, Robert Jay, 226–27, 230, 490, 497, 570n

Light, Donald, 326–28, 329

Lincoln, Abraham, 353, 568n–69n

Lincoln, Mary Todd, 353

Lindemann, Erich, 488, 489, 492, 521

Linehan, Marsha, 323

literature, suicide portrayed in, 86–87, 116, 140–41, 160–61, 167–68, 175–76, 443–44, 494, 495

lithium, 64, 66, 71, 229, 319–20, 564n, 569n

Lithuania, suicide rates of, 197, 246

Litman, Robert:

background of, 298

on ethics of suicide prevention, 356

on Freud, 188

on Monroe suicide, 302

on physicians’ personalities, 251

on risk assessment, 57–58, 316

on self-image expectations, 224, 226

in suicide prevention work, 298, 299, 300, 301, 302, 308–9, 311, 350

suicide zone posited by, 57–58

on therapists’ responses to patient suicide, 329–30

living wills, 371–72, 395, 451

lobotomies, 194, 251

Locke, John, 171–72

Loiseau, Bernard, 223

London, England, suicide rates vs. social isolation in, 249

London Anti-Suicide Bureau, 293

Longmore, Paul, 577n

LoPuzzo, Mike, 23–24, 30, 35, 43, 124

Lorenz, Konrad, 489

Los Angeles County, Death Investigation Team of, 301–2

Los Angeles County General Hospital, 298–99

Los Angeles Suicide Prevention Center (LASPC), 298–304, 305, 474

crisis hotline operated by, 302, 311, 562n–63n

current institutional life of, 282–90, 317, 523

follow-up services tried by, 308–9

group therapy offered at, 324

growth of, 298–99, 302

on mental illness vs. suicidality, 355–56

offices of, 298–99, 303

personnel of, 300–301, 303–4

psychological autopsy developed by, 302, 468, 472

public education work of, 303

start of, 298–99

suicidology analysis of, 301, 303, 313

surviving families’ needs addressed by, 472–73, 524

training programs developed by, 303

loss, 44, 222–24, 438

see also grief

love-pact suicides, 139–40, 143, 175

see also double suicides

Lowell, Robert, 445

Lucretia, 153, 159, 166

Lucretius, 147

Lyle, Katie Letcher, 436

Lynch, Thomas, 239

Lyons, Mark, 403–4

MacArthur, John, Jr., 337

McCollum, Jack, 88

McCollum, John, 86, 88

MacDonald, Richard, 408

McGee, Richard, 306–7

McGoldrick, Monica, 493

McGovern, George, 16

McIntosh, John, 473–74

Mack, John, 357

McLean Hospital, 327, 333

Madame Bovary (Flaubert), 531–32

Mad in America (Whitaker), 194

magical thinking, 49, 81, 540n

Maine, assisted-suicide legislation effort in, 427

Mair, George, 402

Malays, 275

Maleska, Merryl, 455–65, 467, 490, 580n

career of, 458, 459, 481, 485

grieving process of, 481–87, 502–12, 527–30, 535–36

marriage of, 456–58, 460–64

new relationships begun by, 508–10, 527–28, 536

support group attended by, 512, 513, 514–15, 516, 529

as surviving spouse, 455, 465, 477–87, 502–11, 580n

malpractice litigation, 329, 332, 353, 368

Maltsberger, John, 318, 322, 324–26, 327, 328, 330, 333

Man Against Himself (Menninger), 204–5, 237, 270, 277

managed care plans, see health maintenance organizations

Manes, Donald, 223, 554n

manic depression, see bipolar disorder

“Manipulated Suicide” (Battin), 444, 445

Mann, John, 191–92, 193, 196, 197, 322

Marcellus, 152

Maris, Ronald, 308

Marker, Rita, 573n–74n

Marks, Rona (fictitious name), 512, 515, 516

marriage:

divorce rates and, 51, 125, 186, 253

suicidality risk lessened in, 185, 186, 221, 256, 427, 438

Martial, 150

Martin, Sandy, 65–66, 70, 122

Martin, Walter, 204

martyrdom, religious, 1, 152–54, 155, 275, 547n, 548n

Marzuk, Peter, 225

Masada, collective Jewish suicide at, 84, 186

Masako, Princess, 143

Masaryk, Thomas, 183, 184

masked depression, 42

masochism, martyrdom vs., 153

Massachusetts, historical suicide penalties in, 165

Massachusetts Mental Health Center, 326

Massilia, suicide customs of, 147

mass media, violence portrayed in, 54–55, 90–91, 541n, 542n–43n

masturbation, 178, 331, 550n

Mather, Increase, 165

Maupassant, Guy de, 443–44, 445

Medicaid, 432, 434

Medical Histories and Reflections (Ferriar), 366

“Medical Science Under Dictatorship” (L. Alexander), 421

medical treatment, see health care; health insurance; physicians

Medicare, 432, 433, 442

Medici, Alessandro de, 166

medievalism, 158, 162, 167

meditation, 323, 351

Meerloo, Joost, 237, 262, 275, 276–77, 546n, 554n

melancholy, 162–64, 165

Mellaril, 103

Melville, Herman, 249, 276, 278, 569n

Menninger, Karl, 204–5, 206, 237, 547n, 558n

on self-destructive behaviors, 270–71, 272, 277

mental asylums, 180

see also psychiatric hospitalization

Mental Health Center (Seattle), 439

mental health services:

access to, 257, 331, 335, 336, 434, 564n, 566n

coercive utilization of, 352–53, 354–55

deinstitutionalization of, 335, 336

federal support of, 307–8, 562n

professional hierarchy within, 300, 326

survivor support groups and, 524

underutilization of, 257–58, 316–17, 557n, 564n

see also psychiatric hospitalization

mental illness:

civil liberties and, 332, 352, 354–55

denial of existence of, 352, 355

family history of, 181, 197–98

in homeless population, 335

homosexuality considered as, 261–62, 558n

medicalization of, 336

Nazi euthanasia practices in, 367, 570n, 577n

somatic treatments for, 179–80, 194–95

stigma of, 181–82, 316–17, 564n

substance abuse vs., 272

suicide as evidence of, 173, 178–82, 202, 292, 354, 355–57, 550n

surviving family stigmatized by association to, 470–72

see also depression; psychiatric disorders; psychiatric hospitalization

Mercitron, 378, 379, 396

mercy killing, 570n

see also euthanasia

Merian, 178, 355

Merkin, Daphne, 318

Metrazol convulsive therapy, 194

Mexican Americans, 258

Michigan, physician-assisted suicides in, 378–79, 382–83, 427

Middlemarch (Eliot), 49

Midler, Bette, 115

Mihara-Yama, 341

Milan cathedral, 341

Millard, C. Killick, 366

Miller, Derek, 42–43

Miller, Samuel, 87, 469

Milne, A. A., 366

Minot, George R., 416

Mishima, Yukio, 140–41, 142, 560n

Moby-Dick (Melville), 5, 249, 276

modeling, 44, 495

Modern Maturity, 395

Mohr, Myron, 262

Molitor, Karl, 86

Monday, highest suicide rate on, 250

monoamine oxidase, 195

monoamine oxidase inhibitors, 319

“Monody on the Death of Chatterton” (Wordsworth), 175

Monroe, Marilyn, 89, 90, 302

Montaigne, Michel de, 159

Montana, suicide rate of, 247

Montesquieu, Charles-Louis de Secondat de, 138, 167, 170, 173

Monty Python, 435, 551n

Moore, Charles, 366

Morals and Medicine (Fletcher), 415

moral statistics, 183

More, Thomas, 159–60, 164, 443

morphine sedation, 374, 375, 384, 388

Morselli, Henry, 183–84, 185

Moss, Leonard, 43

mother-infant bonding, 46–47

Motto, Jerome, 43, 308, 318, 336, 344

mountaineers, 275, 560n

Mount Fuji, 143, 342

Mount Mihara, 341–42

mourning, see grief

Mourning and Melancholia (Freud), 189

Mudge, George P., 470

murder:

biblical prohibition of, 414–15

of political prisoners, 560n

rates of, 37

suicide as inversion of, 133–34, 189, 224–25, 252

suicide completed after, 90, 140, 225–26

suicide considered as, 154–55, 156, 414–15

suicide rates vs. rate of, 252, 558n

victim’s intentional provocation of, 254, 275–76

Murphy, George, 353

Musonius, 365

Musset, Alfred de, 176

Mussolini, Benito, 543n

Mutsuhito, Emperor of Japan, 139

Myth of Sisyphus, The (Camus), 204

Nally, Kenneth, 337

Napoleon Bonaparte, 85

National Hopeline Network, 310

National Institute of Mental Health (NIMH), 298, 303, 304, 307

National Inuit Youth Council (NIYC), 260–61

National Organization for People of Color Against Suicide (NOPCAS), 557n–58n

National Rifle Association (NRA), 348, 349

National Save-A-Life League, 291–93, 294, 302, 307

National Strategy for Suicide Prevention (NSSP), 310

National Suicide Prevention Week, 351

National Survivors Conference, 474

Native Americans, suicides of, 84, 132–33, 258, 259–61, 558n

Nazism, 222, 293, 367, 413, 421, 422, 444, 560n, 570n, 577n

negotiated deaths, 371

Nembutal, 410

Nero, Emperor of Rome, 149, 150

Nerval, Gérard de, 175

Neser, Johannes, 163

Netherlands:

palliative care deficiencies in, 424, 426, 441–42

physician-assisted euthanasia in, 377, 389–91, 421, 422–26, 573n

neuroanatomy studies, 191–94

neurotransmitters, 192, 195, 319

dopamine, 195

norepinephrine, 195, 275

serotonin, 40, 47–48, 192–93, 195–97, 199, 201, 250

Nevada, highest suicide rates in, 247

Newell, Barbara Spires (fictitious name), 210–11

Newell, Kathy (fictitious name), 210, 211, 215

Newell, Peter (fictitious name), 209–20, 221, 222, 224, 274

Newell, Ruth (fictitious name), 210, 211–12, 216, 217, 219

Newell, Sally (fictitious name), 210–11, 212–13, 216, 217, 218, 219

New England, low suicide rate of, 248

New Jersey Supreme Court, Quinlan case of, 369–70, 371

New Mexico, suicide rate of, 247

New Technology in Self-Deliverance Group (NuTech), 409–10

New Testament, 151, 152

New World in Words, A (Phillips), 268

New York, N.Y., suicide rates of, 249, 252–53, 256

New York State Psychiatric Institute (NYSPI), 191–94

New York State Task Force on Life and the Law, 435

Neylor, Lewis, 340

Niagara Falls, 341

Nicaragua, state censorship of suicide reports in, 246–47

Nicol, Neil, 379

Nietzsche, Friedrich, 311

Nigeria, tribal suicide customs of, 364

Night Falls Fast (Jamison), 95, 335–36, 581n

Nightline, 338–39

nightmares, 490, 501, 502

“Night Thoughts” (Young), 174

NIMH (National Institute of Mental Health), 298, 303, 304, 307

Nitschke, Philip, 410, 437

NIYC (National Inuit Youth Council), 260–61

Nobel, Alfred, 444

“no code” order, 374, 449

Nogi, Kiten, 139

nonabandonment, 384–85

Noonday Demon, The (Solomon), 322, 419

NOPCAS (National Organization for People of Color Against Suicide), 557n–58n

norepinephrine, 195, 275

Norman, Pat, 261

Northern Ireland, low suicide rate of, 246

Norway, suicide rates in, 245, 248

no-suicide contracts, 315

Not Dead Yet, 435, 577n

Nouvelle Héloïse, La (Rousseau), 167–68

November, as month of suicide, 173, 178, 184, 249

NRA (National Rifle Association), 348, 349

NSSP (National Strategy for Suicide Prevention), 310

nuclear arms race, 270

Nuland, Sherwin, 417, 544n, 576n

numbers, Pythagorean theory of, 145

numbing, psychic, 490

nurses:

in elder care, 362

euthanasia performed by, 384

suicide rates of, 251

nursing homes, 362–63, 398, 437

NuTech (New Technology in Self-Deliverance Group), 409–10

NYSPI (New York State Psychiatric Institute), 191–94

Oates, Lawrence, 186

obitiatry, 377

Observations made upon the Bills of Mortality (Graunt), 182–83

Odin, 134

Officer and a Gentleman, An, 88

Okin, Robert, 334

Old Believers, 84

Oldham (bishop), 553n

Oldham, Joyce, 512, 513

Old Order Amish, 198

Old Testament, 151–52, 267, 472

Omaha Indians, 132

Omega, 522

On Death and Dying (Kübler-Ross), 488

“On Suicide” (Hume), 169–70

Oppenheim, David, 85–86, 347

“Oration on the Dignity of Man” (Pico della Mirandola), 158–59

orbital prefrontal cortex, 193

Oregon:

right-to-die legislation in, 3, 4, 385–89, 405, 419, 420, 426–31, 433–34, 441, 442, 572n–73n, 576n

suicide rate of, 247

Oregon Health Plan, 434

Oregon Hospice Association, 429

Osbourne, Ozzy, 86, 88

Ostow, Mortimer, 237

Othello (Shakespeare), 160

Otto, Emperor, 175

oyako shinju (parent-child suicide), 140, 225, 546n

Pachomius, 547n

Padlayat, Adamie, 261

Padmapurana, 136

Paetus, Caecina, 150

Paharis, 132

pain:

anticipation of, 423, 428, 440, 446

endurance of, 365

as justification for euthanasia, 365

psychic, 228–32, 490

spiritual value of, 154, 171, 172, 416

Paine, Thomas, 87

pain management, 406

anesthesia used in, 366, 416, 574n

inadequate, 362, 424, 440

in Netherlands, 424, 426, 441–42

in nursing homes, 362

recent advances in, 440

terminal sedation vs., 366, 374

Palestinian suicide terrorists, 186

palliative care, 424, 426, 428–29, 433, 440–42, 576n

Pangrazzi, Arnaldo, 492–93

Pantites, 145

paradoxical technique, 327–28

parent, loss of, 43–44

parent-child suicide (oyako shinju), 140, 225, 546n

parents:

child-rearing styles of, 52, 98, 245

infant bonding with, 46–47

single, 253

of suicide, 125, 491, 517–21, 532

suicide of, 44, 197–98, 472, 495–96, 497–501

Parish of All Strangers, 291, 292

Parker, Dorothy, 399

Parker, Ellen (fictitious name), 271

passive euthanasia, 369–75, 570n

Pat (crisis hotline volunteer), 281–83, 284–85, 289–90

paternalism, 370, 417, 436

“Patient Monitoring of Suicidal Risk,” 315

Patient Self-Determination Act (1991), 371

patient’s rights:

on end-of-life care, 370, 371–72

in psychiatric treatment, 332, 352, 354–55

Paul, Saint, 292

Pavese, Cesare, 221, 228, 555n

Paxil, 319, 321

Peaceful Pill, 410

Peck, Michael, 50, 52, 313

Pelagia, Saint, 548n

Pellechi, Jimmy, 37, 48, 83

Penn, William, 579n

People’s Temple, 84–85, 567n

Pepper, Stephen, 303

Peregrinus Proteus, 151, 163

Péricles, 241

Permission to Destroy Life Unworthy of Life, The (Hoche and Binding), 367

Persian Letters (Montesquieu), 167

persistent vegetative state, 370, 372, 375, 416

Petrarch, 159

Petronius (Arbiter), 150–51

Pfeffer, Cynthia, 44

Phaedo (Plato), 145–46, 148, 154

Phelps, Edward Bunnell, 89

Philip II, King of Macedon, 83–84, 145

Phillips, David, 89–90, 91, 542n, 543n

Phillips, Edward, 268

philosophy:

classical, 145–47, 149, 151, 365

of Enlightenment, 167–72

phrenology, 178

physical handicaps, euthanasia and, 367, 421, 435–36, 577n

Physician-Assisted Dying (Quill and Battin), 442

physicians:

classical guidelines for, 365–66, 368

death anxieties of, 441

euthanasia opposition of, 388, 416–17, 428

geriatric cases of, 438–39

long-term patient relationships with, 374–75, 384–85, 426, 428, 576n

malpractice lawsuits against, 329, 332, 353, 368, 371, 571n

nonabandonment principle of, 384–85

pain management education of, 440, 441–42

passive euthanasia practices of, 374–75

paternalism of, 370, 417, 425

prolongation vs. quality-of-life decisions of, 368, 369, 370, 441, 570n

suicidal patients disparaged by, 96, 97, 292, 298, 544n

suicides completed by, 223–24, 235, 251, 327

suicidology training of, 316, 326–27, 331–32, 566n

voluntary euthanasia assisted by, 366, 375, 376–91, 423–31, 441–42, 450, 571n–72n, 576n–77n

see also psychiatrists

Physicians for Compassionate Care, 417, 434

Piccione, Joseph, 420

Pico della Mirandola, 158–59

Piero delle Vigne, 157

Pinel, Philippe, 180, 334, 550n

Pisa, Leaning Tower at, 342

Place Vendôme, 342

plague, 84, 182

Plano, Texas, teenage suicides in, 11, 39, 80, 81–82, 83, 92

plastic bags, asphyxiation deaths with, 399, 400, 401, 402, 408, 409, 410, 411, 412

Plath, Sylvia, 11, 229

Plato, 145–46, 148, 154, 156, 365

Pliny (the Elder), 149, 365

Pliny (the Younger), 149

plunge baths, 179, 180

Plutarch, 85, 148

pneumonia, 367–68, 374

Poitier, Sidney, 305

Pokorny, Alex, 249, 316

police:

provocation of fatal shootings by, 254, 275

suicides of, 235, 250

political prisoners, 560n

political protest, 235

political suicide, 276

Pollatsek, Judy, 48

Pope, Alexander, 166

Porter, Lora, 21–22, 26, 122–23, 126

“Portrait, The” (Kunitz), 494

Portwood, Doris, 395, 434, 443

postpartum depression, 225

posttraumatic slavery syndrome, 255

potassium chloride, 377, 378, 379, 382

Poussaint, Alvin, 254–55, 257

poverty, 166–67, 249, 257, 438

Powell, Douglas, 42, 80, 312

powerful public figures, suicides of, 222–23

Praise of Folly, The (Erasmus), 159

prefrontal cortex, 193

prefrontal lobotomies, 194, 251

Press, Bill (father), 361–64

Press, Billie (daughter), 361, 362, 363–64

Preston, Thomas, 375

presuicidal syndrome, 229, 230

Preventing Teenage Suicide (Steele), 116–17

primary care physicians, 331–32, 566n

see also physicians

primitive tribal cultures, 131–36, 364, 365, 431

Prinze, Freddie, 241

prisons:

medical experimentation on death-row inmates of, 377, 383

mental illness in, 335

political dissidents murdered in, 560n

problem-solving skills, 53

profession, suicide risk vs., 235, 236, 250–51

Protestantism, 185, 186, 246

Prozac (fluoxetine), 3, 319, 321, 322–23

Prudhomme, Charles, 256

pseudocide, 276

psychiatric disorders:

bipolar disorder, 41, 42, 64, 229, 272, 318, 319–20, 323, 353, 492, 541n

borderline personality disorder, 41, 323, 351

depression, see depression

schizophrenia, 272, 318, 319, 330,.431

suicidality vs., 41, 119, 173, 178–82, 202, 221, 318, 355, 550n

see also mental illness

psychiatric hospitalization, 332–37

civil liberties restrictions on, 332, 354–55

deinstitutionalization process and, 334–35

discharges from, 64–65, 106, 334

insurance coverage of, 71, 334

involuntary commitment to, 352, 354–55

medications administered in, 63, 319

modernization of, 180

psychotherapy received with, 103, 106–8, 333–34, 484

of suicidal adolescents, 63–65, 71–72, 103–4, 105–10

suicides during, 332, 333

psychiatrists:

emotional challenges experienced by, 328, 329–30, 331

euthanasia candidates evaluated by, 425–26, 429, 430, 576n

inappropriate techniques of, 327–29

palliative care by, 441

patient suicides and, 328–30

suicides completed by, 223–24, 251, 327

suicidology education of, 297, 326–27

psychic numbing, 490

psychoanalysis, 323

psychoanalytic theory, 188–90, 205, 236–37

psychodynamic formulation, 324–26

psychological autopsies, 302, 468

Psychopathology of Everyday Life, The (Freud), 189, 269–70

psychopharmacology:

antidepressants, 3, 57, 143, 192, 195, 318, 319–23, 331, 439, 539n, 564n

other treatment modalities vs., 318, 322–23, 326, 334, 439

psychotherapy, 180, 322–26

for elder patients, 439

in groups, 107–8, 324, 333, 484

in hospital setting, 103, 106–8, 333–34, 484

misjudgments in, 327–28

psychodynamic formulation in, 324–26

psychopharmacology vs., 318, 322–23, 334, 439

religious counseling vs., 336–38

for surviving family members, 472–73, 494, 507, 528–29

varieties of, 323–26

Pufendorf, Samuel von, 163

Punic Wars, 151

Puritans, 165

“Putter-to-Sleep, The” (Maupassant), 443–44

Pythagoreans, 145, 146

quality of life, 364, 368–69, 450

Quill, Timothy, 384–85, 389, 442, 572n

Quinlan, Karen Ann, 369–70, 371, 372, 373, 374, 571n

Rachels, James, 415

racial discrimination, stresses of, 251–58, 557n

racial integration, 256

racial pride, 257

Rationalists, 167, 169–70, 171, 172, 174

rational suicides, 2, 146–50, 354, 357, 417–18, 419

Ray of Hope, 533

Reagan, Nancy, 115

Reasons for Living scale, 314

recovery guilt, 532

Reed, Nicholas, 400, 403, 404

Reflections on Suicide (Staël), 172

regression, 519

Rehkugel, Robert, 294–95

Reich, Warren, 368

Reil, Johann, 180

Religio Medici (Browne), 268

religious beliefs, 201–2

of African Americans, 256

on afterlife, 130, 131, 132–33, 134, 135, 137, 152, 154, 226

Buddhism, 135, 137, 142, 235, 323, 397

collective suicides inspired by, 84

on euthanasia, 370, 414–15, 416, 425

of ghosts of suicides, 131–33, 134, 144, 155, 467

Hinduism, 136, 186, 365, 414

on homosexuality, 266

on life-support technology, 415

martyrdom undergone for, 1, 152–54, 155, 275, 547n, 548n

on murder prohibitions, 414–15

social community vs., 186

of Vikings, 134

see also Christianity; Jewish law; Jews

religious community, psychological counseling in, 336–38

Renaissance, 158–74, 366

Enlightenment philosophy and, 167–72, 174

punishments for suicides in, 164–65, 167

suicidal psychology explored in, 160–64

Resnik, Harvey, 307, 473

respirators, 369–70, 371, 571n

resuscitation, 368, 372, 374, 442, 451

Rethinking Life and Death (Singer), 375

retirement, 437, 438, 439

revenge suicide, 133–34, 153, 224–25, 239

reverse psychology, 327–28

Reynolds, David, 333

Rhapsodies on the Application of Psychic Therapy Methods to Mental Disturbances (Reil), 180

right to die, 3–4

AIDS patients and, 264

of elderly ill, 363–64

English activism on, 366–67, 393, 400–401, 403–4

French movement on, 402–3

legal rulings on, 369–70, 371, 372–74, 382, 383, 571n

life with dignity vs., 443

opponents of, 413–37, 444–45

organizational support of, 386, 393–413, 436, 573n

suicide prevention ethics vs., 352–57

see also euthanasia

Right to Die, The (Humphry and Wickett), 422

Rimbaud, Arthur, 276

Ringel, Erwin, 227, 229, 562n

Risk-Rescue Rating, 314

Rivers, Joan, 474

Roberts, Frank, 375, 376

Robinson, Edwin Arlington, 209

Robinson, Henry Morton, 545n

rock music, 86, 88, 242–43

Rofes, Eric, 261, 262

Roger of Wendover, 84

Rogers, Carl, 287

rollback, 320

Rollin, Betty, 375

Roman, Jo, 444

Roman civilization, 131, 148–51, 154, 156, 173, 186, 233, 291, 550n

Romantic movement, 87, 174–76

Romeo and Juliet (Shakespeare), 116, 160–61, 562n

Roscoe, John, 131–32

Rosen, David, 344, 345

Rosenberg, Mark, 38

Ross, Betsy, 533

Ross, Charlotte, 115

Rossi, Rick, 512, 533

Rossi, Tom, 512, 514, 525, 532, 533

rotary chair, 180

Rounsaville, Bruce, 80

Rousseau, Jean-Jacques, 167–68

Rowley (physician), 181

Roy, Alec, 198–99

Royal Dutch Medical Association, 390

Royal Humane Society, 561n

Rubinstein, Arthur, 353

Ruggiero, Christopher, 82–83

Russell, Bertrand, 353

Russia:

religious suicides in, 84

suicide rates in, 246

Russian roulette, 87–88, 274

Ryerson, Diane, 95, 119, 120

Sackett, Walter, 436

sacrificial suicides, 134–36, 186–87

Sadger, Isidor, 188

SAD PERSONS scale, 315

Safe Place, 512–17, 522–23, 524–26, 527, 529

Sainsbury, Peter, 249

St. John-Stevas, Norman, 416

St. Peter’s Basilica, 341, 342

Saito, Yukio, 143

Salk, Lee, 47

Saltzman, Peter, 97

Salvation Army, 293

Samaritans, 294, 302, 307, 310, 401, 515, 521, 522–23

Samson (biblical figure), 152

samurai code, 137–38, 140, 141, 235, 268, 545n

San Diego, Calif., high suicide rate of, 249

Sandinistas, suicide reports censored by, 246–47

San Francisco-Oakland Bay Bridge, 344–45

San Francisco Suicide Prevention, 309–10

San Mateo County, Calif., adolescent suicide cluster in, 114–15

Satcher, David, 310

Saul (biblical figure), 151, 267

Saunders, Cicely, 421, 441

Savage God, The (Alvarez), 49, 161, 230, 234

Scandinavian culture, 131, 134, 244–45

scapegoats, 492

Schatzberg, Alan, 335

Scheinin, Anne-Grace, 229

Schiavo, Michael, 372, 373

Schiavo, Theresa Marie, 4, 372–74, 416, 435

Schindler, Mary, 372–73

Schindler, Robert, 372–73

schizophrenia, 41, 272, 318, 319, 330

Schonberg, Kenneth, 35, 36, 92

Schonheyde, Dr., 179

Schreber, Dr. (Freudian case history), 189

Schur, Max, 389

Schweitzer, Albert, 415

Scott, Richard, 395

Scott, Robert Falcon, 186

Scythians, suicide practices of, 135, 431

seclusion rooms, 338

Seconal, 386, 393, 419

Second Treatise on Government (Locke), 171–72

Seiden, Richard, 257, 344–45, 346, 420, 437

selective serotonin reuptake inhibitors (SSRIs), 3, 142–43, 192, 319, 320–23, 331

self-defense, killing in, 415

Self-Destruction in the Promised Land (Kushner), 248

self-destructive behaviors:

of adolescents, 45–46, 83

of autoerotic asphyxiation, 83

of children, 539n

extreme recreational risk as, 274–75, 560n

homosexuality seen as, 261–62, 558n

range of, 205

Russian roulette, 274

of self-mutilation, 259, 271

of substance abuse, 41, 46, 48, 62, 73–74, 93, 99–100, 101, 103–5, 106, 263, 271–73

suicide vs., 268–78

as survival technique, 270–71

withdrawal as, 276–77, 278

self-esteem, 43, 46, 47, 260

self-image, damage to, 223–24

self-mutilation, 259, 271

Selzer, Melvin, 274

Senate, U.S., on Schiavo case, 373

Seneca, 149–50, 365, 416, 581n

separation, 46–47

seppuku, 137–39, 141, 142, 186

September 11, 2001, terrorist attacks of, 1–2, 268

Seress, Reszo, 87

serotonin, 40, 47–48, 192–93, 195–97, 199, 201, 250

selective serotonin reuptake inhibitors, 3, 143, 192, 319, 320–23, 331

“Serotonin Chemistry in the Brain of Suicidal Victims” (Arango and Underhill), 201

Servius, 233

Setting Limits (Callahan), 433

Sexton, Anne, 11, 238

sexual abuse, 45

sexual identity, 3, 48, 66, 101–2, 261–66, 558n

Shaffer, David, 48, 118–19, 120, 542n–43n

Shakespeare, William, 160–61, 163, 165, 362

shame:

as suicide motivation, 223

of surviving families of suicides, 455, 467, 468–72, 474, 475–76, 480

Shaw, George Bernard, 366

Shein, Harvey, 327

Shelhamer, Julia, 295

Shelley, Percy Bysshe, 175, 241

Shilts, Randy, 264

ship of fools, 336

Shneidman, Edwin, 229, 295–98

on biological influence vs. psychosocial factors, 199–200

career of, 295–96, 303–4, 305, 307, 350, 351

on degree of risk, 301

on euthanasia, 575n

on Koestler double suicide, 418

on motivation, 221–22, 353

multidisciplinary approach proposed by, 338

on psychological needs of survivors, 473

public education advocated by, 304, 312, 316

research studies of, 296–97, 301, 330

right to suicide repudiated by, 353

on suicide as inverted murder, 189

suicide defined by, 40

on suicide notes, 239, 240

suicide prevention work of, 298, 300, 302, 303–4, 305, 306, 308, 312, 316, 317, 325, 397

shock treatment (electroconvulsive therapy) (ECT), 194, 565n

Short, James, 204

Siam, royal burials in, 135

Siberia, elderly deaths in, 134, 431

Silius Italicus, 134

Silverstein, Michael, 240

Simeon Stylites, Saint, 153, 560n

Simon, Robert, 314, 315

Sinatra, Frank, 23, 224

Singer, Peter, 375

single parents, 253

situational depression, 42, 484

situational suicide, 308

Sixth Commandment, 154, 156, 414–15

60 Minutes, 382

Slater, Eliot, 401, 436

slaves, 150, 151, 154, 255, 352, 467, 557n

sleeping difficulties, 79, 112

Slender Thread, The, 305

slippery slope hypothesis, 420–21, 422–23

Smith, Bridget, 166–67, 174

Smith, Judie, 81

Smith, Kim, 38–39

Smith, Richard, 166–67, 174

smoking, 268

social integration, 185, 186, 187, 204, 245, 249, 256, 257, 438

socialism, 244

Social Meanings of Suicide, The (Douglas), 204

Social Reality of Death, The, 504

Social Security, 439

sociology, as science, 185, 187

Socrates, 145–46, 149, 268, 386, 395, 408

sodium pentothal, 377, 378

soldiers, suicides of, 84, 145, 150, 186, 275

Solomon, Andrew, 322, 419

Sorrows of Young Werther, The (Goethe), 86–87, 89, 168, 175, 176

SOS High School Suicide Prevention Program, 119–20

soul, transformation of, 356

South Africa, anti-apartheid prisoners in, 560n

Soviet Union, suicide statistics suppressed in, 246

Soylent Green, 444

SPC (Suicide Prevention Center), 282–90, 317, 523

Speak of the Devil, 86

Speijer, Nico, 443

Spenser, Edmund, 160

Spirit of Laws, The (Montesquieu), 173

“Spiritualism and Suicide,” 306

Spoonhour, Anne, 15, 16–17, 18, 20–21, 24, 25, 26, 27, 28, 30, 31, 34, 35, 124–26

Spoonhour, Giles, 16–18, 20–21, 24, 26, 28–29, 30–31, 34, 35, 124–26

Spoonhour, Justin Christopher, 15–37, 39–40, 48, 49, 59, 79–80, 111, 122–26, 130

Spoonhour, Leah, 18, 20, 21–22, 26, 30, 124, 125

sports, extreme, 275, 560n

spring, suicide increase in, 184, 249–50

SSI (Beck Scale for Suicide Ideation), 314

SSRIs (selective serotonin reuptake inhibitors), 3, 142–43, 192, 319, 320–23, 331

Stack, Steven, 250–51, 256

Staël, Anne-Louise-Germaine de, 172

starvation, suicides by, 144

state psychiatric hospitals, 334–35

status, loss of, 222–24, 252

status integration, 204

Steele, William, 116–17

Steincrohn, Peter, 277

Stekel, Wilhelm, 188, 236–37, 355

Stelmachers, Zigfrids, 355, 357

Stengel, Erwin, 96, 240

sterilization, compulsory, 367, 570n

Stevens, Kenneth, 417

Stevenson, Robert Louis, 443

stigma, 36, 467, 181–82, 471–76

Stoics, 147, 149–50, 151, 163, 168, 365

Stone, Alan, 327, 328, 332

Strachey, Lytton, 222

Strahan, Samuel, 181, 471

stress, 196

Strozzi, Philip, 166

Styron, William, 44, 229, 333–34, 474

substance abuse, 41, 271–73

adolescent suicide vs., 46, 48, 62, 73–74, 93, 99–100, 101, 103–5, 106

homosexuality and, 263

mental illness vs., 272

success, depressive response to, 224

succinylcholine, 377

Suetonius, 365

suffering:

intrinsic value ascribed to, 154, 171, 172, 416

see also pain; pain management

suicidality, treatment options for, 312–39

compliance issues in, 320, 336, 564n

crisis counseling, 317

early lack of, 297–98

efficacy of, 316, 317

for elderly, 439

electroconvulsive therapy, 565n

under managed care, 331, 566n

medication used in, 3, 57, 143, 192, 195, 318–23, 539n, 564n

misjudgments in, 327–29, 331–32, 565n

multidisciplinary approach advocated for, 338

by primary care physicians, 331–32, 566n

professional training in, 326–27, 331–32, 566n

in psychiatric hospitals, 332–37

psychotherapy as, 318, 322–26, 327–28, 439

by religious counselors, 336–38

therapists’ availability in, 325–26, 329

see also suicide prevention

suicide:

additional unintended victims of, 354

aftermath of, see suicide, surviving family members after

altruistic, 1, 186–87

in anger, 491

anomic, 187, 188, 255, 551n

attempted vs. completed, 38–39, 95–97, 353, 438, 474

biological factors in, 3, 41, 47–48, 178, 191–94, 195–201, 470–72

case histories of, 15–37, 59–79, 93–94, 97–110, 121–26, 209–20

climate effects on, 173–74, 177–78, 183–84, 249–50, 550n

collective, 84–85, 143

concern for others as disincentive to, 497, 581n

contagion of, 78–92, 496

by cop, 254, 275

defined, 267–69

demographics of, see suicide, demographics of

double, 139–40, 143, 175, 225, 392–93, 395, 404, 418–19, 446, 448, 450, 575n

euthanetic, see euthanasia; right to die

as evidence of mental illness, 173, 178–82, 202, 292, 354, 355–57, 550n

exhibitionism and, 151, 341–42

family history of, 197–98, 199, 200, 470–72, 495, 554n

film portrayals of, 87–88, 90–91, 141, 523

fluctuating risk periods for, 57

homosexuality viewed as form of, 261–62, 558n

as literary subject, 86–87, 116, 140–41, 160–61, 167–68, 175–76, 443–44, 494, 495

in mass media, 79, 81, 82–83, 86–92, 542n–43n

medical professionals’ responses to, 96, 97, 292, 298, 544n

metaphorical forms of, 276–78

methods of, 184, 185, 233–39, 251, 346–47, 438–504, 555n

motivations of, 96, 133–34, 221–32, 356, 431–35, 492

multifaceted causality of, 201–2, 204–6

murder followed by, 90, 140, 225–26

notes found after, 239–43, 295–96, 452, 483, 580n

other self-destructive behaviors vs., see self-destructive behaviors

of parent, 44, 197–98, 472, 495–96, 497–501

performance type of, 245

physician-assisted, see euthanasia, physician-assisted

psychiatric disorders vs., 41, 119, 173, 178–82, 202, 221, 318, 355, 550n

in psychiatric hospitals, 332, 333

psychological autopsies on, 302, 468

in public landmark settings, 143, 340–46, 353, 561n, 567n

rates of, 2, 3, 9, 11, 37–38, 51, 56–57, 141–42, 182–84, 185, 197, 244–51, 252, 307, 314, 347, 426, 539n, 551n

rational, 2, 146–50, 354, 357, 417–18, 419

as revenge, 133–34

as revolutionary act, 402

right-to-die debate on, see euthanasia; right to die

scientific research on, 131, 177–201

as sole option, 2, 50, 227

of terrorists, 1–2, 186, 225, 226

timing factors of, 173, 178, 184–85, 249–50, 297

transformation as motive of, 356

see also suicidality, treatment options for; suicide, demographics of; suicide, historical views of; suicide, surviving family members after; suicide prevention

Suicide, 402–3

suicide, demographics of, 244–78

African Americans, 234–35, 251–58, 263, 557n–58n

age of, 134, 147, 185, 221, 253, 258, 427, 437–38; see also adolescent suicide; elderly, suicides of

of cancer patients, 418

in former Soviet states, 3, 246

for Hispanic Americans, 258–59

homicide rates vs., 252, 558n

homosexuality and, 3, 261–66, 558n

in males vs. females, 38, 39, 43, 95, 185, 221, 250–51, 256, 427, 438, 503, 558n

marital status, 185, 186, 221, 256, 427, 438

methods, 184, 185, 233–36, 251, 347

nationality, 183, 184, 187, 197, 222, 234, 244–48

for Native Americans, 258, 259–61

in primitive societies, 186, 551n

profession, 235, 236, 250–51

psychiatric disorders vs., 119, 355

race, 221, 222, 234–35, 251–61, 427, 438, 557n–58n

religious denomination, 186, 246

rural vs. urban, 3, 177, 185, 186, 187, 248–49, 257

seasonal changes vs., 249–50

social class, 184, 222

social integration factors and, 185, 186, 187, 204, 245, 249, 256, 257, 438

substance abuse vs., 41, 272

of surviving family members, 473, 494–95

systemic underreporting of, 246–47

suicide, historical views of, 129–206

Christian, 131, 151, 152–57, 158, 159, 162, 163, 177, 475

in classical civilizations, 144–57, 186, 550n

by Enlightenment thinkers, 167–72, 174, 177, 181

etymology of, 267–68

as evidence of insanity, 173, 178–82, 550n

ghost beliefs in, 131–33, 134, 144, 155, 467

in Greek culture, 144–48, 156, 159, 186, 233, 267, 365, 443, 550n

in Japan, 137–43

as medical problem, 177–82, 201, 468, 469–72

moral judgments in, 131, 132, 134, 154–57, 161, 165–66, 202, 203–4, 553n

in Old Testament, 151–52, 267

in primitive societies, 131–36

psychoanalytic understanding of, 188–90, 205, 236–37

in Renaissance, 158–74, 366

in Roman civilization, 131, 148–51, 154, 156, 173, 186, 233, 267, 291, 550n

Romanticism and, 174–76

in scientific context, 131, 177–90, 194–96, 306, 561n

sociological approaches in, 177, 182–88, 204

state sanctions and, 131, 136, 138, 139, 141, 147, 150, 155–56, 159, 164–65, 167, 168, 171, 172–73, 203, 466, 467–68, 579n

stigmatization in, 181–82, 467–76

surviving families affected by, 466–75, 579n

on treatments, 179–80, 194–95

Suicide, Le (Durkheim), 89, 185–87, 204, 255

suicide, surviving family members after, 455–536

anniversary dates recognized by, 509, 513, 527, 532

answers sought by, 455, 482–83, 493, 503–5, 506, 507, 533, 580n

in case histories, 455–65

celebrities, 474

children, 497–501

conspiracy of silence maintained by, 493–94

denial responses of, 490, 493–94

dreams of, 483–84, 490, 493, 501, 502

estate forfeitures suffered by, 466, 467–68, 475, 579n

friends’ discomfort with, 476, 520–21

grieving processes of, 481–88, 489–94, 497–99, 531–37

guilt feelings of, 455, 473, 482, 483, 490–92, 495, 504–5, 516, 520, 532

historical stigmatization of, 466–76, 579n

holiday observances of, 505–6, 513, 516, 525

numbers of, 474

parents, 475, 491, 494, 517–21, 532

positive changes experienced by, 534

psychotherapeutic counseling received by, 472–73, 494, 507, 528–29

relief experienced by, 492–93

research on, 473–74

shame experienced by, 455, 467, 468–72, 474, 475–76, 480

siblings, 495

spouses, 455, 465, 477–87, 494, 533

suicide risks of, 473, 477, 485, 494–97, 502, 516

support services organized by, 474, 512–17, 521–26, 533

Suicide (Fedden), 182, 472

Suicide Act (1961), 131, 203, 394, 400

Suicide and Insanity (Strahan), 181, 471

Suicide and the Meaning of Civilization (Masaryk), 183

Suicide and the Soul (Hillman), 227, 356

suicide attempts:

of adolescents, 38–39, 95–97, 438

as communication effort, 96

completed suicides vs., 38–39, 95–97, 353, 438, 474

punishment of, 164, 165

repeat occurrences of, 96–97, 229, 271

transformation effects of, 227

“Suicide Club, The” (Stevenson), 443

Suicide Hall, 341

Suicide in America (Hendin), 234–35, 237

suicide prevention:

acute crisis in, 301

for adolescents, 2, 32, 37, 79, 111–20, 259, 260–61, 543n

biological vulnerability tests in, 197

of Canadian Inuits, 260–61

centers established in, 298–311, 362n

civil liberties issues in, 352–57

crisis hotlines, 9, 37, 142, 281–90, 305, 309–11, 317, 439, 562n–63n

development of, 291–308, 561n, 562n

effectiveness of, 118–20, 306–9, 310–11

federal support of, 298, 303, 304, 307–8, 310, 562n

first-hand grief experience as factor in, 496–97

gun ownership precautions and, 347–48, 568n

historical survivor penalties as, 467–68

in Japan, 142

lay volunteers trained in, 286–87, 290, 302, 309

outreach activities in, 292–93, 300, 301, 439

physical barriers installed for, 342–46, 349

prevalent public support for, 349–50

public education on, 304, 312, 316

public safety policies in promotion of, 342–49

resistance to, 125–26, 292, 316–17, 330

risk assessment in, 301, 313–16, 325, 326, 563n, 565n

in schools, 2, 32, 37, 111–20

services refined in, 309–10

surviving families’ needs addressed in, 472–73

verbal/behavioral clues noted in, 112, 115, 301, 312–13, 316, 504

see also suicidality, treatment options for

Suicide Prevention Center (SPC), 282–90, 317, 523

see also Los Angeles Suicide Prevention Center

Suicides Anonymous, 522

“Suicide Solution” (Osbourne), 86, 88

suicidology, 304–6, 562n

Summa Theologiae (Thomas Aquinas), 156

support groups, 474, 512–17, 521–26, 533

Supreme Court, U.S., right-to-die cases of, 4, 371, 374, 382, 383

surgeons, 251

surrender, suicide vs., 84, 145

survivor guilt, 497

survivors, see suicide, surviving family members of

Survivors of Suicide (Cain), 473

Sutherland, Kathleen, 387

Sutherland, Peggy, 387–88

suttee, 136, 186

Sweden, suicide rates of, 244–245, 246, 248, 252, 566n

Switzerland:

assisted suicide permitted in, 573n

suicide rate of, 246

Sym, John, 163–64, 269

“Symptomatology and Management of Acute Grief, The” (Lindemann), 488

Szasz, Thomas, 352, 354–55, 356–57

Tacitus, 149

Takashimadaira public housing complex, 567n

Takeyoshi, Ohara, 138

Tale of Two Cities, A (Dickens), 241

Tarquinius Priscus, Lucius, 291

Tartars, 431

technological innovations, death delayed with, 368–75, 415, 431–32, 571n

TeenScreen, 120

television programs, 53–54, 55, 90–91, 542n–43n

Temptation of Saint Anthony, The (Flaubert), 153

terminal illness:

defined, 381

discoveries in treatment of, 416

HIV/AIDS as, 264

pain management in, 440

psychological effects of, 417–18, 429

spiritual value of, 416

terminal sedation, 374

terrorists, 1–2, 186, 225, 226

Tertullian, 153

Tezcatlipoca, 135

Thomas Aquinas, Saint, 156, 171

Thorazine (chlorpromazine), 63, 318–19, 518

Thracian sacrificial suicide, 135

thrift (economic) suicide, 134, 166–67, 431–32, 434–35, 437, 551n

thrill seeking, 274–75, 560n

Thucydides, 145

Tiebout, John, 46

Timon (of Athens), 147

Titanic, 523

Tokyo, Japan, suicide landmarks in, 567n

Tolstoy, Leo, 353

Tomita, Masako, 341

Tondo, Leonardo, 319, 320

Too Young to Die, 504

Totem and Taboo (Freud), 189

Toynbee, Arnold, 455

Traitor Within, 250

tranquilizers, 319, 482

Treatise on Madness, A (Battie), 177–78

tricyclic antidepressants, 319, 320, 321

Tschuktschi, 431

Tshi-speaking peoples, 133

Tuke, D. H., 550n

Tuke (English cleric), 163

21 Delightful Ways of Committing Suicide (Bruller), 573n

twin studies, 198–99

Ueki, Mieko, 341

Uganda, tribal suicide customs in, 364

Ulysses (Joyce), 471

Undertaking, The (Lynch), 239

Underwood, Mark, 191–92, 193, 201

unemployment, 247, 253

United States:

antisuicide laws in, 165

ethnic minorities of, 234–35, 248, 251–61, 263, 557n–58n

euthanasia legislation in, 366, 376, 377

gun ownership in, 347–49

migrations within, 248, 256–57

suicide prevention begun in, 291–93, 294–95

suicide rates in, 9, 37–38, 56–57, 247–49, 252, 256, 258–59, 307

Western states of, 247–48

urban life, 3, 177, 183, 185, 186, 248–49

Urquhart, A. R., 470

utilitarianism, 167, 421

Utopia (More), 159–60, 164, 443

Utter, Robert, 337

Valentine’s Day, 249

Valerius Maximus, 147, 149

Van Helmont (physician), 179

van Praag, Herman, 201

Varah, Chad, 294

Veith, Ilza, 354

Vermont, suicide rate of, 248

Victorian era, 471

Victoroff, Victor, 117–18

video games, 541n

Vienna, Austria, suicide prevention in, 293

Vienna Psychoanalytic Society, 86, 188, 190, 347

Vierkandt, Alfred, 551n

Vietnam War, 38, 235, 247

Vigny, Alfred-Victor de, 176

Vikings, 131, 134

Villemair, 184

violence:

in African-American experience, 252–55

family history of, 252–53

media portrayals of, 54–55, 90–91, 541n, 542n–43n

of suicide method, 237, 407

Virgil, 156, 166

Vitelli, Karen (fictitious name), 499–501

Vitelli, Linda (fictitious name), 499–500, 501

Vitelli, Mary (fictitious name), 499–501

Vitelli, Rose (fictitious name), 499, 500–501

Voices of Death (Shneidman), 229

Voltaire (François-Marie Arouet), 167, 168–69, 174, 469

voluntary euthanasia, 375, 388–91

see also euthanasia

Voluntary Euthanasia Society, 366–67, 393, 400, 404, 436

Vonnegut, Kurt, 444

Wacker, Warren, 96

Wajagga, 132

Wallace, Samuel, 354

Walpole, Horace, 174

Walters, Paul, 42

“Wanting to Die” (Sexton), 238

war:

biblical murder prohibition vs., 415

military suicides and, 84, 145, 150, 186, 275

soldiers’ heroism in, 275

suicide rates during, 186, 247

thrill of, 275

warning signs, 37, 42, 79, 112–16, 163, 304, 312–13, 316

Warren, Henry Marsh, 291–93

Warren, Henry Marsh, Jr., 293

warrior cultures, 134, 137–38, 145, 259, 291

Washington, assisted-suicide ballot measure in, 385, 405

Web sites, suicide-related, 91, 143

Webster, Daniel, 222

Wechsler, James, 475–76

Wechsler, Michael, 476

Weisman, Avery, 314

Weiss, Nathan, 188

Weissman, Myrna, 80

Welch, Tom, 512–13, 515–16, 522, 524–25, 526, 531, 533

“Welcome to the Monkey House” (Vonnegut), 444

welfare policies, 244, 245

Weller, Sheila, 491

Welles, John, 375–76

Wells, H. G., 366

Werther effect, 89, 90

Wertherism, 87

Wesley, John, 174

Westchester County Mental Health Association Interagency Task Force on Adolescent Depression and Suicide, 113–14, 119

Westchester suicide cluster, 11, 78–79, 82–83, 88, 92, 114

Westermarck, Edward, 364–65

Whalley, Elsa, 303

Wheat, William, 328–29

Wheeler, Jim, 265–66

Whitaker, Robert, 194

Whose Life is It Anyway? (Clark), 369

Why Survive? (Butler), 437, 439–40

Wickett, Ann, 394, 395, 404, 573n–74n, 575n

widows:

sacrificial suicides of, 135–36, 145, 222, 226, 235

see also suicide, surviving family members of

Wiener, Jerry, 331

Williams, Huntington, 375–76

Williams, S. D., 366

Wiltsie, Gordon, 275

Winslow, Forbes, 83, 179, 180, 470–71

Winter Name of God, The (Carroll), 277–78

witchcraft, 548n

Wobber, Harold, 340, 342

Wolf, Diana, 27, 31–32, 33, 35, 124

Wolfgang, Marvin, 275

Wolf Man (Freudian case history), 189

Wollstonecraft, Mary, 241

Woman at Scotland Yard, A (Wyles), 203

women:

eating disorders of, 273

elderly, 443

male depression rates vs., 43, 95

in male-dominated professions, 251

male suicide rates vs., 38, 39, 43, 185, 221, 250–51, 256, 427, 438, 503, 558n

Wood, J. M. S., 470

Woolf, Virginia, 224

Worden, William, 314, 488

Wordsworth, William, 49, 175

World Trade Center, 1, 2, 268

wrist-cutting, 96–97, 271, 327–28

Wurtzel, Elizabeth, 319

Wyles, Lilian, 203

Wyoming:

Native-American suicide cluster in, 259

suicide rate of, 247

Xanax, 482

Yellow Ribbon Suicide Prevention Program, 120

Yolles, Stanley, 303

Youk, Thomas, 382, 389

Young, Edward, 174

Youngner, Stuart, 418

Youth in Crisis, 117

Zeno, 147

Zilboorg, Gregory, 43, 202, 205, 295, 558n

Zimri (biblical figure), 151–52

Zoloft, 319, 321