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This note looks at what has variously been characterised
as cybersuicide, suicide surfing, exit chat rooms and e-suicide.
It covers –
- introduction
- what is cybersuicide?
- statistics
and sensationalism – questions about the number of
sites, their nature and their impact
- media
circuses and moral panics? - cybersuicide as a media
phenomenon and focus for social anxieties or discontents
- regulation
- restrictions on publication and interaction
- Australia
- experience in Australia and New Zealand, including key
figures and the Criminal Code Amendment (Suicide Related
Material Offences) Bill 2004
- studies
- writings about suicide online and offline
It
supplements the discussion elsewhere on this site regarding
censorship & free speech,
usenet, chat
rooms and life online.
introduction
Policymakers, pundits and the media periodically discover
'internet suicide sites' and chatrooms at home and abroad.
That ongoing rediscovery is marked by -
- expressions
of alarm, typically about an "alarming rise" in
the number of deaths (or merely number of sites)
- calls
for the strengthening of existing restrictions and establishment
of new restrictions that are specific to the net
- claims
that the net is uniquely powerful and that such sites are
associated with a range of disorders or pseudo-disorders
such as 'internet addiction'
- exposes
of the lives of those who have completed or attempted suicide
- often with only a peripheral connection to the net - and
more recently to other people online who have "preyed
on them" as "peddlers of death" or "psychopaths"
- a
concentration on "the depressed and disturbed"
(or the exotic, such as suicide pacts in Japan and South
Korea) rather than those people whose demise is perceived
to be "respectable" because they are in intolerable
physical pain through for example cancer.
Skeptics
have questioned much of the anxiety, noting the paucity of
major studies and hard data, or questioning the efficacy of
some legislative fixes. Some have commented that the net is
arguably less powerful than traditional media in romanticising
death or promoting emulation. Others have
What has been bundled as cybersuicide encompasses a range
of online activity, including -
information
sources about religious, ethical or broader cultural aspects
of suicide. Some are discrete sites or pages; others form
part of academic, personal or commercial collections of
resources regarding individual philosophers such as David
Hume
and Aquinas, the relationship between the individual
and the state, the literary imagination or other matters
technical resources, including guides (of varying accuracy)
about using and obtaining poisons or other tools for felo-de-se
online content that provides psychological guidance
chatrooms - virtual meeting-places in which participants
can exchange text/other messages on a near real-time basis.
Criticism
of static publications and fora about suicide has taken two
forms.
Some critics have argued that information should not be available
online, as online access supposedly lacks the safeguards provided
by retailers, librarians or other intermediaries encountered
offline. Others claim that information online is likely to
be inaccurate or without context, for example not juxtaposed
with texts on the sacredness of life.
That has been characterised as essentially an argument against
ease of access: the same information (accurate or otherwise)
is available offline in bookstores, highschool classrooms,
newspapers and biopics about pop figures.
Calls for 'quarantining' online information have been dismissed
as unfeasible, given -
- the
global nature of the web
- disagreement
about what should be taken offline or restricted through
an age-based access mechanism
- the
apparent low priority of most societies - or merely most
governments - in expunging information about basic chemistry
or ethical issues.
A somewhat more serious argument is the claim that the interaction
of people in chatrooms - and indeed in usenet and email newsgroup
postings - is more potent than merely reading a few pages
of Pavese, Plath, Camus or Goethe. Some vulnerable people
may, it is claimed, be led astray or egged on by others. Australian
academic Pierre Baume has thus warned about 'bragging' in
such fora as a driver for suicidal behaviour among young people,
particularly those whose most intimate interaction occurs
via a keyboard.
statistics and sensationalism
One reason for caution in accepting or dismissing such claims
is the paucity of detailed and rigorous studies. There have
been a handful of academic papers, most - as discussed below
- drawing on tiny populations and offering little evidence
regarding causation.
How many 'suicide sites' are there? How many people are using
them? What are the demographics?
Answers about the number of sites vary widely: we have encountered
estimates of 900 sites and estimates of over 20,000, although
counts are blurred by disagreement regarding what constitutes
a suicide site or a suicide-related forum. It would be surprising
if, among the millions of sites
and billion plus pages on the net, there wasn't content devoted
to suicide methods. Commercial metrics services have not been
interested in identifying such content or chat. It is thus
difficult to substantiate hyperbole such as
The
Internet is packed with what are called suicide sites, where
those with the urge to end it all can find the best way
to go about doing themselves in and can even find buddies
so they don't have to perish alone.
So much for Dorothy Parker's advice that
Razors
pain you;
Rivers are damp;
Acids stain you;
And drugs cause cramp.
Guns aren't lawful;
Nooses give;
Gas smells awful;
You might as well live
Our
rough counts in 1997, 2000 and 2004 suggested that there were
in fact more sites, more web pages and more support networks
dedicated to helping potential suicides (and, as importantly,
their families/acquaintances) than sites urging people to
shuffle off the mortal coil.
Detailed figures about use of suicide sites and fora such
as the Alt.Suicide.Holiday (ASH)
usenet group - simply are not available.
Has access to the net - and to chat rooms or 'exit' sites
- resulted in significant increases in the number of attempted
and completed suicides?
One answer is that no-one knows. Rigorous large-scale information
about a remaining great taboo is still lacking in most societies
and analysts have rightly warned about confusing correlation
and causation in what is often complex behaviour. It is difficult
to discern a clear influence, in contrast to the so-called
Werther Effect that is associated with the demise of adults
younger people emulating their peers after suicides publicised
in print, broadcast or by word of mouth. For the historian
some of the recent claims about cybersuicide are strongly
reminiscent of 1980s hype about heavy
metal, with susceptible teens being led on a downward
spiral to despair by listening to headbangers in black tshirts
and purple lipstick.
Have researchers identified particular susceptibilities?
One striking feature of the literature about cybersuicide
is its thinness and - in welcome contrast to far-reaching
claims by proponents of internet addictive disorder - its
modesty. There is little detailed writing; most citations
are to a handful of letters or articles rather than in-depth
research. The conclusions drawn by the authors are often unexceptional.
The much-cited 1999 AJP Letter
by Alao Adekola, Jennifer Yolles & Wendy Armenta on Cybersuicide:
The Internet and Suicide thus reports
on two suicide attempts in which information about the methods
used were obtained from the Internet. Both cases illustrate
the danger of having access to information by means of the
Internet. Such information may prove detrimental to vulnerable
psychiatric patients. ...
Mental health care providers should counsel patients about
alternatives to surfing the Web at times of crisis. Help
may be available by calling crisis lines, clinicians, friends,
or family members.
Much
the same might be said about the dangers of access to libraries
or - given concerns about legitimation and emulation - to
reporting in the mass media and in novels and videos.
Cybersuicide or Werther-Effect online: Suicide chatrooms or
forums in the World Wide Web paper by Katja Becker, Mahha
El-Faddagh & Martin Schmidt similarly comments that
advice
in the mass media is of utmost importance in suicide prevention
with regard to copying suicide methods. The internet, and
the opportunities it provides for anonymous exchanges of
thoughts poses additional risks for vulnerable adolescents
with suicidal ideas. Chatrooms provide a space for adolescents
- whether suicidal or interested in suicide - to exchange
their thoughts, and may therefore allow risks and fantasies
to be reduced, or may possibly increase the desire to commit
suicide.
It
concludes that
Scientific
studies are necessary to document internet media effects.
Physicians, psychotherapists, and parents should be informed
about suicide web pages and chatrooms. Internet-specific
media guidelines, internationally valid laws, and suitable
online information channels should be established.
The
net has, however, received little attention in government
mental health and suicide prevention strategies. The recent
National Suicide Prevention Strategy for England for example
simply failed to mention the internet, with officials subsequently
responding to media brouhaha with a statement about plans
to
investigate
the legality and feasibility of censuring websites which
promote or encourage people to take their own lives.
The
World Health Organization estimates that around one million
people die from suicide each year (one death every 40 seconds),
with a global mortality rate of 16 per 100,000. The WHO claims
that suicide rates have increased by 60% worldwide over the
past 45 years, arguably a reflection of both affluence and
of the weakening of taboos against reporting attempted/completed
suicide. Its aggregation of national figures is here.
Other base data is -
media circuses and moral panics?
One journalist commented to us that "e-death is going
to be funkier than kiddie porn and can be discussed over dinner
without making your guests lose their lasagne".
Media coverage has centred on
- the
existence of online suicide instructions and their potential
restriction
- claims
that chat rooms include "encouragers" (ie participants
goading the unhappy into suicide but not joining them in
an attempt)
- online
suicide pacts, with claims that groups connect online for
organisation of "mass suicides".
That coverage has featured lines such as
"Lives
burn out in embers of online death pacts"
"moral rape" by internet "psychopaths"
"suicide sites are as dangerous and pernicious as child
porn sites are to young children"
"They met in an Internet chat room, engaged in bleak
dialogues, and planned a mass suicide for Valentine's Day"
or
the more modest "Evidence exists that at least one person
downloaded carbon monoxide poisoning instructions from the
[ASH] site before killing herself".
In
a 2005 UK House of Commons debate an MP commended a colleague
for highlighting
the
case of Sarah who, after discussing suicide in an internet
chat room, purchased a book from Amazon.com on how to commit
suicide and subsequently killed herself. My hon. Friend,
in his early-day motion, called for legal action to be taken
against those who write, publish or sell material or distribute
information on the internet about how to commit suicide.
I echo that call. ...
Our regional newspaper, the Lancashire Evening Post,
and its campaign "Stop the peddlers of death"
have highlighted this and other tragic cases of suicide.
Does my hon. Friend agree that libraries that stock manuals
to encourage suicide should remove them from their shelves
immediately?
Suicidologist
John Connolly fretted that
Young
men spend a lot of time surfing the net and they are also
those at most risk of suicide … We know that if vulnerable
people get into these sites it can easily tip them over
the edge. Some of them are sick and bizarre but for a lonely
and isolated young person they can give a sense of credibility
and recognition. They normalise suicide and that is unhealthy.
Since 2000 most attention has involved online suicide pacts,
particularly in parts of Asia with a tradition of multiple
suicides - "Every night across Japan, hundreds of people
meet on-line, looking for strangers to die with".
Pacts are not new; they have involved figures such as Heinrich
von Kleist and as Sundararajan Rajagopal noted in a thin 2005
BMJ item on 'Suicide Pacts and internet' a suicide
pact occurs roughly once a month in the UK, typically involving
people well known to each other, mostly spouses, most of
them childless. Most of the victims belong to social classes
I, II, and III, and a noteworthy proportion work in professions
allied to medicine.
The
prevalence of completed pacts involving more than two people
and the net is unclear, although our survey of newspaper coverage
in 2005 suggests that outside East Asia it has only a curiosity
value ... most people are still dying alone.
regulation
Constraints on attempted/completed suicide, on its discussion
and its 'promotion' or 'facilitation' vary from jurisdiction
to jurisdiction. Those constraints in the past have included
-
- criminalisation
of attempted suicide (decriminalised in England in 1828)
-
public hanging of completed/attempted suicides
- burying
the departed (along with witches, heretics and sodomites)
under crossroads or excluding them from 'proper burial'
- confiscation
of the estates of completed suicides
- censorship
of texts that "glamorize" suicide or provide guidance
about suicide mechanisms
- bans
on films and broadcasts that encourage suicide
- government
expectations that the mass media will "exercise restraint"
in reporting suicides
- criminalisation
of those directly/indirectly "abetting" suicide.
Contemporary
legislation about suicide sites/rooms varies considerably,
reflecting community perceptions about the responsibilities
of the state, emphases on free speech and the impact of particular
campaigns that have sought to address concerns about online
access to bombmaking information, 'death kits' or pornography.
That legislation is necessarily territory-based and accordingly
is challenged by the global nature of the net. It is unclear
whether any sites/rooms have sought to evade restrictions
by moving to a friendlier jurisdiction. Some appear to have
relied on a low profile, on the defense that information online
is readily available offline or that information is offered
in the spirit of scholarship or even entertainment.
One Swedish site thus notes
This
file is provided for the purposes of amusement, and the
actual use of any of these methods is not recommended without
first considering other possibilities, such as dying of
old age. Please do not pass it onto people whom you know
to be actively suicidal ... you may find yourself in jail
for considerable periods.
In
Australia the Customs Act forbids the export and
import under "any circumstances" of 'suicide devices',
ie
Devices
designed or customised to be used by a person to commit
suicide, or to be used by a person to assist another person
to commit suicide.
2002
amendments to the Customs (Prohibited Imports) Regulations
1956 included an absolute prohibition on "documents
that promote the use of such devices or counsel, incite or
instruct a person to commit suicide using such devices".
That is arguably of little value if potential readers can
simply turn to Google rather than their post box or bookshop.
Australia
Anxieties in Australia and New Zealand about cybersuicide
have followed the same trajectory as overseas, with opportunistic
statements by some advocacy groups and experts, claims by
politicians and health service professionals, and inclusion
of boilerplate in government strategies aimed - appropriately
or otherwise - at 'high risk' groups (notably young males).
The suicide rate in Australia in 1996 was 13 deaths per 100,000
of population. That rate was broadly the same as the average
for suicide in Australia over the preceding 75 years, given
fluctuations associated with wars and the 1930's economic
depression. Suicides in younger men tripled between 1960 and
1990 before youth suicide rates stabilised in the 1990s.
Rates for immigrants are approximately similar to suicide
rates for the Australian-born. Unsurprisingly, rates appear
to be higher for individuals born in cultures that have higher
suicide rates (eg Northern and Eastern Europe and Oceania)
and lower for individuals who migrated from cultures with
lower suicide rates (eg Southern Europe, Asia and Muslim countries).
In 1992 around 25% of all suicides in Australia were by migrants,
with about 40% of those by migrants from English-speaking
countries
The rate of completed and attempted suicide in Australia is
generally recognised as being under-reported, with deaths
for example attributed to other causes such as motor accidents
or drug overdoses.
Males accounted for around 75% of New Zealand suicide deaths
in 1997 (440 males, 121 females), with a male suicide rate
of 22.3 per 100,000 population. Maori deaths accounted for
18% of suicide deaths. The highest number of male suicide
deaths was in the 25–29 years age group. For females
it was in the 15–19 years cohort. Suicide Trends
in New Zealand 1978–98 notes
that the most common method of suicide in 1997 for both males
and females was hanging (40%), followed by gassing (motor
vehicle exhaust) with 28%.
Initiatives in Australia have largely centred on youth suicide.
The 1996 Access to Means of Suicide by Young People: a
background report by Australian Institute of Suicide
Research & Prevention (AISRAP)
concluded that
increased availability of a culturally accepted method of
suicide tends to result in an increase in the rate of suicide
for that method. Restricting the availability of a method
of suicide tends to result in a decline in suicides by that
method and may, but does not always, result in a decline
in the suicide rate overall
In 2003 the Federal Justice & Customs Minister announced
that "promoting suicide through the internet will become
a crime", with new legislation and fines of up to $110,000.
The Minister commented that the internet should not be used
to provide information "that encourages vulnerable individuals
to take their own lives". The legislation would reinforce
existing bans on importing and exporting documents relating
to suicide kits.
A year later the Criminal Code Amendment (Suicide Related
Material Offences) Bill 2004 was spun out of the broader
Crimes Legislation Amendment (Telecommunications Offences
and Other Measures) Bill 2004. It featured new offences
involving use of a carriage service to access, transmit or
make available material that counsels or incites suicide.
It also covered possession, production or supply material
that promoted and provided instruction on a particular method
of suicide.
The Bill was overtaken by the 2004 Federal election. Submissions
to the Senate Committee inquiry
on the Bill are here.
studies
A useful point of entry to the medical literature is The
International Handbook of Suicide and Attempted Suicide
(New York: Wiley 2004) edited by Keith Hawton & Kees van
Heeringen. Riaz Hassan's Suicide explained: the Australian
experience (Carlton: Melbourne Uni Press 1995) is of
particular value for Australasia.
For literary and historical perspectives five works are Anthony
Alvarez' The Savage God (Harmondsworth: Penguin 1970),
Georges Minois' History of Suicide: Voluntary Death in
Western Culture (Baltimore: Johns Hopkins Uni Press 2001),
Leaving You: The Cultural Meaning of Suicide (Chicago:
Dee 2003) by Lisa Lieberman, Suicide in the Middle Ages
(Oxford: Oxford Uni Press 1999, 2001) by Alexander Murray
and Suicide & Euthanasia: Historical and Contemporary
Themes (Dordrecht: Kluwer Academic Publishers 1989) edited
by Baruch Brody. Emile Durkheim's 1897 Suicide remains
of interest for insights and its status as a foundation text
in sociology.
Maurice Pinguet's Voluntary Death in Japan (Oxford:
Polity 1993) and Mamoru Iga's The Thorn in the Chrysanthemum:
Suicide and Economic Success in Modern Japan (Berkeley:
Uni of California Press 1986) explore the 'Japanese invention'.
For the US see Herbert Hendin's Suicide in America
(New York: Norton 1995).
Philosophical discussion includes Jean Amery's On Suicide:
A Discourse on Voluntary Death (Bloomington: Indiana
Uni Press 1999), Margaret Battin's Ethical Issues in Suicide
(Englewood Cliffs: Prentice Hall 1995) and Zilla Cahn's Suicide
in French Thought from Montesquieu to Cioran (New York:
Peter Lang 1999). Major works include Hume's
landmark essays on Suicide and the Immortality
of the Soul, Seneca's On Taking Ones Own Life
(Letter
77), Arthur Schopenhauer's
On Suicide, Cesare Pavese's superb Il mestiere
di vivere, Goethe's The Sorrows of Young Werther,
Albert Camus's The Myth of Sisyphus and Other Essays
(New York: Vintage 1991).
Discussions of practicalities feature in works such as Suicide
& Attempted Suicide: Methods and Consequences (New
York: Carroll & Graf 1999) by George Stone and Final
Exit: The Practicalities of Self-Deliverance and Assisted
Suicide for the Dying (New York: Bantam 1998) by Derek
Humphry.
Among the thin literature about cybersuicide we recommend
the 1997 Cybersuicide: The Role of Interactive Suicide
Notes on the Internet by Pierre Baume, Christopher Cantor,
Andrew Rolfe (in Crisis: The Journal of Crisis Intervention
and Sucide Prevention) and the 2001 Suizidforen im
Internet (PDF)
by Georg Fiedler & Reinhard Lindner, available in translation
here.
A 2001 RCP Psychiatric Bulletin item
by Vibhore Prasad & David Owenson explores Using the
internet as a source of self-help for people who self-harm.
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