What is Suicide?
Not every self-inflicted death is a suicide. A man, who crashes his car into a tree after falling asleep on the wheel, is not trying to kill himself. Edwin Shneidman (1999, 1993, 1981, 1963), one of the most influential writers on this topic, defines suicide as an intentioned death—a self-inflicted death in which one makes an intentional, direct and conscious effort to end one’s life. Intentional death may take various forms. Shneidman distinguished four kinds of people who intentionally end their lives: the death seeker, death initiator, death ignorer, and death darer. Death seekers clearly intend to end their lives at the time they attempt suicide. The singleness of purpose may last only a short time. It can change to confusion the very next hour or day, and then return again in short order. Death initiators also clearly intend to end their lives, but they act out of a belief that the process of death is already under way and that they are simply hastening the process.. Some expect that they will die in a matter of days or weeks. Many suicides among the elderly and very sick fall into this category. Death ignorers do not believe that their self-inclined death will mean the end of their existence. They believe they are trading their present lives for a better or happier existence. Many child suicides fall into this category, as do those of adult believers in a hereafter who commit suicide to reach another form of life. Death darers experience mixed feelings, or ambivalence, in their intent to die even at the moment of their attempt, and they show this ambivalence in the act itself. Although to some degree they wish to die, and they often to die, their risk-taking behavior does not guarantee death. Many death dares are as interested in gaining attention, making someone feel guilty, or expressing anger as they are in dying. When individuals play indirect, covert, partial or unconscious roles in their own deaths, Shneidman classifies them in a suicide-like category called sub-intentional death (Shneidman, 1993, 1981). Seriously ill people who consistently mismanage their medicines may belong in this category.
Parasuicide is a suicide attempt that does not result in death. Kreitman (1977) observed that there can be self-harm even though there is not a clear intent to suicide. In many cases suicide intent cannot be documented and may not even be present. For example, with most non-fatal drug overdoses it is routinely not clear that a suicidal outcome was intended. Such self-harming actions may be the result of impulse, stress, confusion, anger, panic, anxiety, and depression. Kreitman (1977) calls these actions parasuicides. More precisely a “parasuicide” is a non-fatal act in which an individual deliberately causes self-injury or ingests a substance in excess of any prescribed or generally recognized dosage (Kreitman, 1977:3).
History of Suicide
During our race through history, we find that self-killing as an exclusively human behavior has been present since the beginnings of culture. The inarticulate suicide committed by the desperate sick, old, or humiliated, mainly by hanging always prevailed, but civilizations gave birth to the new model of the “shame” suicide model requiring the sophisticated means of a weapon. Growing internalization created the concept of guilt. Suicide was not condemned in Western thought until fourth century, when Saint Augustine proclaimed it a crime because it violated the Sixth Commandment, “Thou shalt not kill”. Saint Thomas Aquinas elaborated on this view in the thirteenth century, declaring suicide a mortal sin because it usurped God’s power over life and death. So, although neither the Old Testament nor the New Testament explicitly forbids suicide, the Western world came to regard it as a crime and a sin (Shneidman, 1973). This paradigm was challenged by renaissance thinking and refined by Christian reformers, to be fundamentally rejected by...