Suicide by hanging is the intentional killing of oneself (suicide) via suspension from an anchor-point such as an overhead beam or hook, by a rope or cord or by jumping from a height with a noose around the neck.
Hanging is often considered to be a simple suicide method that does not require complicated techniques; a study of people who attempted suicide by hanging and lived usually suggests that this perception may not be accurate.It is one of the most commonly used suicide methods and has a high mortality rate; Gunnell et al. gives a figure of at least 70 percent. The materials required are easily available, making it a difficult method to prevent. In the International Statistical Classification of Diseases and Related Health Problems, suicides by hanging are classified under the code X70: "Intentional self-harm by hanging, strangulation, and suffocation."
Hanging is divided into suspension hanging and the much rarer drop hanging — the latter can kill in various ways. People who survive either because the cord or its anchor point of attachment breaks, or because they are discovered and cut down, can face a range of serious injuries, including cerebral anoxia (which can lead to permanent brain damage), laryngeal fracture, cervical spine fracture, tracheal fracture, pharyngeal laceration, and carotid artery injury. Ron M. Brown writes that hanging has a "fairly imperspicuous and complicated symbolic history".There are commentaries on hanging in antiquity, and it has various cultural interpretations. Throughout history, numerous famous people have died due to suicide by hanging.
People who survive hanging report seeing flashing lights and hearing ringing sounds.The neck of people who are hanged are usually marked with furrows where the ligature had constricted the neck. An inverted V mark is also often seen. Because of the pressure on the jaw, the tongue is sometimes protruding, causing it to dry. Depending on the circumstances, petechiae may be present on the eyes, face, legs, and feet. Cervical spine fractures are rare unless the hanging is a drop hanging, which usually causes an injury known as hangman's fracture. Suspension hanging usually results in cerebral hypoxia and decreased muscle tone around the neck. According to Aufderheide et al., the most common cause of death of hangings is cerebral hypoxia.
Most people who are hanged die before they are found; the term "near hanging" refers to those who survive (at least for a while—for example, until they reach hospital).Initial treatment of survivors follows the "usual priorities of airway, breathing, and circulation (ABC)". Treatment should be "directed at airway control with endotracheal intubation, ventilation using positive end expiratory pressure (PEEP), and hyperventilation with supplemental oxygen to control intracranial pressure". One study of people who experienced near-hanging who were treated appropriately at hospital found that 77 percent of them survived.
According to Anton J. L. van Hooff, hanging was the most common suicide method in primitive and pre-industrial societies.A 2008 review of 56 countries based on World Health Organization mortality data found that hanging was the most common method in most of the countries, accounting for 53 percent of the male suicides and 39 percent of the female suicides.
In England and Wales, hanging is the most commonly used method, and is particularly prevalent in the group of males aged 15–44, comprising almost half of the suicides in the group. It is the second most common method among women, behind poisoning. In 1981 hanging accounted for 23.5 percent of male suicides, and by 2001 the figure had risen to 44.2 percent.The proportion of hangings as suicides in 2005 among women aged 15–34 was 47.2 percent, having risen from 5.7 percent in 1968. In the United States it is the second most common method, behind firearms, and is by far the most common method for those in psychiatric wards and hospitals. Hanging accounts for a greater percentage of suicides among younger Americans than among older ones. Differences exist among ethnic groups; research suggests that hanging is the most common method among Chinese and Japanese Americans. Hanging is also a frequently used method for those in custody, in several countries.
In general, there are two methods of hanging: suspension hanging (the suspension of the body at the neck) and drop hanging (a calculated drop designed to break the neck). Manual strangulation and suffocation may also be considered all together with hanging.
To perform a suspension hanging, a rope or other ligature is tied into a noose which goes around the neck, a knot (often a running knot, which tightens easily) is formed, and the other end of the rope is tied to a ligature point; the body is then suspended, which tightens the ligature around the neck.[ citation needed ]
Regardless of the material used to form the noose, suspension hanging will kill the person in three ways: compression of the carotid arteries, the jugular veins, or the airway. 11 lb (5 kg) of pressure is required to compress the carotid artery; 4.4 lb (2 kg) for the jugular veins; and at least 15 kg (33 lb) for the airway. The amount of time it takes to lose consciousness and die is difficult to predict accurately and depends on several factors. Some believe unconsciousness occurs in five seconds, though Alan Gunn writes that it generally takes longer. It took a man who filmed his hanging 13 seconds to become unconscious, 1 minute and 38 seconds to lose muscle tone, and 4 minutes and 10 seconds for muscle movement to cease. Full suspension is not required; most hanging suicides are done by partial suspension, according to Wyatt et al. Geo Stone, author of Suicide and Attempted Suicide: Methods and Consequences, suggests that death by obstruction of the airway is more painful than by the other ways.About
The aim of drop hanging, which is also frequently used in executions, is to break the neck. Participants fall vertically with a rope attached to their neck, which when taut applies a force sufficient to break the spinal cord, causing death.The length of the drop, usually between 1.56 and 2.75 metres long, is calculated such that it is short enough to allow a less painful death, but long enough to avoid leaving the person handicapped and alive. This form of suicide is much rarer than suspension hanging and is likely to be less painful.
The majority of deaths by hanging in the UK and US are suicides, although there are some cases involving erotic asphyxiation.Homicides may be disguised as a hanging suicide. Features that suggest that the death is a homicide include the ligature marks being under the larynx, scratch marks on the ligature, and the presence of significant injury on the skin of the neck.
Historically, countries that have had a recent history of using hanging as a method of capital punishment tend to have a low rate of hanging suicides, which may be because such suicides were regarded as shameful, according to Farmer and Rodhe.Hanging, with its connection to justice and injustice, is what the Department of Health and Aged Care of Australia calls a "particularly confronting display of resistance, defiance, individual control and accusatory blame"; it is "a rebuke and statement of uncaring relations, unmet needs, personal anguish, and emotional payback". A 2010 study by the British Journal of Psychiatry that investigated the motivations of people who had made a near-fatal suicide attempt found that those who had attempted a hanging considered it a painless, quick, simple, and clean method, while those who had opted for a different method held an opposing view.
There is a popular belief in Chinese culture that the spirits of those who have died by suicide by hanging will haunt and torment the survivors, because they had died in rage and with feelings of hostility and anger.Angry and oppressed women would use this method as an act of revenge. Lee & Kleinman write that hanging, the most common method in traditional China, was the "final, but unequivocal, way of standing still against and above oppressive authorities, often with the suicidée ceremonially dressed prior to the ultimate act".
In ancient Rome, death by hanging—suicide or otherwise—was regarded as particularly shameful, and those who had died by this method were refused a burial.Virgil's Aeneid , for example, refers to the noose as nodum informis leti ("the coil of unbecoming death"). Timothy Hill writes that there is no conclusive explanation of why the stigma existed; it has been suggested that hanging was a method of the poor. The Greeks considered hanging as a woman's death because many women had died by this method. A study found that, in literary sources, 1.5–10 percent and 30 percent of suicides in the Roman and Greek civilizations, respectively, were by hanging.
Suicide by hanging is particularly common among Indigenous Australians, who have a high suicide rate, especially among young men.Ernest Hunter and Desley Harvey suggest that hanging accounts for two-thirds of indigenous suicides. Hanging has deep symbolic meanings in Indigenous Australian culture, beyond those attached to the act generally. Hanging appears in indigenous art, film, music, and literature. There are reports of voices encouraging people to kill themselves, and of ghostly figures holding a noose, but saying nothing.
Tracheal intubation, usually simply referred to as intubation, is the placement of a flexible plastic tube into the trachea (windpipe) to maintain an open airway or to serve as a conduit through which to administer certain drugs. It is frequently performed in critically injured, ill, or anesthetized patients to facilitate ventilation of the lungs, including mechanical ventilation, and to prevent the possibility of asphyxiation or airway obstruction.
Hanging is the suspension of a person by a noose or ligature around the neck. The Oxford English Dictionary states that hanging in this sense is "specifically to put to death by suspension by the neck", though it formerly also referred to crucifixion and death by impalement in which the body would remain "hanging". Hanging has been a common method of capital punishment since medieval times, and is the primary execution method in numerous countries and regions. The first known account of execution by hanging was in Homer's Odyssey. In this specialised meaning of the common word hang, the past and past participle is hanged instead of hung.
Autoerotic fatalities are accidental deaths that occur during sexual self-stimulation when an apparatus, device or prop that is being employed to enhance pleasure causes the death. Researchers only apply the term to unintentional deaths resulting from solitary sexual activity, not suicide or acts with a partner. The incidence of autoerotic fatalities in Western countries is around 0.5 per million inhabitants each year.
Tracheotomy, or tracheostomy, is a surgical procedure which consists of making an incision (cut) on the anterior aspect (front) of the neck and opening a direct airway through an incision in the trachea (windpipe). The resulting stoma (hole) can serve independently as an airway or as a site for a tracheal tube or tracheostomy tube to be inserted; this tube allows a person to breathe without the use of the nose or mouth.
Strangling is compression of the neck that may lead to unconsciousness or death by causing an increasingly hypoxic state in the brain. Fatal strangling typically occurs in cases of violence, accidents, and is one of two main ways that hanging causes death.
Airway management includes a set of maneuvers and medical procedures performed to prevent and relieve airway obstruction. This ensures an open pathway for gas exchange between a patient's lungs and the atmosphere. This is accomplished by either clearing a previously obstructed airway; or by preventing airway obstruction in cases such as anaphylaxis, the obtunded patient, or medical sedation. Airway obstruction can be caused by the tongue, foreign objects, the tissues of the airway itself, and bodily fluids such as blood and gastric contents (aspiration).
Major trauma is any injury that has the potential to cause prolonged disability or death. There are many causes of major trauma, blunt and penetrating, including falls, motor vehicle collisions, stabbing wounds, and gunshot wounds. Depending on the severity of injury, quickness of management, and transportation to an appropriate medical facility may be necessary to prevent loss of life or limb. The initial assessment is critical, and involves a physical evaluation and also may include the use of imaging tools to determine the types of injuries accurately and to formulate a course of treatment.
Erotic asphyxiation is the intentional restriction of oxygen to the brain for the purposes of sexual arousal. The term autoerotic asphyxiation is used when the act is done by a person to themselves. Colloquially, a person engaging in the activity is sometimes called a gasper.
Epiglottitis is inflammation of the epiglottis—the flap at the base of the tongue that prevents food entering the trachea (windpipe). Symptoms are usually rapid in onset and include trouble swallowing which can result in drooling, changes to the voice, fever, and an increased breathing rate. As the epiglottis is in the upper airway, swelling can interfere with breathing. People may lean forward in an effort to open the airway. As the condition worsens stridor and bluish skin may occur.
A suicide method is any means by which a person chooses to end their life. Suicide attempts do not always result in death, and a nonfatal suicide attempt can leave the person with serious physical injuries, long-term health problems, and brain damage.
Ludwig's angina is a type of severe cellulitis involving the floor of the mouth. Early on the floor of the mouth is raised and there is difficulty swallowing saliva, which may run from the person's mouth. As the condition worsens, the airway may be compromised with hardening of the spaces on both sides of the tongue. This condition has a rapid onset over hours.
A suicide crisis, suicidal crisis or potential suicide is a situation in which a person is attempting to kill themself or is seriously contemplating or planning to do so. It is considered by public safety authorities, medical practice, and emergency services to be a medical emergency, requiring immediate suicide intervention and emergency medical treatment. Suicidal presentations occur when there is an emotional problem or predicament that the individual cannot solve and suicide is a solution to them. Clinicians should re-frame suicidal crises, point out that suicide is not a solution and help the individual identify and solve or tolerate the problems.
Excited delirium (EXD), also known as agitated delirium, is a controversial syndrome described as a combination of psychomotor agitation, delirium, and sweating. It may include attempts at violence, unexpected strength, and very high body temperature. Complications may include rhabdomyolysis or high blood potassium.
Suicide is the act of intentionally causing one's own death. Mental disorders, physical disorders and substance abuse are risk factors. Some suicides are impulsive acts due to stress, relationship problems, or harassment/bullying. Those who have previously attempted suicide are at a higher risk for future attempts. Effective suicide prevention efforts include limiting access to methods of suicide—such as firearms, drugs, and poisons; treating mental disorders and substance misuse; careful media reporting about suicide; and improving economic conditions. Even though crisis hotlines are common, they have not been well studied.
Tracheobronchial injury is damage to the tracheobronchial tree. It can result from blunt or penetrating trauma to the neck or chest, inhalation of harmful fumes or smoke, or aspiration of liquids or objects.
Benzodiazepine overdose describes the ingestion of one of the drugs in the benzodiazepine class in quantities greater than are recommended or generally practiced. The most common symptoms of overdose include central nervous system (CNS) depression, impaired balance, ataxia, and slurred speech. Severe symptoms include coma and respiratory depression. Supportive care is the mainstay of treatment of benzodiazepine overdose. There is an antidote, flumazenil, but its use is controversial.
Gender differences in suicide rates have been shown to be significant. There are different rates of completed suicides and suicidal behavior between males and females. While women more often have suicidal thoughts, men commit suicide more frequently. This is also known as the gender paradox in suicide.
A suicide bag, also known as an exit bag or hood, is part of a euthanasia device consisting of a large plastic bag with a drawcord used to commit suicide through inert gas asphyxiation. It is usually used in conjunction with a flow of an inert gas like helium or nitrogen, which prevents the panic, sense of suffocation and struggling before unconsciousness, known as the hypercapnic alarm response caused by the presence of high carbon dioxide concentrations in the blood. This method also makes the direct cause of death difficult to trace if the bag and gas canister are removed before the death is reported.
A suicide attempt or an attempt at suicide is an attempt to die by suicide resulting in survival. It may be referred to as a failed suicide attempt or nonfatal suicide attempt, but the latter terms are subject to debate among researchers. The term and statistics on suicide attempts may include parasuicide, such as self-harm where there is no actual or consistent intention of killing oneself.
Aluminium phosphide poisoning is poisoning that occurs as a result of excessive exposure to aluminium phosphide (AlP), which is readily available as a fumigant for stored cereal grains and sold under various brand names such as QuickPhos, Salphos and Celphos. Aluminium phosphide is highly toxic, especially when consumed from a freshly opened container. Acute aluminium phosphide poisoning (AAlPP) is a large though under-reported problem throughout the world, particularly in the Indian subcontinent.