A Swift Route to Suicide

The controversial book Final Exit by Derek Humphry, former president of the Hemlock Society, suggests ways in which terminally ill patients can kill themselves easily and quickly. But could it increase the number of successful suicides among physically healthy people? That possibility is raised in a study by New York City's Cornell Medical Center, to be published this week in the New England Journal of Medicine. The paper notes a dramatic rise in the number of people who asphyxiate themselves by tying plastic bags over their heads, a method recommended in Final Exit for "self-deliverance" within three to four minutes. In 1991, the year the book came out, there were 437 plastic-bag suicides across the U.S., up 30% from 1990.

The Cornell researchers investigated 144 New York City suicides by techniques suggested in Final Exit. At least 15 of the victims had consulted the book, and six of those had no physical problems at the time. Psychiatrist Peter Marzuk, who led the study, speculates that some of the suicides might have called for help or otherwise survived if they had used a slower method, such as a tranquilizer overdose. Only 30,000 of 300,000 annual suicide attempts are successful, but Marzuk fears that this ratio could go up if the plastic-bag technique continues to spread. Advocates for the right to euthanasia point out that the overall suicide rate has not risen. They put another interpretation on the numbers: people who would have killed themselves anyway are switching to less grisly means.