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Suicide by hanging

April 16, 2023

For information on methods of suicide intervention, see Suicide prevention.

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.

Early 20th century engraving of a woman discovering a suicide by hanging

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.[1] 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.[2] The materials required are easily available, making it a difficult method to prevent.[2] 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."[3][4]

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".[5] 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.

Medical effects and treatment

See also: Hanging § Medical effects

People who survive hanging report seeing flashing lights and hearing ringing sounds.[6] 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.[7] Because of the pressure on the jaw, the tongue is sometimes protruding, causing it to dry.[8] Depending on the circumstances, petechiae may be present on the eyes, face, legs, and feet.[8][9] Cervical spine fractures are rare unless the hanging is a drop hanging,[10] which usually causes an injury known as hangman's fracture.[11] Suspension hanging usually results in cerebral hypoxia and decreased muscle tone around the neck.[12] According to Aufderheide et al., the most common cause of death of hangings is cerebral hypoxia.[13]

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 a hospital).[14][15] 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".[16] One study of people who experienced near-hanging who were treated appropriately at a hospital found that 77 percent of them survived.[14]

Prevalence

 
Ixtab (Rope Woman), the ancient Maya goddess of suicide by hanging. Under certain circumstances, suicide was considered an honorable way to die and Ixtab would act as a psychopomp for these individuals.

According to Anton J. L. van Hooff, hanging was the most common suicide method in primitive and pre-industrial societies.[17] 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,[18] accounting for 53 percent of the male suicides and 39 percent of the female suicides.[19]

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.[3] 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.[20] In the United States it is the second most common method, behind firearms,[21] and is by far the most common method for those in psychiatric wards and hospitals.[22] Hanging accounts for a greater percentage of suicides among younger Americans than among older ones.[23] Differences exist among ethnic groups; research suggests that hanging is the most common method among Chinese and Japanese Americans.[24] Hanging is also a frequently used method for those in custody, in several countries.[2]

Process

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.[25]

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.[8][26] About 11 lb (5 kg) of pressure is required to compress the carotid artery; 4.4 lb (2 kg) for the jugular veins;[8] and at least 33 lb (15 kg) for the airway.[14] 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. A man who filmed his own hanging took 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.[27][28] Full suspension is not required; most hanging suicides are done by partial suspension, according to Wyatt et al.[29] 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.[25]

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.[25][30] 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.[31] This form of suicide is much rarer than suspension hanging[14] and is likely to be less painful.[32]

Related elements

The majority of deaths by hanging in the UK and US are suicides, although there are some cases involving erotic asphyxiation.[16] Homicides may be disguised as a hanging suicide.[33] 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.[8]

Cultural aspects

 
Painting by Giotto depicting a person committing the sin of desperatio, the rejection of God's mercy, because while choked they are unable to ask for repentance.[34]

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.[35][36] 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".[37] 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.[38]

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.[39] Angry and oppressed women would use this method as an act of revenge.[40] 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".[41]

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.[42] Virgil's Aeneid, for example, refers to the noose as nodum informis leti ("the coil of unbecoming death").[43] 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.[44] The Greeks considered hanging as a woman's death because many women had died by this method.[45] 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.[46]

Suicide by hanging is particularly common among Indigenous Australians, who have a high suicide rate, especially among young men.[47][48] Ernest Hunter and Desley Harvey suggest that hanging accounts for two-thirds of indigenous suicides.[47] Hanging has deep symbolic meanings in Indigenous Australian culture, beyond those attached to the act generally.[30][49] Hanging appears in indigenous art, film, music, and literature.[50] There are reports of voices encouraging people to kill themselves, and of ghostly figures holding a noose, but saying nothing.[51]

See also

References

  1. ^ Biddle, Lucy; Donovan, Jenny; Owen-Smith, Amanda; Potokar, John; Longson, Damien; Hawton, Keith; Kapur, Nav; Gunnell, David (September 2010). "Factors influencing the decision to use hanging as a method of suicide: qualitative study". The British Journal of Psychiatry. 197 (4): 320–325. doi:10.1192/bjp.bp.109.076349. PMID 20884956. S2CID 4892401. from the original on 31 August 2015.
  2. ^ a b c Gunnell, D.; Bennewith, O; Hawton, K; Simkin, S; Kapur, N (2005). "The epidemiology and prevention of suicide by hanging: A systematic review". International Journal of Epidemiology. 34 (2): 433–42. doi:10.1093/ije/dyh398. PMID 15659471.
  3. ^ X70 Intentional self-harm by hanging, strangulation and suffocation 2 November 2014 at the Wayback Machine ICD-10: 2007 version.
  4. ^ The Art of Suicide. Reaktion Books. p. 226.
  5. ^ Elsevier Comprehensive Guide. Elsevier India. 2009. p. 616. ISBN 978-81-312-1620-0.
  6. ^ Dolinak, David; Matshes, Evan; Lew, Emma O. (2005). Forensic Pathology: Principles and Practice. Elsevier. p. 211. ISBN 978-0-08-047066-5.
  7. ^ a b c d e Riviello, Ralph (ed) (2010). Manual of Forensic Emergency Medicine: A Guide for Clinicians. Jones & Bartlett Learning. pp. 15–7.
  8. ^ Forensic Pathology, p. 213.
  9. ^ Gunn, p. 181.
  10. ^ Matsuyama, Takeshi; Okuchi, Kazuo; Seki, Tadahiko; Murao, Yoshinori (2004). "Prognostic factors in hanging injuries". The American Journal of Emergency Medicine. 22 (3): 207–10. doi:10.1016/j.ajem.2004.02.012. PMID 15138959.
  11. ^ Hanna, S.J (2004). "A study of 13 cases of near-hanging presenting to an Accident and Emergency Department". Injury. 35 (3): 253–6. doi:10.1016/S0020-1383(03)00110-4. PMID 15124792.
  12. ^ Aufderheide, Tom P.; Aprahamian, Charles; Mateer, James R.; Rudnick, Eric; Manchester, Elizabeth M.; Lawrence, Sarah W.; Olson, David W.; Hargarten, Stephen W. (1994). "Emergency airway management in hanging victims". Annals of Emergency Medicine. 24 (5): 879–84. doi:10.1016/S0196-0644(94)70206-3. PMID 7978561.
  13. ^ a b c d Adams, Nick (1999). "Near hanging". Emergency Medicine Australasia. 11: 17–21. doi:10.1046/j.1442-2026.1999.00314.x.
  14. ^ Wyatt, et al., p. 226.
  15. ^ a b Howell, M A; Guly, H R (1996). "Near hanging presenting to an accident and emergency department". Emergency Medicine Journal. 13 (2): 135–136. doi:10.1136/emj.13.2.135. PMC 1342658. PMID 8653240.
  16. ^ Comprehensive Textbook of Suicidology, pp. 97–8.
  17. ^ Ajdacic-Gross, Vladeta; Weiss, MG; Ring, M; Hepp, U; Bopp, M; Gutzwiller, F; Rössler, W (2008). . Bulletin of the World Health Organization. 86 (9): 726–32. doi:10.2471/BLT.07.043489. PMC 2649482. PMID 18797649. Archived from the original on 23 September 2011.
  18. ^ O'Connor, Rory C.; Platt, Stephen; Gordon, Jacki. (eds) (2011). International Handbook of Suicide Prevention: Research, Policy and Practice. John Wiley & Sons. p. 34.
  19. ^ Biddle, L.; Brock, A.; Brookes, S. T; Gunnell, D. (2008). "Suicide rates in young men in England and Wales in the 21st century: Time trend study". BMJ. 336 (7643): 539–42. doi:10.1136/bmj.39475.603935.25. PMC 2265363. PMID 18276666..
  20. ^ "Suicide in the U.S.: Statistics and Prevention" 24 October 2010 at the Wayback Machine. National Institute of Mental Health. Retrieved 2 August 2011.
  21. ^ (2001). Front Line of Defense: The Role of Nurses in Preventing Sentinel Events. Joint Commission Resources. p. 91.
  22. ^ Comprehensive Textbook of Suicidology, pp. 290–1.
  23. ^ Maris, Ronald W.; Berman; Alan L.; Maltsberger, John T.; et al. (eds) (1992). Assessment and Prediction of Suicide. Guilford Press. p. 385.
  24. ^ a b c Stone.
  25. ^ Comprehensive Textbook of Suicidology, pp. 302–3.
  26. ^ Sauvageau, Anny; Racette, Stéphanie (2007). "Agonal Sequences in a Filmed Suicidal Hanging: Analysis of Respiratory and Movement Responses to Asphyxia by Hanging". Journal of Forensic Sciences. 52 (4): 957–9. doi:10.1111/j.1556-4029.2007.00459.x. PMID 17524058. S2CID 32188375.
  27. ^ Gunn, p. 187.
  28. ^ Wyatt, et al., p. 106.
  29. ^ a b Tatz, Colin (2001). Aboriginal Suicide is Different: A Portrait of Life and Self-Destruction. Aboriginal Studies Press. pp. 65–6.
  30. ^ Wyatt, et al., p. 107.
    • For the length, see Miletich and Lindstrom.
  31. ^ Miletich and Lindstrom.
  32. ^ Wyatt, et al., p. 107.
  33. ^ Comprehensive Textbook of Suicidology, pp. 108–9.
  34. ^ Farmer, R.; Rohde, J. (1980). "Effect of availability and acceptability of lethal instruments on suicide mortality AN ANALYSIS OF SOME INTERNATIONAL DATA". Acta Psychiatrica Scandinavica. 62 (5): 436–46. doi:10.1111/j.1600-0447.1980.tb00632.x. PMID 7211428. S2CID 27848391.
  35. ^ Comprehensive Textbook of Suicidology, p. 292.
  36. ^ Hunter, et al., p. 22. For the second quote, see p. 24.
  37. ^ Biddle, L.; Donovan, J.; Owen-Smith, A.; Potokar, J.; Longson, D.; Hawton, K.; Kapur, N.; Gunnell, D. (2010). "Factors influencing the decision to use hanging as a method of suicide: Qualitative study". The British Journal of Psychiatry. 197 (4): 320–5. doi:10.1192/bjp.bp.109.076349. PMID 20884956.
  38. ^ H. X. Lee, Jonathan; Nadeau, Kathleen. (2011). Encyclopedia of Asian American Folklore and Folklife. ABC-CLIO. p. 11.
    • Lee, Evelyn (1997). Working with Asian Americans: A Guide for Clinicians. Guilford Press. p. 59.
  39. ^ Bourne, PG (1973). "Suicide among Chinese in San Francisco". American Journal of Public Health. 63 (8): 744–50. doi:10.2105/AJPH.63.8.744. PMC 1775294. PMID 4719540.
  40. ^ Lee & al. (2003), p. 297.
  41. ^ Hill, p. 190.
    • Kyle, Donald G. (2001). Spectacles of Death in Ancient Rome. Routledge. pp. 131–2.
  42. ^ Edwards, Catharine (2007). Death in Ancient Rome. Yale University Press. p. 107.
  43. ^ Hill, p. 289.
  44. ^ Loraux, Nicole (1991). Tragic Ways of Killing a Woman. Harvard University Press. pp. 9–10. Translated by Anthony Forster.
  45. ^ Murray, p. 499.
  46. ^ a b Hunter, Ernest; Harvey, Desley (2002). "Indigenous suicide in Australia, New Zealand, Canada and the United States". Emergency Medicine Australasia. 14 (1): 14–23. doi:10.1046/j.1442-2026.2002.00281.x. PMID 11993831.
  47. ^ Graham, Anne; Reser, Joseph; Scuderi, Carl; Zubrick, Stephen; Smith, Meg; Turley, Bruce (2000). "Suicide: An Australian Psychological Society Discussion Paper". Australian Psychologist. 35: 1–28. doi:10.1080/00050060008257463.
  48. ^ Hunter, et al., pp. 21, 24.
  49. ^ Hunter, et al., p. 25.
  50. ^ Hunter, et al., pp. 25, 29–30.

Further reading

  • "The processes and physiology of judicial hanging". capitalpunishmentuk.org. Retrieved 9 August 2011. Archived 9 August 2011.
  • Layton, Julia. "How does death by hanging work?". HowStuffWorks. Retrieved 9 August 2011.
  • Mann, John Dixon (1908). Forensic Medicine and Toxicology. Taylor & Francis. pp. 208–13.
  • Bowen, David A.LL. (1982). "Hanging – A review". Forensic Science International. 20 (3): 247–9. doi:10.1016/0379-0738(82)90124-4. PMID 7141362.
  • Van Hooff, Anton J. L. (1990). From Autothanasia to Suicide: Self-Killing in Classical Antiquity. Routledge.
  • Simounet, C; Bourgeois, M (1992). "Suicides and attempted suicides by hanging". Annales médico-psychologiques. 150 (7): 481–5. PMID 1343195.
  • Pounder, Derrick J. (June 1993). "Why Are the British Hanging Themselves?". American Journal of Forensic Medicine and Pathology. 14 (2): 135–40. doi:10.1097/00000433-199306000-00006. PMID 8328433. S2CID 40274951.
  • Aufderheide, Tom P.; Aprahamian, Charles; Mateer, James R.; Rudnick, Eric; Manchester, Elizabeth M.; Lawrence, Sarah W.; Olson, David W.; Hargarten, Stephen W. (1994). "Emergency airway management in hanging victims". Annals of Emergency Medicine. 24 (5): 879–84. doi:10.1016/S0196-0644(94)70206-3. PMID 7978561.
  • Samarasekera, Ananda; Cooke, Clive (1996). "The Pathology of Hanging Deaths in Western Australia". Pathology. 28 (4): 334–8. doi:10.1080/00313029600169294. PMID 9007952. S2CID 43075665.
  • Kaki, Abdullah; Crosby, Edward T.; Lui, Anne C. P. (1997). "Airway and respiratory management following non-lethal hanging". Canadian Journal of Anesthesia. 44 (4): 445–50. doi:10.1007/BF03014468. PMID 9104530.
  • Scott-Clark, C.; Levy, A. The Sunday Times Magazine. 1 February 1998. pp. 13–21.
  • Brancatelli, G.; Sparacia, G.; Midiri, M.; d'Antonio, V.; Sarno, C.; Lagalla, R. (2000). "Brain damage in hanging: A new CT finding". Neuroradiology. 42 (3): 209–10. doi:10.1007/s002340050048. PMID 10772145. S2CID 37717139.
  • Reser, Joseph P. (1999). "Indigenous suicide in cross-cultural context" (PDF). South Pacific Journal of Psychology. 11 (2): 95–110. doi:10.1017/S0257543400000663.
  • Green, H.; James, R.A.; Gilbert, J.D.; Byard, R.W. (2000). "Fractures of the hyoid bone and laryngeal cartilages in suicidal hanging". Journal of Clinical Forensic Medicine. 7 (3): 123–6. doi:10.1054/jcfm.2000.0419. PMID 16083660.
  • Elliott-Farrelly, Terri (2004). "Australian Aboriginal suicide: The need for an Aboriginal suicidology?". Advances in Mental Health. 3 (3): 138–145. doi:10.5172/jamh.3.3.138. S2CID 71578621.
  • Oehmichen, Manfred; Auer, Roland N.; König, Hans Günter. (2006). Forensic Neuropathology and Associated Neurology. Springer Science+Business Media.
  • Jevon, Philip; Bowden, David F.; Halliwell, David. (2007). Emergency Care and First Aid for Nurses: A Practical Guide. Elsevier. pp. 126–8.
  • Benomran, F.A.; Masood, S.E.; Hassan, A.I.; Mohammad, A. A. (2007). "Masking and bondage in suicidal hanging". Medicine, Science and the Law. 47 (2): 177–180. doi:10.1258/rsmmsl.47.2.177. PMID 17520966. S2CID 32094890.
  • Dedouit, Fabrice; Tournel, Gilles; Bécart, Anne; Hédouin, Valéry; Gosset, Didier (2007). "Suicidal Hanging Resulting in Complete Decapitation – Forensic, Radiological, and Anthropological Studies: A Case Report". Journal of Forensic Sciences. 52 (5): 1190–3. doi:10.1111/j.1556-4029.2007.00503.x. PMID 17645743. S2CID 8017102.
  • Yip, Paul S. F. (2008). Suicide in Asia: Causes and Prevention. Hong Kong University Press.
  • (PDF). Archived from the original (PDF) on 24 August 2011. Retrieved 30 July 2011. (667 KB). World Health Organization. 2008. 30 July 2011. See .

April 16, 2023
suicide, hanging, information, methods, suicide, intervention, suicide, prevention, intentional, killing, oneself, suicide, suspension, from, anchor, point, such, overhead, beam, hook, rope, cord, jumping, from, height, with, noose, around, neck, early, 20th, . For information on methods of suicide intervention see Suicide prevention 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 Early 20th century engraving of a woman discovering a suicide by hanging 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 1 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 2 The materials required are easily available making it a difficult method to prevent 2 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 3 4 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 5 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 Contents 1 Medical effects and treatment 2 Prevalence 3 Process 4 Related elements 5 Cultural aspects 6 See also 7 References 8 Further readingMedical effects and treatmentSee also Hanging Medical effects People who survive hanging report seeing flashing lights and hearing ringing sounds 6 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 7 Because of the pressure on the jaw the tongue is sometimes protruding causing it to dry 8 Depending on the circumstances petechiae may be present on the eyes face legs and feet 8 9 Cervical spine fractures are rare unless the hanging is a drop hanging 10 which usually causes an injury known as hangman s fracture 11 Suspension hanging usually results in cerebral hypoxia and decreased muscle tone around the neck 12 According to Aufderheide et al the most common cause of death of hangings is cerebral hypoxia 13 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 a hospital 14 15 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 16 One study of people who experienced near hanging who were treated appropriately at a hospital found that 77 percent of them survived 14 Prevalence Ixtab Rope Woman the ancient Maya goddess of suicide by hanging Under certain circumstances suicide was considered an honorable way to die and Ixtab would act as a psychopomp for these individuals According to Anton J L van Hooff hanging was the most common suicide method in primitive and pre industrial societies 17 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 18 accounting for 53 percent of the male suicides and 39 percent of the female suicides 19 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 3 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 20 In the United States it is the second most common method behind firearms 21 and is by far the most common method for those in psychiatric wards and hospitals 22 Hanging accounts for a greater percentage of suicides among younger Americans than among older ones 23 Differences exist among ethnic groups research suggests that hanging is the most common method among Chinese and Japanese Americans 24 Hanging is also a frequently used method for those in custody in several countries 2 ProcessIn 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 25 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 8 26 About 11 lb 5 kg of pressure is required to compress the carotid artery 4 4 lb 2 kg for the jugular veins 8 and at least 33 lb 15 kg for the airway 14 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 A man who filmed his own hanging took 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 27 28 Full suspension is not required most hanging suicides are done by partial suspension according to Wyatt et al 29 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 25 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 25 30 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 31 This form of suicide is much rarer than suspension hanging 14 and is likely to be less painful 32 Related elementsThe majority of deaths by hanging in the UK and US are suicides although there are some cases involving erotic asphyxiation 16 Homicides may be disguised as a hanging suicide 33 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 8 Cultural aspects Painting by Giotto depicting a person committing the sin of desperatio the rejection of God s mercy because while choked they are unable to ask for repentance 34 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 35 36 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 37 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 38 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 39 Angry and oppressed women would use this method as an act of revenge 40 Lee amp 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 suicidee ceremonially dressed prior to the ultimate act 41 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 42 Virgil s Aeneid for example refers to the noose as nodum informis leti the coil of unbecoming death 43 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 44 The Greeks considered hanging as a woman s death because many women had died by this method 45 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 46 Suicide by hanging is particularly common among Indigenous Australians who have a high suicide rate especially among young men 47 48 Ernest Hunter and Desley Harvey suggest that hanging accounts for two thirds of indigenous suicides 47 Hanging has deep symbolic meanings in Indigenous Australian culture beyond those attached to the act generally 30 49 Hanging appears in indigenous art film music and literature 50 There are reports of voices encouraging people to kill themselves and of ghostly figures holding a noose but saying nothing 51 See alsoSuicide prevention List of suicide crisis lines IxtabReferences Biddle Lucy Donovan Jenny Owen Smith Amanda Potokar John Longson Damien Hawton Keith Kapur Nav Gunnell David September 2010 Factors influencing the decision to use hanging as a method of suicide qualitative study The British Journal of Psychiatry 197 4 320 325 doi 10 1192 bjp bp 109 076349 PMID 20884956 S2CID 4892401 Archived from the original on 31 August 2015 a b c Gunnell D Bennewith O Hawton K Simkin S Kapur N 2005 The epidemiology and prevention of suicide by hanging A systematic review International Journal of Epidemiology 34 2 433 42 doi 10 1093 ije dyh398 PMID 15659471 a b Trends X70 Intentional self harm by hanging strangulation and suffocation Archived 2 November 2014 at the Wayback Machine ICD 10 2007 version The Art of Suicide Reaktion Books p 226 Elsevier Comprehensive Guide Elsevier India 2009 p 616 ISBN 978 81 312 1620 0 Dolinak David Matshes Evan Lew Emma O 2005 Forensic Pathology Principles and Practice Elsevier p 211 ISBN 978 0 08 047066 5 a b c d e Riviello Ralph ed 2010 Manual of Forensic Emergency Medicine A Guide for Clinicians Jones amp Bartlett Learning pp 15 7 Forensic Pathology p 213 Gunn p 181 Matsuyama Takeshi Okuchi Kazuo Seki Tadahiko Murao Yoshinori 2004 Prognostic factors in hanging injuries The American Journal of Emergency Medicine 22 3 207 10 doi 10 1016 j ajem 2004 02 012 PMID 15138959 Hanna S J 2004 A study of 13 cases of near hanging presenting to an Accident and Emergency Department Injury 35 3 253 6 doi 10 1016 S0020 1383 03 00110 4 PMID 15124792 Aufderheide Tom P Aprahamian Charles Mateer James R Rudnick Eric Manchester Elizabeth M Lawrence Sarah W Olson David W Hargarten Stephen W 1994 Emergency airway management in hanging victims Annals of Emergency Medicine 24 5 879 84 doi 10 1016 S0196 0644 94 70206 3 PMID 7978561 a b c d Adams Nick 1999 Near hanging Emergency Medicine Australasia 11 17 21 doi 10 1046 j 1442 2026 1999 00314 x Wyatt et al p 226 a b Howell M A Guly H R 1996 Near hanging presenting to an accident and emergency department Emergency Medicine Journal 13 2 135 136 doi 10 1136 emj 13 2 135 PMC 1342658 PMID 8653240 Comprehensive Textbook of Suicidology pp 97 8 Ajdacic Gross Vladeta Weiss MG Ring M Hepp U Bopp M Gutzwiller F Rossler W 2008 Methods of suicide international suicide patterns derived from the WHO mortality database Bulletin of the World Health Organization 86 9 726 32 doi 10 2471 BLT 07 043489 PMC 2649482 PMID 18797649 Archived from the original on 23 September 2011 O Connor Rory C Platt Stephen Gordon Jacki eds 2011 International Handbook of Suicide Prevention Research Policy and Practice John Wiley amp Sons p 34 Biddle L Brock A Brookes S T Gunnell D 2008 Suicide rates in young men in England and Wales in the 21st century Time trend study BMJ 336 7643 539 42 doi 10 1136 bmj 39475 603935 25 PMC 2265363 PMID 18276666 Suicide in the U S Statistics and Prevention Archived 24 October 2010 at the Wayback Machine National Institute of Mental Health Retrieved 2 August 2011 2001 Front Line of Defense The Role of Nurses in Preventing Sentinel Events Joint Commission Resources p 91 Comprehensive Textbook of Suicidology pp 290 1 Maris Ronald W Berman Alan L Maltsberger John T et al eds 1992 Assessment and Prediction of Suicide Guilford Press p 385 a b c Stone Comprehensive Textbook of Suicidology pp 302 3 Sauvageau Anny Racette Stephanie 2007 Agonal Sequences in a Filmed Suicidal Hanging Analysis of Respiratory and Movement Responses to Asphyxia by Hanging Journal of Forensic Sciences 52 4 957 9 doi 10 1111 j 1556 4029 2007 00459 x PMID 17524058 S2CID 32188375 Gunn p 187 Wyatt et al p 106 a b Tatz Colin 2001 Aboriginal Suicide is Different A Portrait of Life and Self Destruction Aboriginal Studies Press pp 65 6 Wyatt et al p 107 For the length see Miletich and Lindstrom Miletich and Lindstrom Wyatt et al p 107 Comprehensive Textbook of Suicidology pp 108 9 Farmer R Rohde J 1980 Effect of availability and acceptability of lethal instruments on suicide mortality AN ANALYSIS OF SOME INTERNATIONAL DATA Acta Psychiatrica Scandinavica 62 5 436 46 doi 10 1111 j 1600 0447 1980 tb00632 x PMID 7211428 S2CID 27848391 Comprehensive Textbook of Suicidology p 292 Hunter et al p 22 For the second quote see p 24 Biddle L Donovan J Owen Smith A Potokar J Longson D Hawton K Kapur N Gunnell D 2010 Factors influencing the decision to use hanging as a method of suicide Qualitative study The British Journal of Psychiatry 197 4 320 5 doi 10 1192 bjp bp 109 076349 PMID 20884956 H X Lee Jonathan Nadeau Kathleen 2011 Encyclopedia of Asian American Folklore and Folklife ABC CLIO p 11 Lee Evelyn 1997 Working with Asian Americans A Guide for Clinicians Guilford Press p 59 Bourne PG 1973 Suicide among Chinese in San Francisco American Journal of Public Health 63 8 744 50 doi 10 2105 AJPH 63 8 744 PMC 1775294 PMID 4719540 Lee amp al 2003 p 297 sfnp error no target CITEREFLee amp al 2003 help Hill p 190 Kyle Donald G 2001 Spectacles of Death in Ancient Rome Routledge pp 131 2 Edwards Catharine 2007 Death in Ancient Rome Yale University Press p 107 See also Langlands Rebecca 2006 Sexual Morality in Ancient Rome Cambridge University Press p 184 Hill p 289 Loraux Nicole 1991 Tragic Ways of Killing a Woman Harvard University Press pp 9 10 Translated by Anthony Forster Murray p 499 a b Hunter Ernest Harvey Desley 2002 Indigenous suicide in Australia New Zealand Canada and the United States Emergency Medicine Australasia 14 1 14 23 doi 10 1046 j 1442 2026 2002 00281 x PMID 11993831 Graham Anne Reser Joseph Scuderi Carl Zubrick Stephen Smith Meg Turley Bruce 2000 Suicide An Australian Psychological Society Discussion Paper Australian Psychologist 35 1 28 doi 10 1080 00050060008257463 Hunter et al pp 21 24 Hunter et al p 25 Hunter et al pp 25 29 30 Further reading The processes and physiology of judicial hanging capitalpunishmentuk org Retrieved 9 August 2011 Archived 9 August 2011 Layton Julia How does death by hanging work HowStuffWorks Retrieved 9 August 2011 Mann John Dixon 1908 Forensic Medicine and Toxicology Taylor amp Francis pp 208 13 Bowen David A LL 1982 Hanging A review Forensic Science International 20 3 247 9 doi 10 1016 0379 0738 82 90124 4 PMID 7141362 Van Hooff Anton J L 1990 From Autothanasia to Suicide Self Killing in Classical Antiquity Routledge Simounet C Bourgeois M 1992 Suicides and attempted suicides by hanging Annales medico psychologiques 150 7 481 5 PMID 1343195 Pounder Derrick J June 1993 Why Are the British Hanging Themselves American Journal of Forensic Medicine and Pathology 14 2 135 40 doi 10 1097 00000433 199306000 00006 PMID 8328433 S2CID 40274951 Aufderheide Tom P Aprahamian Charles Mateer James R Rudnick Eric Manchester Elizabeth M Lawrence Sarah W Olson David W Hargarten Stephen W 1994 Emergency airway management in hanging victims Annals of Emergency Medicine 24 5 879 84 doi 10 1016 S0196 0644 94 70206 3 PMID 7978561 Samarasekera Ananda Cooke Clive 1996 The Pathology of Hanging Deaths in Western Australia Pathology 28 4 334 8 doi 10 1080 00313029600169294 PMID 9007952 S2CID 43075665 Kaki Abdullah Crosby Edward T Lui Anne C P 1997 Airway and respiratory management following non lethal hanging Canadian Journal of Anesthesia 44 4 445 50 doi 10 1007 BF03014468 PMID 9104530 Scott Clark C Levy A The Sunday Times Magazine 1 February 1998 pp 13 21 Brancatelli G Sparacia G Midiri M d Antonio V Sarno C Lagalla R 2000 Brain damage in hanging A new CT finding Neuroradiology 42 3 209 10 doi 10 1007 s002340050048 PMID 10772145 S2CID 37717139 Reser Joseph P 1999 Indigenous suicide in cross cultural context PDF South Pacific Journal of Psychology 11 2 95 110 doi 10 1017 S0257543400000663 Green H James R A Gilbert J D Byard R W 2000 Fractures of the hyoid bone and laryngeal cartilages in suicidal hanging Journal of Clinical Forensic Medicine 7 3 123 6 doi 10 1054 jcfm 2000 0419 PMID 16083660 Elliott Farrelly Terri 2004 Australian Aboriginal suicide The need for an Aboriginal suicidology Advances in Mental Health 3 3 138 145 doi 10 5172 jamh 3 3 138 S2CID 71578621 Oehmichen Manfred Auer Roland N Konig Hans Gunter 2006 Forensic Neuropathology and Associated Neurology Springer Science Business Media Jevon Philip Bowden David F Halliwell David 2007 Emergency Care and First Aid for Nurses A Practical Guide Elsevier pp 126 8 Benomran F A Masood S E Hassan A I Mohammad A A 2007 Masking and bondage in suicidal hanging Medicine Science and the Law 47 2 177 180 doi 10 1258 rsmmsl 47 2 177 PMID 17520966 S2CID 32094890 Dedouit Fabrice Tournel Gilles Becart Anne Hedouin Valery Gosset Didier 2007 Suicidal Hanging Resulting in Complete Decapitation Forensic Radiological and Anthropological Studies A Case Report Journal of Forensic Sciences 52 5 1190 3 doi 10 1111 j 1556 4029 2007 00503 x PMID 17645743 S2CID 8017102 Yip Paul S F 2008 Suicide in Asia Causes and Prevention Hong Kong University Press Suicide and Suicide Prevention in Asia PDF Archived from the original PDF on 24 August 2011 Retrieved 30 July 2011 667 KB World Health Organization 2008 30 July 2011 See webpage Retrieved from https en wikipedia org w index php title Suicide by hanging amp oldid 1144918552, wikipedia, wiki, book, books, library,

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