Dr. Taylor, an associate professor of medicine and clinical bioethicist at Queen's University in Kingston, Ontario, suggests that it is fundamentally important to understand that people commit suicide for different reasons and to evaluate those reasons. In cases in which a person's reasoning is skewed because of depression or other mental illness, suicide clearly would be considered 'irrational.' In such cases, the illness causing the skewed worldview should be treated and assistance is unambiguously not at issue.

"On the other hand," says Taylor, "some will argue that suicide can be 'rational' in the realm of terminal illness or untreatable suffering. It is in these instances that discussion of assisted suicide might take place."

Responsible Reporting:
Media and Suicide Contagion

Research indicates that media reports and fictional presentations of suicide affect suicidal behavior and contribute to suicide contagion.

Suicide contagion is "the process by which a prior suicide facilitates the occurrence of a subsequent suicide." In addition to contagion through exposure to media reports of suicide, contagion can occur through exposure to suicide or suicidal behaviors within family or peer groups. Suicide contagion affects individuals already at risk for suicide and is linked to increases in suicidal behaviors especially in adolescents and young adults.

In response to this evidence, a group of agencies has released recommendations for media coverage of suicide. The recommendations were developed by the Annenberg Public Policy Center of the University of Pennsylvania, the American Foundation for Suicide Prevention, Office of the Surgeon General, the Centers for Disease Control and Prevention, the National Institute of Mental Health, the World Health Organization and other national and international agencies. They have been widely disseminated to the media, including every newspaper in the country and all college newspapers.

The media can help educate the public about suicide and suicide prevention, but "the job of the media is to decide when suicide is newsworthy," says Kathleen Hall Jamieson, Ph.D., dean of the Annenberg School of Communications at the University of Pennsylvania and director of the Annenberg Public Policy Center. When it is, she says, "the reporter's obligation is to get the story right." This includes understanding the complex causes of suicide and the roles played by mental disorders, substance abuse disorders and other predisposing factors in suicide and suicidal behavior.

In addition to recommended language and suggestions for angles to pursue and stories to consider covering, the recommendations document research on the media and suicide contagion and list resources for additional information about suicide and suicide prevention.

Reporting on Suicide: Recommendations for the Media is at www.appcpenn.org.

Explaining the Gender Gap

Women in the United States attempt suicide far more frequently than men, but rates of completed suicide are higher for men than for women. This pattern is true across age groups in the United States. Similar patterns exist in most other countries as well.

Differences in the rates of completed suicide appear to result from the different methods used. Men are more likely to choose immediately lethal methods such as firearms and hanging. Women tend to choose methods that are less likely to be fatal right away, like drug overdoses or the ingestion of poisons, making discovery and successful treatment more likely.

Researchers have begun to investigate factors influencing the methods people choose and speculate that differences in impulsiveness and aggression between men and women may play a role. Women also may be more concerned about violence and disfigurement. Some researchers also speculate that higher rates of deliberate self-harm in women may indicate that they are less intent on suicide, and that they use self-harm to signal distress.

Other factors that may lead to differences in rates of completed suicides include differences between men and women in patterns of social interaction, including forming and maintaining close social ties. In elderly people, a higher proportion of men who completed suicide were single or divorced.

Women may also respond more favorably to treatment for depression and other psychiatric illnesses, leading to decreased risk for suicide attempts and suicide completions. Culture-specific gender roles, such as differences in emotional expression (for example, women in the United States are more likely to disclose emotions) also may play a role in differences in suicide risk for men and women.

The National Hopeline Network 1-800-SUICIDE provides access to trained telephone counselors, 24 hours a day, 7 days a week. Or for a crisis center in your area, go here.

next: Depression in Women: What Every Woman Should Know

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