Should people who want to kill themselves be allowed to die?

A high proportion of pesticide suicides are impulsive, with people contemplating harming themselves for less than 30 minutes. In fact, most persons who engage in suicidal or self-harming behaviour are ambivalent about wanting to die, with the act serving as a response to psychosocial stressors. Self-harm is used as communication – expressing for example pain, hurt, shame or anger. The great majority who now survive the act in Sri Lanka – because the pesticides ingested are no longer lethal – go on to lead successful productive lives.

Replacing the often lethal HHPs with less toxic alternatives allows more people to survive the acute stress and receive the community and medical help they need.

This is clearly shown by the Sri Lankan experience in which the bans of HHPs resulted in a remarkable 75% overall reduction in suicide. People who no longer died from pesticide poisoning with the less toxic pesticides did not then go out to kill themselves with another lethal method such as jumping off a bridge. This is because the spontaneity of pesticide poisoning results in the nearest pesticide often being drunk, with little thought. If this is highly hazardous, many people die. If it is less hazardous, because HHPs are no longer available, the person will survive.

We also believe that people with mental illness require mental health services and support to get better and live fulfilling lives.

Resources:

Deisenhammer E, Ing C, Strauss R, Kemmler F, Hinterhuber H, Weiss E, The duration of the suicidal process: how much time is left for intervention between consideration and accomplishment of a auicide attempt? J Clin Psychiatry 70:1, January 2009.

Conner KR, Phillips MR, Meldrum S, Knox KL, Zhang Y, Yang G, Low-planned suicides in China. Psychol Med. 205 Aug; 35 (8): 1197-204,

Eddleston M, Karunaratne A, Weerakoon M, Kumarasinghe S, Rajapakshe M, Sheriff MH, Buckley NA, Gunnel D, Choice of poison for intentional self-poisoning in rural Sri Lanka, Clin Toxicol (Phila) 2006; 44(3):283-6.

WHO Restricting Access to the Means for Suicide, at http://www.who.int/mental_health/prevention/suicide/pesticides/en/.