Suicide

Suicide is the act of voluntary and intentional self-destruction. Many Western philosophers have employed the concept of suicide as a starting point for reflection on human existence. Suicide was decriminalized in Canada in 1972; someone who now attempts suicide is not liable to sanction under the Criminal Code. However, anyone found guilty of counselling another to take his or her own life or of aiding a suicide is liable to imprisonment of up to 14 years, whether or not the suicide attempt is successful. A peace officer or a physician may order involuntary detention of any person judged to be a danger to himself or herself.

Assisted Suicide

There is continuing debate in provincial and federal legislatures concerning the right of individuals to physician or other-assisted suicide, particularly in cases where the person is too disabled to commit the act without assistance. In 1993 prohibitions in the Criminal Code were challenged by Sue Rodriguez (Rodriguez v British Columbia, 1993), resulting in considerable public discussion of the issue. The status quo was upheld by the Supreme Court of Canada, and Rodriguez ended her life assisted by an unknown physician. Subsequently, other accounts of suicides by people with incurable illnesses who were assisted by others have been made public.

Suicide statistics are described in Statistics Canada records as "deaths reported by coroners and medical examiners of official death registrations as having been due or 'probably due' to suicide, following the usual postmortem inquiry, investigation, or inquest as required by law." Official statistics on suicide in most countries are likely to be underestimated because of poor record-keeping, insufficient information and tendencies on the part of medical personnel and other officials to mislabel or hide suicides, or to refrain from investigations of suspicious deaths to protect the survivors of the victim. However, suicide statistics from many nations do indicate trends over time, differences among countries, and differences among specific groups within a country.

Rates

Canada's 1996 rate of 13.0 suicides per year per 100 000 people places this country between nations with rates of over 20 suicides per 100 000 - eg, Hungary, Russia and Finland - and those with rates of consistently below 10 - eg, Mexico, Greece and Portugal. Émile Durkheim's observation in his monograph Suicide (1897) on the suicide rates of nations is still true: a given nation has a characteristic suicide rate which fluctuates very little from year to year and which generally remains relative to rates of other nations. In 1996, 3941 suicides were recorded in Canada, 2923 by males, 786 by females. Suicide is among the top 10 causes of death in Canada and is second to accidents as the leading cause of death for people under 35. The suicide rate for males is 21.5; for females 5.3. Males are more likely to employ more violent and certain methods (for example, firearms, explosives or hanging), while females are more likely to use drugs.

There is substantial regional variation in suicide rates. Rates are generally higher in the west than they are in the east. Among the provinces, Newfoundland has the lowest suicide rates and Alberta has the highest. While computed rates of the Territories are high, the computations should be interpreted with extreme caution because their small populations and low suicide counts result in unstable statistics.

Highest Risk Groups

In Canada (as well as around the world) suicide rates of men are much higher than those of women. In this country, men under 30 and over 75 and young members of FIRST NATIONS are among the highest risk groups for suicide. Moreover, there is increasing concern about suicide among youth. Among industrialized nations, Canada ranks third, behind New Zealand and Finland, in its rate of suicide by people aged 15-19. The rate for this age group almost doubled between 1970 (7.0 per 100 000) and 1991 (13.5 per 100 000), and it is mainly young men who contributed to the increase.

While it has been established that climate and heredity bear no relationship to the incidence of suicide, a considerable array of social and psychological characteristics have been linked with self-destruction. Students of suicide agree that some personality types seem to be more vulnerable to suicidal behaviour. The major psychological theory of suicide, deriving from Freud, links suicide with hostile impulses turned back upon the self. Karl Menninger has suggested that every suicide reflects the wish to kill, the wish to be killed, and the wish to die. Immediate difficulties (for example, loss of a loved one, a career), despair, loneliness or an unhappy home life may also precipitate self-destruction.

Programs aimed at preventing suicide range from those that attempt to identify potential suicides to those that provide effective first-aid and follow-up for suicide attempters. Restrictions on the availability of firearms, barriers on bridges and other "attractive hazards" and reductions in the toxicity of gas have reduced suicide rates in some locations. Recently, the growth of crisis or distress centres, which provide the opportunity for people to contact trained volunteers and discuss problems anonymously, has been regarded as a hopeful development in suicide prevention.