Jared Daniels
Staff Writer
Wyoming, according to the American Foundation for Suicide Prevention, is ranked third highest for death by suicide in 2017, but how accurate are these statistics?
The Center for Disease Control’s Medical Examiners’ and Coroners’ Handbook on Death Registration and Federal Death Reporting draws a tight line between the difference of reporting a death as an accident or as a suicide. The main difference between the definitions is that the accidental death appears not to show intent. Suicide is described as being intentionally done to oneself. How does the medical examiner determine intent when there is no or contradicting physical evidence? In the handbook another option, Cannot Be Determined, is available to the coroner if investigation reached its peak and one label does not stand out.
The determination of suicide is later expanded on in this handbook by two criteria: First, there is pathological and psychological evidence suggesting individuals self inflicted their death and second, the individual understood the intended actions would inevitably end in their death. In this instance, no knowledge of their actions could lead to an accidental death label.
Therefore, where is the line drawn? If an individual with no extensive knowledge of vehicles were to leave the car on in an enclosed space, how is the intent of their actions determined? Could it not be said they did not know it would lead to their death and were just sitting in the car for some other reason?
The second expansion is further assessed to express verbal or nonverbal and implicit or indirect actions that show the intent. However, how does one observe indirect and nonverbal intent and how are these actions deemed as contributors to their death? If these actions go unnoticed, undiagnosed and untreated, how are they witnessed and later told to the examiner?
These factors that determine a person’s death label are obtained by witnesses to these actions as the dead cannot reveal all of their actions. This is problematic as it can lead to some bias in that the person may be entitled to insurance compensation, social stigma and even reputation within the community. In a 2015 interview with the Casper Star Tribune, Natrona County’s coroner Connie Jacobsen discribed that suicide is stigmatized and seen as sinful and shameful.
Coroners themselves may change the label put onto death as an accident as a way to aid the family of the individual. In a 2011 interview with the Casper Star Tribune Keith Hotle, a leader for the suicide prevention team for the Wyoming Department of Health, estimated that suicides in rural areas may be underreported by up to 300%.
Social stigma around suicide has been aparent for a long time. One instance is that, according to Volume 2 of The Halsbury Laws of England, individuals whose death was determined to be a suicide would have their body was driven through with a stake and buried in a public higway and the individuals property became willed to the crown.
A study over stigma and psychological distress in suicide survivors, according to the Journal of Psychosomatic Research Volume 94, found subjects bereaved by suicide that had high levels of distress also had high levels of percieved stigma toward suicide.
Factoring in the stigmatism behind suicide, denial attached to grief, insurance and your personal beliefs, would you help determine a suicide? Would others? If so, how does this impact the suicide statistcs in Wyoming and what can we do to show this? How can we help fix these numbers?
