Epidemiological Approach to the Study of Male Adolescent Suicide in Idaho
Throughout history suicide has remained an enigma in cultures that are far and different from each other. The act of taking one's life has been a representation of religious beliefs, cultural attitudes, and the answer to pain and suffering. Although suicide is mainly frowned upon in the western world is such countries as Japan and India the act of suicide is a requirement of honor and social acceptability and the passage of time has seen the emergence, and rejection, of varying attitudes toward suicide. For example, during the persecution of Christians by the Romans an acceptable practice of a Christian woman to prevent herself from being "deflowered" by a Roman soldier the act of suicide was not only accepted but expected as well. In fact the Romans and Greeks both were of the opinion that suicide was a responsible and socially acceptable and sometimes necessary course of action. Socrates drank hemlock in the company of his friends and in certain parts of rural India it is still permissible for the wife of a deceased husband to commit suicide by throwing herself onto his funeral pyre. What is important to remember is that suicide places the victim in a voluntary position wherein facilitation of the act is determined by the individual him or herself and, for the suicide there is no question of symmetry or consent. For these individuals suicide may well be a rational argument to end one's life in the context of prolonged physical pain or metal anguish. On the other hand, however, there are numerous situations wherein ambiguity rings clear and the act is a reflection of an emotional dysfunction wherein the ability to rationalize outside the constraints of the illness lead to suicide. In other words, the powers of reasoning have been suspended. In fact affective mod disorders that lead to suicide, or evoke the desire to commit suicide, must be treated in the same vein.
If suicide is both culturally influenced and psychologically determined the question becomes one of differentiation. Although this particular philosophical debate is beyond the scope of this paper mention must be made by way of consequential interests. The leading question, therefore, is suicide a defensible action given certain contextual situations. For example, does the death of one person become socially and morally correct if the act ensures the continuance of life for a greater number of people? Continuing this example further consider a soldier who constantly risks his/her life for the well-being of others. Should the bomb explored and the soldier be killed does society consider the person's death an act of suicide? Can one actually question the morality of the soldier who was in full possession of the knowledge of the risks involved? Most would agree that even St. Thomas, who was vehemently opposed to the act of suicide, would deem the act excusable when the primary intent of the action is altruistic. In other words a socially and morally unacceptable action completed in principle is morally acceptable if an obligation exists to exercise an action benefiting the larger majority.
The act of suicide must also be looked at from the viewpoint of a natural or unnatural response to pain. As a side bar note it is interesting to point out that animals suffering from extreme pain do not actually commit suicide. The haunting question is, therefore, what is the defining feature in man that permits the act of suicide to emerge? Is it because, right or wrong, man has the ability to make the argument on a hypothetical level, to reason, and to logically arrive at a conclusion? If this is the case, what tempts or causes man to be illogical in decisions ending in suicide? Or, what influences are so strong that rational man decides that suicide is the only probable answer to a dysfunctional situation? The answer, of course, lies in the epidemiology of the construct of suicide itself, namely risk factors that are sociodemographic, psychiatric, biological, familial, and situational.
The remainder of this paper will take a more epistemological look at the issue of suicide, especially male teen suicide with respect to the phenomenon existing in the state of Idaho. The secondary phase of the report will pay particular attention to the role of the nursing profession in suicide rate reduction. The end product, or result, will be the formulation of a testable hypothesis seeking to determine whether or not the nursing profession is equipped to become a forcible entity in lowering the rate of male teen suicide in Idaho through preventative programming.
The Epidemiology of Teen Male Suicide. By broad definition epidemiology refers to the study of an event occurrence or phenomenon from a causative stance. As such the goal of epidemiological studies is to uncover the relationship that exists between exposure to various environmental conditions that can produce a certain medical illness whether the illness is neuro-biological, sociological, or psychological. Epidemiological research investigations study the distribution and determinants of various health-related states and events with respect to specified populations (Last, 1983). In the end, epidemiological studies apply the results of the research investigations to help control the health problem being investigated. Basically there are two types of epidemiological studies, namely, descriptive and analytical wherein descriptive studies are concerned with existing health-related variables and absent of a testable hypothesis and not set up to test causality in any manner. On the other hand analytical studies are designed to examine the existence of hypothesized associations and relationships, and focus on measuring the effects of a specific health related risk factor or factors (Bailar, 1997). The health-related topic of this assignment, adolescent male suicide in Idaho is basically an analytical meta analysis study wherein research pertaining to an identified group of individuals (male teens) is examined with respect to mortality rates for the whole population. As the study does not examine the relationship between exposure to certain elements impacting upon the rate of male teen suicide in Idaho the information garnered will be useful for generating a scientific hypothesis to test the efficacy of preventative treatment programs for the purpose of lowering male teen suicide rates in Idaho along with the usefulness of the nursing profession in the preventative program. The testable hypothesis is, therefore, based on the research question of whether or not preventative measures can be implemented to lower the rate of male teen suicide in the state of Idaho. In order to accomplish a meta analysis study with respect to male teen suicide in Idaho and the possible impact of nursing involvement certain reporting criteria must be met. They are as follows:
1. Clear identification of the study population (male teens in Idaho) and related groups (nurses);
2. Extracting and applying the results of other studies in a clear and straightforward fashion;
3. Making sure that what is being extracted from other studies is comparable across the board and the results are expressed consistently; and, if possible,
4. Assess the results of all studies review statistically.
As the current project is an epidemiological approach to the study of male teen suicide in Idaho a statistical analysis is not required.
Teen Suicide. Death, regardless of occasion or reason is an emotional burden for all to carry. Even in modern times the questions as to why someone commits suicide has no easy answer. Unfortunately those who endure unbearable pain, physical or psychological, the act of living is a tremendous burden to carry. The primary risk or epidemiological factors surrounding the suicide phenomenon are generally identified as major depression, severe personality disorders, the male gender, substantive abuse, the elderly, previous suicide attempts, living alone and physical illness. In the United States suicide is most prevalent among the elderly and young (15-24) (CDC, 2003). In addition, according to Shafer and Hicks (1993) among the youth group between 0.01 and 10% will attempt the act. This is a staggering number when one considers the birth rate in the United States to be 4,019,280 in 2002 (CDC, 2003). Simple mathematics equates this to a completed suicide population of young people between 40,192 and 401,928 per year.
As stated in the previous paragraph Every year between 4,000 teenagers between the ages of 15 and 400,000attempt suicide and approximately 5-6,000 complete the act and the number of suicides might be even higher because some families report the suicides as accidents or murders (Klagsburn, 1976). In addition, for the past 20 years suicide now ranks as the third leading cause of death among people ages 15 to 24, trailing only accidents and homicides" (Worsnop, 1991). According to several research studies the primary cause of male teen suicide is depression.
Only in the past two decades, have depression and suicide been taken seriously as an illness that involves the body, mood and thoughts. Not only does depression affect the way a person eats and sleeps, feels about themselves, and the way they think of the things around them but also strongly linked…