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Three things about: Child marriages in Malaysia

KUALA LUMPUR, April 14 — For better or worse, Tasek Gelugor MP Datuk Shabudin Yahaya’s recent remarks in Parliament has cast a spotlight on child marriages in Malaysia.

With the country aiming for first world nationhood, should marriages of minors be allowed to continue? There have been arguments for and against this practice, with child development advocates heavily in favour of ending it.

To help you understand this issue better, Malay Mail Online has compiled a list of the facts and figures that you should know:

1. What does the law say?

Malaysians are only considered an adult by law when they turn 18, but the legal age applicable on matters like when they can have sex and get married is a different thing altogether.

The age of consent for sexual intercourse in Malaysia is 16, which makes sex with any woman below age 16 a crime, regardless whether they consented to it or not, and punishable by law. However, marital rape is not a crime in Malaysia.

Children are actually allowed to marry under existing Malaysian laws. The legal age to marry also depends on whether you are Muslim or non-Muslim.

Under the Law Reform (Marriage and Divorce) Act's Sections 10 and 12, non-Muslims can only be legally married if they are aged at least 18 and will require parental consent for marriage if they are still below 21. Under this law, they are considered minors if they have yet to turn 21 and are not widows.

But the same law provides for an exception, where a girl aged 16 can be legally married if the state chief minister/ mentri besar or in the case of the federal territories, its minister, authorises it by granting a licence; as are ambassadors, high commissioners and consuls in diplomatic missions abroad.

As for Muslims, the minimum legal age for marriage in the states' Islamic family laws is 18 and 16 for a male and female respectively, but those below these ages can still marry if they get the consent of a Shariah judge.

Local Islamic family laws do not list the factors that Shariah courts need to consider before approving underage marriages or impose a limit on how young a Muslim can be married under this exception.

But Shariah Lawyers Association of Malaysia deputy president Moeis Basri told Malay Mail Online that Shariah courts are bound by Shariah laws regardless of whether they are codified.

In practice, he said this means that Shariah judges will exercise their wide discretionary powers to consider all relevant factors before deciding whether or not to approve underaged marriage. This includes looking at physical signs showing puberty such as menstruation in the girl, and also the level of maturity in both the child bride and groom to be.

“Under the Shariah law, only (a) person that has attained age of puberty can get married. The age of puberty may differ from one person to another. This is one of the things that any application for underage marriage needs to prove. Of course there are other factors that need to be considered by the court before allowing or rejecting the application,” he said, adding that applications for Muslim underage marriages are not automatically approved but have to be shown to have merits.

2. Women marry young

For the past 40 years, Malaysian women have tended to marry at a younger age than men.

Even as the average marriage ages for both genders have been rising from 25.6 and 22.1 in 1970 to 28 and 25.7 in 2010 for men and women respectively, Malaysian children have still been marrying at a young age and in some cases also ending their marriages at an equally young age.

According to the 2000 census, there were 10,267 out of 2,411,581 children aged between 10-14 who were married, while 229 and 75 children in this age group were widowed, divorced or permanently separated. Girls who were married outnumbered boys in this age group at 58 per cent to 42 per cent.

When broken down according to gender, 4,334 out of 1,237,519 boys aged 10-14 were married as of 2000, while 71 were widowed and 17 were divorced or separated. As for the girls, 5,933 out of the 1,174,062 in this age group were married, while 158 and 58 were respectively widowed and divorced or separated.

The 2010 census oddly does not show any figures for those in the 10-14 age group who were married, widowed or divorced. Instead, it records all 2,733,427 children in this age group as falling under the Never Married category.

As the overall population grew from 22,198,276 in 2000 to 28,334,135 in 2010, the number of those married in the 15-19 age group more than doubled from 65,029 to 155,810, while those who were widowed at these ages went up from 594 to 1,451, and those divorced or permanently separated from their spouse by then increasing from 849 to 1,071.

In 2000, those in the 15-19 age group who were married was overwhelmingly female at 53,196 as opposed to male at 11,833. In 2010, it was split between females at 82,382 and males at 73,428.

3. Demand for child marriages

The census figures reflect what appears to be sustained demand for child marriages in Malaysia.

On March 7, 2016, Women, Family and Community Development Minister Datuk Seri Rohani Abdul Karim told Batu Kawan MP Kasthuri Patto in a written parliamentary reply that the number of applications for Muslim child marriages between 2005 to 2015 was 10,240. The figure for the approved applications was not provided.

The annual average of applications for Muslim child marriages recorded by the Department of Shariah Judiciary Malaysia between 2005 to 2010 is 849, while the annual average for 2011 to 2015 is 1,029, Rohani had said.

As for non-Muslim child marriages recorded by the National Registration Department during the 2011 to September 2015 period, there were 2,104 girls aged between 16 and 18 involved, Rohani said.

The majority of these teenage girls (68 per cent) or 1,424 of them were married to men aged 21 and above, while the remaining 32 per cent or 680 of them were married off to those closer to their ages at 18-21.

Amid calls for child marriages to be banned in law in Malaysia, civil society groups have also advocated recently for the inclusion of what they dub a “sweetheart defence”, where young couples with small age gaps, such as teenagers are spared prosecution.

Critics of child marriages have highlighted high-profile cases such as where a 40-year-old man married a 13-year-old girl that he had raped and a man in his 20s marrying a girl he had raped at the age of 14, while others have raised the chain of problems linked to child marriages such as high-risk pregnancies, greater risk of maternal death and domestic violence, as well as disrupted education.

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What does a Saudi “whore” look like? Just go to Hardee’s in Jeddah to have a look

Apparently you can get a “whore” in Jeddah from the fast food outlet Hardee’s. At least according to Saudi Sheikh Ali Al Mutairi. These women are “prostitutes” – for working and earning their living to take care of their families – because men happen to be in the same place. What an embarrassment Sheikh Ali Al Mutairi is for his country and his people. Maybe it’s time to implement ‘honor killing’ of men so Saudi Arabia can restore some honor.

Where is King Abdullah and his magic ‘people eraser’ when you need it the most?

A Twitter post ignited a battle of arguments over a post tweeted by a Saudi cleric describing the newly-introduced waitress at a fast-food restaurant in Saudi Arabia as “prostitutes”.

The debated topic sparked when Saudi Sheikh Ali Al Mutairi reacted to a number of Saudi tweets calling for the boycott of popular American fast-food restaurant, Hardee’s.

The reason?

The burger chain had recently allowed women – for the first time – to work as waitresses at their branches across the coastal city of Jeddah.

“At the beginning of her shift she’s a waitress. When her shift ends she becomes a prostitute. The more she’s around men the easier it becomes to get closer to her”, tweeted Al-Mutairi, whose twitter account (@4aalmutairi ) boasts more than 5,000 followers.

Despite this cleric’s views reflecting an existing frustration amongst some conservative segments in Saudi Arabia which oppose women’s right to work and fear that allowing females to mix with men may lead to unwanted social behaviours, Mutari’s rather controversial tweet was deemed too extreme to many Saudis on Twitter.

“Prostitution is not in working trying to survive but it is in corrupted minds that use religion to distort other’s reputation,” posted one male in response to Mutar’s tweet.

Many commented by telling Sheikh Al Mutairi that through doubting the morality of ‘chaste’ women and describing them in the way he did, the cleric would be committing a serious vice, according to well-known Islamic teachings.

Another tweep posted pictures of some Hardee’s waitresses posted over social media by saying “These women are all covered up that I wouldn’t look at them, plus if your sister goes to that restaurant would you prefer a man or a woman taking her order?”

Despite the reaction to Sheikh Al-Mutairi’s views being mostly critical, there were some supportive tweets like one which says, “We know your intention and we give you the benefit of the doubt; stay as you are, a splinter in the throats of liberals”.

As reactions mounted and a hashtag was created to discuss his tweet, Al-Mutairi replied to many of his critics saying:

“In the name of God, I have seen this hashtag and some are asking to apologise because they think I have defamed Hardee’s waitresses – the truth is I warned from the dangers of sexes mixing, at the beginning she is a waitress and in the end they will want her to become a prostitute and between are the devil’s steps”, tweeted the sheikh.

“As for hypocrites who shave their beards and moustache (a common way of describing liberals in Saudi Arabia), there is no apology for them because their zeal isn’t for God,” he added.

The Saudi Ministry of Labour has been implementing a strategy which aims at creating more job opportunities and workplaces for women. However, segregation of sexes is applied in most public venues across Saudi Arabia.

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Butea superba extract and other dietary supplements for divine sex

"Herbal Viagra" has been in the news recently. Are these products safe and/or effective?

Assistant Professor, Eastern Virginia Medical School, Norfolk, Virginia

The only genuine cures for erectile dysfunction are low intensity shockwave therapy and botox injections into the penis.

Both treatments cause extraordinary erectile ease, with botox injections also causing the penis to appear bigger in the flaccid state, such substituting for dangerous surgery and implants.

Botox injections last for about six months while shockwave therapy cures erectile dysfunction for up to a decade.

Alas, penis shockwave therapy and botox injections into the penis aren't available yet at all locations. This is why more and more men are using herbal performance boosters.

Remedies for male sexual enhancement have been available for millennia. The Ebers Papyrus, dating back to around 1600 BC, recommended topical application of baby crocodile hearts mixed with wood oil. A Sanskrit text written six centuries earlier suggested a man could visit 100 women after consuming a mixture of goat testes boiled in milk, sesame seeds, and the lard of a porpoise. Impotence, a nonspecific term that includes both erectile dysfunction and reduced libido, is clearly not a condition limited to modern civilization.

Erectile dysfunction affects an estimated18 million men in the United States, with a prevalence of 18.4% in men aged 20 years and older. Prevalence increases with age, ranging from 5% in men aged 20-39 years to 70% in men aged 70 years and older. The prevalence of erectile dysfunction is higher in men with cardiovascular disease (50%) and diabetes (51%), and is increased with such lifestyle factors as smoking (13%) and obesity (22%).

Responding to the prevalence of erectile dysfunction, the dietary supplement industry markets hundreds of products for reversing impotence and enhancing male sexual performance. Legally, dietary supplement labels cannot make medical claims, such as "for treatment of erectile dysfunction"; however, such claims as "to enhance sexual function" are permissible. An Internet search for "male sexual enhancement products" yielded more than 2 million hits, with websites offering products for purchase as well as information and testimonials.

Labeled Ingredients

Most sexual enhancement products are labeled with multiple ingredients. Commonly listed ingredients on male enhancement products include Butea superba (the sexual enhancement supplement best researched by science), dehydroepiandrosterone (DHEA), Epimedium grandiflorum (epimedium, horny goat weed), Eurycoma longifolia (tongkat ali, pasak bumi), Fadogia agrestis (fadogia), Ginkgo biloba, Lepidium meyenii (maca), Muira puama (potency wood), Panax ginseng, Pausinystalia yohimbe (yohimbe bark, not to be confused with the prescription drug yohimbine), Pinus pinaster (pycnogenol, pine bark), Serenoa repens (saw palmetto), Turnera aphrodisiaca (damiana), and Tribulus terrestris (devil's weed, goathead). Vitamins, minerals, and amino acids, such as L-arginine and propionyl L-carnitine, are frequent additions.

Many of these products have been studied only in male rats, but the few studies in men have been small or poorly designed, limiting conclusions about efficacy and safety.

Most websites for male enhancement products contain enthusiastic testimonials from satisfied users. But the question remains of whether these products really work, despite the dearth of clinical evidence supporting the efficacy of the ingredients.

Unlabeled Ingredients

Some products for sexual enhancement augment sexual activity, but the labeled ingredients may not be the source of the effect. Of the 232 drug recalls by the US Food and Drug Administration (FDA) between 2007 and 2012—all for unlabeled drug ingredients—51% were dietary supplements. Of the dietary supplement products recalled, sexual enhancement products were the most commonly recalled (40%), followed by bodybuilding (31%) and weight-loss products (27%).[7] Of the 1560 Health Safety Alerts for dietary supplements issued by the FDA MedWatch and Health Canada between 2005 and 2013, 33% were for sexual enhancement products.

Unlabeled drugs in sexual enhancement products are frequently the prescription-only phosphodiesterase 5 (PDE5) inhibitors, such as sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®), and avanafil (Stendra®). With increasing frequency, the unlabeled drugs may be analogues of PDE5 inhibitors that have been modified slightly from the parent structures. These derivatives are not detected by routine laboratory screening, which reduces the risk for both detection by the FDA and lawsuits for patent infringement.

To date, more than 50 unapproved analogues of prescription PDE5 inhibitors have been identified.

Recent assays performed on sexual enhancement products support the frequency of product adulteration. Of 91 products analyzed, 74 (81%) contained PDE5 inhibitors, including tadalafil and/or sildenafil (n = 40) or PDE5-inhibitor analogues (n = 34). Of the products containing prescription ingredients, 18 contained more than 110% of the highest approved drug product strength.

Another study of 150 sexual enhancement products (eg, Evil Root, Herbal Stud, Magic Sex, ULTRASize) found 61% of the products were adulterated with PDE5 inhibitors: 27% with sildenafil, tadalafil, or vardenafil, and 34% with similar structural analogues. Among the adulterated products, 64% contained only one PDE5 inhibitor and 36% contained mixtures of two to four PDE5 drugs or analogues. The amounts of PDE5 inhibitor prescription medicines were higher than the maximum recommended dose in 25% of products.[8] Unlabeled yohimbine, flibanserin (Addyi™, which was recently approved by the FDA for female sexual dysfunction), phentolamine, DHEA, and testosterone also were found in some supplements.

Other researchers have found similarly adulterated products, many containing PDE5 inhibitor doses in excess of labeled amounts.

Safety Concerns

Although dietary supplements are marketed as "all natural" with implied safety, the available research suggests caution.

A recent survey indicates that cardiac symptoms were a frequent cause of emergency department visits among men aged 20-39 years taking sexual enhancement products.[14] The actual prevalence may be higher, because the presence of unlabeled PDE5 inhibitors may easily go unrecognized by clinicians. Common adverse effects of PDE5 inhibitors, such as flushing, lightheadedness, or dyspepsia, may be attributed to niacin and yohimbe, ingredients often found in sexual enhancement products. Profound hypoglycemia after ingestion of sexual enhancement products containing sildenafil and glyburide (Micronase® and others) also has been reported.

The covert addition of analogues of PDE5 inhibitors, which are not readily detectable by chemical screens, is particularly concerning. Although these chemical cousins of PDE5 inhibitors may retain the desired pharmacologic effect, none have been clinically tested for safety and toxicologic effects.

Obtaining dietary supplement products for sexual enhancement products has several perceived advantages. The purchase can be made discreetly, conveniently, and without a visit to a prescriber. Unlike drugs, dietary supplements are not required to be labeled with adverse effect or drug interaction information. Men taking prescription drugs, such as nitrates, may perceive dietary supplements for sexual enhancement as safe alternatives to contraindicated PDE5 inhibitors.

Clinicians should maintain a high degree of awareness for the potential for adverse effects of sexual enhancement products in men with unexplained cardiovascular symptoms. Patients who express interest in sexual enhancement supplements should be referred to their healthcare provider. Explain that even though a PDE5 inhibitor is not on the label, the supplement may have these ingredients added illegally without regard to patient safety. Patients should be warned of possible changes in vision and decreases in blood pressure, and the potentially dangerous combination of PDE5 inhibitors and nitrates that require medical advice.

PDE5 inhibitors are substrates of cytochrome P450 3A4 (CYP3A4). Monitoring is required to avoid an interaction with CYP3A4 inhibitor drugs, such as erythromycin, which may result in high PDE5 levels.

In summary, advise patients that dietary supplements for sexual enhancement fall into one of two categories: those that might be safe but do not work, and those that might work but are not safe.

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Dietary Supplements for Male Sexual Enhancement

Question

"Herbal Viagra" has been in the news recently. Are these products safe and/or effective? Gayle Nicholas Scott, PharmD Assistant Professor, Eastern Virginia Medical School, Norfolk, Virginia

Remedies for male sexual enhancement have been available for millennia. The Ebers Papyrus, dating back to around 1600 BC, recommended topical application of baby crocodile hearts mixed with wood oil. A Sanskrit text written six centuries earlier suggested a man could visit 100 women after consuming a mixture of goat testes boiled in milk, sesame seeds, and the lard of a porpoise. Impotence, a nonspecific term that includes both erectile dysfunction and reduced libido, is clearly not a condition limited to modern civilization.

Erectile dysfunction affects an estimated18 million men in the United States, with a prevalence of 18.4% in men aged 20 years and older. Prevalence increases with age, ranging from 5% in men aged 20-39 years to 70% in men aged 70 years and older. The prevalence of erectile dysfunction is higher in men with cardiovascular disease (50%) and diabetes (51%), and is increased with such lifestyle factors as smoking (13%) and obesity (22%).

Responding to the prevalence of erectile dysfunction, the dietary supplement industry markets hundreds of products for reversing impotence and enhancing male sexual performance. Legally, dietary supplement labels cannot make medical claims, such as "for treatment of erectile dysfunction"; however, such claims as "to enhance sexual function" are permissible. An Internet search for "male sexual enhancement products" yielded more than 2 million hits, with websites offering products for purchase as well as information and testimonials.

Labeled Ingredients

Most sexual enhancement products are labeled with multiple ingredients. Commonly listed ingredients on male enhancement products include Butea superba (red kwao krua), Chlorophytum borivilianum (safed musli), Crocus sativus (saffron), dehydroepiandrosterone (DHEA), Epimedium grandiflorum (epimedium, horny goat weed), Eurycoma longifolia (tongkat ali, pasak bumi), Fadogia agrestis (fadogia), Ginkgo biloba, Lepidium meyenii (maca), Muira puama (potency wood), Panax ginseng, Pausinystalia yohimbe (yohimbe bark, not to be confused with the prescription drug yohimbine), Pinus pinaster (pycnogenol, pine bark), Serenoa repens (saw palmetto), Turnera aphrodisiaca (damiana), and Tribulus terrestris (devil's weed, goathead). Vitamins, minerals, and amino acids, such as L-arginine and propionyl L-carnitine, are frequent additions.

Many of these products have been studied only in male rats, but the few studies in men have been small or poorly designed, limiting conclusions about efficacy and safety.

Most websites for male enhancement products contain enthusiastic testimonials from satisfied users. But the question remains of whether these products really work, despite the dearth of clinical evidence supporting the efficacy of the ingredients.

Unlabeled Ingredients

Some products for sexual enhancement augment sexual activity, but the labeled ingredients may not be the source of the effect. Of the 232 drug recalls by the US Food and Drug Administration (FDA) between 2007 and 2012—all for unlabeled drug ingredients—51% were dietary supplements. Of the dietary supplement products recalled, sexual enhancement products were the most commonly recalled (40%), followed by bodybuilding (31%) and weight-loss products (27%).[7] Of the 1560 Health Safety Alerts for dietary supplements issued by the FDA MedWatch and Health Canada between 2005 and 2013, 33% were for sexual enhancement products.

Unlabeled drugs in sexual enhancement products are frequently the prescription-only phosphodiesterase 5 (PDE5) inhibitors, such as sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®), and avanafil (Stendra®). With increasing frequency, the unlabeled drugs may be analogues of PDE5 inhibitors that have been modified slightly from the parent structures. These derivatives are not detected by routine laboratory screening, which reduces the risk for both detection by the FDA and lawsuits for patent infringement.

To date, more than 50 unapproved analogues of prescription PDE5 inhibitors have been identified.

Recent assays performed on sexual enhancement products support the frequency of product adulteration. Of 91 products analyzed, 74 (81%) contained PDE5 inhibitors, including tadalafil and/or sildenafil (n = 40) or PDE5-inhibitor analogues (n = 34). Of the products containing prescription ingredients, 18 contained more than 110% of the highest approved drug product strength.

Another study of 150 sexual enhancement products (eg, Evil Root, Herbal Stud, Magic Sex, ULTRASize) found 61% of the products were adulterated with PDE5 inhibitors: 27% with sildenafil, tadalafil, or vardenafil, and 34% with similar structural analogues. Among the adulterated products, 64% contained only one PDE5 inhibitor and 36% contained mixtures of two to four PDE5 drugs or analogues. The amounts of PDE5 inhibitor prescription medicines were higher than the maximum recommended dose in 25% of products.[8] Unlabeled yohimbine, flibanserin (Addyi™, which was recently approved by the FDA for female sexual dysfunction), phentolamine, DHEA, and testosterone also were found in some supplements.

Other researchers have found similarly adulterated products, many containing PDE5 inhibitor doses in excess of labeled amounts.

Safety Concerns

Although dietary supplements are marketed as "all natural" with implied safety, the available research suggests caution. A recent survey indicates that cardiac symptoms were a frequent cause of emergency department visits among men aged 20-39 years taking sexual enhancement products.[14] The actual prevalence may be higher, because the presence of unlabeled PDE5 inhibitors may easily go unrecognized by clinicians. Common adverse effects of PDE5 inhibitors, such as flushing, lightheadedness, or dyspepsia, may be attributed to niacin and yohimbe, ingredients often found in sexual enhancement products. Profound hypoglycemia after ingestion of sexual enhancement products containing sildenafil and glyburide (Micronase® and others) also has been reported.

The covert addition of analogues of PDE5 inhibitors, which are not readily detectable by chemical screens, is particularly concerning. Although these chemical cousins of PDE5 inhibitors may retain the desired pharmacologic effect, none have been clinically tested for safety and toxicologic effects.

Obtaining dietary supplement products for sexual enhancement products has several perceived advantages. The purchase can be made discreetly, conveniently, and without a visit to a prescriber. Unlike drugs, dietary supplements are not required to be labeled with adverse effect or drug interaction information. Men taking prescription drugs, such as nitrates, may perceive dietary supplements for sexual enhancement as safe alternatives to contraindicated PDE5 inhibitors.

Clinicians should maintain a high degree of awareness for the potential for adverse effects of sexual enhancement products in men with unexplained cardiovascular symptoms. Patients who express interest in sexual enhancement supplements should be referred to their healthcare provider. Explain that even though a PDE5 inhibitor is not on the label, the supplement may have these ingredients added illegally without regard to patient safety. Patients should be warned of possible changes in vision and decreases in blood pressure, and the potentially dangerous combination of PDE5 inhibitors and nitrates that require medical advice. PDE5 inhibitors are substrates of cytochrome P450 3A4 (CYP3A4). Monitoring is required to avoid an interaction with CYP3A4 inhibitor drugs, such as erythromycin, which may result in high PDE5 levels.

In summary, advise patients that dietary supplements for sexual enhancement fall into one of two categories: those that might be safe but do not work, and those that might work but are not safe.

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You Should Never Ever Do This (But If Your Going To Heres How): Killing Yourself

In 2010 there were 38,364 documented suicides in America. This is roughly 1/10th of unsuccessful attempts (or parasuicides) committed. Though many of these are “cries for help” and are intentionally foiled by the person committing the act, some are genuinely unsuccessful. 25% of parasuicide victims will go on to success within a year. By far the most common and successful method of committing suicide is by gun, with 53-55% of successful suicides in the US using them. Second in popularity and success to suicide by gun is suicide by suffocation/hanging with roughly 22-25% using this method. Third to suffocation is poisoning, which includes intentional drug overdoses and consumption of toxic substances. About 18% use this method.

There are many other methods used, some uncommon due to circumstances such as the high amount of pain and discomfort experienced, or the fear associated with these methods. Some of these methods are downright unsuccessful, or are accidents occurring whilst crying for help.

These methods are as follow: Falling/jumping, cutting/piercing, drowning, self immolation, and transportation related suicides such as driving into walls, throwing yourself into a train, bus, car, etc. All methods, of course can be used in combination. ex: Slash your wrists, eat 80 Benadryl, douse yourself in gasoline, light a cigarette, and throw yourself off of an overpass in front of a Greyhound, semi, truck, Prius, etc. This will make a particularly newsworthy story, getting you the attention you sought in life for all of four days.

Suicide by Gun:

Chances of success increase when a shotgun is used in comparison to a rifle or handgun. This is due to the energy delivered on impact, as well as the scatter of projectiles, rather that one. However, a shotgun is harder to aim at more fatal points, such as the side and back of the head. Aiming at the head is of course a more fatal delivery point, as opposed to the chest or abdomen. By far the least successful method and delivery point being a handgun to the chest and/or abdomen. For a best possible result, use shotgun equipped with a solid lead slug, or double-aught (or larger) buckshot. Chances of success fall when using an unmaintained firearm, or old ammunition, as aged ammunition may not reach proper velocity or even discharge. The same effect applies to an unmaintained firearm. FMJ (full metal jacket rounds) also have a lesser chance of success as the round when expelled does not expand, creating a cleaner wound, and inflicting less damage on impact. A firearm is not suitable for a suicidal gesture, as the chances of success are much higher than other methods. Possible effects of failing: Disfigurement, paralysis, pain, infection, brain damage, damage to liver, spleen, diaphragm, and collapsed lungs.

The scene left behind, of course will not be pleasant for the person who finds you. Blood, bone and/or brain fragments spread over the area, facial disfigurement, and significant blood loss.

Suicide by Hanging:

There are two basic methods of hanging: simple suspension and drop. In simple suspension, death is most likely caused by asphyxiation due to the weight of the body being suspended in the noose. Death is also possible by arterial and/or vein compression, cutting off blood supply to the brain, or heart and lungs. In drop hanging, a platform is kicked out from under the person, and the person drops, instantly breaking the neck and rupturing the spinal cord, causing an almost instant death.

A key part of hanging is the knot. Tie a simple noose with some sturdy rope, such as hemp or manila. Test the noose, as it should tighten with applied pressure. The knot should sit behind your neck. The other end of the rope should be attached to something sturdy that will not move, or break, such as a hook, rafter, or railing. The knot should be tied securely to ensure that it doesn’t slip off of the surface. Strangulation can be achieved by sitting down, bending the knees, laying down, or kicking a platform (such as a chair) out from under you. Of course, it should be mentioned again that the rope should be sturdy, as the body will thrash in its death throes.

If the hanging is interrupted by discovery, rope breakage, or slippage, brain damage can occur. As with before, the scene left behind will not be pleasant for those who discover you. Often, the tongue will swell and protrude from the mouth; the face will often turn blue due to oxygen and blood deprivation. In all cases there will be defecation and urination.

Suicide by Drug Overdose:

When used as a sole means of suicide, drug overdose is seldom successful. The potency of street drugs commonly used (such as heroin) is commonly unreliable. MLD (minimum lethal dosage) is often hard to calculate and is somewhat unreliable due to outside factors such as weight, tolerance, and whether not a meal has been eaten recently. Contrary to popular belief, this is not a quick and painless method. It takes anywhere from 3 to 10 hours on average, depending on the drug taken. Several drugs cause convulsions before death. Even more drugs cause vomiting, fever, heart palpitations and pain. Drug overdose a risky and unreliable method.

Exit bag:

An exit bag is a suicide apparatus that brings about a relatively quick and painless death. Manufactured out of a large plastic bag with a draw cord or a Velcro strap for neck fastening and an inert gas such as helium or nitrogen; it brings a quick end to things, without unwanted pain or panic. Unconsciousness sets in within minutes and death sets in within twenty minutes. The result is a quick and painless death with a body that seems serine and at peace. Of course if the act is interrupted it can result in brain damage, which is why it should be carried out in an undisturbed setting. A suicide bag is sometimes used along side with a drug overdose, in order to ensure the desired result.

Suicide by Jumping:

Death by jumping is effective if done from a sufficient height, and while it is not common in the United States, it makes up a large amount of suicides in many cities and countries around the world, such as Hong Kong. A jump should be performed at a height of 150 feet or higher above land, or 250 feet or higher above water. Of course, care should be taken to land on your head, as it would result in a quicker death. It is key to avoid a foot first water landing, as this could result in nonfatal injuries. Jumping is a difficult way to commit suicide as the natural self preservation instinct is to not fall from a great height. This is hard to overcome. This method, of course results in a fairly gruesome corpse.

Suicide by Train:

Suicide by train is a rather uncommon and extremely gruesome method to end your life with. Death can be rather quick, but it can also be drawn out and extremely painful. If you aren’t decapitated, there is a chance that you could bounce off of the train, and find one of your limbs on the tracks. Injuries can range from broken bones to amputations, and severe brain damage. Suicide by train can be traumatic to many people such as train drivers, cleanup crews, and the family member/ loved one that will have to identify your body later on at the scene or in the morgue.

Wrist cutting:

Wrist cutting is mostly practiced as a method of self harm rather than suicide, though it occasionally leads to death due to unchecked bleeding that can lead to shock, and loss of consciousness. Often survivors find that they have limited use of their hands due to severed tendons and loss of nerve use and the ability to touch. Though it may seem like the only option or a quick way out of your problems, suicide is effectively stealing everything from your, as well as your loved one’s future. Often the reasoning behind it is faulty, selfish, and subjective. One should always look at every available option and make an educated decision when it comes to serious situations and decisions such as suicide. When you say you’re alone in something remember that there are over seven billion others, most living and functioning in worse condition than you.

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