Suicide watch: The internet's deadly influence

I recently became aware of a very disturbing fact about this blog.

Looking at Canadian Medicine's traffic numbers not long ago, I noticed that the tenth most popular article on the site in terms of the number of pageviews is my short October 12, 2007 entry "The best way to die," which was a summary of and reference to a very good piece in The New Scientist. It's nearly a year old now, and not something I would have guessed would be of particular interest to many readers seeing as it's largely a recommendation to read the New Scientist article, but there it was: #10 overall. That's odd, I thought to myself. So I clicked on another button to examine the search-engine keywords that people have been using to find that article.

The most common terms weren't surprising: variations on 'best way to die,' predictably, find my piece near the top of Google's search results. But as I began flipping through the search-engine terms that occurred less frequently -- just one or two or three times -- I discovered that some readers seemed not to be searching for a sort of tongue-in-cheek article like the New Scientist's that explores the science behind fatal accidents, but instead appeared to genuinely be looking for information on how to kill themselves.

Searches that readers used to turn up my article include:

best way to die from carbon monoxide
"best way to die" "hanging"
best way to cut vein
best way to die cyanide?
best way to die heroin
best way to die poison monoxide in home
die from hanging whats the best hieght
drowning the best way to die?
exsanguination how long to die
fast way to die
is carbon monoxide a painful way to die
is cutting the arota the fastest way to die
the best way to die now

This is a disturbing thing to learn, that my article may be serving as a resource in some manner or another for people who want to commit suicide.

I'm not unaware of the medical literature on the influence of the internet on suicides. University of Bristol researcher Lucy Biddle and a team of colleagues published an excellent report in the British Medical Journal in April that, while acknowledging the potential of beneficial effects of internet use in preventing suicide by connecting patients with support communities and other helpful information, also showed that 19% of search engine hits for terms similar to mine (such as "how to kill yourself") pointed to pro-suicide sites.

Now, of course, I don't believe that means that my article was necessarily in bad taste -- there's nothing wrong per se with writing or reading about death -- but I can't help but worry that things I wrote about an "optimal way to go" could be used by readers who want to do themselves harm.

But at this point, there emerges a journalism ethics question: Is it incumbent upon a journalist to protect the public from information that could cause someone harm?

I think the answer is that there is no easy answer. I can think of cases where the answer is yes, and clearly so -- publishing the military's troop movements, for instance, or printing the home address of a public official or celebrity -- but what about opinion articles or editorial cartoons (as in the outrage over the Danish cartoons of Muhammad, which sparked riots), or cases like mine in which the information is based on science and was never private to begin with?

Rather than remove potentially harmful information -- Biddle et al sensibly write: "Any attempt to regulate suicide promotion needs to strike a balance between freedom of expression and public protection and the global nature of the internet" -- the report recommends:

"It may be more fruitful for service providers to pursue website optimisation strategies to maximise the likelihood that suicidal people access helpful rather than potentially harmful sites in times of crisis."

What the report is referring to is efforts to influence search-engine rankings (a field called search-engine optimization, or SEO), but I think the concept can be applied just as well in my case.

The solution, then, it seems to me, is to append a short warning to the article to provide readers with the website addresses and telephone numbers of suicide hotlines (in Canada and in the US). Just in case.

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