Get access

Confidential Death to Prevent Suicidal Contagion: An Accepted, but Never Implemented, Nineteenth-Century Idea


  • I. Parrish, Case of Suicide in a Child. American Journal of the Medical Sciences, 21 (November 1837), 258–259. All quotations attributed to Parrish are from this report. Quotations from Friends Hospital's medical records are from manuscript physician notes. Search of the Index-Catalogue of The Library of the Surgeon General's Office, United States Army and review of 45 American medical journals published before 1838 did not identify an earlier article reporting the psychological circumstances and autopsy of an American suicide.

Address correspondence to Edward C. Leonard, Jr., M.D., Friends Hospital, 4641 Roosevelt Boulevard, Philadelphia, PA 19124–2399; Email:


Nineteenth-century medical literature often admonished the popular press to limit reports of suicide, because of a belief that knowledge of another's suicide could stimulate some persons to kill themselves. An 1837 case report (perhaps the earliest attempt at a psychological autopsy in an American medical journal) is discussed, because it presciently clarifies the concept of psychological sensitization. Its study leads to documentation of two examples of falsified death certificates. The power to prevent publicity of suicide by not reporting it may have diminished efforts for newspaper restraint, as did editorial resistance and later acceptance of Emile Durkheim's (1897/1951) strongly expressed belief that reports of suicide did not cause an overall increase in suicide. Despite lack of success over the past two centuries, efforts to keep reports of self-inflicted death confidential continue to flow from concern about suicidal contagion. Today, uncensored websites and books advocating suicide may limit the benefit of the U. S. Surgeon General's “call to action” to prevent suicide, which again supports voluntary media restraint in reporting suicide.