by John Bateson
University of California Press, 2012
Review by Tony O'Brien, RN, MPhil on Nov 13th 2012
The Golden Gate bridge at San Francisco is one of the world's most well-known landmarks. Constructed in 1937, it is considered a great engineering achievement, and one of the most striking examples of art deco architecture. As John Bateson explains in The Final Leap. Suicide on the Golden Gate Bridge the Golden Gate bridge is also a magnet for suicidal individuals who seek to end their lives in what is to many of them, a worthy death from an iconic structure. Over 1500 individuals have jumped form the bridge, but the toll is considered to be higher owing to the problems of confirming deaths when bodies have been washed many miles away, and even in recording leaps from the bridge that may have gone undetected. The Final Leap is both a testimonial to those individuals who have committed suicide from the Golden Gate Bridge, and a plea for those responsible for administering the bridge to act on advice received many times and provide suicide prevention barriers. Such barriers, Bateson argues, would greatly lower the death toll, and perhaps eliminate it altogether. The Final Leap is thus a work of suicidology and of public health advocacy. It is also an analysis of bureaucratic obfuscation and perseverance of family members who seek to honor the life of their relatives by preventing the deaths of others.
The Final Leap contains eight chapters on the history of the Golden Gate bridge and the recorded suicides since 1937. These chapters cover the allure of the bridge, and why this particular structure apparently draws people to it for the purposes of suicide when others would do just as well. The decisions of suicidal individuals are explored, illustrating the almost arbitrary, in some cases, decision to suicide, the role of impulsivity, and the life course of those who have either survived the jump (a small number) or who have been distracted or dissuaded from their attempt. The effects of suicide on families is examined, often with interview data from family members supportive of Bateson's project. The work of coroners and rescue services is explored, and there is discussion of the lives of some survivors of suicide attempts from the bridge. There is a chapter on the work of suicide counselors, and something of an exposé of the officials responsible for administration of the bridge. The current state of debate about suicide from the bridge is then examined. The final chapters provide an overview of theory of suicide, a list of available resources, and finally a catalog of those known to have died after jumping from the bridge.
The main focus of The Final Leap is on author Bateson's argument that a barrier is both practically feasible and ethically almost beyond argument. On the basis of the arguments provided it seems hard to argue. During construction of the bridge nets were provided for workers who accidentally fell from the site. When the nets were damaged due to a structural collapse they were replaced at great cost. However on completion, the nets were soon removed, and a (so far) endless series of suicides began. In the meantime other modifications to the bridge structure to prevent injuries to cyclists, motorists and pedestrians have been made. There have even been fences constructed to protect people from rubbish thrown from the bridge. But when it comes to suicide prevention only limited action has been taken, and it has not prevented suicides. Bateson mentions other tourist sites, such as the Eiffel Tower and Sydney Harbour bridge that have erected suicide barriers, apparently without detriment to the visual appeal of those structures. In my own city of Auckland, New Zealand, barriers have reduced suicides on Grafton Bridge to zero, an outcome quite common with this sort of preventative approach. In San Francisco arguments are made about the spectacular visual appeal of the bridge, and how barriers would detract from that. Bateson argues that it is the Californian love of individual liberty that prevents the people of San Francisco from demanding either barriers or nets, the two most feasible preventative measures. It might also be that the bridge authority, the Bridge District, a unique body in Californian administration, is simply beyond the reach of political processes that influence other public bodies, and so continues to enact its own cultural values. There are financial arguments too, but they seem specious in the scheme of things.
Bateson's book makes compelling reading. From a suicide prevention perspective one can only wish him well in his efforts to help achieve what seventy-five years of advocacy have failed to accomplish. In cases such as this debate about whether the State has any role in preventing individuals from acting on their freely made choices seems to be trivial given the overwhelming evidence that impulsivity and availability of means play a major part in the dynamics of suicide. There is very limited evidence that suicidal individuals will simply choose another means; in fact the evidence points in the opposite direction. Those who consider jumping from specific places would in most cases not attempt suicide at all if access to their chosen means were denied.
Earlier this year I reviewed the late Professor Thomas Szasz's libertarian critique of suicide prevention. While Szasz, as always, had some valid arguments to make about State intrusion into the lives of individuals, his general position of opposition to suicide prevention seems wrong in cases such as the Golden Gate Bridge. If there is any loss of individual liberty involved in this sort of suicide prevention it seems trifling compared to the benefit of lives saved. As Bateson argues, there are also the surviving families who are spared the premature loss of a loved one, and a burden of grief and guilt. Of course the State is not responsible for these problems, but it seems uncaring and callous not to prevent suffering when it is possible to do so, and the costs are not prohibitive.
The Final Leap is a highly readable book, more in journalistic than academic style, and so is accessible to a wide range of readers. Suicide is not musicalized, it is examined as a complex behavior driven by a multitude of factors, and unique in every case. If I have a quibble at all it is that there is no diagram or photographs illustrating the sides of the bridge and the proposed barrier solutions. Nor is there any image of the bridge itself. That seems an omission, given that most readers will not have seen the Golden Gate Bridge and will therefore have to imagine the visual impact of barriers and their preventative potential. On the basis of Bateson's arguments I'm prepared to take his word for it, but I'd like to have seen a diagram or two. Currently there seems some hope that a solution is at hand in the form of nets similar to those used in construction. As an outsider I would say this seems rather ham-fisted compared to the possibility of an architecturally integrated solution consistent with the design values of the bridge. It also seems vulnerable to policy reversal, as nets can easily be removed.
© 2012 Tony O'Brien
Tony O'Brien, RN, MPhil is a lecturer in mental health nursing at the University of Auckland, New Zealand