Each method is rated using a consistent, clinical framework. A chapter begins with a graph that assesses the technique on five dimensions: pain it causes, effort of preparation required, the appearance of the body, the disturbance it may cause for others, and its deadliness. Each matter is also rated by skulls, with five skulls indicating the highest rating. Wording such as “completely painless” and “marvelous experience” is used to indicate which methods are more painless and fatal.
The book was written during a time when Japan was experiencing a period of economic recession, and the country's suicide rate was on the rise. The author, Wataru Tsurumi, claimed that his intention was to provide a comprehensive guide for individuals who were contemplating suicide, as a means of helping them make an informed decision. Each method is rated using a consistent, clinical framework
Research into suicide contagion (the Werther Effect) strongly indicates that detailed media descriptions of suicide methods increase attempts, especially among young people. A 1998 study in the Japanese Journal of Psychiatry found that after the book’s release, suicides by certain methods described in it rose significantly among teenage boys. effort of preparation required