Ethan is in prison, having been successfully framed as the Origami Killer by Carter Blake, with origami figures scattered all over his cell. Tortured by the loss of Shaun and unable to take the suffering anymore, he hangs himself in his jail cell.
- Ethan is either:
- Shaun dies. This means that:
- Madison must die (either before reaching the warehouse, or before Shaun is rescued if she reaches it alone or with Norman) or fail to locate the warehouse.
- Norman must die (either before reaching the warehouse, or in the fight with Scott if he reaches it with Madison), give up on the final puzzle, or accuse the wrong suspect.
- This is considered to be Ethan's worst epilogue due to him being falsely accused of being the Origami Killer, and losing Shaun.
- This ending along with "Dead Heroine," "Smoking Mirror," and "Unpunished" are considered by many to be the worst combination of endings. This is because all the main characters except Scott die, including Shaun and Lauren.
- This is one of five epilogues to have a death scene, the others being "Origami Blues," "Tears in the Rain," "Smoking Mirror," and "A Mother's Revenge."
- This ending, along with "Unpunished" and "Origami Blues," is one of three that never has dialogue.
- Of the three endings in which Ethan commits suicide, this is the only one in which he doesn't do so by shooting himself in the head.
- The player can still get this ending if Scott is identified as the Origami Killer in "News Report." For this to happen, Madison and/or Norman must survive but not reach the warehouse. The same applies to "Unpunished."
- It is interesting to note that Ethan's suicide would not usually be possible in the real world, as prison guards and personnel would generally not allow an inmate time alone with a length of rope which could be suitably fashioned into a noose.
- It is unclear who created all the origami figures scattered across Ethan's cell.
- One theory is that the victims' families made the origami figures and sent them to Ethan as a twisted reminder of what they think he was responsible for, since he was framed for being the Origami Killer. However, there is no compelling evidence that any of the victims' families know origami or would be inclined to torment the killer if they knew his identity.
- Another theory is that Scott Shelby made the origami figures and sent them to Ethan to torment him for his failure to save Shaun. This is supported by this ending being impossible to receive if Scott dies in "The Old Warehouse." (However, Scott can still be killed in one of his epilogues whether or not Ethan receives this ending.)
- The most likely theory is that Ethan went mad with grief and made the origami figures himself. This is probably a holdover from a scrapped concept: as explained in Heavy Rain: Cutting Room Floor, an early version of the game had Ethan's and Scott's consciousnesses become intertwined after Jason's death, and Ethan would black out and create an origami figure each time the Origami Killer claimed a victim. This theory explains why Ethan awakens on the street of the construction site where Scott's brother died years earlier, holding an origami dog (which, as Ann Sheppard mentions, is John's favorite), and can also apply to "Origami Blues."