Hidden suicide in the developing world
Authors: Pritchard, C.
Ambivalence about suicide exists across most cultures, even in Japan despite its Samurai tradition (Leenaars, 2004) and, in many Western Developed Countries (WDC), the stigma continues. Indeed, in rural Greece, suicides may sometimes be refused burial in 'hallowed ground,' and it was only in 1962 that suicide was decriminalized in Great Britain (Pritchard & Hansen, 2005a, 2005b). The stigma surrounding suicide led to some authorities to suggest that, in order to save families further distress, sometimes Open or Misadventure Verdicts be given rather than suicide (Stanistreet, et al., 2001; Linsley, et al., 2001, Salib, et al., 2005). Such verdicts are classified by the WHO as undetermined and appear as Other External Causes of Death' (OECD). It has been argued that OECD may be the depository of hidden suicides and should be included in studies of the incidence of suicide (Linsley, et al., 2001; Stanistreet, et al., 2001; Salib, et al., 2005). Moreover, OECD are often violent and are undetermined because "information is insufficient to enable the medical or legal authority to make a distinction between accident, self-harm and assault" (WHO, 1992). The types of lethality are often methods of suicide, such as hanging, drowning and falls, and so OECD may also contain hidden homicides as well as hidden suicides. This leads us to consider the extent to which developing countries may also have possible hidden suicides as a result of cultural attitudes towards suicide. Such attitudes stem largely from a country's religious traditions. The four great faiths (Buddhism, Hinduism, Christianity and Islam) have different views, ranging from an acceptance in Buddhism to formal rejection in Islam, although it is recognized that, within these major faiths, there are different views even between countries of the same faith (Becker, 1990; Jayaram, 2007; Neeleman, et al., 1997; Pritchard & Amunalla, 2007). Suicide is mentioned in the Christian Bible and the Jewish Talmud but without any moral comment (Barraclough, 1992). However, during Saint Augustine's time (354 AD-430 AD), the Christian church theologically reprimanded suicides. This still persists in the Roman Catholic and 'Orthodox' (Bulgarian, Greek, Macedonian and Russian) Churches and, traditionally, suicides are condemned to hell. In Islam suicide is expressly forbidden in the Qur'an. Surah 4 verse 29 states, "Do not kill or destroy yourself" while verse 30 condemns offenders to the extreme penalty (Al-Hilali & Khan, 1420 AH). However, there are different emphases and interpretations of the Qur'an in the various Islamic regions (Hourani, 2002). In some countries, such as Kuwait or Pakistan, suicide is still a criminal offence (Suleiman, et al., 1989, Khan & Hyder, 2006). However, there is good historical evidence of an advanced, liberal and humane non-judgmental response to mental illness, with Islamic doctors such as the great Avicenna and Elrazi influencing positively their more primitive medieval European contemporaries (Hourani, 2002; Okash, 2005). This chapter draws together new research of possible hidden suicides in the most traditional Catholic and Islamic countries, namely 17 predominately Islamic and 18 Latin American (LA) developing countries, although all such countries contain minorities of others faiths and denominations. Patterns of suicide and OECD are analyzed by gender to explore the possibility of hidden suicides amongst OECD rates. The suicide/OECD ratios of developing countries are compared with those of the ten WDC, with a focus upon Younger Aged [15-34] people because of the recent rise in suicide in WDC by Younger Aged males (Pritchard & Hansen, 2005a). A detailed exposition of the methodology and literature can be found elsewhere (Pritchard & Baldwin, 2000; Pritchard & Hansen, 2005a, 2005b; Pritchard & Amunalla, 2007; Pritchard & Hean, 2008). © 2012 by Nova Science Publishers, Inc. All rights reserved.