Suicide in China

Suicide in China has a long history as a cultural practice. Commemoration of Qu Yuan's patriotic suicide is popularly considered the basis for the annual Dragon Boat Festival. Study of modern suicide in China is complicated by political concerns which cause official statistics to vary (sometimes greatly) from the findings of independent studies. China's suicide rates were one of the highest in the world in the 1990s; however, by 2011, China had one of the lowest suicide rates in the world.[1][2] According to the World Health Organization, the suicide rate in China was 9.7 per 100,000[3] as of 2016. As a comparison, the suicide rate in the U.S. in 2016 was 15.3.[3] Generally speaking, China seems to have a lower suicide rate than neighboring Japan and Korea, with the practice more common among women than men and more common in the Yangtze Basin than elsewhere.

A 2014 overview pointed at the economic crisis years (2007-2008) as a period from which suicide rates surged globally. The study was about China's suicide rates which have been declining instead: in the 1990s China was among the countries with the highest suicide rates in the world (above 20 per 100,000), but by the global economic crisis they kept dropping as significantly (as they were by the end of 1990s) with the main force having been migration from rural to urban areas.[4] By 2011, China had one of the lowest suicide rates in the world, even less than the USA.[5][6] Between 1990 and 2016, suicide rates in China fell by 64%, making China the #1 country in the world in suicide reduction.[7][8] According to the WHO, in 2016, the suicide rate in China was 9.7, while the suicide rate in the U.S. was 15.3.[3] Among men, the suicide rate in the U.S. was more than 2.5 times the suicide rate in China -- 23.6 for American men versus 9.1 for Chinese men, as of 2016.[3] The years after 2001 were also a turning point for reliability of data: before then, many countries had no globally recognized official rates, particularly African countries.[9]

Statistics

Statistics are somewhat controversial in that independent studies often produce estimates that are greatly at odds with official statistics provided by the country's government. On the basis of data gathered in 1999, the government estimated an overall rate of 13.9 per 100,000 people,[10] much lower than the rate in other East Asian countries: Japan (18.5) and South Korea (28.9). Family conflicts are the number one cause of suicide in China, other common causes include poverty, and disease of the body and mind.[11]

The most recent government data provides statistics more inline with external estimations. According to a 2016 WHO report, China's suicide rate is 9.7 people out of every 100,000.[3] This rate places the country among the countries with the lowest suicide per capita in the world. For 2009–2011, 44% of all suicides occurred among those aged 65 or above and 79% among rural residents.[12] However, a 2014 study conducted by the Centre for Suicide Research and Prevention at the University of Hong Kong reported that China's suicide rate has dropped significantly, among the lowest levels [13] in the world. An average annual rate of about 9.8 people out of every 100,000 died by suicide as of 2009 to 2011, a 58% drop from average annual rate of 23.2 per 100,000 in 1990 to 1995, largely as a result of population migration from rural areas and urbanization of middle class. Paul Yip, a co-author of the recent study and professor at the University of Hong Kong, said "no country has ever achieved such a rapid decline in suicides".[14]

Demographics

In China, marginally more women than men die by suicide each year. China is one of the few countries in the world that has a higher suicide rate by women over men.[11] It was found that females that attempted suicide were less likely to have been diagnosed with a mental disorder than males who attempted to commit suicide.[15] According to WHO's statistics: in 2016, the suicide rate in China per 100,000 people was 9.1 for men and 10.3 for women,[3] one of the lowest female suicide rates in the world. Bangladesh is also among the few countries where the female rate is higher than the male rate. According to official PRC government statistics, the Chinese male rate (9.1 per 100,000 men per year) is lower than in many other countries, including some Western countries, such as the United States, Australia, and Germany.[3] Among men, the suicide rate in China was 60% lower than the suicide rate in the U.S.-- 23.6 for American men versus 9.1 for Chinese men, as of 2016.[3]

By 2016, suicide rates among Chinese men and women were almost the same -- 9.1 for men and 10.3 for women.[3] A 2008 study -- which was based on data from the 1990s -- found that: female suicides outnumbered male suicides by a 3:1 ratio; rural suicides outnumbered urban suicides by a 3:1 ratio; a large upsurge of young adult and older adult suicides had occurred; a comparatively high national suicide rate two to three times the global average was evident; and a low rate of psychiatric illness, particularly clinical depression, existed in suicide victims.[16] According to the journal Culture, Medicine and Psychiatry, there were over 300,000 suicides in China annually in the 1990s;[17] however, the suicide rates in China fell by 64% between 1990 and 2016, making China #1 in the world in reduction of suicide.[18] As of 2016, China accounted for about 17% of the world's suicides.[19] The suicide rate in the Yangtze Basin was about 40% higher than in the rest of China in the 1990s.[20]

History

Male suicide

For male members in the Han, physical mutilation and suicide were among the highest crimes, threats not only to the self but to the lineage.[21] Ritual suicide was long practiced in traditional Chinese culture, owing both to the power of the state to enforce collective punishment against the families of disgraced ministers and to Confucian values that held that certain failures of virtue were worse than death, making suicide morally permissible or even praiseworthy in some altruistic contexts.[22] Confucius wrote, "For gentlemen of purpose and men of ren while it is inconceivable that they should seek to stay alive at the expense of ren, it may happen that they have to accept death in order to have ren accomplished."[23] Mencius wrote:

Fish is what I want; bear's palm is also what I want. If I cannot have both, I would rather take bear's palm than fish. Life is what I want; yi is also what I want. If I cannot have both, I would rather take yi than life. On the one hand, though life is what I want, there is something I want more than life. That is why I do not cling to life at all cost. On the other hand, though death is what I loathe, there is something I loathe more than death. That is why there are dangers I do not avoid ... Yet there are ways of remaining alive and ways of avoiding death to which a person will not resort. In other words, there are things a person wants more than life and there are also things he or she loathes more than death.[24]

Due to the above-mentioned aversion to physical mutilation (originating from the belief that the body was a gift from one's parent's and desecrating it therefore an unfilial act[25]), the preferred methods -as recorded in for instance the Book of Han- appear to have been those that did not leave the corpse significantly disfigured, notably hanging/strangulation.

Notable suicides include Wu Zixu, whose compelled suicide was regretted by King Fuchai of Wu when he was proved right about the danger of Yue, and Qu Yuan, whose despair over his exile by King Qingxiang of Chu and sorrow over the capture of his capital by Qin in 278 BC is commemorated by China's annual Dragon Boat Festival.

Female suicide

Female suicide became a common practice towards the end of the Ming dynasty and reached a high during the early Qing dynasty. There were many different ideologies and social circumstances which led to this spike. Historians such as Janet Theiss have stated that the Han had a practice of women committing suicide to preserve their chastity, while the Manchus had a practice of wives committing suicide to follow their husbands into death.[26] The loss of a woman's chastity was viewed as shameful to the family so the act of suicide to preserve chastity was seen as a heroic act. Conversely, the Chinese have also historically seen suicide as a great act against filial piety, as bodies are gifts from parents and as such, should not be harmed without their parents' permission. According to Liu Meng, it was decided that the principle of preserving chastity was more important than preserving life and was considered exempt from this criticism.[11]

Chastity was greatly valued but widowed women, especially those who had not borne a son, were very likely to be forced into a new marriage by their in-laws. Scholars have stated that these women were made to choose between losing their chastity and potentially shaming their families or taking their own lives. Eventually this type of ideological thinking came to the point where some women felt that their only option to obtain glory was to kill themselves and become a martyr. The Qing government passed a law attempting to help preserve female chastity by allowing widows to inherit their husbands wealth and property, which led families to want to marry off their widowed daughter-in-laws so that the fortune would be returned to the clan.[27]

Legality

The legality of suicide in China is unclear. The China's National People's Congress has considered several proposals to legalize physician-assisted suicide, but as of 2011, had rejected these proposals. In 1992, a physician was acquitted of the murder of a terminally ill cancer patient who was given a lethal injection. In May 2011, a farmer received a two year jail term for criminal negligence after assisting a friend in committing suicide, but in that case the farmer had mistakenly buried the friend alive, after the friend took poison, but in an insufficient dose.[28]

The Qing dynasty tried to reduce female suicide by creating preventative laws. One of the laws made making lewd comments towards a woman equivalent to rape if she later committed suicide due to these comments.[27] The Qing dynasty also made suicide illegal, so that any person that completed the act would not be able to receive any awards or special honors. The Qing would, however, frequently make exceptions to this when it was believed the act was done to preserve a woman's chastity.[26]

See also

References

  1. ^ May 17, Chelsea Follett This article appeared in CapX on; 2018. (2018-05-17). "The Remarkable Fall in China's Suicide Rate". Cato Institute. Retrieved 2019-06-22.
  2. ^ Zhang, Jie; Sun, Long; Liu, Yuxin; Zhang, Jianwei (2014). "The Change in Suicide Rates between 2002 and 2011 in China". Suicide and Life-Threatening Behavior. 44 (5): 560–568. doi:10.1111/sltb.12090. ISSN 1943-278X.
  3. ^ a b c d e f g h i "GHO | By category | Suicide rate estimates, crude - Estimates by country". WHO. Retrieved 2019-06-22.
  4. ^ "Back from the edge - A dramatic decline in suicides". economist.com. 28 June 2014.
  5. ^ May 17, Chelsea Follett This article appeared in CapX on; 2018. (2018-05-17). "The Remarkable Fall in China's Suicide Rate". Cato Institute. Retrieved 2019-06-22.
  6. ^ Zhang, Jie; Sun, Long; Liu, Yuxin; Zhang, Jianwei (2014). "The Change in Suicide Rates between 2002 and 2011 in China". Suicide and Life-Threatening Behavior. 44 (5): 560–568. doi:10.1111/sltb.12090. ISSN 1943-278X.
  7. ^ Anne Gulland, Global health security correspondent. "Drop in suicide rate in China fuels global fall in deaths". The Telegraph. Retrieved 2019-06-22.
  8. ^ Naghavi, Mohsen (2019-02-06). "Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016". BMJ. 364: l94. doi:10.1136/bmj.l94. ISSN 0959-8138.
  9. ^ Suicide rates per 100,000 by country, year and sex (Table). WHO. 2011. Archived on 22 January 2012.
  10. ^ Suicide rates (per 100,000), by gender, China 1987-1999 World Health Organization
  11. ^ a b c Meng, Liu (October 2002). "Rebellion and revenge: the meaning of suicide of women in rural China". International Journal of Social Welfare. 11 (4): 300–309. doi:10.1111/1468-2397.00239.
  12. ^ Wang, Chong-Wen (2014). "Suicide rates in China from 2002 to 2011: an update". Social Psychiatry and Psychiatric Epidemiology. 49 (6): 929–41. doi:10.1007/s00127-013-0789-5. PMID 24240568.
  13. ^ "China's suicide rate has dramatically declined in recent years: Report". Shanghaiist. 27 June 2014. Retrieved 29 June 2014.
  14. ^ [ http://www.economist.com/node/21605942/ A dramatic decline in suicides: Back from the edge]
  15. ^ Sun, Long; Zhang, Jie (June 2017). "Gender differences among medically serious suicide attempters aged 15–54 years in rural China". Psychiatry Research. 252: 57–62. doi:10.1016/j.psychres.2017.02.042. PMC 5438887. PMID 28249203.
  16. ^ Law, Samuel & Liu, Pozi (February 2008), "Suicide in China: Unique demographic patterns and relationship to depressive disorder", Current Psychiatry Reports, 10 (1): 80–86, doi:10.1007/s11920-008-0014-5, PMID 18269899
  17. ^ Phillips, Michael R.; Liu, Huaqing; Zhang, Yanping (November 3, 2004), "Suicide and Social Change in China", Culture, Medicine and Psychiatry, 23: 25–50, doi:10.1023/A:1005462530658
  18. ^ Anne Gulland, Global health security correspondent. "Drop in suicide rate in China fuels global fall in deaths". The Telegraph. Retrieved 2019-06-22.
  19. ^ "WHO | Suicide data". WHO. Retrieved 2019-06-22.
  20. ^ He, Zhao-Xiong (November 9, 2004), "A suicide belt in China: The Yangtze Basin", Archives of Suicide Research, 4 (3): 287–289, doi:10.1023/A:1009609111621
  21. ^ Lewis, Mark Edward, and Timothy Brook. The Early Chinese Empires: Qin and Han. First Harvard University Press, 2010, Page 160.
  22. ^ Iga, Mamoura; KS Adam (1980), "Stress and Suicide in Japan" (PDF), Transcultural Psychiatric Research Review, 17 (4): 243–244, doi:10.1177/136346158001700405
  23. ^ Analects, trans. D.C. Lau, second edition, (Hong Kong: Chinese University Press, 1992), XV:9D
  24. ^ Mencius, trans. D.C. Lau, (Hong Kong: Chinese University Press, 1984), VI A:10
  25. ^ Analects 8:3, Xing Bing and Zhu Xi commentaries
  26. ^ a b Theiss, Janet (2001-06-01). "MANAGING MARTYRDOM: FEMALE SUICIDE AND STATECRAFT IN MID-QING CHINA". NAN NÜ. 3 (1): 47–76. doi:10.1163/156852601750122991. ISSN 1387-6805.
  27. ^ a b Ropp, Paul (2001-06-01). "PASSIONATE WOMEN: FEMALE SUICIDE IN LATE IMPERIAL CHINA-INTRODUCTION". NAN NÜ. 3 (1): 3–21. doi:10.1163/156852601750122973. ISSN 1387-6805.
  28. ^ "China: Case of Assisted Suicide Stirs Euthanasia Debate". The Law Library of Congress. August 17, 2011.
Chengdu bus fire

On June 5, 2009, a mass murder–suicide attack occurred on a bus in Chengdu, People's Republic of China. It resulted in 27 deaths, and 76 injuries. The attack had no evidence initially connected to terrorism.

Gelsemine

Gelsemine (C20H22N2O2) is an indole alkaloid isolated from flowering plants of the genus Gelsemium, a plant native to the subtropical and tropical Americas, and southeast Asia, and is a highly toxic compound that acts as a paralytic, exposure to which can result in death. It has generally potent activity as an agonist of the mammalian glycine receptor, the activation of which leads to an inhibitory postsynaptic potential in neurons following chloride ion influx, and systemically, to muscle relaxation of varying intensity and deleterious effect. Despite its danger and toxicity, recent pharmacological research has suggested that the biological activities of this compound may offer opportunities for developing treatments related to xenobiotic- or diet-induced oxidative stress, and of anxiety and other conditions, with ongoing research including attempts to identify safer derivatives and analogs to make use of gelsemine's beneficial effects.

Indians in China

The Indians in China are migrants from India to China and their descendants. Historically, Indians played a major role in disseminating Buddhism in China. In modern times, there is a large long-standing community of Indians living in Hong Kong, often for descendants with several generations of roots, and a growing population of students, traders, and employees in Mainland China.

National College Entrance Examination

The National College Entrance Examination (NCEE), commonly known as Gaokao (高考; gāokǎo; 'High[er Education] Exam'), is an academic examination held annually in the People's Republic of China. This Standardized test is a prerequisite for entrance into almost all higher education institutions at the undergraduate level. It is usually taken by students in their last year of senior high school, and there has been no age restriction since 2001.

The exams last about nine hours over a period of two or three days, depending on the province. The Standard Chinese language and mathematics are included in all tests. Candidates can choose one of the subjects in English, French, Japanese, Russian, German and Spanish as a foreign language test (although the six languages were identified as college entrance examination subjects in 1983, the vast majority of candidates regard "foreign language" as "English", and English is the choice of the most candidates). In addition, students must choose between two concentrations in most regions, either the social-science-oriented area (文科倾向) or the natural-science-oriented area (理科倾向). Students who choose social sciences receive further testing in history, politics and geography (文科综合), while those who choose natural sciences are tested in physics, chemistry and biology (理科综合).

In 2006, a record high of 9.5 million people applied for tertiary education entry in China. Of these, 8.8 million (93%) took the national entrance exam and 27,600 (0.28%) were exempted (保送) due to exceptional or special talent. Everyone else (700,000 students) took other standardized entrance exams, such as those designed for adult education students. In 2018, it was reported that 9.75 million people applied for tertiary education entry.

The overall mark received by the student is generally a weighted sum of their subject marks. The maximum possible mark varies widely from year to year and also varies from province to province.

Generally, the modern College Entrance Examination takes place from 7 to 8 June every year, though in some provinces it can last for an extra day.

Self-immolation protests by Tibetans in China

As of 5 June 2017 there have been 148 confirmed and two disputed self-immolations reported in Tibet since 27 February 2009, when Tapey, a young monk from Kirti Monastery, set himself on fire in the marketplace in Ngawa City, Ngawa County, Sichuan. In 2011, a wave of self-immolations by Tibetans in Tibet, as well as in India and Nepal, occurred after the self-immolation of Phuntsog of 16 March 2011 in Ngawa County, Sichuan. Protests are ongoing.

Strain theory (sociology)

In sociology and criminology, strain theory states that social structures within society may pressure citizens to commit crime. Following on the work of Émile Durkheim, strain theories have been advanced by Robert King Merton (1938), Albert K. Cohen (1955), Richard Cloward, Lloyd Ohlin (1960), Neil Smelser (1963), Robert Agnew (1992), Steven Messner and Richard Rosenfeld (1994).

Suicide

Suicide is the act of intentionally causing one's own death. Mental disorders, including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders, and substance abuse—including alcoholism and the use of benzodiazepines—are risk factors. Some suicides are impulsive acts due to stress, such as from financial difficulties, troubles with relationships, or bullying. Those who have previously attempted suicide are at a higher risk for future attempts. Effective suicide prevention efforts include limiting access to methods of suicide—such as firearms, drugs, and poisons; treating mental disorders and substance misuse; proper media reporting of suicide; and improving economic conditions. Even though crisis hotlines are common, there is little evidence for their effectiveness.The most commonly used method of suicide varies between countries, and is partly related to the availability of effective means. Common methods of suicide include hanging, pesticide poisoning, and firearms. Suicides resulted in 828,000 global deaths in 2015, an increase from 712,000 deaths in 1990. This makes suicide the 10th leading cause of death worldwide.Approximately 0.5% of people die by suicide. In a given year this is roughly 12 per 100,000 people. Rates of completed suicides are generally higher among men than among women, ranging from 1.5 times as much in the developing world to 3.5 times in the developed world. Suicide is generally most common among those over the age of 70; however, in certain countries, those aged between 15 and 30 are at the highest risk. Europe had the highest rates of suicide by region in 2015. There are an estimated 10 to 20 million non-fatal attempted suicides every year. Non-fatal suicide attempts may lead to injury and long-term disabilities. In the Western world, attempts are more common among young people and among females.Views on suicide have been influenced by broad existential themes such as religion, honor, and the meaning of life. The Abrahamic religions traditionally consider suicide as an offense towards God, due to the belief in the sanctity of life. During the samurai era in Japan, a form of suicide known as seppuku (harakiri) was respected as a means of making up for failure or as a form of protest. Sati, a practice outlawed by the British Raj, expected the Indian widow to kill herself on her husband's funeral fire, either willingly or under pressure from her family and society. Suicide and attempted suicide, while previously illegal, are no longer so in most Western countries. It remains a criminal offense in many countries. In the 20th and 21st centuries, suicide has been used on rare occasions as a form of protest, and kamikaze and suicide bombings have been used as a military or terrorist tactic.

Suicide legislation

Suicide is a crime in some parts of the world. However, while suicide has been decriminalized in the western countries, the act is still stigmatized and discouraged. In other contexts, suicide could be utilized as an extreme expression of liberty, as is exemplified by its usage as an expression of devout dissent towards perceived tyranny or injustice which occurred occasionally in cultures like ancient Rome or medieval Japan.

While a person who has died by suicide is beyond the reach of the law, there can still be legal consequences in the cases of treatment of the corpse or the fate of the person's property or family members. The associated matters of assisting a suicide and attempting suicide have also been dealt with by the laws of some jurisdictions. Some countries criminalise suicide attempts.

Historically, laws against suicide and mercy killing have developed from religious doctrine, for example, the claim that only God has the right to determine when a person will die.

Video game addiction

Video game addiction also known as gaming disorder or internet gaming disorder is generally defined as problematic, compulsive use of video and/or internet games, that results in significant impairment in an individual's function in various life domains over a prolonged period of time. This and associated concepts have been under considerable research, debate and discussion among experts in several disciplines, and have generated controversy from the medical, scientific and gaming communities. The disorder may present itself as compulsive gaming, social isolation, mood swings, diminished imagination, and hyperfocus on in-game achievements, to the exclusion of other events in life. Such disorders can be diagnosed when an individual engages in gaming activities at the cost of fulfilling daily responsibilities or pursuing other interests, and without regard for the negative consequences.

The World Health Organization included gaming disorder within the 11th revision of its International Statistical Classification of Diseases. The American Psychiatric Association (APA), while stating there is insufficient evidence for the inclusion of internet gaming disorder in the Diagnostic and Statistical Manual of Mental Disorders in 2013, considered it a condition for further study.Controversy around the diagnosis includes whether the disorder is a separate clinical entity, or a manifestation of underlying psychiatric disorders. Research has approached the question from a variety of viewpoints, with no universally standardised or agreed definitions, leading to difficulties in developing evidence based recommendations.

Women's health in China

Women’s health in China refers to the health of women in People’s Republic of China (PRC), which is different from men’s health in China in many ways. Health, in general, is defined in the World Health Organization (WHO) constitution as “a state of complete physical, mental, and social well being and not merely the absence of disease or infirmity". The circumstance of Chinese women’s health is highly contingent upon China’s historical contexts and economic development during the past seven decades. A historical perspective on women's health in China entails examining the healthcare policies and its outcomes for women in the pre-reform period (1949-1978) and the post-reform period since 1978.

In general, women’s health in China has seen significant improvements since the foundation of People’s Republic of China in 1949, witnessed by improvements in multiple indexes such as Infant Mortality Rate(IMR), Physical Quality of Life Index (PQLI), etc. However, due to traditional Chinese ideology on gender inequality and complexities of Chinese political system, challenges in terms of many aspects of women’s health, such as reproductive health and HIV/AIDS, are still mounting.

Zhang Shuhong

Zhang Shuhong (Chinese: 张树鸿, 1957 – 11 August 2007) was a Chinese businessman and factory owner. Zhang committed suicide after toys made at his factory for Fisher-Price (a division of Mattel) were found to contain lead paint.

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