Suicide in China

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 Korea and Japan, and it is more common among women than men and more common in the Yangtze Basin than elsewhere.

Suicide
Social aspects
Crisis
Types
Methods
Epidemiology
History
In warfare
Related phenomena
By country
Organizations

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.[1][5] Between 1990 and 2016, suicide rates in China fell by 64%, making China the #1 country in the world in suicide reduction.[6][7] 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.[8]

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,[9] 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.[10]

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.[11] Moreover, 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 [12] 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".[13]

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.[10] 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.[14] 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.[15] According to the journal Culture, Medicine and Psychiatry, there were over 300,000 suicides in China annually in the 1990s;[16] however, the suicide rates in China fell by 64% between 1990 and 2016, making China #1 in the world in reduction of suicide.[6] As of 2016, China accounted for about 17% of the world's suicides.[17] The suicide rate in the Yangtze Basin was about 40% higher than in the rest of China in the 1990s.[18]

History
See also: Philosophy of suicide § Confucianism

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.[19] 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.[20] 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."[21] 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.[22]

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[23]), 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.[24] 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.[10]

Chastity was greatly valued by 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.[25]

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.[26]

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.[25] 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.[24]

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.CS1 maint: numeric names: authors list (link)
  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. PMID 24690079.
  3. "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". The Economist. 28 June 2014.
  5. 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. PMID 24690079.
  6. Anne Gulland, Global health security correspondent (8 June 2019). "Drop in suicide rate in China fuels global fall in deaths". The Telegraph. Retrieved 2019-06-22.
  7. 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. PMC 6598639. PMID 31339847.
  8. Suicide rates per 100,000 by country, year and sex (Table). WHO. 2011. Archived on 22 January 2012.
  9. Suicide rates (per 100,000), by gender, China 1987-1999 World Health Organization
  10. 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.
  11. 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. S2CID 22314831.
  12. "China's suicide rate has dramatically declined in recent years: Report". Shanghaiist. 27 June 2014. Retrieved 29 June 2014.
  13. [ http://www.economist.com/node/21605942/ A dramatic decline in suicides: Back from the edge]
  14. 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.
  15. 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, S2CID 24474367
  16. Phillips, Michael R.; Liu, Huaqing; Zhang, Yanping (November 3, 2004), "Suicide and Social Change in China", Culture, Medicine and Psychiatry, 23 (1): 25–50, doi:10.1023/A:1005462530658, PMID 10388942, S2CID 26060744
  17. "WHO | Suicide data". WHO. Retrieved 2019-06-22.
  18. 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, S2CID 143708605
  19. Lewis, Mark Edward, and Timothy Brook. The Early Chinese Empires: Qin and Han. First Harvard University Press, 2010, Page 160.
  20. Iga, Mamoura; KS Adam (1980), "Stress and Suicide in Japan", Transcultural Psychiatric Research Review, 17 (4): 243–244, doi:10.1177/136346158001700405, S2CID 144018059
  21. Analects, trans. D.C. Lau, second edition, (Hong Kong: Chinese University Press, 1992), XV:9D
  22. Mencius, trans. D.C. Lau, (Hong Kong: Chinese University Press, 1984), VI A:10
  23. Analects 8:3, Xing Bing and Zhu Xi commentaries
  24. 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. PMID 19484900.
  25. 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. PMID 19484897.
  26. "China: Case of Assisted Suicide Stirs Euthanasia Debate". The Law Library of Congress. August 17, 2011.
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