DOCSLIB.ORG

Decriminalising Physician-Assisted Suicide in Singapore

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Decriminalising Physician-Assisted Suicide in Singapore (2010) 22 SAcLJ Decriminalising Physician-assisted Suicide 379 DECRIMINALISING PHYSICIAN-ASSISTED SUICIDE IN SINGAPORE This article evaluates the primary reasons for and against the decriminalisation of physician-assisted suicide of terminally- ill patients. It contends that the benefits of decriminalisation outweigh the harms, and sets out to formulate legislation for adoption in Singapore based on the best features of the regulatory models devised by the Netherlands, Oregon and the Northern Territory of Australia. ∗ TOH Puay San LLB (Hons) (National University of Singapore); Deputy Public Prosecutor, Attorney General’s Chambers, Singapore. Stanley YEO LLB (Hons) (University of Singapore), LLM (Wellington), LLM, PhD, LLD (Sydney); Professor of Law, National University of Singapore. I. Introduction 1 Every human being must confront death at some point in their lives. Due to the advances in modern medical technology, ways have been found to prolong life and delay death. However, this does not necessarily result in human lives being enriched in a full and meaningful manner because, in some cases, it merely lengthens the physical or biological existence of a person. Many people do not fear death as much as they fear the “tragic figure”1 they may become before death. In order to minimise their suffering and to honour their dignity, these people should be afforded more control over the timing and manner of their deaths. 2 In Singapore, the Advance Medical Directive Act2 gives Singaporeans some control over their deaths by allowing a person of sound mind to sign an advance medical directive (“AMD”) declaring that he or she does not wish to receive extraordinary life-sustaining ∗ The views expressed in this article are those of the author’s alone, and not representative of the official views of the Attorney General’s Chambers. 1 M Cheang, “Voluntary Euthanasia” (1977) 18 Singapore Medical Journal 265 at 266. 2 Cap 4A, 1997 Rev Ed. 380 Singapore Academy of Law Journal (2010) 22 SAcLJ treatment in the event of terminal illness. As our ageing population3 grows, more measures need to be put in place to deal with end-of-life issues. Recently, Health Minister Khaw Boon Wan expressed that “ageing will throw up many more human stories of agony and suffering”.4 The Minister’s remarks have spawned a public debate over whether voluntary active euthanasia (“VAE”) should be legalised.5 The Ministry of Health has announced plans to make the process of signing the AMD less complicated and to expand palliative care systems in Singapore. Importantly, however, it is observed that although optimum palliative care might minimise physical pain, it cannot remove the strong sense of helplessness and mental or emotional anguish that some patients experience as a result of the progressive deterioration of their bodies.6 3 This article argues that the options available to dying patients need to be increased. In the event that palliative care is unable to meet a patient’s need of having his or her physical, mental or emotional health attended to adequately, the patient ought to have another option – physician-assisted suicide (“PAS”). While a patient has made the decision to end his or her life, he or she may not have the knowledge or means to do so in a painless and dignified manner and would require help. Assistance from physicians is more desirable than that from laypersons due to the former’s medical training and access to drugs and equipment. Such assistance would also provide the patient with 3 It has been reported that between now and 2030, Singapore will witness an unprecedented profound age shift. In 2012, the first batch of baby boomers (those born between 1947 and 1964) will reach 65 years of age. By 2030, the number of residents aged 65 years or older will multiply threefold from the current 300,000 to 900,000. This means that one out of every five residents will be a senior. See further Committee on Ageing Issues, Report on the Ageing Population (3 February 2006), available at <http://www.mcys.gov.sg/successful_ageing/report/CAI_report.pdf> (accessed 23 January 2010). 4 P Forss, “S’pore to expand palliative care systems to deal with ageing population” Channel NewsAsia (14 October 2008), online: Channel NewsAsia, available at <http://www.channelnewsasia.com/stories/singaporelocalnews/view/ 382729/1/.html> (accessed 23 January 2010). Subsequently, Mr Khaw said that, while his Ministry encouraged “public discussion of death and end-of-life matters, it was not promoting PAS but palliative care for the terminally ill”: S Khalik, “Health Minister against planned euthanasia talk” The Straits Times (25 April 2009) at p A18. 5 For example, see “Can you please kill me?” Special report on euthanasia, Sunday Times (26 October 2008) at p 6; R Basu, “Helping the dying with living” The Straits Times (5 November 2008) at p A8; “Euthanasia no substitute for palliative care” The Straits Times (6 November 2008) at p A26; R Basu, “Allowing euthanasia is no panacea” The Straits Times (15 November 2008), at p A25; J Yeo & M Mohan, “Right to die – or licence to kill?” The Straits Times (24 December 2008) at p A15. 6 E Jackson, “Death, Euthanasia and the Medical Profession” in Death Rites and Rights (B Brooks-Gordon et al eds) (Hart Publishing, 2007) at pp 44–46. (2010) 22 SAcLJ Decriminalising Physician-assisted Suicide 381 information about his or her prognosis and options, together with psychological support.7 4 The thrust of this article is that Singapore should decriminalise assisted suicide performed by physicians on terminally-ill patients facing imminent death, suffering unbearably, and holding the conviction that there is no other reasonable solution for the situation they are in. To this end, the authors have drafted a statute which incorporates the best features of the laws and regulations of three jurisdictions which have legalised PAS. In doing so, the authors should not be seen as arguing against improvements in palliative care and its utilisation; if patients prefer such care, their choice must be respected. Indeed, it is proposed that, as a pre-condition of PAS, a patient must undergo palliative care. Neither should this proposal to decriminalise PAS be viewed as a prelude to the decriminalisation of VAE. To this issue we now turn. II. Decriminalising physician-assisted suicide but not voluntary active euthanasia 5 Among the many forms of medical intervention that shorten life, PAS and VAE are the methods that are most frequently discussed. Although they have much in common, it is contended that significant distinctions can be drawn and the legalisation of PAS is to be preferred over VAE. In both PAS and VAE, the patient forms an intention to die and the physician intentionally helps the patient to end his or her life. However, in PAS, the patient makes the final decision and performs the fatal act, that is, he or she is the “final causal actor”8 in his or her own death. As such, PAS is an expression of the patient’s autonomy, right to self-determination, and control. Conversely, although the patient similarly forms an intention to die in cases of VAE, the physician performs the final act and this creates a greater risk of physician malfeasance. 6 Accordingly, the underlying premise for advocating the decriminalisation of PAS is that it was the patients themselves, and not the physician, who had made the decision to terminate their own lives, and who had themselves done the act which terminated it. This double act by the patient of requesting assistance to commit suicide and following up with committing suicide, sets it apart from VAE where only the first act of the patient is present. In this regard, it is noteworthy that, 7 T Cipriani, “Give Me Liberty and Give Me Death” (1995–1996) 3 Journal of Law and Medicine 177 at 183. Such support excludes a physician encouraging his or her patient to opt for PAS. It will be proposed below that physicians should be legally prohibited from offering such encouragement. 8 N Gorsuch, The Future of Assisted Suicide and Euthanasia (Princeton University Press, 2006) at p 6. 382 Singapore Academy of Law Journal (2010) 22 SAcLJ in the Netherlands where both PAS and VAE by physicians are legalised, medical guidelines call for assisted suicide to be preferred over euthanasia because it “makes the patient’s determination and willingness to take responsibility clearer”.9 This extra “firewall” renders PAS a limited activity which can be safely legalised and controlled without automatically leading to the legalisation of VAE.10 III. The current law and its constitutional validity 7 Although suicide is not an offence in Singapore, attempted suicide is by virtue of s 309 of the Penal Code.11 That section, when read together with the abetment provision of s 107 of the Code, makes the abetting of attempted suicide a crime.12 Where the attempt to commit suicide succeeds, s 306 of the Code makes the abetment of suicide a crime.13 8 PAS is criminalised in Singapore on account of these provisions. Thus, a physician who aids a patient in ending his or her life would be subject to prosecution. A physician’s liability would not be absolved by s 88 of the Penal Code which provides that it is not an offence to commit an act which is not intended to cause death that was done with the consent of the person harmed, in good faith for the benefit of that person.14 A physician engaged in PAS cannot plead this exception 9 Royal Dutch Medical Association (KNMG), Position of the Federal Board of the KNMG concerning Euthanasia (KNMG, 2003) at p 9. 10 This fact persuaded the House of Lords in its First Report of the Select Committee on Assisted Dying for the Terminally Ill (TSO, 2005) to recommend legalising only PAS in its second Assisted Dying Bill.
Load more

Recommended publications
  • SUICIDE in SINGAPORE Dr Chia Boon Hock & Audrey Chia
    PSYCHiatrY Updates UNIT NO. 6 SUICIDE IN SINGAPORE Dr Chia Boon Hock & Audrey Chia ABSTRACT SINGAPORE SUICIDE STATISTICS: 2000-2004 The aim of this article is to provide readers with a There were 1717 Singapore resident (citizen and permanent guide on how to assess suicide risk in Singapore. Often resident) suicides from 2000-2004. Thus, on an average, there it is not just one factor, but a combination of factors were approximately 350 suicides per year, or one suicide per which triggers a person to suicide. It is through the day. Most were aged between 25 and 59 (63.5%), with the understanding of these risk factors, that we can better youngest being 10 and the oldest being 102 years. In terms of assess the risk of suicide in our patients. suicide rates, these were highest in elderly Chinese males (40.3 per 100,000), and lowest in Malay females (1.8 per 100,000). SFP2010; 36(1): 26-29 During the same period, there were also 162 non-resident suicides (8.6%) consisting mainly of female Indonesian maids and male construction workers from India and Thailand. INTRODUCTION Suicide accounts for 2.2% of all death in Singapore. This Suicide is an international public health problem. Over a percentage is highest for young females aged 20-39 (18.5%) and million people kill themselves a year and more than half of young males also aged 20-39 (14.2%) where deaths from other these occur in Asia1. Suicide rates are calculated as number of causes (e.g. heart attack, strokes and cancers) are uncommon.
    [Show full text]
  • Euthanasia: a Matter of Life Or Death?
    Singapore Med J 2013; 54(3): 116-128 SMA Lecture 2 012 doi:10.11622/smedj.2013043 Euthanasia: a matter of life or death? Sundaresh Menon1 INTRODUCTION specifically in choosing the point of death. It is, as perhaps only a In a sense it all began here, in a bar in Singapore in 1995, when lawyer would say, a question of whether there is an option for the a young Englishwoman met a Cuban jazz musician, and despite early termination of our lease on life. her not being able to speak a word of Spanish and him not being able to utter a word of English, they fell in love. Debbie Purdy The manner of such termination is also of legal significance. had already begun to experience early symptoms of Multiple Death can be induced by either an act or an omission. The Sclerosis when she met Omar Puente, but in the first flush of their common law has long recognised that a person has the right relationship any thought of death and disease must have been to refuse treatment on the basis that forcing him to suffer such the furthest thing from their minds. One would hope that they treatment would entail an impermissible invasion of his bodily look back on their time in Singapore as a brief stop in paradise, integrity. This right of refusal is a time-honoured cornerstone given how much they have endured together since. They of personal autonomy. It has even been extended to situations travelled through Asia for the next three years as Ms Purdy’s where a patient is unable to express his wish to refuse treatment health steadily deteriorated, gradually leaving her more dependent by recasting it as a question of whether the continuation of on her companion.
    [Show full text]
  • Patterns of Otolaryngologic Sequelae of Suicide Attempts Seen in Nigerian Tertiary Hospitals
    Research Article American Journal of Otolaryngology and Head and Neck Surgery Published: 08 Aug, 2019 Patterns of Otolaryngologic Sequelae of Suicide Attempts Seen in Nigerian Tertiary Hospitals Olajuyin OA1*, Olajide TG2, Oluwole LO3, Lawal MA4, Ali A5, Olajuyin AB6 and Olajuyin AA7 1Department of ENT, Ekiti State University Teaching Hospital, Nigeria 2Department of ENT, Ekiti and Afe Babalola University, Nigeria 3Department of Psychiatry, Ekiti State University Teaching Hospital, Nigeria 4Department of Psychiatry, Ekiti and Afe Babalola University, Nigeria 5Department of ENT, Federal Teaching Hospital, Nigeria 6Department of Family Medicine, Ekiti State University Teaching Hospital, Nigeria 7Department of Obstetrics-Gynaecology, Ekiti State University Teaching Hospital, Nigeria Abstract Background: Otolaryngologic sequelae of suicide attempts are rarely reported as an entity. In this report, we describe the patterns otolaryngologic sequelae of suicide attempts seen in Nigerian tertiary hospitals. Objective: To improve among clinicians, knowledge of the patterns of otolaryngologic sequelae of suicide attempts with a view to promote their management at the three tiers of health care delivery. Methodology: A retrospective analysis of clinical records of survivors of suicide attempts seen in Nigerian tertiary hospitals. Results: In all, 52 patients were seen. Of this, 34 were cases of otolaryngologic sequelae. Majority, (56.0%) of the sequelae were corrosive oesophagitis. Other sequelae were: corrosive oropharyngoesophagitis (14.7%), corrosive oropharyngitis (8.8%), and corrosive laryngitis (5.9%), hypertrophy scar on the neck (5.9%), laryngeal stenosis (2.9%), pharyngocutaneous fistula (2.9%) and sudden hearing loss (2.9%). The sudden hearing loss was caused by overdose of diazepam. There OPEN ACCESS was discordance in the prevalence of isolated corrosive oesophagitis and oropharyngitis as noted by *Correspondence: the 56.0% vs.
    [Show full text]
  • Completed Suicides in the District of Timur Laut, Penang Island – a Preliminary Investigation of 3 Years (2007-2009) Prospective Data
    Completed Suicides in the ORIGINALDistrict of Timur Laut, ARTICLE Penang Island Completed Suicides in the District of Timur Laut, Penang Island – A Preliminary Investigation of 3 Years (2007-2009) Prospective Data S Bhupinder DMJ(Path); T K Kumara BSc, A M Syed(AMO) Department of Forensic Medicine, Penang Hospital, 10990 Jalan Residensi, Penang, Malaysia SUMMARY RESULTS This article describes the completed suicide patterns which The suicide deaths in the Timur Laut district were between occurred in the Timur Laut district of Penang Island, 41-52 cases during the three years study period (Table II). Malaysia. In a prospective cohort study over the three years The main method of the suicide deaths was jumping from period (2007-2009) there were 138 cases of suicide deaths. height (47.1%, n=65), followed by hanging (34.1%, n=47) The number of suicide deaths for the year 2007, 2008 and and drowning (10.9%, n=15) (Table III). The age groups of 2009 were 45, 41 and 52 deaths, respectively. Majority of 35-39, 40-44 and 55-59 years were at high risk (Table IV). the suicide deaths were by jumping from height (47.1%), Chinese contributed 77.5% (n=107) of the suicide deaths in followed by hanging (34.1%) and by drowning (10.9%). Timur Laut district, Penang Island followed by Indians The male victims outnumbered females in a 3 : 1 ratio. (10.9%, n=15) and others (8.7%, n=12)(Table IV). Among the 138 suicide deaths, Malaysians contributed 90% (n=124) of the total suicide deaths (Table I).
    [Show full text]
  • Suicide in Asia: Opportunities and Challenges
    Epidemiologic Reviews Vol. 34, 2012 ª The Author 2011. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. DOI: 10.1093/epirev/mxr025 All rights reserved. For permissions, please e-mail: [email protected]. Advance Access publication: December 7, 2011 Suicide in Asia: Opportunities and Challenges Ying-Yeh Chen, Kevin Chien-Chang Wu, Saman Yousuf, and Paul S. F. Yip* * Correspondence to Dr. Paul S. F. Yip, Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong, China (e-mail: [email protected]). Downloaded from https://academic.oup.com/epirev/article/34/1/129/498617 by guest on 29 September 2021 Accepted for publication September 8, 2011. Asian countries account for approximately 60% of the world’s suicides, but there is a great mismatch in the region between the scale of the problem and the resources available to tackle it. Despite certain commonalities, the continent itself is culturally, economically, and socially diverse. This paper reviews current epidemiologic patterns of suicide, including suicide trends, sociodemographic factors, urban/rural living, suicide methods, sociocultural religious influences, and risk and protective factors in Asia, as well as their implications. The observed epidemiologic distributions of suicides reflect complex interplays among the traditional value/culture system, rapid economic transitions under market globalization, availability/desirability of suicide methods, and sociocultural permission/ prohibitions regarding suicides. In general, compared with Western countries, Asian countries still have a higher average suicide rate, lower male-to-female suicide gender ratio, and higher elderly-to-general-population suicide ratios. The role of mental illness in suicide is not as important as that in Western countries.
    [Show full text]
  • Suicide Seasonality
    Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1383 Suicide Seasonality Theoretical and Clinical Implications GEORGIOS MAKRIS ACTA UNIVERSITATIS UPSALIENSIS ISSN 1651-6206 ISBN 978-91-513-0108-2 UPPSALA urn:nbn:se:uu:diva-330907 2017 Dissertation presented at Uppsala University to be publicly examined in Gunnesalen, Ing 10, Akademiska sjukhuset, Uppsala, Thursday, 7 December 2017 at 13:00 for the degree of Doctor of Philosophy (Faculty of Medicine). The examination will be conducted in Swedish. Faculty examiner: Professor Emeritus Hans Ågren (Institution för Neurovetenskap och fysiologi, Göteborg Universitet). Abstract Makris, G. 2017. Suicide Seasonality. Theoretical and Clinical Implications. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1383. 74 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-513-0108-2. Background: Although suicide seasonality has been well-documented, surprisingly little is known about its underlying mechanisms. Methods: In this thesis, data from three Swedish registers (Cause of Death Register, National Patient Register, Prescribed Drugs Register) and data from the Swedish Meteorological and Hydrological Institute were used. In Study I, the amplitude of suicide seasonality was estimated in completed suicides in 1992-2003 in individuals with different antidepressant medications or without antidepressants. In Study II, monthly suicide and sunshine data from 1992-2003 were used to examine the association between suicide and sunshine in groups with and without antidepressants. In Study III, the relationship between season of initiation of antidepressant treatment and the risk of suicidal behavior was explored in patients with a new treatment episode with antidepressant medication. In Study IV, the complex association between sunshine, temperature and suicidal behavior was investigated in patients with a new treatment episode with an antidepressant in two exposure windows (1-4 and 5-8 weeks) before the event.
    [Show full text]
  • Regional Changes in Charcoal-Burning Suicide Rates in East/Southeast Asia from 1995 to 2011: a Time Trend Analysis
    Regional Changes in Charcoal-Burning Suicide Rates in East/Southeast Asia from 1995 to 2011: A Time Trend Analysis Shu-Sen Chang1,2,3,4, Ying-Yeh Chen5,6*, Paul S. F. Yip1,2, Won Jin Lee7, Akihito Hagihara8, David Gunnell4 1 Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Pokfulam, Hong Kong SAR, China, 2 Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China, 3 Ju Shan Hospital, Taoyuan, Taiwan, 4 School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom, 5 Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan, 6 Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei City, Taiwan, 7 Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Republic of Korea, 8 Department of Health Services Management and Policy, Kyushu University Graduate School of Medicine, Fukuoka, Japan Abstract Background: Suicides by carbon monoxide poisoning resulting from burning barbecue charcoal reached epidemic levels in Hong Kong and Taiwan within 5 y of the first reported cases in the early 2000s. The objectives of this analysis were to investigate (i) time trends and regional patterns of charcoal-burning suicide throughout East/Southeast Asia during the time period 1995–2011 and (ii) whether any rises in use of this method were associated with increases in overall suicide rates. Sex- and age-specific trends over time were also examined to identify the demographic groups showing the greatest increases in charcoal-burning suicide rates across different countries.
    [Show full text]
  • Publications April 2021
    1 1964 1 Heim, A. W. & Lester, D. Performance of children on the Shaw Blocks Test. Perceptual & Motor Skills, 1964, 18, 740. 1966 2 Lester, D. Consistency and validity of the Shaw Blocks Test: a preliminary study. Perceptual & Motor Skills, 1966, 22, 134. 3 Lester, D. The Shaw Blocks Test: a description. Journal of Clinical Psychology, 1966, 23, 88-89. 4 Lester, D. Antecedents of the fear of the dead. Psychological Reports, 1966, 19, 741-742. 5 Lester, D. Checking on the Harlequin. Psychological Reports, 1966, 19, 984. 6 Lester, D. Sibling position and suicidal behavior. Journal of Individual Psychology, 1966, 22, 204-207. 7 Lester, D. A note on Gellerman series. Psychological Reports, 1966, 18, 426. 8 Lester, D. Partial reinforcement effect after a small number of training trials. Psychological Reports, 1966, 19, 1335-1336. 9 Lester, D. Determinants of resistance to extinction after three training trials: 1, chronological age and mental age. Psychological Reports, 1966, 19, 970. 1967 10 Lester, D. The Shaw Test: simultaneous measures of intelligence, originality, and rigidity. Perceptual & Motor Skills, 1967, 24, 1106. 11 Lester, D. Exploratory behavior in peripherally blinded rats. Psychonomic Science, 1967, 8, 7-8. 12 Lester, D. Sex differences in exploration: toward a theory of exploration. Psychological Record, 1967, 17, 55-62. 13 Lester, D. Sex differences in exploration of a familiar locale. Psychological Record, 1967, 17, 63-64. 14 Lester, D. Exploratory response of rats to stimuli of differing complexity. Perceptual & Motor Skills, 1967, 24, 133-1334. 15 Lester, D. Effects of fear on exploratory behavior. Psychonomic Science, 1967, 9, 117-118.
    [Show full text]
  • University of London Thesis
    2809289003 REFERENCE ONLY UNIVERSITY OF LONDON THESIS Degree | 0 V\ Year0 ^ ^ Name of Authorly p Q . • COPYRIGHT This is a thesis accepted for a Higher Degree of the University of London. It is an unpublished typescript and the copyright is held by the author. All persons consulting the thesis must read and abide by the Copyright Declaration below. COPYRIGHT DECLARATION I recognise that the copyright of the above-described thesis rests with the author and that no quotation from it or information derived from it may be published without the prior written consent of the author. LOAN Theses may not be lent to individuals, but the University Library may lend a copy to approved libraries within the United Kingdom, for consultation solely on the premises of those libraries. Application should be made to: The Theses Section, University of London Library, Senate House, Malet Street, London WC1E 7HU. REPRODUCTION University of London theses may not be reproduced without explicit written permission from the University of London Library. Enquiries should be addressed to the Theses Section of the Library. Regulations concerning reproduction vary according to the date of acceptance of the thesis and are listed below as guidelines. A. Before 1962. Permission granted only upon the prior written consent of the author. (The University Library will provide addresses where possible). B. 1962 - 1974. In many cases the author has agreed to permit copying upon completion of a Copyright Declaration. C. 1975 - 1988. Most theses may be copied upon completion of a Copyright Declaration. D. 1989 onwards. Most theses may be copied. This thesis comes within category D.
    [Show full text]
  • Suicide and Culture David Lester
    Original Paper Suicide and Culture David Lester Abstract The impact of culture on suicide, both at the aggregate level and the individual level, is discussed. The deleterious impact of a changing culture, especially for native and aboriginal groups, is noted, and the assumption of the cultural invariability of suicidal phenomena questioned. The implications of cultural differences for counselling the suicidal client are explored. Culture provides a set of rules and standards that are shared by members of a society. These rules and standards shape and determine the range of appropriate behavior. Culture influences the behavior of nationalities, ethnic groups and subgroups within a nation. The aim of this paper is to present an overview of some of the topics and issues which are present in the interaction of suicide and culture. A major dichotomy here, of course, is the level of analysis. The interaction can be explored for the aggregate suicide rate of a culture and also for the individual suicide living in a particular society or culture. Let us first look at the interaction at the aggregate level. Key words: Suicide, culture, society, ethnic groups WCPRR Apr 2008: 51-68. © 2008 WACP ISSN: 1932- 6270 SOCIETAL AND CULTURAL SUICIDE RATES It is an obvious fact that societal suicide rates differ widely. As shown in Table 1, male suicide rates in 2000 ranged from 80.4 per 100,000 per year in Lithuania to 0.1 in Egypt. For females, the suicide rates ranged from 16.9 in Lithuania to 0.0 in Egypt. Knowledge of worldwide trends in suicide are limited because many African, Middle East and Central and South American countries do not report their suicide rates to the World Health Organization.
    [Show full text]
  • Identifying the Patterns of Self-Harm and Suicide Attempts in Children and Adolescents in Singapore ASEAN Journal of Psychiatry, Vol
    Identifying The Patterns Of Self-Harm And Suicide Attempts In Children And Adolescents In Singapore ASEAN Journal of Psychiatry, Vol. 18 (2), July - December 2017: XX-XX ORIGINAL ARTICLE IDENTIFYING THE PATTERNS OF SELF-HARM AND SUICIDE ATTEMPTS IN CHILDREN AND ADOLESCENTS IN SINGAPORE Goo Kai-Lin Sabrina*, Radha Srikanth**, Ong Say How***, Neo Hui Min Shaina#, Tan Juanmin#, Vicknesan Jeyan Marimuttu*** *Lee Kong Chian School of Medicine, Nanyang Technological University, 639798 Singapore; **Child and Adolescent (Wollemi Kids) Mental Health Unit, Western NSW Local Health District, New South Wales, 2800 Australia; ***Child and Adolescent Mental Wellness Service, KK Women’s and Children’s Hospital, 229899 Singapore; #Yong Loo Lin School of Medicine, National University of Singapore, 117549 Singapore. Abstract Objective: In the past decade, self-harm and suicidal behaviours in adolescents have increased with teen suicides in Singapore reaching a record high in 2015. Globally, completed suicide is reported to be second leading cause of death in this demographic. This study aims to explore the methods of self-harm and suicide attempts employed by young people who are admitted to a tertiary paediatric hospital in Singapore. Methods: A cross-sectional retrospective medical record review was conducted for a 3-year period from 2012 to 2014. All patients admitted with self-harm or suicide attempts and referred for inpatient consultation were included in the study. Data was collected on the following: age, gender, race, if the attempt was a suicide attempt or self-harm, and method used. Results: A total of 106 cases were referred for self-harm or suicide attempt; 15 of these cases were male patients and 91 were female patients.
    [Show full text]
  • The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors
    International Journal of Environmental Research and Public Health Article The Burden of Suicide in Rural Bangladesh: Magnitude and Risk Factors Shumona Sharmin Salam 1,*, Olakunle Alonge 2, Md Irteja Islam 1, Dewan Md Emdadul Hoque 1 ID , Shirin Wadhwaniya 2, Md Kamran Ul Baset 3, Saidur Rahman Mashreky 3 ID and Shams El Arifeen 1 1 International Centre for Diarrhoeal Disease Research, GPO Box 128, Dhaka 1000, Bangladesh; [email protected] (M.I.I.); [email protected] (D.M.E.H.); [email protected] (S.E.A.) 2 Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MA 21205, USA; [email protected] (O.A.); [email protected] (S.W.) 3 Center for Injury Prevention and Research, House # B-162, Road # 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh; [email protected] (M.K.U.B.); [email protected] (S.R.M.) * Correspondence: [email protected] Received: 5 July 2017; Accepted: 6 September 2017; Published: 9 September 2017 Abstract: The aim of the paper is to quantify the burden and risk factors of fatal and non-fatal suicidal behaviors in rural Bangladesh. A census was carried out in seven sub-districts encompassing 1.16 million people. Face-to-face interviews were conducted at the household level. Descriptive analyses were done to quantify the burden and Poisson regression was run to determine on risk factors. The estimated rates of fatal and non-fatal suicide were 3.29 and 9.86 per 100,000 person years (PY) observed, respectively. The risk of suicide was significantly higher by 6.31 times among 15–17 and 4.04 times among 18–24 olds compared to 25–64 years old.
    [Show full text]