Suicide Prevention in Pakistan

Sohaib Hassan February 27, 2009

Tags: suicide , Pakistan

In recent years, incidences of suicide appear to have increased in Pakistan and suicide has
become a major public health problem. From available evidence it appears that most
suicides occur in young people (single men and married women) under the age of 30
years. Hanging, use of insecticides and firearms
are the most common methods and interpersonal relationship problems
and domestic issues as the most common reasons for suicide.

Mental illness is rarely mentioned. Lack of resources, poorly established primary and
mental health services and weak political processes make suicide prevention a formidable
challenge in Pakistan. Public and mental health professionals need to work with
government and non-governmental organizations to take up this challenge.

Pakistan is a South Asian developing country with a population of approximately 162

million. With 97% Muslims. Suicide is a condemned act in Islam. Traditionally, suicide
numbers were low but in recent years, they have shown an increase and suicide has
become a major public health problem in Pakistan.

There are no official statistics on suicide from Pakistan. Suicide deaths are not included
in the national annual Mortality statistics. National rates are neither known nor reported
to the World Health Organization (WHO).

Under Pakistani law (based on tenet of Islam) both suicide and deliberate self-harm
(DSH) are illegal acts, punishable with a jail term and financial penalty. All suicide cases
must be taken to one of the government hospitals, designated as medico-legal centers
(MLC).

In DSH cases many people avoid going to these centers for fear of harassment by the
police and stigma. Instead they seek treatment from private hospitals that neither
diagnose suicide nor report them to police. Incidences of suicide and DSH are therefore,
grossly underestimated in Pakistan.
Information on suicide in Pakistan comes from a number of sources including
newspapers, reports of non-governmental organizations (NGOs), voluntary and human
rights organizations and police departments of different cities. Further information is
available from hospital based studies, e.g. on acute intentional poisoning, deliberate-self
harm and autopsies carried out by Forensic Medicine departments.

These studies show that suicide cuts across all ethnic, provincial and rural/urban
boundaries. In one study suicide was reported from at least 35 cities and towns (and their
surrounding villages) of Pakistan.
Suicide has been reported from most major cities of Pakistan including Karachi, Larkana,
Lahore, Multan, Bahawalpur, Faisalabad, Rawalpindi and Peshawar.

Suicide has also been reported from the remote Ghizer District, in the Northern Areas of
Pakistan.

While official rates of suicide are lacking, it has been possible to calculate rates of suicide
in at least six different cities of Pakistan.

Crude rates vary from a low of 0.43/100,000 per year (average for 1991-2000) in
Peshawar to a high of 2.86/100,000 for Rawalpindi (in 2006), with other cities falling in
between: Karachi, 2.1/100,000 (1995-2001); Lahore, 1.08/100,000 (1993-95); Faisalabad,
1.12/100,000 (1998-2001) and Larkana, 2.6/100,000 (2003-2004).
Gender- specific rates show that for men, highest rates are 5.2/100,000 in Rawalpindi,
while for women the highest rates are 1.7/100,000 in Larkana.

The highest age- and gender-specific rates for men and women are in the age group 20-40
years: 7.03/100,000 and 3.81/100,000 in Larkana respectively.

Recently, a non-governmental organization reported 5,800 suicides in nine months

(January to September) of 2006.

A review of relevant studies that listed methods used shows that poisoning and hanging
to be the two most common methods, followed by firearms, drowning, self-immolation
and jumping from a height. Use of medications for suicide featured in only a small
minority of cases.

As far as suicide prevention is concerned, this requires a multi-sectoral approach. Almost

34% of Pakistani population suffers from common mental disorders and depression is
implicated in more than 90% of suicides. This needs to be addressed at the community
level.

Ideally mental health and suicide prevention programmes should be integrated within the
primary health care (PHC) system. Unfortunately, in Pakistan public funded PHC system
is largely ineffective. Hence training PHC staff to screen for suicidal patients would be
impractical. Perhaps the solution lies in low cost community mental health programs,
involving mental health care workers and lay counselors. Suicide prevention as part of
the programme would be more effective then.

It is estimated for every suicide there are at least 10-20 DSH acts. Based on current
figures, there would be in excess of 100,000 DSH acts in Pakistan annually. A previous
history of DSH is one of the strongest predictors of future suicide. Along with medical
management of DSH, the underlying psychological issues should be addressed as well.
Every DSH subject, no matter how innocuous the act may appear, should receive a
psychiatric assessment. Training emergency room personnel can contribute significantly
 to suicide prevention.

The `criminalization' of DSH has lead to a stigma, avoidance of health seeking help and
lack of involvement of professionals and limitations in developing innovative programs
for suicide prevention. There is an urgent need to review and repeal the law regarding
DSH and suicide in Pakistan so that people who need psychological help can do so
without fear of being persecuted by the police.

The new Mental Health Ordinance, 2001 that superseded the Lunacy Act of 1912 has
been a step forward and provides for a psychiatric assessment of survivors of suicide
attempt. Section 49 of the Ordinance pertains to suicide and DSH and states: 'A person
who attempts suicide shall be assessed by an approved psychiatrist and if found to be
suffering from a mental disorder shall be treated appropriately under the provisions of
this Ordinance'.

However it does not go far enough to categorically decriminalize DSH.

In Pakistan the three most common methods are hanging, ingestion of insecticides and
firearms. While hanging is difficult to control, restricting availability of latter two can
potentially prevent 50% of suicides. Public education campaigns to promote safe storage
of insecticides are needed.

Crisis intervention centers and suicide prevention telephone hotlines play an important
role in helping suicidal people, as shown in neighboring Sri Lanka. There is a need to
establish such services in Pakistan.

To reduce the incidence of suicide in young people school- based interventions, as

recommended by WHO Suicide Prevention Strategies should be initiates.

These include crisis management, self-esteem enhancement, development of social skills

and healthy decision making.
There appears to be a strong association between poor socio-economic conditions and
suicide in Pakistan.

Government must implement social policies that are just, equitable and fair that address
the problems of the common man. Resource allocation for mental health is abysmally low
and squandered away by corruption and mismanagement. There is need for increased
spending on mental health as well as proper utilization of available resources.

Mortality statistics on suicides should be collected through a standard system of

registration, recording and diagnosis of suicides, at all town/city, district and provincial
levels. Information obtained can be used for epidemiological-analytical, intra-country and
cross national studies. A mandatory reporting of suicide mortality statistics to the WHO
would improve data collection and surveillance on suicide.
 In summary, the traditional low rates of suicide and the protective influence of Islam
appears to have undergone a radical change in Pakistan and suicide has become a major
public health problem. There is need for collaboration between government, non-
governmental organizations and public and mental health professionals to take up this
challenge.
Sohaib Hassan is a Physiotherapist in Pakistan
The Center of Bioethics and Culture was established in Karachi, Pakistan in 2004. The underlying
objective of its activities is to assist in capacity-building of faculty and staff in biomedical ethics
and promote ethical medical practice in the country.

The postgraduate diploma (PGD) in biomedical ethics was introduced in 2006.The PGD at the
Center is a one-year structured programme and at the moment is the only postgraduate-awarding
degree programme in biomedical ethics in Pakistan. In 2007, 14 mid-career professionals from all
over Pakistan were selected. The group comprises physicians from clinical and basic health
sciences, a research scientist and a dentist. These students are required to participate in a web-
based discussion group. The PGD bioethics 2007 discussion group has been set up to drive
independent student learning. (1) Students take responsibility for selecting and discussing various
ethical issues that crop up in their daily practice or that make headlines.

The PGD discussion group is a forum to discuss important bioethical issues. Discussions have
been on such diverse subjects as stem cell research, organ trade, pharmaceutical industry and
physician interaction, informed consent and patient autonomy in developing countries, and self-
experimentation.

Recently a student initiated a discussion on suicide. This edited dialogue, based on an exchange
of emails, provides an insight into the different opinions and ideas about suicide amongst medical
professionals in Pakistan.

Ali: Dear Group, I have experienced today one of the most trying and confusing days of my life. I
was torn between my duty as a physician and compassion for my patient. One of my oldest
patients (more of a friend) came to see me today. I had not seen him since I referred him to an
oncologist. He had come to tell me that he had been diagnosed as having acute leukaemia. He
went on to say that he did not want to suffer a prolonged illness in which there would be
unbearable pain, and he did not want to be a burden to his family. He asked me if I could help
him. I told him that I could prescribe something for the anxiety he was experiencing. But he
wanted something stronger. I knew what he was asking me for. I told him that I would do
everything I could to help him with his pain. He looked at me with tears in his eyes and said
goodbye.

I feel awful that this is all that I could do. Should I have done more?

Ashraf: Suicide and physician-assisted suicide are contrary to the sanctity of life. They are illegal
and forbidden in Islam. You yielded to the "Do no harm" principle of the Hippocratic Oath.

Studies have highlighted that most individuals who contemplate or succeed at suicide are
depressed or have other psychiatric conditions (2). In addition, in terminally-ill patients who
contemplate suicide, the desire to die fluctuates over time (3). The absence of effective pain
relief, compassion and care from their healthcare providers - or family or friends - or the fear that
they will not receive these when needed have been implicated as factors that may induce suicidal
thoughts in terminally-ill patients (4).

You did the right thing.

Natasha: I am sitting here mulling over an article I read on suicide in today's issue of the
newspaper Dawn (5). According to a report issued by the Lawyers Committee for Human Rights,
Pakistan, in 2006 there was an average of 483 suicides every month in the country.

Why would a person do this? What makes you not want to get out of bed in the morning? Many
of us are lucky enough to have lots of reasons to be thankful that we are alive. But what if one
doesn't have a reason, what if life is no longer worth living? When, after measuring life against
death, death seems to be a better option? Weighing the options, if your choice is not
disadvantaging others, should there be moral objection to end your life?

People who commit suicide or attempt it are readily condemned by society and religions. If
almost 500 people a month are willing to defy God and become sinners and opt for burning in hell
then things must be pretty bad for them.

Can we not let someone just die if they want to?

Moin: This is a difficult question to answer. According to Kant's rights-based moral theory, if
everyone has a right to life, it follows that everyone has a right to choose to die. If I have a right to
life, it is your duty not to kill me: but I can release you from this duty by requesting you to kill me
or give you my consent.

From a utilitarian perspective, the morality of any action is judged by its consequences for the
agent and all others concerned. A person who asks for death has come to the conclusion that for
him dying is better than staying alive. His choice of death will be morally right so long as the
benefit of his remaining alive is less than the burden on him and others taking care of him.

Natasha: I searched for some more details on suicide in Pakistan and there were very few data.
In fact we still do not have an age-standardised rate because of the religious and legal status of
the act as a crime. However Prof Murad Khan, chairman of the department of psychiatry, Aga
Khan University, has kindly provided me with the following details on suicide in Pakistan:

 There were a total of 5,800 suicides in Pakistan from January to September of 2006.
 In a study published in 2000, Khan and Reza (6) identified 306 suicides reported in Dawn
during 1996-199The typical suicide was male (68 per cent of the cases reviewed) under the age
of 30 (82 per cent), single (58 per cent), committing suicide for domestic reasons (78 per cent),
and ingesting poisons (39 per cent). The men were more often single and the women married.
The women were also a little younger than the men (23.4 versus 26.8 years). The men were
most often unemployed and the women housewives.
 Age- and gender-specific rates show most suicides occurred in the age group 20-40 years
and were more common in men, similar to the western world.

Reported suicide rates are probably an underestimation of the true extent of the problem in
Pakistan. Because the law states that suicide and attempted suicide are illegal acts, both are
likely to be underreported because of the consequences. Perhaps if suicide were not such a
taboo people in need of help would be able to speak to someone without the fear of any
consequences. It will be more productive to understand these people and encourage them to
discuss their problems.

Bushra: People are not only inclined to commit suicide as a result of a pathological process:
depression, desperation and so on. Will you not entertain a situation when a person says that he
has lived his life and makes a rational decision without duress and with a sound mind to die since
he is used to making all his decisions all his life, why not this one? He is lucid. He has made a
decision. The fact that the decision appears irrational to us does not make him crazy. Can a sane
man want to kill himself? If so, should he be allowed to, morally?

You are basically saying suicide is a problem among our youth so we need to counsel them to
prevent unnecessary death. It is a problem among unemployed men so we need to counsel them
and prevent them from doing it. However, when it comes to someone who is terminally ill and
wants to kill themselves, are you saying that we should help them?

Natasha: The eventuality of a terminally-ill patient is death. I do not think it is wrong to lessen the
pain and anguish for such an individual. I think it comes to determining if the person is making a
rational decision or not. Would that decision change if circumstances were to change? For
example for patients on dialysis may be found to suffer from severe depression had suicidal
thoughts but when treated for the depression they may no longer have such notions. I feel it is
important to discuss thoughts of suicide with someone. A society that condemns suicide
religiously and legally inhibits discussion and a possible solution. If at the end of the day the
individual is lucid and has made a rational decision, then I see nothing morally wrong in that.

Moin: We see patients who have been have been put on artificial life support. These patients
have failed to respond to treatment. As physicians we know that it is better for the patient that we
withdraw life support but letting a patient die feels wrong. As doctors we have been trained to
save patient lives. Daniel Callahan in his article 'When self-determination runs amok' (6) says that
it feels wrong to physicians because they feel that they are causally responsible for the death of
that patient. It appears to breach expectations, obligations to the patient and family.

But morally, Callahan continues, the physician has no duty to continue treatment once it has been
proved to be ineffective. A doctor should stop treatment once it will no longer benefit a patient.
The doctor should step aside to allow an inevitable event.

Ali: A friend of mine is a physician. His father had terminal cancer with metastasis to the bones.
The pain was so intense that he needed morphine to relieve pain. In order to relieve the
excruciating pain the morphine dose had to be increased to dangerous levels. My friend was
caught in this dilemma between relieving his father's pain and at the same time risk taking his
father's life. In the end he opted to let his father die in peace, free of pain. In medical ethics
parlance this is known as the doctrine of "double effect"

Discussion

Adult learning is built on the assumption that adults are autonomous and self directed learners.
The web-based discussion group format is useful because it is tailored for busy healthcare
professionals. The various ethical issues are selected by students who draw on their experiences
to explore ethical issues and dilemmas.

As the members of the group are healthcare professionals they can identify themselves with
situations where they have been involved in end-of-life issues, in situations where they have
withdrawn or withheld treatment from critically ill patients. They have felt the anguish of such
difficult situations, as have other physicians; that it might be better for a patient to die than suffer
in agony (6). Research on the topic is difficult because suicide and attempted suicide are
considered illegal acts. There have been few reports on suicide in Pakistan (7).

Physician-assisted suicide is a growing concern for medical professionals. Few reports on

physician-assisted suicide in Pakistan are available. Qidwai et al have reported on the perception
of patients towards physician-assisted suicide at a teaching hospital in Karachi, Pakistan (8). The
study found that nine per cent of patients advocated physician-assisted suicide. Of course, this
study cannot be generalised to the rest of the country.

The group explored various aspects of this sensitive issue, to examine the moral and
philosophical reasons for committing suicide. It felt that there should be systems of
communication to enable individuals in the community to talk about suicide. The authors also feel
the need for more research on suicide and physician-assisted suicide in Pakistan.

Acknowledgments: The authors would like to thank Dr Aamir Jafarey and Dr Ali Lanewala for
their advice and suggestions and acknowledge the post-graduate diploma group for the spirited
discussion which was the inspiration for this article.

References:

Suicide (Latin suicidium, from sui caedere, "to kill oneself") is the term used for the
deliberate self-destruction by a living being, resulting in their own death. Such actions are
typically characterised as being made out of despair, or attributed to some underlying
mental disorder which includes depression, bipolar disorder, schizophrenia, alcoholism
and drug abuse.[1] Financial difficulties, interpersonal relationships and other undesirable
situations play a significant role.[2]

Over one million people commit suicide every year. The World Health Organization
estimates that it is the thirteenth-leading cause of death worldwide.[3] It is a leading cause
of death among teenagers and adults under 35.[4][5] There are an estimated 10 to 20 million
non-fatal attempted suicides every year worldwide.[6]

Views on suicide have been influenced by broader cultural views on existential themes
such as religion, honor, and the meaning of life. The Abrahamic religions consider
suicide an offense towards God due to religious belief in the sanctity of life. In the West
it was often regarded as a serious crime. Conversely, during the samurai era in Japan,
seppuku was respected as a means of atonement for failure or as a form of protest. In the
20th century, suicide in the form of self-immolation has been used as a form of protest,
and in the form of kamikaze and suicide bombing as a military or terrorist tactic. Sati is a
Hindu funeral practice in which the widow would immolate herself on her husband's
funeral pyre, either willingly, or under pressure from the family and in-laws.[7]

Medically assisted suicide (euthanasia, or the right to die) is currently a controversial

ethical issue involving people who are terminally ill, in extreme pain, or have (perceived
or construed) minimal quality of life through injury or illness. Self-sacrifice for others is
not always considered suicide, as the goal is not to kill oneself but to save another;
however, Émile Durkheim's theory termed such acts "altruistic suicide."[8]

Every breath of a human, every moment of his or hers life in all

Religious traditions, their teachings, their guidance, their viewpoints,
their perspectives is worth more than a priceless gem. These breaths
the human being takes in order to survive in life and the moments of
life itself are like the pearls of a necklace. Just as a pearl will embellish
the appearance of that neck that wears the necklace of pearls, in the
same way the life of a individual is enhanced by that person who looks
after the moments of his life. No Treasure trove of any Ruler, no
Sultanate of any Sultan, no Kingdom of any King, no Rulership of any
Queen in tantamount is equal in value to one moment of an individuals
life. Life in-fact in numerous places of the Quraan, either directly or
indirectly, is described by Allah as a favour on human beings.
In one verse of the Quraan, Allah says,
" How can you disbelieve? Seeing that you were dead and He gave you
life. Then He will give you death, then again will bring you to life (on
the Day of Resurrection) and then unto Him you will return." (Surah Al-
Baqarah Verse 28)

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Out of all the bounties Allah has bestowed upon human beings, the
most precious is the gift of life. Each one us should remember that this
life Allah has granted us, it is not our personal possession or our
personal property. In-fact it is a trust from Allah, making us merely
trustees. Because we are trustees we should utilise each and every
moment of our lives in the paths that please Allah.
In one verse of the Quraan Allah informs mankind,
"And I (Allah) created not the jinn and mankind except that they should
worship Me (Alone)". (Surah Adh-Dhariyat Verse 56)
From this verse we can learn the reason why Allah created mankind.
How precious is this gift of life, we can learn through the Holy Quraan,
Ahadeeth (Traditions and Sayings of Prophet Muhammad (Peace be
upon him)) and the Shariah (Islamic Law).
For instance, in one verse of the Quraan, Allah says,
"He has forbidden you only the carrion (flesh of dead animals), and
blood, and flesh of swine, and that which is slaughtered as a sacrifice
for others than Allah (or has been slaughtered for idols, on which
Allah’s Name has not been mentioned whilst slaughtering). But if one is
forced by necessity without wilful disobedience nor transgressing due
limits, then there is no sin on him. Truly, Allah is Oft-Forgiving, Most
Merciful."(Surah Al-Baqarah Verse 173)
In the closing stages of this verse Allah talks about one who is forced
to consume Haraam (unlawful) items due to the fear of death. Allah
says, then there is no sin in him. For example, one is in severe hunger,
such hunger that could lead to ones death, he consumes something
that is Haraam (unlawful) e.g. Carrion, on the Day of Judgement he will
not be questioned regarding these Haraam (Unlawful) items he
consumed in order to save his life. Similarly one is fasting in the Month
of Ramadhaan and severe thirst over-takes him, again it is permissible
for him to break his fast in order to saves ones life. Even if he broke
the fast by consuming Haraam (Unlawful) fluids e.g. Blood, Alcohol he
will not be questioned regarding this. From this verse we can
undoubtedly acknowledge how precious and valuable life is in the eyes
of The Almighty Allah.

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Life in many people’s opinion is a journey. Some even sees it as a

pilgrimage. In the Islamic perspective it is a journey far beyond death.
It is like a trip around the world. We stop in many different Continents,
Countries, Cities, Towns and Villages. Some bring happiness and some
give us grief. The white beaches, beautiful rainforests, buildings etc
would force a smile on the face of many a person regardless of what
grief he is in, but the sight of the poor, war-stricken and weak will give
one intense grief. Life is a test from Allah, He tests people in various
ways and times. He tests some by blessing them with countless
bounties to see if the servant appreciates what he has been blessed
with by Allah and he shows gratitude towards Allah for blessing him
with these bounties. At times Allah in his infinite wisdom, puts a person
in intense grief, to see if the servant turns to Allah and seeks guidance
and help.
Excellent examples of both situations are found in the life and story of
the Prophet of Allah, Ayyub (AS). Allah granted him many bounties,
then he gave him such illness that the people around him could not
bear. Prophet Ayyub (AS) turned to Allah for help and Allah in his
infinite mercy returned all the past bounties upon him. In some
narrations it has been said that Allah gave him more bounties than the
amount he had before his illness.
In the Quraan Allah has mentioned the call for help of Prophet Ayyub
(AS). Allah says:
"And (Remember) Ayyub (Job), when he cried to his Lord: "Verily,
distress has seized me, and you are the Most Merciful of all those who
show mercy". So We answered his call, and removed the distress that
was on him, and We restored his family to him (that he had lost) and
the like thereof along with them as a mercy from Ourselves and a
reminder for all those who worship Us. (Surah Al-Anbiya Verse 83-84)
In another Surah of the Quraan Allah says regarding Prophet Ayyub
(AS):
"And remember Our slave Ayyub (Job), when he invoked his Lord
(saying):"Verily Satan has touched me with distress (by ruining my
health) and torment (by ruining my wealth)! (Allah said to him): "Strike
the ground with your foot: This is (a spring of) water to wash in, cool
and a (refreshing) drink". And We gave him back his family, and along
with them the like thereof, as a Mercy from Us, and a Reminder for
those who understand."And take in your hand a bundle of thin grass
and strike therewith (your wife), and break not your oath. Truly, We
found him patient. How excellent a slave! Verily, he was ever oft-
returning in repentance (to Us).
Like Prophet Ayyub, each and every one of us is tested by Allah in
someway or another. Some turn to Allah and seek help, as in the case
of Prophet Ayyub and others turn completely to the opposite side,
which leaves many in grief. These people upon whom many grieve and
mourn are the people who have turned to suicide.

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Suicide, or self-killing, has been known throughout the whole of
recorded history and has been a phenomenon in every culture and
social setting. It was noted in the Biblical Times within the Jewish and
Christian faiths. It is mentioned in the Bhagavad Gita within the Hindu
faith, in classical Greece and Rome, and later throughout the Middle-
Ages, when the reaction to the heresy of suicide was severe hostility
from the Universal Church, whose later fathers railed against the
canonical sin of despair.
Suicide occurs in every culture, not only in the Western developed
world, but also in India, China and, despite severe theological
prohibitions, in Islam.

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Within the Judaeo-Christian tradition, there are eleven instances of

suicide described in the Bible's Old Testament and one in the New
Testament. Perhaps the most famous death in the former is the suicide
of King Saul following his defeat in the hands of the Philistines, heard in
David’s lament, and ‘how are the mighty fallen’. Saul had sought the
assistance of his bodyguard to help kill himself. The soldier was
horrified at the irreligious notion of killing his appointed King, and
turned the sword upon himself. Saul, apparently aided by such an
example, then followed suit. It appears that the avert prohibition
against suicide was first formerly pronounced by Saint Augustine, who
in his City of God describes the action as a ‘moral sin’.
The Church did not always condemn suicide when, for example,
following some severe assault, such as rape, the victim took a
‘virtuous’ or honourable way out. She could then claim sympathy and
the forgiveness of her society and family, in both Roman and Christian
times.

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As shown, neither the Judaic nor Christian parts of the Bible are there
direct injunctions against suicide. However, this is not the case in the
traditions of the true religion, Islam, which continues to be a major
influence upon many Islamic people.
There are a few quite specific sanctions expressed in the Quraan
against self-killing. The Prophet Muhammad (SAW) also assigns suicide
to the lower levels of Hell.
Allah says explicitly in the Quraan,
"And do not kill yourselves. Surely, Allah is Most Merciful to you".
(Surah An-Nisa Verse 29)
In another verse of the Quraan, Allah says:
"And do not throw yourselves in destruction". (Surah Al-Baqarah Verse
195)
The impact of this injunction still has considerable force in Islamic
countries, and it may be one reason why, with the exception of Jordan
and Turkey, there is no recorded suicide in national statistics of the
Islamic Nations. But, in the last decade or so there has been a
substantial increase of suicide in Muslims living in Non-Muslim
countries, namely Britain and America.

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The current attitude and dilemmas, unlike in previous times, suicide

can be discussed relatively easily today, even within the mass media
of the late twentieth century. For example, in the worldwide magazine
Time there have been three major articles concerning suicide, which
while acknowledging dilemmas, were mainly concerned with where
firm baselines should be drawn, accepting without question the
‘obvious’ rationality of such actions in many situations. Yet a little
more than 100 years ago, Robert Louis Stevenson, in what was
considered to be a horrendous book, The Suicide Club, found himself
almost at the extreme end of the case of language, because he could
not describe in sufficiently villainous terms the leader of this ‘devilish’
club. Constantly, modern poets and novelist have almost celebrated
suicide.

SUICIDE

God is our creator, he is the giver of life, and he alone has the right to end it. Suicide is
forbidden in Islam; this sin is listed among the "enormities" in Reliance of the Traveller,
a manual of Sharia in the tradition of Imam Shafi'i.

Those who committed suicide ...

• to be roasted in a fire,

Do not kill yourselves, for Allah is compassionate towards you. Whoever does so,
in transgression and wrongfully, We shall roast in a fire, and that is an easy matter
for Allah. (an-Nisaa 4:29-30)

• forbidden Paradise,

Narrated Thabit bin Ad-Dahhak:

The Prophet said, "Whoever intentionally swears falsely by a religion other than
Islam, then he is what he has said, (e.g. if he says, 'If such thing is not true then I
am a Jew,' he is really a Jew). And whoever commits suicide with piece of iron
will be punished with the same piece of iron in the Hell Fire." Narrated Jundab
the Prophet said, "A man was inflicted with wounds and he committed suicide,
 and so Allah said: My slave has caused death on himself hurriedly, so I forbid
Paradise for him." (Sahih Bukhari 2.445)

• will be punished in hell by whatever used for suicide,

Narrated Abu Huraira:

The Prophet said, "He who commits suicide by throttling shall keep on throttling
himself in the Hell Fire (forever) and he who commits suicide by stabbing himself
shall keep on stabbing himself in the Hell-Fire." (Sahih Bukhari 2.446, 2.445)

On the other hand, "SUICIDE BOMBERS" are celebrated as martyrs.

Further Reading:

1.

SufiSoul
member

No doubt that Finacial differences between poor and rich are increasing.
But suicides(Disappointment) is the sign of non-muslims.We don't have such
disapointment to go with and ruin this and after Life..
What does we need to do on Belief and Finacial Economy Level?????

POSTED 1 MONTH AGO ON 28 JUN 2010 22:00 #

2.

Mirza Ghalib
member

SufiSoul Sahib, Salam. I'm oversjoyed to hear your voice again. A growing list of
suicides in Pakistan is not owing to a lack of Muslim faith, I don't think. Unbearable
despair is the reason, I suppose. And the answer, I'd say, would be a bank which
would lend poor people driven to the last extremes money with no interest
whatsoever and the very minimum of bureaucracy = fuss and bother.

POSTED 1 MONTH AGO ON 29 JUN 2010 0:42 #

 3.

aslam786
Member

SufiSoul, what right you have to say suicide is sign of non muslim? Every taliban
commander from darra adem khel to kandahar will disagree with you!

POSTED 1 MONTH AGO ON 29 JUN 2010 4:18 #

4.

Salam
member

perhaps brother sufisoul is referring to "mayusi kufr hay" and this is well established
from Qur'an & Sunnah

there is no doubt that it is a major sin as there are repeated evidences commanding
muslims to never get disappointed from rahmat of Allah swt, there evidence from
Qur'an that only non-believers get disappointed from rahmat of Allah swt (Yusuf 87)
but i am not scholar to pass judgement on this action, it is clear that it is haram and
has warning with sever punishment-

wallahualam

POSTED 1 MONTH AGO ON 29 JUN 2010 4:49 #

5.

aslam786
Member
Maybe the suicides were conducted in a state of khusshi towards the life after? If
same person committed suicide with bomb in front of police chowki, we would hail
him or her as hero no?

So how do you know what is in the heart of someone committing suicide and what
has made him non muslim?

POSTED 1 MONTH AGO ON 29 JUN 2010 5:04 #

6.

Salam
member

dear aslam

we are no one to pass judgement on any person's heart or mind, as humans we can
only assess based on actions visible to us, what is outcome on hereafter is none of
our business, suicide is condemned in islam and there is no disagreement among
scholars on this one

please do not mix american war with poor people who are committing suicide due to
extreme economic conditions, i hope you are aware of the cases covered by the
media, none of them were in "state of khusshi"

thx

POSTED 1 MONTH AGO ON 29 JUN 2010 6:30 #

7.

Hussain Farooqui
Member

Mirza Ghalib Sb.

Spiritual guidence can be very helpful in stopping the incidents of suicides. If you
review the biographies of Godly people, you will conclude that most of those great
people lived in austerity and poverty. They underwent a lot of tribulations in their
lives. That is how they acquired the status of Allah's blessed people.

Unfortunately, most of our Ulemas in these days are indulged in sectarian wars,
occupation of plots for Masjids and Maderesas, political mileages,,etc. They are not
available for people's guidence.

POSTED 1 MONTH AGO ON 29 JUN 2010 6:41 #

8.

msyedh
Member

I doubt that all these suisides belong to poverty or food, may be most of these
suisides related to family issues as usual, but media find easy target this ppp
government to make interesting and high rating for their talkshows.

(Pakistan ka media dewana aur pagal ho gia ha aik dusaray se rating agay lay janay
key liay.)

POSTED 1 MONTH AGO ON 29 JUN 2010 7:08 #

9.

Mirza Ghalib
member

Excellent comments all down. Back in the swing of things, I note with relief. But I
was misunderstood. I'm not defending "suicide", except by way of jihad when it's a
question of defending the faith and the Muslim people.

But even a staunch believer can be overcome by despair. And since the cause of
some of these suicides (there are not many, I agree. On the worldwide count of
suicides per country, Muslim countries would probably come out at the bottom of the
list) is financial, we should seriously consider the idea of setting up these absolutely
non-interest banks lending only to the poor which I suggested above.

HF, the Prophet (PBUH) would spend days and days without a lit fire in his home,
contenting himself with eating dates and drinking water. We, alas, in our grerat love
for him, have not been able to follow his example. We Muslims have lost our
momeens. We Muslims seem to have replaced them all by West-guided jackals in
everything that concerns our country. But our faith still remains pure. And we shall
pray for those amongst us who succumbed to despair.

POSTED 1 MONTH AGO ON 29 JUN 2010 9:13 #

10.

aslam786
Member

Salaam,

"please do not mix american war with poor people who are committing suicide due to
extreme economic conditions"

Why not mix the two? Both cases are due to extreme cases of poor people, so what
is the difference? We are told on one hand that suiciders are full of happiness to see
jaanaat and hoors and on other hand told that they are doing this due to poor
conditions, injustice and state of shock, so which is it?

POSTED 1 MONTH AGO ON 30 JUN 2010 4:22 #

11.

expakistani
Member
unfortunately poor and myaus people are not ready to kill or even reject same old
political leaders.

when people of pakistan will be ready for inqlab?

woh din kab aye ga jes ka wada tha

POSTED 1 MONTH AGO ON 30 JUN 2010 5:42 #

12.

Hussain Farooqui
Member

aslam 786

True that the causes of suicides in Pakistani and the developed societies like America
are different. In our case, there are no leaders available to guide the general
masses. After 1971, Bengalis lived in the worst conditions for couple of decades, but
there were incidents of suicides in Bangladesh. Now they have grown financially
better than us.

POSTED 1 MONTH AGO ON 30 JUN 2010 7:52 #

13.

hariskhan
member

Assalam-o-Alaikum-Warahmat-ULLAH ALL,

Justice. Non-availability of justice among our ranks.

Poor people among us, who 'see' no end in sight to injustice are committing
suicide, as a reaction.
By giving up their lives, they have started paving the way for the coming bloody
revolution.

(1) Asking forgiveness from ALLAH ALMIGHTY for wrong-doings

(2) Returning back to ALLAH ALMIGHTY
(3) Imparting justice

is the way to stop the coming bloody revolution.

POSTED 1 MONTH AGO ON 30 JUN 2010 10:21 #

14.

aslam786
Member

As haris khan says above, taliban is also involved in this "non-muslim" practice of
suicide bombing due to injustice. Why support that and not other suicides?

Growing poverty, curtailed social support

surge suicide trend in Pakistan
PPI
09 July 2010 Friday | 12:21:00
Font size:

Karachi, Growing poverty, dwindling real incomes, alarming price hike and deep
cuts in government spending on social sector have resulted in a sharp surge in trend
of suicides in Pakistan.

At least 783 people including 119 children have committed suicides in the first six
months of current year. Gloomy economic conditions, denial of justice, police atrocities,
unemployment, ethnic and sectarian polarization, shattered law and order, rampant
corruption and bad governance are the other factors enhancing the feeling of despair in
Pakistani society. This growing despair, depression and hopelessness force people either
to become violent, or silently end their lives by committing suicide. Recently, a 36-years-
old rickshaw driver of Lahore, Akber Ali, poisoned himself and his three daughters to
death to escape the miserable trap of poverty. His wife, who had also taken poison,
survived. The sad incident jolted the whole Pakistani nation and people now openly
question the performance of state regarding alleviating poverty.

They question the liberal spending on rulers on their own luxuries while blatantly
ignoring the poor and hungry masses. Sadaf Birch, Program Manager, Madadgaar
Helpline, the first helpline for women and children in Pakistan, says the increase in
number of suicide cases is a serious phenomenon, which shows we individually or
collectively are failing to discharge our social responsibilities. She said women and
children are the most vulnerable sections of society, adding the state and society must
give extra attention to mitigate their sufferings. She said Madadgaar helpline has been
collecting and compiling data on violence against women for last 10 year. Based in
Karachi, Madadgaar is being run in collaboration with UNICEF. She said the data
collected by the Madadgaar, which monitors 18 English, Urdu and Sindhi newspapers
daily and compile exhaustive data on trends of violence against women and children,
shows during the first six months of current year (January-June 2010) as many as 783
people including 119 children committed suicides in various parts of the country. She
said UNICEF defines "child" as anyone below the age of 18.

Those committed suicides include 216 women, 446 men, 62 girls, and 57 boys. The
Madadgaar helpline data shows 438 suicide cases during the first six months of current
year were reported from Sindh, 304 from Punjab, 37 from Khyber-Pakhtoonkhwa and
three from Balochistan. Less number of cases from Khyber-Pakhtoonkhwa and
Balochistan is due to weak media and strict social and cultural taboos and stigmas in
these feudal-tribal societies. Overall, the Madadgaar Helpline has reported 3879 suicide
cases from various areas of the country during the period 2000-2010. She said children
are our future and we must utilize all-out resources to save them. She said the UNICEF
understands that children in Pakistan face a variety of serious challenges ranging from
malnutrition and poor access to education and health facilities to exploitation in the form
of child labor. Their low status in society can leave them victim to daily violence at home
and in school as well as to organized trafficking and sexual exploitation. Girls are
specially affected as conservative attitudes may impede them attending or finishing
school.

Talking about the issues facing Pakistani children, she said one in ten children does not
survive their fifth birthday with the majority of deaths due to diarrhea, pneumonia or
vaccine-preventable diseases. Thirty per cent of children are chronically malnourished
and lack safe water and household sanitation, especially in rural areas. Pakistan spends
less than 2.5 per cent of its GDP on the education sector. Just over half of the 19 million
children of primary school going age are enrolled in primary education. Compared to 58
per cent of boys, there are 48 per cent of girls enrolled in primary school. She said just
over a third of Pakistani women are literate. She said the violence against women and
children and serious efforts are needed to address the situation. Sadaf Birch, terming the
growing suicide cases a wakeup call for whole society, urged the government to allocate
more resources to social sector, especially for education, healthcare and social welfare
projects. Efforts should be taken to provide effective social justice to poor people.
The glaring inequality in distribution of wealth should be tackled on war footing basis.
Liberal subsidies should be provided to daily use commodities and utilities, especially
kitchen items. Rampant corruption that is eroding the foundations of our society must be
checked at all levels. She said there is a need to raise awareness about the basic rights of
people. She said in our society the rights of women and children are taken for granted and
this negative attitude must be changed now for good. She said without empowering
women and giving them equal opportunities in all walks of life, the dream of a rapid
socioeconomic development of Pakistan could not be materialized. She said the
institutionalized mechanisms should be introduced to alleviate poverty.

She said labor-intensive projects should be started to create more and more job
opportunities to address rampant joblessness. She said both micro and macro economic
policies of the country should be changed to make the country a truly welfare state. She
said welfare and well-being of people should be the topmost priority of government.
Sadaf Birch said rising trend of suicides is an alarming sign for any society, because it
shows that the state and society have failed to address the core problems of people. She
said all stakeholders of the society including government, political parties, civil society
organizations; judiciary and media have to play their effective role to curtail the growing
despair and hopelessness from the Pakistan society that is resulting in rise in suicide
trend.

Number of suicides on the rise in Pakistan

Shahnaz Javed Mahmood
For CentralAsiaOnline.com
2009-09-23

KARACHI — There has been a sharp rise in the number

of suicides in Pakistan because of depression, poverty,
mental illness and family crises, according to a statement
Aga Khan University (AKU) issued on September 10 in Homeless people sleep on a
connection with World Suicide Prevention Day. footpath in Hyderabad, in
Pakistan's southern Sindh
province. (Reuters/Akram
Shahid)
On the basis of its study conducted in Pakistan this year, AKU stated that the number of
suicide-related deaths will reach 8,000, up from 5,000 just a year ago.

“More than 90 percent of all suicides can be linked to mental illness, poverty, social
isolation, financial losses, relationship difficulties and workplace problems,” said Dr.
Murad Moosa Khan, chief of the Department of Psychiatry at AKU. He called for
immediate mental health intervention in Pakistan to reduce access to poison, the most
commonly used method of suicide in the country.

To create awareness and curb suicides in Pakistan, World Suicide Prevention Day was
observed on September 10 in collaboration with the International Association for Suicide
Prevention (IASP) and the World Health Organisation (WHO). Every year, there are
more than one million suicides worldwide, AKU quoted IASP President Prof. Brian
Mishara as saying. Many mllions more attempt suicide and require medical treatment,
and more than six million people are affected each year by the disastrous impact of the
suicide of a close friend or family member, the AKU statement added.

In Muslim countries, suicide rates are generally lower, but Pakistan is an anomaly
because of growing socio-economic crises, civil unrest and other social burdens, he
added.

Unsuccessful suicide attempts have enormous psychological, social and economic

consequences. AKU senior media advisor Rida Turabi elaborated by citing losses of
productivity and health, as well as social care costs of billions of dollars a year.

Turabi said the Suicide Prevention and Research Interest Group at AKU is organising a
seminar and workshop on September 30 in an attempt to better understand the scope of
the problem in Pakistan and discuss ways of preventing suicide.

Currently, the media provides the only effective platform to inform people and assist
suicide prevention efforts. She noted that thus far, no suicide prevention telephone
hotlines have been established in Pakistan.

Opinion: Embracing Death - The Poor in

Pakistan Turn to Suicide
+ The poor in Pakistan have found a proven way to end thier financial worries -
Suicide. A series of suicides among the poor is ringing alarms of an
endangered Pakistani populaton.
It is a wave of depression, the deadly edge of penurious life, when the poor can’t pay
it all and throw themselves down the dark abyss of DEATH. In different parts of the
country, particularly in the poor population of Punjab province, several people
committed suicide due to their financial troubles. Where is Pakistan heading?
The most shocking incident that banged out to the entire nation earlier this week
took place in Lahore city where 36 years old Akbar Ali, a poor Rickshaw driver,
poisoned himself and his three daughters to death to escape the misery of debt and
penury. Ali’s wife, who also took the poison, survived the incident and was left to
look after her only son – six-year-old Ali Raza (who wasn’t poisoned).
The incident was covered in depth by Meher Bokhari of News Beat fame.
A few days later, Meher then went to another part of the city where a young
vegetable-seller committed suicide. The reason was the same – financial worries and
debt. Other deaths were also reported due to poverty. People whom Meher talked to
expressed loss of any hope and begged for government support. The scene
represented misery and darkness.
With people turning to suicide, Pakistan continues to suffer from VIP culture where
billions are spent on security issues. The catch-22 for the Pakistani masses is: Which
way you want to die – suicide or murder? Any large-scale poverty alleviation
schemes may be a source of relief for the endangered population of this country. But
will corruption let it happen? The answer in itself is a dark note.