Criminalising suicide only makes it worse

Edinburgh: Punishing those who attempt to kill themselves is an example of legislation designed for public good that actually makes the problem of suicide worse.

But even if suicide attempts were not criminalised, the threat of police involvement and the stigma associated with suicide may contribute to the perception it is against the law.

Interestingly, although attempted suicide has never been criminalised in Nepal there is a widely held perception it is, creating barriers to suicide reporting and prevention.

In Nepal, the idea of criminalising attempted suicide is associated with the need to protect vulnerable groups, particularly women and children. In this low-income country of 30 million, there have been a few cases where women were driven to suicide by domestic violence, abuse from in-laws, and dowry-related murders disguised as suicides.

Nepal's 2017 Criminal Code introduced the criminalisation of aiding and abetting suicide, which prohibits provoking or generating a situation that encourages someone to take their life.

Anyone found guilty under this clause is liable to a five-year jail sentence and a fine. This is a legitimate policy measure: UN Women advises that legislation should criminalise any act and attempts to intentionally advise, encourage, abet or assist another in ending their life.

The criminalisation of aiding and abetting suicide should not be confused with the criminalisation of suicide attempt. While the offence of aiding and abetting suicide is a legitimate measure of protection for vulnerable groups from violence, intimidation, threats, and pressure, criminalisation of suicide attempt is an outdated concept that is widely criticised due to its many harmful effects.

Criminalising suicide attempts harms human rights A handful of countries still criminalise suicide attempts. Several have only just recently repealed this measure (Cayman Islands, Cyprus, India, Singapore, Pakistan, and Guyana).

Criminalising suicide attempt hinders the achievement of public health and human rights goals. If its aim is to deter people from ending their lives and protect the vulnerable it does not achieve these purposes.

Studies show that the suicide rate is no lower in countries that punish it than in countries that do not. Overall, no data supports the belief the threat of incarceration or fine has a preventative effect.

On the contrary, the threat of punitive action reinforces the stigma associated with suicide and deters people from seeking mental health and social support services.

It also creates barriers to suicide reporting, leading to underreporting and misreporting of suicide, resulting in an inaccurate picture of the scale of the problem. The criminalisation of suicide attempt is an example of a law that, although created for public health purposes, inhibits it and creates barriers to addressing the problem it is created to solve.

The criminalisation of suicide attempt is harmful, not only from a public health approach, but from a human rights perspective.

In 2019, the UN Special Rapporteur on the Right to Health called for a human-rights approach to suicide prevention to make life more livable. People who attempt suicide need help not punishment. They - as any other person - have rights to heath, life, dignity, autonomy and protection from discrimination.

The right to health, the most relevant of these rights, is entrenched in Article 12 of the International Covenant on Economic, Social, and Cultural Rights. It states that everyone has the right "to the enjoyment of the highest attainable standard of physical and mental health".

When people who attempt suicide are punished, and not given help to access prevention, treatment and support services, this contradicts the human rights approach. It may also constitute a denial of health care and suicide prevention services, undermining the right to health.

How suicide became a crime The criminalisation of suicide emerged in Europe in the Middle Ages when, due to the disapproval of suicide by Christianity, suicide was considered a sin against God, and a crime against nature and society.

Life was a gift of God, which only he can take away. It was also seen as belonging to the monarch who was the ultimate ruler of their subjects' lives. The idea that a person might have ownership of their own body and life seemed preposterous.

With the Enlightenment, the increased autonomy of citizens, and a decrease in the authoritarianism of state rule, suicide was decriminalised in many European countries. It happened much later in England in Wales where, until the passage of the Suicide Act in 1961, both attempted suicide and suicide were punishable acts.

Several non-European cultures that had permitted or sanctioned religious or altruistic suicide in certain circumstances were influenced by the laws in England and Wales. This led to them adopting similar laws, making suicide and suicide attempt illegal. At least 12 countries where suicide attempt is still an illegal act are members of the Commonwealth.

A change of views In the 19th and 20th centuries, the views on suicide changed from an offence to a mental health problem, with survivors seen as needing care and treatment, not punishment. Later in the 20th century, this attitude changed further to encompass a public health perspective. It was realised that criminalisation did not deter people who wanted to die but kept them from seeking help and receiving treatment.

Currently, with a deepened understanding of personal dignity, autonomy, and human rights, the attitude is further changing. Human beings have become rights-bearers, with the autonomy to decide their fate and matters related to life and death.

Acceptance of a person's autonomy has led to the possibility of medically assisted suicide or euthanasia, in limited circumstances and following strictly defined rules. With the change in emancipation and autonomy, suicide has become viewed as a complex socioeconomic problem rather than a mere medical condition.

Suicide prevention measures that work Every state has a legitimate interest in preserving the lives of its residents. It is done through the adoption of suicide prevention and mental health strategies, the provision of suicide prevention and mental health services, and other policy and treatment measures.

In Nepal, the government is working on a comprehensive strategy to address suicide. It will include a suicide prevention registry to improve the reporting of suicide, the provision of mental health support, and restrictions on highly hazardous pesticides as means of suicide.

It is hoped its suicide prevention measures will include helping police, health care workers, media and civil society become more sensitive to the stigma associated with suicide, and make more people aware that suicide attempt is not illegal.

Means restriction one of the most reliable and cost-effective suicide prevention methods consists of restrictions on the availability of the means of suicide, including installation of barriers on bridges and railway platforms to prevent jumping, restrictions on the sale of highly toxic chemicals and medicine to prevent poisoning, and a restriction on the sale of guns.

These measures together with responsible media reporting, fostering life skills of young people, and early identification and support of everyone affected are recommended by the WHO as the most effective suicide prevention measures.

These measures and not criminalisation of suicide can be given priority in governments' response to suicide. (360info.org)