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Published On:16 October 2011
Posted by Indian Muslim Observer

Suicide among Muslims

What is the general response among Muslims to the phenomenon of suicide? Can we tease out a pattern by looking at case studies?

By Dr M Aamer Sarfraz and David Castle

There is some evidence that religious beliefs are protective against suicide, but little consensus regarding the pathway analysis. Historically, Donne considered religious prohibition, Durkheim proposed social integration and Stalk regarded religious commitment, especially in females, to be responsible for low suicide rates. A negative linear association between aggregate levels of religion and suicide rates was found when suicide rates were examined in 26 countries. Suicide has been researched, mostly in the West, in Christian populations. This is not surprising because Muslim countries do not send suicide death returns to the World Health Organization. The majority of Muslims lives in Asian and African countries. However, a significant minority lives in the West; the USA has around six million Muslim citizens. The growth of the Muslim populations in the West demands an understanding by health professionals and services of their religious beliefs regarding death and bereavement.

Some researchers highlighted socioreligious and legal hurdles while examining suicide rates in certain parts of Muslim countries. Suicide at an individual level among Muslims has not been widely studied. We report the case of a young Muslim male who completed suicide, and discuss its implications.

MD was a 22 year-old single university student. He was born in Pakistan. His birth and developmental milestones were normal. He went to school till age 11 in Pakistan. Then he moved to a Western country with his parents and two sisters. He faced initial difficulties at school and in the neighborhood, along with his two sisters, before settling down. MD described his father as 'liberal, quiet, and friendly'. He settled into his new job gradually and made friends at the office and in the community. MD described his mother as 'quick tempered, domineering and holding on to conservative Muslim religious views'. She was a housewife but found that role isolating in her adopted country.

MD worked hard at school, helped his mother at home and liked playing basketball. During senior school he joined friends in a 'Boy Band' as a lead singer. Meanwhile, his elder sister joined a bank and the younger planned to study law. There was pressure on MD, particularly from his mother, to study medicine or engineering. MD was interested in music, and wanted to race cars. His mother declared his interest in music 'Unislamic', which turned into a family conflict. MD performed worse than expected in high school examination and refused to study further. His father understood the decision but his mother blamed his interest in music and his friends for his 'fall from grace'. MD resorted to work as a salesman in a local store. The conflict continued for three years during which his sister married another Muslim from a similar background.

MD was assessed twice at the request of his parents over a period of six weeks. He had no history of alcohol or substance misuse. There was no history of psychiatric disorder in his family. MD was diagnosed to have a Mild Depressive Episode. His family was advised to find a compromise between MD's wishes and their aspirations for his future. MD was prescribed antidepressant medication. There was no further contact with MD or his family. Six months later, MD was found dead in his university hostel room, after having shot himself in the head. He had not taken the antidepressants and the family had pressurized him into further education.

The suicide verdict became known to the Muslim community locally and back in Pakistan. MD's family received few condolences. They had to accept a postmortem examination due to the nature of his death. Subsequently, the local Muslim community and imam were reluctant for MD's burial in the Muslim graveyard due to his 'haram' death. MD's body had to be taken to Pakistan. The family had a suspicious and cold reception on arrival, from their own relatives. They decided on a quick and quiet burial.

MD's family continues to live with guilt, shame and withdrawal of social support from their extended family and the Muslim community, both at home and abroad. His sister has since been divorced; suicide and resulting ostrasization of his family were cited as the main reasons. His younger sister has received no traditional marriage proposal despite her good looks, high income and a large extended family. The family has stopped visiting Pakistan for holidays due to the extended family's attitude. Lately, they are also thinking of moving to a different part of the country to escape the ongoing trauma.

Multiple aetiological factors including the impact of immigration, culture, religion and family dynamics lie behind MD's suicide. The authors choose to concentrate on religion because the others have been examined extensively elsewhere. Furthermore, immigrants may adopt aspects of the dominant culture and religion but death can take them back to observing their original practices.

In Islam, death is considered a gateway from mortal existence to a higher form of life. Muslims may belong to different schools of thought but observe the same practices regarding death and dying. For example, early burial is preferred and postmortem examination is considered undesirable. Initial bereavement period is for 3 days (finishes in 40 days), during which relatives and friends visit the bereaved family to remember and pray for the deceased. Islam considers life as a sacred trust from God; the individual has no right to end it. The Quran, source of supreme law for Muslims, says 'Do not kill yourself, for God is compassionate towards you. He who does it in transgression and wrongfully, will burn in hell...' Since most Islamic states incorporate Sharia in their legal system, suicide and parasuicide are criminal offences. In line with that, Muslim societies also have an unclear yet hostile view of suicide. A study by Lester & Akende among college students found that Muslims had inaccurate information and a more negative attitude towards suicide.

It is a myth that suicide is rare among Muslims. There is some evidence that suicide rates among Muslim groups in Africa are low as compared to Christian groups; the explanation lies in the Islamic disapproval of suicide, which encourages underreporting to avoid social stigma. Suicide rates in non-reporting countries were also found either equal or surpassing the highest reported official figures. A higher number of young married females commit suicide in a Muslim country (Pakistan), which is against the international trends. Suicide evokes feelings of guilt, shame, anger and sadness among survivors. These feelings are multiplied in Muslim families because of their close-knit nature. Many suicide surviving families become social outcasts and marriage prospects for the females diminish. Police involvement and legal complications following suicide, in the Muslim countries, result in financial setback and further public disgrace for the relatives.

Suicide prevention is a major public health target in the world. The United Nations guidelines for formulation and implementation of comprehensive suicide prevention strategies emphasize the importance of 'conceptual frameworks' and 'government backing' for a successful outcome. Completed suicide is highly associated with psychiatric problems, and with socioeconomic deprivation. The safety and socioeconomic well-being of its citizens are strictly the responsibilities of an Islamic State. Majnoun (insightless/mentally incompetent) individuals are protected under Islamic Law as not being responsible for their actions. The suicide phenomenon needs to be considered in that context by the religious scholars and legislators in Muslim countries. Once laws regarding suicide are successfully re-appealed in the light of Quranic law and current scientific knowledge, Muslim communities can be re-educated about the suicide phenomenon through their leaders at home and abroad.

[Dr M Aamer Sarfraz is a consultant psychiatrist in London and Prof David Castle is based in Melbourne.]

(Courtesy: The Friday Times)

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Posted by Indian Muslim Observer on October 16, 2011. Filed under , , , , . You can follow any responses to this entry through the RSS 2.0. Feel free to leave a response

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