Will The Police Search A Suicide Phone

Ind Psychiatry J. 2014 Jan-Jun; 23(1): 4–ix.

(De-) criminalization of attempted suicide in India: A review

Rajeev Ranjan

Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India

Saurabh Kumar

Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, Bharat

Raman Deep Pattanayak

Department of Psychiatry, All Republic of india Establish of Medical Sciences, New Delhi, Republic of india

Anju Dhawan

¹National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi, India

Rajesh Sagar

Section of Psychiatry, All India Institute of Medical Sciences, New Delhi, India

Abstract

Attempted suicide is a serious problem requiring mental health interventions, simply it continues to be treated as a criminal offence nether the section 309 of Indian Penal Code. The article reviews the international legal perspective beyond diverse regions of the earth, discusses the unintended consequences of section 309 IPC and highlights the demand for decriminalization of attempted suicide in India. The Mental Wellness Care Nib, 2013, still under consideration in the Rajya Sabha (upper house), has proposed that attempted suicide should not be criminally prosecuted. Decriminalization of suicidal effort will serve to cut downwardly the undue stigma and avoid punishment in the aftermath of incident, and atomic number 82 to a more accurate collection of suicide-related statistics. From a policy perspective, it volition further emphasize the urgent demand to develop a framework to deliver mental wellness services to all those who attempt suicide.

Keywords: Attempted suicide, decriminalization, India

Suicide attempt tin can exist defined every bit a not-fatal self-directed potentially injurious behavior with an intent to dice.[1] More than ane lakh persons (1,35,445) in India lost their lives by committing suicide in the year 2012 alone. The number of suicides in the country during the decade (2002-2012) has recorded an increase of 22.seven% (1,35,445 in 2012 from 1,x,417 in 2002).[ii] Attempted suicide are at least 20 times more common than the completed suicide.[3] Of all those who engage in non-fatal suicidal behaviors, one-3rd echo the behavior within a year and nearly 10% eventually commit suicide.[iv,5] Most countries beyond the world no longer criminalize the suicidal attempts, however India has connected to hold it as a punishable offence. The recently drafted Mental Wellness Intendance Nib, 2013, introduced to the Rajya Sabha (upper house), makes an attempt to rectify information technology but is still nether consideration. Till engagement, suicide continues to be a criminal offense.

Research suggests that psychiatric illness constitutes a major crusade for nonfatal suicidal behavior. Risk factors for non-fatal suicide attempts by adults or youth include depression and other mental disorders.[6,vii,8] Other risk factors are childhood adversities such as sexual/physical abuse, corruption of alcohol or drugs, stressful life events such as death of a loved one, loss of a task or relationship, financial bankruptcy, imminent criminal prosecution and suffering from, or having recently been diagnosed with, a terminal illness.[9] Essentially, people who attempt suicide are in need of help rather than punishment in view of association with a high psychiatric or psychological morbidity. The philosophical dilemmas surrounding the individual's right to life and death has been debated, albeit inconclusively, beyond several disciplines with differing outlook and perspectives.[ten,eleven,12,thirteen]

The article reviews the Indian and international legal perspective of attempted suicide, discusses the unintended consequences of department 309 IPC and highlights the demand for decriminalization of attempted suicide in Bharat. For the same, a review of published scientific literature was undertaken and the information from some Indian sources/reports was incorporated. It was felt that the doctor-assisted suicide/euthanasia is a subject for carve up discussion and is out of telescopic for present newspaper.

LEGAL Status OF ATTEMPTED SUICIDE: INDIAN SCENARIO

According to Commodity 21 of the Indian constitution, "No person shall be deprived of his life or personal liberty except according to procedure established by the law". While the constitution covers the correct to life or liberty, information technology does not include the 'right to die'. The attempts at taking one'southward own life are not considered to fall under purview of constitutional correct to life.

Section 309 of the Indian Penal Lawmaking (IPC) clearly states as follows: "Whoever attempts to commit suicide and does any human activity towards the commission of such offence, shall be punished with simple imprisonment for a term which may extend to one year or with fine or both."

Several questions are raised in the context of department 309. Outset, information technology comes under the category of crimes defined nether Chapter Sixteen of Indian penal code. All other crimes in this category include those committed to the 'human body of the other person' and suicidal attempt is clubbed with them in same category of crimes. The act of attempted suicide is inferred on basis of intention, which is inferred from circumstances. Just the intention may exist unclear or cryptic in many cases. Farther, the question of legal treatment of attempted suicide as a crime against state does non detect many takers.

Delhi Loftier court in a landmark judgment of 1985 had commented that "the continuance of Section 309 I.P.C. (criminalizing suicide) is an anachronism unworthy of a man society similar ours." The Indian Penal Code had been formulated during British Raj Regime of 1860, and was mainly governed by British law of that time. Ironically, India continues to follow the archaic law even though U.k. itself had decriminalized suicide way back in 1961.

It is to be noted that the abetting of the commission of suicide (but non the abetting of attempt to commit suicide) is covered nether Department 306 IPC and the abetment of suicide of a child is covered under Department 305 IPC. The punishment for these varies from 1-ten years of imprisonment and heavy fines. Repealing of Department 309, per se, would non affect or touch on the above sections on abetment of completed suicide.

LEGAL Condition OF ATTEMPTED SUICIDE: A REVIEW OF INTERNATIONAL SCENARIO

Much of the legal stance against suicide originated from the declaration by St. Augustine of suicide being a sin (354-430 CE). Historically, the influence of religious institutions was instrumental in shaping the legal opinion favoring the criminalization of suicidal attempts. Later on the French Revolution, forth with other socio-cultural changes in Europe, the attitude towards suicide and attempted suicide gradually started to alter.[14,15] During 19^th and twenty^th century, nearly of the developed countries take repealed criminalization of attempted suicide, but some countries including India, go on to treat suicidal try every bit a criminal criminal offence.

Countries with criminalization of attempted suicide

Countries that have retained attempted suicide equally a criminal crime are mainly from 2 regions viz. North African region and S Asian region.

In the African region, Kenya, Malawi, Nigeria, Rwanda, Tanzania, Ghana and Uganda are amongst the countries that currently criminalize nonfatal suicidal behavior. For example, In Rwanda, a person who engages in nonfatal suicidal behavior is liable, on conviction, to a ii-v year prison house sentence. In Uganda, non-fatal suicidal beliefs is a felony punishable by up to ii years imprisonment. In Republic of ghana Criminal Lawmaking (Deed 29, 1960), non-fatal suicidal behavior is considered a crime.[16,17,eighteen]

In the S Asian region, India, Pakistan, Malaysia, Singapore, Bangladesh are amidst the countries that continue to criminalize the suicidal attempt. In Singapore, a person who attempts suicide can exist imprisoned for up to i year. Additionally, Democratic people's republic of korea besides criminalizes suicide with a peculiar deterrent, where the family and relatives of the suicide victim might be penalized as a course of collective penalisation for the act of suicide.[xix]

Countries with decriminalization of attempted suicide

Countries that have decriminalized attempted suicide have continued to criminalize the abetment to suicide, suicide pacts and at times, deliberate self-harm.

In the Australian land of Victoria, the survivor of a suicide pact can be charged with manslaughter and abetting other person's suicide. In New Zealand, the abetment of the suicides of others is a crime and similarly in Russian federation, inciting someone to suicide is punishable by upward to 5 years in prison. Attempted suicide has been decriminalized in Ireland every bit early as 1993, but self-harm is not seen as a form of attempted suicide. Suicide and attempted suicide are not crimes nether the Roman-Dutch constabulary. Some of united states of america (Alabama, Oregon and South Carolina) of U.S. continue to accept laws against suicide pacts, aiders and abettors, and for insurance purposes. But a few countries from Southern asia, which include Srilanka, Indonesia, Maldives and Thailand do non care for attempted suicide as a offense.

Currently, World Health Organization identified 59 countries across the world that have decriminalized suicide.[3] As seen from above, the attempted suicide has been decriminalized in whole of Europe, N America, much of South America and few parts of Asia.

Decriminalization of suicidal attempt occurred relatively late in countries which were influenced by the English language common constabulary. Similarly, the legal and coroners' involvement in suicide certification tends to exist much college in these countries compared to the continental Europe and Scandinavian region where doctors are allowed to certify suicidal deaths without recourse to legal regime. [Table ane].[20,21]

Table i

Countries which decriminalized attempted suicide

An external file that holds a picture, illustration, etc. Object name is IPJ-23-4-g001.jpg

ARGUMENTS AGAINST DECRIMINALIZATION: ARE THEY VALID?

Two major kind of arguments are by and large put forth for criminalization of suicidal attempts, though in the gimmicky political and sociocultural times, these have been challenged.

The kickoff major argument is rooted in the religious belief that only God should accept the right to dictate the terminate of life of a person and when a person attempts to end the life himself or herself, it should be considered as a sinful act. Traditionally, suicide has been condemned by religions beyond the globe. In some ethnic groups, the suicidal deaths are kept devoid of the customary funeral rituals. In Hinduism, information technology is believed that expiry past suicide exercise not lead to achievement of salvation (moksha). In full general, suicidal decease is associated with bringing dishonor to the entire lineage, social stigma and other consequences.[11] Only at the same time, many religions take also hailed suicide as necessary in sure situations or circumstances. The aboriginal Hindu living principles sanctioned some suicides such as, to expiate sins such as incest, those suffering from incurable disease and unable to perform their religious duties, 'sati' (a one time-culturally sanctioned practice where widow commits suicide by jumping in the burning pyre of dead husband). Similarly many Rajput women from India chose decease over humiliation in the backwash of war. Jainism accept canonical of the practice of catastrophe ane's life past ane's ain deed in certain circumstances (Sallekhana), while condemning it in other circumstances. The mental attitude of Buddhism has been ambiguous, though information technology has encouraged altruistic suicide nether certain circumstances.

Another major argument for criminalization is the belief that constabulary can act as a deterrent against other such attempts in the club.[12] However, it is even so not clear whether having a law to prosecute suicide attempters indeed acts as a deterrent or non. Internationally, the research on the impact of repeal of anti-suicide legislation has yielded mixed results. In 1992, Lester compared suicide rates in Canada in the ten-yr periods earlier and after decriminalization of suicide, and found no increase in the rate of suicide following decriminalization. Similarly, no change was observed in the New Zealand during the decade earlier or after decriminalization [Lester (1993)]. Lester (2002)[22] compared the suicide rates in 7 countries (Canada, England and Wales, Finland, Hong Kong, Republic of ireland, New Zealand, and Sweden) v years prior and v years following decriminalization, with an increase in the suicide rates later on decriminalization of suicide. This increment in suicide rates tin can be possibly explained due to better reporting of such attempts as before they could have been reported every bit accidents to prevent legal hassles.

In Indian context, while the level of awareness well-nigh existence of department 309 cannot exist deemed to be too high, just a pregnant proportion are aware of its existence, but not deterred to make a suicidal attempt. A study of 200 attempted suicides in a General Infirmary Emergency facility revealed that 46.2% males and 26.half dozen% females were aware of the existing law before making the attempt.[12]

WHAT Tin can Be ACHIEVED WITH DECRIMINALIZATION?

The criminal prosecution and the imposition of custodial and financial penalties on those bedevilled of suicidal behaviors plant an affront to human dignity.[11] In a large majority, the suicidal behavior is typically a symptom of psychiatric illness or is an act of psychological distress, indicating that the person requires assistance in his personal and psychological life, not punishment past fine and/or imprisonment. As many as 93% of suicide attempters were found to be psychiatrically ill at the fourth dimension of commission of the act, though a psychiatric contact was established by only 33-50% of them. Penal sanctions will simply serve to exacerbate suicidal persons' run a risk for depression, feet, and repetitive suicidal behavior.[xviii]

Further, many a times, the suicidal behavior is a effect of a host of factors, some of which are outside a person's control, such as endogenous biological causes, socioeconomic causes such as poverty, frustration in beloved, setbacks in finances, family or other such reasons. Technically, information technology may not be considered as an offence against the state. On the reverse, the state itself may be indirectly responsible for the plight of the victim who is left with no other alternative, except but to end his life.[23]

In Indian context, the cases admitted after attempted suicide should take a 'medico-legal' stamp on the case record which is confidential and kept in safe custody. The Medical Superintendent of the infirmary is required to inform the police for the necessary proceedings and action. The constabulary ordinarily visit the hospital and collects data about the circumstances of the suicide attempt from the person/family unit. At that place are often unnecessary delays or even refusals from hospitals, fear of punitive activeness and added trauma and stigma of having to bargain with constabulary and courts. The following case demonstrates the harsh reality and untoward consequences of criminalizing suicide for the individual and family unit.

A 40-year-quondam male, clerk, from middle socioeconomic status suffered from a depressive disease and tried to commit suicide by consuming the insecticide, but family members establish out and took him to a nearby hospital immediately. The infirmary refused to acknowledge him due to fearfulness of legal hassles associated with attempted suicide; finally the family unit members took him to another hospital and had to report the case as adventitious overdose in order to avoid further filibuster. From a legal perspective, what happens to this person in case his life is saved? He is, then, prosecuted for a criminal offence under department 309 IPC!

Most importantly, equally a majority of attempted suicides are reported to the authorities to be accidental, so the necessary emotional and mental wellness support is not bachelor to those who have attempted suicide. With decriminalization, the patients and their families volition exist in a better position to openly seek mental health care afterward the attempt.

From a societal perspective, decriminalization is a more sensitive and humane way of dealing with the trouble compared to prosecution. Additionally, information technology volition also help in improving the reporting and generation of improve epidemiological data on suicidality. The criminalization of suicidal acts causes the trouble of suicide to go hole-and-corner, making it difficult for suicidal persons to receive necessary assist.[xvi] Improved and accurate statistics can aid in better planning and resource allocation for efforts towards suicide prevention.

PROSECUTION OF ATTEMPTED SUICIDE IN INDIA: CASE EXAMPLES

Three different categories of attempted suicide are presented as case examples in gild to delineate the variety of circumstances and the differential role played past police or state.

Starting time, the recent high profile cases of fasting unto death for a social or political crusade. Anna Hazare announced the fast-until death in August, 2011 in Delhi to demand for a stronger Lokpal legislation empowering people. He continued information technology for 12 days with public back up, after which the law intervened when physicians reported a danger to health. Similarly, Iron Lady of Manipur- Irom Chanu Sharmila'south hunger strike started a decade dorsum in order to demand the repeal of Military machine Special Powers Act in the state of Manipur. She is being strength-fed through a nasal tube and has been arrested/released multiple times by the police. These are the instances in which public persons or leaders pale their lives for a public cause or to protest the state's policy. State has intervened in virtually such cases especially when the health deteriorates or at that place is an immenent danger to life.

Second i is 'santhara or Salekhana' an historic period-former religious do followed in Jainism. Information technology is essentially a spiritual decision to abandon the body, purify one soul and reach conservancy. On i mitt, the articles 25, 26 and 29 in Indian constitution protects all religious practices, but at the same time, it is besides punishable nether department 309 IPC. In practice, the state does not steer in the way of the religious practices aimed to end one's life. A public interest litigation (PIL) has been filed before High court of Rajasthan for proclamation of 'salekhana' as illegal practice, but a concluding verdict is yet awaited.

Third one is the more common scenario where suicidal attempts occur in the groundwork of adverse life events or stressors. For instance, Mumbai police filed criminal charges on a woman from Versova who attempted suicide afterward seeing her boyfriend dice a violent death (as reported in popular media in the calendar month of January, 2012). Some other example is of Mr. Jain, unemployed, bankrupted by wellness-care costs for a eye ailment and raising five daughters between the ages of 6 and 16, tried to kill himself with an overdose of sedatives. He was convicted for the attempt, though was sentenced to prison house for just the token time that the court remained in session. In his verdict, the Additional Sessions Judge remarked that the 'attempts to commit suicide are made due to extreme poverty and helplessness. There is no justification for imposing severe penalty on such convicts.' (as reported in The Globe and Mail, 2012).

As seen from above, the police enforcement officials do not normally interfere wherever religious sentiments tin can be injure. In case of political or mass leaders announcing the fast until death for their demands to be met, discretion is used and force-feeding is done after health deterioration. While bulk of attempted suicide are reported or dismissed as accidental, but there have been occasions when charges accept been filed confronting individual persons who endeavour suicide subsequently stressful life events.

In the recent times, the court verdicts, however, have supported the humane treatment of suicide attempters. Non a unmarried judgment was given by Supreme Court which support suicide as a crime over the past ane decade. Supreme Court in landmark judgment in March 2011, while giving guideline to passive euthanasia, had recommended to Parliament to consider decriminalizing attempt to suicide saying the provision had get anachronistic. Government had agreed to the proposal to bring out an amendment to delete department 309 IPC. As information technology comes in concurrent list (cardinal and state government), therefore, the cardinal government took the blessing of 25 out of 29 states. Finally, the Mental Health Care Bill, 2013 which was existence revised and drafted during that fourth dimension incorporated the sub-sections for decriminalization.

Contempo ATTEMPTS TOWARDS DECRIMINALIZING SUICIDE IN Bharat

The Indian judiciary and polity both accept recognized the need to repeal the section and several attempts have been made starting from 1970, as summarized in Table two. Supreme Courtroom had recommended to Parliament to consider decriminalizing attempt to suicide, saying the provision had become anachronistic. Somewhen, information technology was included in a few sections of the recently drafted Mental Wellness Care Beak 2013 which has recently been introduced to Rajya Sabha, and is still pending an approval before it can take effect as a police. Some experts are of the stance that the Indian Penal Lawmaking should be amended through a split up beak, and not nether Mental Health Care Bill.

Table 2

Landmarks in repealing the section 309 IPC

An external file that holds a picture, illustration, etc. Object name is IPJ-23-4-g002.jpg

Some sections of the proposed mental wellness care bill which are relevant for decriminalization include:

Section 124 of the beak describes nigh the decriminalization of the 'attempt to commit suicide'
Section 124 (1) recognizes person who has attempted to commit suicide is exempted from punishment under the I.P.C every bit presumed to exist 'suffering from a mental disease unless proven otherwise'
Section 124 (ii) recognizes the suffering being undergone by a person who effort suicide and seeks to provide them with care and consideration, instead of subjecting them to criminal prosecution.

ISSUES AND CHALLENGES: THE Route AHEAD

Even if the proposed Mental Health Care Bill is implemented every bit a law in well-nigh future in India, some issues need to be deliberated in more than detail. Section 124 states that the person may be exempt from 'punishment' and not 'prosecution'. A possibility volition remain that the police force tin remand a person who attempted suicide in custody and produce earlier a magistrate since the presumption of the law is that the 'person with attempted suicide has a mental disease.' Magistrate has powers (under Section 111 of the Pecker) to run into that any person with mental illness is conveyed to a public mental health institution for assessment/treatment for upwards to 10 days. Therefore, the persons with attempted suicide may continue hesitate in seeking medical treatment afterward a suicidal attempt, because of perceived fear of possible institutionalization confronting their ain will. Other issues related to possible misuse of above provision may ascend e.yard. in case of victims of attempted suicide in the background of domestic violence. Whether the decriminalization of suicidal attempts should be done through a split up amendment (rather than as function of mental wellness care nib) with more than careful consideration of various relevant issues which may arise in the context of suicide attempts, remains open up to debate.

With a shift in official position from 'legal' to a 'medical' model of attempted suicide, an of import challenge from a policy perspective will exist to provide an admission to mental health care for all those with attempted suicide. Patients presenting with an attempted suicide should be advised for a psychiatric consultation in all cases. In this context, there is a tremendous need to classify the necessary resources for strengthening the primary mental health care services in all districts of the country.

There is a need to further increment the emphasis on the public health approach to suicide prevention e.g. increased sensation generation, restrictions on access to ordinarily used lethal methods of suicides (insecticides, prescription medications) and control over facilitating factors such as booze. There is a need to develop an effective framework integrating the mental health with social welfare, instruction and other related sectors.

To conclude, the recent steps to accomplish decriminalization of suicide in India are laudable, but were long overdue. Decriminalization will reduce the trauma and potential prosecution in the backwash of a suicidal endeavor. Yet, there is a need to improve the mental health coverage and provide a framework to deliver essential mental health services to all those who attempted suicide.

Footnotes

Source of Support: Nil.

Conflict of Interest: None declared.

REFERENCES

ane. Krug East. Vol. 1. Genèva: World Health Arrangement; 2002. World Study on Violence and Health; p. 185. [Google Scholar]

ii. Accidental deaths and suicide in India. National Criminal offense Records Bureau. Ministry building of Domicile Diplomacy. 2012. [Terminal accessed on 2014 Sep 18]. Available from: http://ncrb.nic.in/CD-ADSI-2012/ADSIHome2012.htm .

4. Pirkis J, Beautrais A, Durkee T. Suicide attempts in New Zealand and Australia. In: Wasserman D, Wasserman C, editors. Oxford Textbook of Suicidology and Suicide Prevention: A Global Perspective. Oxford: Oxford University Press; 2009. pp. 127–31. [Google Scholar]

v. Silverman M. Suicide attempts in North America. In: Wasserman D, Wasserman C, editors. Oxford Textbook of Suicidology and Suicide Prevention: A Global Perspective. Oxford: Oxford Academy Press; 2009. pp. 117–21. [Google Scholar]

6. Kessler RC, Borges M, Walters EE. Prevalence of and take chances factors for lifetime suicide attempts in the National Comorbidity Survey. Curvation Gen Psychiatry. 1999;56:617–26. [PubMed] [Google Scholar]

vii. Chang B, Gitlin D, Patel R. The depressed patient and suicidal patient in the emergency department: Evidence-based direction and treatment strategies. Emerg Med Pract. 2011;13:1–23. [PubMed] [Google Scholar]

viii. Bertolote JM, Fleischmann A, De Leo D, Wasserman D. Psychiatric diagnoses and suicide: Revisiting the show" Crunch. 2004;25:147–55. [PubMed] [Google Scholar]

9. Joiner T. Cambridge: Harvard Academy Press; 2010. Myths about suicide. [Google Scholar]

eleven. Yadwad BS, Gouda HS. Is attempted suicide and offence? J Indian Acad Forens Med. 2005;27:108–11. [Google Scholar]

12. Latha KS, Geetha N. Criminalizing suicide attempts: Tin it be a deterrent? Med Sci Law. 2004;44:343–7. [PubMed] [Google Scholar]

13. Kahn DL, Lester D. Efforts to decriminalize suicide in Ghana, India and Singapore. Suicidol Online. 2013;4:96–104. [Google Scholar]

14. Sareen H, Trivedi JK. Legal implication of suicide problems specific to South Asia. Delhi Psychiatry J. 2009;12:121–5. [Google Scholar]

fifteen. Trivedi JK. Punishing attempted suicide a anachronism of xx^th century. Indian J Psychiatry. 1997;39:87–9. [PMC free commodity] [PubMed] [Google Scholar]

16. Wendo C. Suicide cases on the rise-Survey. The New Vision. 2007. Aug 31, [Last accessed on 2014 Sep eighteen]. Available from: http://world wide web.newvision.co.ug/PA/viii/12/584299 .

17. Schlebusch L, Burrows S. Suicide attempts in Africa. In: Wasserman D, Wasserman C, editors. Oxford Textbook of Suicidology and Suicide Prevention: A Global Perspective. Oxford: Oxford University Printing; 2009. pp. 105–eight. [Google Scholar]

18. Adinkrah One thousand. Criminal prosecution of suicide attempt survivors in Republic of ghana. Int J Offender Ther Comp Criminol. 2013;57:1477–97. [PubMed] [Google Scholar]

19. Jiang Yard, Cheng Q. Suicide attempts in Asia. In: Wasserman D, Wasserman C, editors. Oxford Textbook of Suicidology and Suicide Prevention: A Global Perspective. Oxford: Oxford University Press; 2009. pp. 109–12. [Google Scholar]

20. Neelman J. Suicide as a crime in the UK: Legal history, international comparisons and nowadays implications. Acta Psychiatr Scand. 1996;94:252–7. [PubMed] [Google Scholar]

21. Rutz EM, Schmidtke A. Suicide attempts in Europe. In: Wasserman D, Wasserman C, editors. Oxford Textbook of Suicidology and Suicide Prevention: A Global Perspective. Oxford: Oxford University Press; 2009. pp. 123–6. [Google Scholar]

22. Lester D. Decriminalization of suicide in vii nations and suicide rates. Psychol Rep. 2002;91:898. [PubMed] [Google Scholar]

Articles from Industrial Psychiatry Journal are provided here courtesy of Wolters Kluwer -- Medknow Publications