COMMENT | Why decriminalising suicide is not enough

Content warning: This article discusses sensitive topics such as suicide that some readers may find distressing.

COMMENT | When the bill to decriminalise suicide in Malaysia was finally tabled in Parliament, lawmakers were supportive of the government’s plan and believe it is a progressive way forward for mental health reforms. 

The bills were tabled for the first reading by the Minister in the Prime Minister's Department (Law and Institutional Reform), Azalina Othman Said and the second reading of the bills will be tabled during the next sitting. The effort was initiated in 2020 to help prevent suicide attempts, destigmatise suicide and encourage those suffering to get the help and treatment they need.

The Health Ministry voiced support the following year as the Covid-19 pandemic exacerbated the need to address mental health issues. However, the crime of aiding and abetting suicide under Sections 305 and 306 of the Penal Code will still remain but with heftier punishment for cases involving vulnerable groups. 

The efforts to decriminalise suicide in Malaysia have spurred a series of engagement sessions and meetings with government agencies, parliamentarians, state assemblypersons and relevant ministries. This mirrored a similar campaign in India, where stakeholder engagement played a crucial role in highlighting the importance of decriminalising suicide.

The discussions in Malaysia provided an opportunity for experts and policymakers to explore viable strategies and recommendations that can enhance mental health support once suicide is no longer considered a criminal offence. 

According to the World Health Organisation (WHO), suicide claims the lives of more than 700,000 individuals worldwide annually, which equates to one life lost every 40 seconds with 77 percent of these deaths in low and middle-income countries.

Suicide is the fourth leading cause of death for those aged between 15 and 29. There are still at least 17 countries, including Malaysia, where suicidal behaviour is a criminal offence. In Malaysia, it carries a maximum penalty of up to three years in prison.

Many survivors suffer from an underlying mental health condition. They are not just denied the support they need but — along with family members — also face possible arrest or threats. These remnant laws of British colonial rule view suicide as a transgression against God.

Interestingly, acceptance of the concept that mental or emotional distress is biological in nature, exacerbated by the environment and other physical factors has helped society towards becoming more sensitive to this issue. Hence, there have been numerous calls to repeal the law. 

What happens after Malaysia decriminalises suicide is pivotal. The effort is already undermined by numerous competing factors even at the proposal stage. There is a grave imbalance between the need to protect the sanctity of human life, the entwined religious and cultural belief system, and the right to self-determination, among others.

The reluctance to repeal the law is heavily influenced by the lingering legacy of British colonial rule that considers the act of criminalising attempted suicide as deterring others from committing the same “sin”.

Regardless that there is insufficient data supporting the decrease in the suicide rate, criminalisation continues to be a convenient avenue in addressing situations as foreign as suicidal behaviour and that “the law is doing something”.

It is no surprise this has resulted in a vague interpretation of Section 84 of the Penal Code and Section 342 of the Criminal Procedure Code relating to criminal responsibility and fitness to plead, suggesting that repealing Section 309 of the Penal Code is unnecessary.

These provisions are applicable to those charged under Section 309 and are said to be a better alternative than removing Section 309 altogether. While Section 342 pertains to evaluating an individual's ability to stand trial and fitness to plead, Section 309 criminalises attempted suicide. 

The process under Section 342 involves a lengthy evaluation process that may take up to a month in a designated psychiatric hospital while individuals who are tried under Section 309 require immediate action by enforcement officers to safeguard the well-being of the individual.

Based on a study, not all patients who were charged for attempting suicide within the premises of the psychiatric hospital were assigned for assessment under Section 342 based on the discretion of the magistrate. This process questions the effectiveness of the provision to allow for critical mental health support for people who attempt suicide.

Uncertain outcomes

Criminalising suicide is rarely associated with positive changes in preventing suicide, though decriminalising has its own uncertainties. One study indicated an inconsistent relationship between decriminalisation and the suicide rate. In Canada and Ireland, suicide rates increased after suicide was decriminalised in 1972 and 1993 respectively.

However, suicide rates in Sri Lanka had decreased since attempted suicide was decriminalised in 1998. This may have been due to suicide prevention initiatives implemented following the repeal of the law.

The uncertain outcomes of decriminalising suicide may have impeded efforts in a conservative and religious country like Malaysia despite growing calls for action since 2019, with another push by the Health Ministry in 2020 when it proposed a moratorium on the prosecution and conviction of suicide attempts.

In 2021, several groups renewed their call for Section 309 of the Penal Code to be repealed after years of advocating the issue. Unfortunately, things are divided between these groups and policymakers, stalling prospects of decriminalisation.

Without a concerted effort by a coalition of groups working towards a common goal, it may take longer to build the momentum needed for an official action to roll out. This reflects the absence of shared evidence-based research in Malaysia in delineating common objectives and reliable information to inform dialogue and policy decisions.

For instance, the Association of Women for Action and Research, a suicide prevention organisation in Singapore, has shared its findings with the Singaporean government on the psychological repercussion of criminalisation via case studies conducted among those who have attempted suicide.

Carefully evaluating Section 309 of Singapore's Penal Code proved that scientific research can foster greater collaboration between stakeholders, resulting in more effective suicide prevention and support efforts.

Suicide has long been a subject of conflicting legal, ethical, medical, religious, cultural, and human rights outlooks. Each perspective holds different assumptions regarding the causes, consequences, and implications, which shape how we understand and address this issue. The presumption that there ought to be a repeal of the law reflects modern society, but the law alone may not solve everything. 

Reconciling the many concerns of various stakeholders requires the adoption of a collaborative care approach which centres on the provision of assistance and resources to individuals experiencing a crisis, with the primary objective of mitigating the imminent danger of harm and prioritising safety. 

Legislators could go further than decriminalisation and include improving access to mental health services, expanding the availability of mental health clinics and providers and reducing barriers — social stigma, cost and geography — to accessing mental health care.

Malaysians are hopeful that with healthcare professionals onboard and an Attorney-General Chamber's report mentioned in Hansard, revisiting the Mental Health Act 2001 to improve on its response to address mental disorder issues will provide adequate protection of the rights of the patient and enable a shift from the management and treatment of mental illness to prevention and intervention initiatives.

Systematically analysing a legislative move is among the lessons learned from India where despite the implementation of the Mental Health Care Act in 2017 and subsequent de facto decriminalisation of suicide, suicide prevention efforts have stalled.

As a result, police and health professionals are ill-equipped with adequate training and are inept at providing appropriate support to survivors. While the building of mental health resources and infrastructures is progressing, the government can focus its initiatives on destigmatising suicide and encourage people to seek help through public education campaigns. 

The government has demonstrated a commendable commitment to reducing the stigma surrounding mental health issues by acknowledging the importance of mental health and resorting to a more empathetic approach for individuals with suicidal thoughts.

Decriminalising suicide is just the beginning of a long and arduous journey towards creating a society that values the complexity of mental health issues and provides the necessary support.

It signifies an unwavering commitment to advocating better mental health policies, breaking down the barriers that prevent individuals from receiving treatment and creating a safe and nurturing environment for everyone. 

If this article has raised issues for you, or if you’re concerned about someone you know, visit here. 

NURUS SAKINATUL FIKRIAH MOHD SHITH PUTERA is a lecturer at the Law Faculty, Universiti Teknologi Mara (UiTM) specialising in interdisciplinary law. SITI NURAMANI ABDUL MANAB is a senior lecturer at the Law Faculty, UiTM with an extensive academic background in criminal procedure and criminal law. Siti Nuramani was a deputy public prosecutor at the Attorney-General's Chambers of Malaysia. 

Originally published under Creative Commons by 360info™.

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