Suicide and Justice

A Chinese Perspective

Fei Wu

• Publisher: Routledge
• Year: 2009
• eBook ISBN: 9781135248024
• Edition: 1
• Topic: Politics & International Relations
• Subtopic: Politics
• Index: Politics & International Relations

Sociological and psychiatric studies on suicide based on Western ideas about human nature see suicide as social or individual disorder. Suicide in China, however, should be understood differently.

By analyzing 30 cases, Wu Fei studies the dynamics of suicide in terms of family politics and local psychology and finds that suicide is committed when a power balance is broken in the games of power in the family. Unlike public injustice, domestic injustice is not only closely related to, but also often strengthened by emotional interdependence. Suicide and depression are different responses to the same situation of domestic injustice. The book also covers suicide as perceived by rural people outside the family; how suicide is viewed in politics; suicide prevention and studies of suicide in Chinese modern intellectual history.

Showing that suicide in China is not mainly caused by too traditional values, but reflects a dilemma in Chinese modernity, this book should be of interest to students and scholars in Chinese studies; sociology; anthropology and suicide studies.

Part I
Introduction

1 Suicide as a Chinese problem

1.1 Understanding suicide in China

In 2002, Michael Phillips and his colleagues disclosed in Lancet that the suicide rate in China is between 23 and 30 cases in every 100,000 people (Phillips et al. 1999; He and Lester 1999; Phillips, Li et al. 2002; Phillips 2003; Wang Lijun et al. 2003; Zhao and Ji 2002), which is one of the highest suicide rates in the world. This attracted attention from all over the world and marked a new stage in the study of suicide in China (Da Dan 2001: 15–17).

After Phillips published his data, scholars who study suicide, both inside and outside China, focused on several key issues: 1) Why are there more women who commit suicide? 2) Why is suicide more frequent in rural areas? 3) What does pesticide, the major suicide instrument, mean to Chinese people? and most importantly 4) What is the relationship between mental illnesses and suicide? All these features are somehow different than those found in other places of the world (Institute of Medicine 2002; Qin and Mortensen 2001).

The fact that women are more prone to commit suicide is not particular to the contemporary period (He and Lester 2002; Dominio et al. 2001–02; Pearson and Liu 2002). Some scholars notice that female suicide was already an important issue in traditional China (Ropp 2001; Carlitz 2001; Theiss 2001). Margery Wolf argues that the patriarchal family system is the major factor that leads to female suicide, in both traditional and modern China (Wolf 1975). The magazine Rural Women Knowing All (later changed to Rural Women) initiated a program on female suicide in rural areas in 1996, and published The Report of Female Suicide in Chinese Countryside in 1999. This influential book offers a comprehensive picture of female suicide in today’s China. In an article “Factor Analysis of Rural Female with Attempted Suicide,” the authors argue that personality characteristics, family environment and mental disorders all contribute to female suicide (Xie 1999; Lu Yingzhi et al. 2001). In her article “On the Problem of Village Women’s Suicide in Our Country,” Kang Qiong argues that female suicide results from multiple factors, including education problems, lack of social support, medical conditions and family environment (Kang 2002). These authors show that the reality might be more complex than Wolf argues. In an ethnographic description of the suicide of Ling, a young woman, Pearson and Liu show that this woman’s suicide resulted from complex power struggles (Pearson and Liu 2002).

The fact that suicide happens more often in rural areas also attracts some scholarly attention; compared with other aspects of suicide, however, this is one of the most understudied issues. Li Xianyun et al. studied 326 cases of attempted suicide in rural areas (Li et al. 2002). Zhang Yanping et al. analyzed the same sample (Zhang et al. 2003). Both articles focus on mental disorders but neither addresses the characteristics of attempted suicide in rural areas.

One interpretation of the high suicide rate in rural areas is that pesticide is more available in the countryside. The ingestion of pesticide is the most prevalent means of committing suicide in today’s China (Eddleston and Phillips 2004; Jiang Yonghua et al. 2003). It is said that pesticide is less concentrated now than in the past, but it is still very dangerous if one drinks several mouthfuls. Although some scholars have noticed this issue, it still needs more systematic study.

All of above issues are somewhat related to the central debate in the study of suicide in China: is the phenomenon caused by depression or other mental illnesses? (Shen et al. 1992; Phillips et al. 1999). Michael Phillips and his colleagues show that at most 63% (Phillips, Yang et al. 2002: 104) of completed suicides in China involve mental problems, while more than 90% of such suicides do in most Western countries (Institute of Medicine 2002: 69). Several other studies also show that mental illness is not the major factor that leads to suicide in China (Li et al. 2003; Zhang et al. 2002; Pearson and Liu 2002).

Although most Western-trained psychiatrists might wonder why so many fewer suicidal people in China have mental illnesses, we have to inquire into a no less important aspect in this number, i.e., that there are still more than half of all suicides who do have mental problems. Apparently suicide in China is not entirely unrelated to mental illness, but it must be related to mental illness in a different way than in the West, where suicide is more or less regarded as being caused by mental illnesses. Therefore, at stake is not only why mental illness is not found so often in Chinese suicides, but also what mental illness means to those people who suffer from it.

According to Phillips and his colleagues, suicide risk increases substantially when people are exposed to multiple risk factors. In order of importance, the major risk factors are:

High depression symptom score, previous suicide attempt, acute stress at time of death, low quality of life, high chronic stress, severe interpersonal conflict in the 2 days before death, a blood relative with previous suicidal behavior, and a friend or associate with previous suicidal behavior. (Phillips, Yang et al. 2002)

Among the 265 deceased people they study, none of those exposed to only one of the risk factors committed suicide, 30% committed suicide with two or three of them, 85% with four or five, and 96% with six or more (ibid). This finding is very important to the study of suicide in China. It tells us that depression still contributes to suicide, but it often operates severely when compounded. In some cases, people who do not suffer from depression also commit suicide when they have other problems. What is the relationship between depression and other problems that happen simultaneously? Is suicide in which depression is a factor significantly different from that in which it is not a factor?

In modern psychiatry focusing on suicide, impulsivity is seen as important in suicidal psychodynamics (Institute of Medicine 2002: 81, 91, 95). This is also found in China (Li et al. 2003). According Li and her colleagues, however, impulsive suicide attempters in China usually have no depression symptoms and enjoy a higher quality of life.

Although most scholars agree that suicide in China is not mainly caused by mental illnesses, still many scholars believe that psychological method should be applied in both the study and prevention of suicide. Jie Zhang et al. argue that the Western-developed psychological autopsy is still a feasible method in suicide study in China (Zhang et al. 2002). The method that Michael Phillips used to study suicide risk is essentially that of psychological autopsy (Phillips, Yang et al. 2002).

In the literature on Chinese suicide, psychological method is still the dominant method used. Some scholars study suicides among patients with mental illnesses (Lin and Xu 2002; Zhao Baolong et al. 2002; Chen et al. 2003). There are many studies about the relationship between depression and suicide. Niu Jingui and his colleagues have published at least two articles dealing with the general relationship between depression and suicide (Niu 2003; Niu et al. 2003). They merely emphasize the correlation between depression and suicide in general psychiatry, but do not have sufficient empirical data to test the correlation in the Chinese context. Liu Zongfeng et al. and Du Yongsheng focus on delusive depression and argue that this type of depression more frequently leads to suicide (Liu Zongfeng et al. 2003; Du Yongsheng 2002). Zou Shaohong et al. argue that depression is often caused by domestic violence (Zou et al. 2003). Zou’s conclusion shows that it is not sufficient to study depression only, and we might have a better understanding of depression after examining domestic violence.

The relationship between schizophrenia and suicide is also widely discussed. Tang Yong studied family history factors in schizophrenic suicide (Tang 2001); Zhang Huishi et al. studied attempted suicides among schizophrenics (Zhang Huishi et al. 2002); Xue Dewang et al. studied the characteristics of schizophrenic suicides (Xue et al. 2003); Jiang Huimin focuses on the suicides of schizophrenic patients (Jiang Huimin 2003). These scholars all show that suicide is frequent among schizophrenic patients, but they neither tell us the rate of schizophrenia among suicidal people nor examine the cultural meaning of schizophrenia in Chinese society. The fact that schizophrenic patients often commit suicide reveals the characteristics of schizophrenia, but does not tell us very much about suicide.

Other mental illnesses are not very often mentioned in suicide studies in China. The article of He Chuan and Niu Xiuying is one of quite few that argue that alcoholism leads to suicide in China (He and Niu 2004).

In addition to these psychological studies, some psychiatrists also notice that social factors contribute to suicide in China. Ji et al. show that suicide is usually seen as a social problem but not a medical one in China (Ji et al. 2001). Although Zhai Shutao wrote extensively about the psychiatric aspects of suicide, he did not overlook the social factors that contribute to suicide (Zhai 2001, 2002). Some scholars specialize in the suicides of “normal people” (Yang 2002).

Lee and Kleinman began to view suicide in China from the perspective of social science. These authors argue that “suicide can be seen as a means of resisting social power and thereby as a strategy in the inter-subjective struggles of everyday social experience” (Lee and Kleinman 2003: 295).

The ethnographic study done by Pearson and Liu is another attempt to understand suicide in China from a social and cultural point of view (Pearson and Liu 2002). Instead of seeing suicide as being caused by mental illnesses, they argue that Ling’s suicide was the result of complex power struggles in the family.

Both studies indicate that we should have a more cultural as well as political understanding of suicide in China. In these stories of suicide, some psychological factors certainly play important roles, but we would be greatly oversimplifying them if we were to define them with current psychiatric terminologies. By this I do not imply that psychiatry cannot play some role in the control of suicide in China. Indeed psychiatry is becoming a powerful force to safeguard the mental health of Chinese people. Because people who suffer domestic injustice are likely to become depressed and commit suicide, of course psychiatry will play an important role in the control of suicide; but people do not merely want to be mentally healthy. They also want to be happy and lucky, and this is already beyond the reach of psychiatry. After a long period of fieldwork on suicide, I have come to understand suicide from the perspective of justice.

1.2 Fieldwork and methodology

In order to understand this puzzling and sensitive phenomenon, I conducted 17 months of fieldwork (July–August 2000, June–August 2001, September 2002–August, 2003) in Mengzou¹ County.

Mengzou is a small county in north China, with a population of about 320,000 in 2002. The county is divided into nine townships, and Gouyi is one of them.

The county was established in the Warring States period (475–221 BC), and the city wall from in the Han dynasty (206 BC–AD 220) is still visible. Mengzou was one of the first counties in north China to be occupied by the Communist troops during World War II, and the Party never relinquished control over the area. It is not far from the east coast and is also close to Beijing and Tianjin. Although Mengzou is not the richest county in north China, its per capita income is above average for Chinese rural areas. Recently two railways were built across Mengzou, and this was very beneficial to its development.

Most people in Mengzou are of Han ethnicity. There are a few Muslims and a small mosque in the county seat. Catholicism was introduced to Mengzou in the nineteenth century, and there are several churches in Mengzou. In the village Shouzhen, there is a temple in honor of Liu Shouzhen, a famous doctor in the Jin dynasty (1115–1234). Since its re-establishment in the 1990s, it has attracted many pilgrims. There are various small temples in the county.

Gouyi is one of the biggest villages in Mengzou and the seat of Gouyi Township. Gouyi got its name from a temple built there in honor of Empress Gouyi of the Han dynasty. This temple was very popular before 1949, and there was an important temple festival each year. The temple was destroyed in the 1950s, but during my fieldwork, I witnessed local people celebrating this festival.

Abu-Lughod said that she was the first anthropologist who conducted fieldwork accompanied by her father (1986: 11); perhaps I am the first student of anthropology whose fieldwork has heavily relied on the help of his mother.

I first went to the Bureau of Public Security² and the county hospital when I undertook this study in the summer of 2000. When I came to the Bureau of Public Security, the police were dealing with two suicide cases. The first case was that of Haopeng, a middle school student who had hanged himself on the campus. Haopeng’s parents launched a suit against the school. Although there was no evidence that the school had caused the student to commit suicide, it was forced to pay a good deal of money to the student’s family. The second case was that of Zhuilu, a young wife who apparently committed suicide after being maltreated by her husband. Her grandfather alleged that it was her husband who had killed Zhuilu. Although it was evident that Zhuilu’s husband had indeed mistreated her, the police could not charge him since he had had no opportunity to kill Zhuilu.

In both cases, suicide was related to justice in a certain sense, but there is some interesting contrast. While Haopeng’s parents had no concrete proof that Haopeng had suffered injustice in the school, the police had to consider their protest seriously. Although Zhuilu’s grandfather was sure that Zhuilu’s husband had mistreated her, there was no way for the police to avenge Zhuilu. In Haopeng’s case, no matter whether Haopeng was murdered or had committed suicide, the school would be punished; but in Zhuilu’s case, her husband would not be punished if she had committed suicide.

A forensic medicine expert showed me the records of unnatural deaths in Mengzou between 1995 and 2001. He said that the police would intervene only if people could not decide whether someone had died because of homicide or suicide, or if there was a dispute after the suicide. If it was clear that someone had committed suicide, it would not be the police’s business.

When I learned that the police did not have direct responsibility for suicide, I went to a local hospital. The records of the emergency room are more systematic than that the police files. In the records from 2000, there are 499 cases of hospitalization, including 114 cases of suicides and attempted suicides. In other words, in that year over 25% of all hospitalizations were suicide cases. In the records from the first six months of 2001, 357 people were hospitalized, and among them were 65 attempted suicide and only four cases of completed suicide. A doctor said: “If a person does not seriously injure himself or herself, or if that person is too seriously injured to be healed, he or she is not sent to the hospital. When a hopeless suicide case comes to the hospital and the doctors cannot do anything for him or her, the hospital does not record it. The hospital records only suicide patients who have stayed for a period in the hospital. When a patient who has attempted suicide is admitted to the hospital, he or she is unlikely to die. Our medicine is not that bad, and most patients do not die in our hospital.” I could not find any data concerning the causes for suicide in their records. “We don’t care about that. Our responsibility is to cure and save them. It is not our business to investigate why people commit suicide.” “So you never ask about the cause when a patient comes?” “Sometimes we also chat with them, but in most cases, we only care about their physical conditions.”

Both the police and the hospital have some relationship with suicide cases, but neither is directly responsible for them. The police are responsible for suicide cases only insofar as suicide is sometimes an issue of public security; the hospital is responsible for suicide only insofar as suicide cases often become a health problem. But essentially, suicide is neither a police issue nor a health one. Most suicide cases are of Zhuilu’s type, in which injustice is involved, but not the kind of injustice to be dealt with by the police. It is a kind of injustice in the family, which I term as “domestice injustice,” in contrast to public injustice.

Since I could not study suicide without further inquiring into domestic injustice, I decided to conduct more interviews in family settings. Because my mother used to live for a long time in Gouyi, she accompanied me to that village in the summer of 2000. My fieldwork in Gouyi was very successful, and I managed to form a preliminary impression about suicide in this county. In the summer of 2001, my fieldwork in the county seat also went smoothly.

When I planned to do more fieldwork between September 2002 and August 2003, however, I worried about whether I would get enough data. It was a difficult thing to ask people about the suicide of their relatives or their own attempted suicide, and I was rebuffed by angry villagers more than once. When I finally found some people who were willing to tell me the truth, they often remarked: “I want to tell you this sto...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Preface and Acknowledgement
• Personae
• Part I: Introduction
• Part II: Domestic justice
• Part III: Human dignity
• Notes
• Bibliography