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Fulltext Suicide pact in Malaysia: a case report

Sumeet Kaur, Syaril Ezuan

ASEAN Journal of Psychiatry, 2018;19(1):0-0.
MyJurnal

Objective: Suicide pacts are rare subsets of suicides amounting to less than 1% of suicides globally. Usually, there is one dominant participant to persuade the other by their shared experiences to agree to the suicide pact. There is also the perceived loss of a partner (which is a contributing factor in about 20% of cases) with the impending death of one member acting as a trigger.

Methods: We report a 46-year-old Burmese lady who presented with deliberate self- poisoning immediately after the death of her husband to honour a suicide pact they made. She had no previous history of psychiatric illnesses. The pact, initiated by her husband, was well planned six months prior to his death.

Result: She was discharged well after a thorough medical evaluation and supportive therapy. Input of family members knowledgeable in Buddhism helped allay her obligation to the pact citing religious reasons.

Conclusion: The case highlights a suicide pact that was initially unrecognised in the ward. In a multicultural country, psychiatrists need to be more sensitive and aware of erroneous beliefs that may lead to a suicide pact.

Matched MeSH terms: Buddhism
Fulltext Secular versus religious norms against smoking: which is more important as a driver of quitting behaviour among Muslim Malaysian and Buddhist Thai smokers?

Yong HH, Savvas S, Borland R, Thrasher J, Sirirassamee B, Omar M

Int J Behav Med, 2013 Jun;20(2):252-8.
PMID: 22302214

BACKGROUND: This paper prospectively examined two kinds of social normative beliefs about smoking, secular versus religious norms.
PURPOSE: The purpose of this paper is to determine the relative importance of these beliefs in influencing quitting behaviour among Muslim Malaysian and Buddhist Thai smokers.
METHODS: Data come from 2,166 Muslim Malaysian and 2,463 Buddhist Thai adult smokers who participated in the first three waves of the International Tobacco Control Southeast Asia project. Respondents were followed up about 18 months later with replenishment. Respondents were asked at baseline about whether their society disapproved of smoking and whether their religion discouraged smoking, and those recontacted at follow-up were asked about their quitting activity.
RESULTS: Majority of both religious groups perceived that their religion discouraged smoking (78% Muslim Malaysians and 86% Buddhist Thais) but considerably more Buddhist Thais than Muslim Malaysians perceived that their society disapproved of smoking (80% versus 25%). Among Muslim Malaysians, religious, but not societal, norms had an independent effect on quit attempts. By contrast, among the Buddhist Thais, while both normative beliefs had an independent positive effect on quit attempts, the effect was greater for societal norms. The two kinds of normative beliefs, however, were unrelated to quit success among those who tried.
CONCLUSIONS: The findings suggest that religious norms about smoking may play a greater role than secular norms in driving behaviour change in an environment, like Malaysia where tobacco control has been relatively weak until more recently, but, in the context of a strong tobacco control environment like Thailand, secular norms about smoking become the dominant force.

Matched MeSH terms: Buddhism/psychology*
Fulltext Adult smokers' perception of the role of religion and religious leadership on smoking and association with quitting: a comparison between Thai Buddhists and Malaysian Muslims

Yong HH, Hamann SL, Borland R, Fong GT, Omar M, ITC-SEA project team

Soc Sci Med, 2009 Oct;69(7):1025-31.
PMID: 19695758 DOI: 10.1016/j.socscimed.2009.07.042

In recent years, attempts have been made to incorporate religion into tobacco control efforts, especially in countries like Malaysia and Thailand where religion is central to the lives of people. This paper is a prospective examination of the perceived relevance and role of religion and religious authorities in influencing smoking behaviour among Muslims in Malaysia and Buddhists in Thailand. Data were collected from 1482 Muslim Malaysian and 1971 Buddhist Thai adult smokers who completed wave 1 (early 2005) of the International Tobacco Control Southeast Asia Survey (ITC-SEA). Respondents were asked about the role of religion and religious leadership on smoking at Wave 1 and among those recontacted, quitting activity at Wave 2. Results revealed that over 90% of both religious groups reported that their religion guides their day-to-day behaviour at least sometimes, but Malaysian Muslims were more likely to report that this was always the case. The majority (79% Muslims and 88% Buddhists) of both groups believed that their religion discourages smoking. About 61% of the Muslims and 58% of the Buddhists reported that their religious leaders had encouraged them to quit before and a minority (30% and 26%, respectively) said they would be an influential source to motivate them to quit. Logistic regression models suggest that these religious factors had a clear independent association with making quitting attempts in both countries and this translated to success for Malaysian Muslims but not for the Thai Buddhists. Taken together, results from this study indicate that religion and religious authorities are both relevant and important drivers of quitting, but whether this is always enough to guarantee success is less clear. Religion can be a culturally relevant vehicle to complement other tobacco control efforts.

Matched MeSH terms: Buddhism/psychology*
Human Embryonic Stem Cell Research: Ethical Views of Buddhist, Hindu and Catholic Leaders in Malaysia

Sivaraman MA, Noor SN

Sci Eng Ethics, 2016 Apr;22(2):467-85.
PMID: 26049934 DOI: 10.1007/s11948-015-9666-9

Embryonic Stem Cell Research (ESCR) raises ethical issues. In the process of research, embryos may be destroyed and, to some, such an act entails the 'killing of human life'. Past studies have sought the views of scientists and the general public on the ethics of ESCR. This study, however, explores multi-faith ethical viewpoints, in particular, those of Buddhists, Hindus and Catholics in Malaysia, on ESCR. Responses were gathered via semi-structured, face-to-face interviews. Three main ethical quandaries emerged from the data: (1) sanctity of life, (2) do no harm, and (3) 'intention' of the research. Concerns regarding the sanctity of life are directed at particular research protocols which interfere with religious notions of human ensoulment and early consciousness. The principle of 'do no harm' which is closely related to ahimsa prohibits all acts of violence. Responses obtained indicate that respondents either discourage research that inflicts harm on living entities or allow ESCR with reservations. 'Intention' of the research seems to be an interesting and viable rationale that would permit ESCR for the Buddhists and Hindus. Research that is intended for the purpose of alleviating human suffering is seen as being ethical. This study also notes that Catholics oppose ESCR on the basis of the inviolability of human life.

Matched MeSH terms: Buddhism*
Materialism and life satisfaction: the role of religion

Rakrachakarn V, Moschis GP, Ong FS, Shannon R

J Relig Health, 2015 Apr;54(2):413-26.
PMID: 25811060

This study examines the role of religion and religiosity in the relationship between materialism and life satisfaction. The findings suggests that religion may be a key factor in understanding differences in findings of previous studies regarding the inverserelationship found in the vast majority of previous studies. Based on a large-scale study in Malaysia—a country comprised of several religious subcultures (mainly Muslims, Buddhists, and Hindus), the findings suggest that the influence of religiosity on materialism and life satisfaction is stronger among Malays than among Chinese and Indians, and life satisfaction partially mediates the relationship between religiosity and materialism. The paper discusses implications for theory development and further research.

Matched MeSH terms: Buddhism/psychology
Using Surplus Embryos and Research Embryos in Stem Cell Research: Ethical Viewpoints of Buddhist, Hindu and Catholic Leaders in Malaysia on the Permissibility of Research

Sivaraman MAF

Sci Eng Ethics, 2018 02;24(1):129-149.
PMID: 28281154 DOI: 10.1007/s11948-017-9893-3

The sources of embryos for Embryonic Stem Cell Research (ESCR) include surplus embryos from infertility treatments, and research embryos which are created solely for an ESCR purpose. The latter raises more ethical concerns. In a multi-religious country like Malaysia, ethical discussions on the permissibility of ESCR with regard to the use surplus and research embryos are diversified. Malaysia has formulated guidelines influenced by the national fatwa ruling which allows the use of surplus embryos in ESCR. Input from other main religions is yet to be documented. In light of this, this study addresses (i) the ethical viewpoints of Buddhist, Hindu and Catholic leaders on the permissibility of using surplus and research embryos; and (ii) the moral standpoints of religious leaders towards attaining a consensus on the practice of ESCR in Malaysia. Responses from the religious leaders were obtained via semi-structured, face-to-face interviews. The findings show that generally the Buddhist and Hindu leaders approve the use of surplus embryos. Their responses on the creation of research embryos for ESCR are varied. Meanwhile, the Catholic leaders distinctively objected to ESCR regardless of the embryo sources, referring to it as the destruction of life. Taking into account the diverse views, this study explores the response of the religious leaders for a general consensus wherever possible. The ethical discourse surrounding ESCR in a multi-religious setting offers new perspective, which needs to be explored in a broader global community.

Matched MeSH terms: Buddhism*
Fulltext Ethical Guiding Principles of "Do No Harm" and the "Intention to Save Lives" in relation to Human Embryonic Stem Cell Research: Finding Common Ground between Religious Views and Principles of Medical Ethics

Sivaraman MAF

Asian Bioeth Rev, 2019 Dec;11(4):409-435.
PMID: 33717326 DOI: 10.1007/s41649-019-00103-4

One of the goals of medicine is to improve well-being, in line with the principle of beneficence (do no harm). Likewise, scientists claim that the goal of human embryonic stem cell (hESC) research is to find treatments for diseases. In hESC research, stem cells are harvested from a 5-day-old embryo. Surplus embryos from infertility treatments or embryos created for the sole purpose of harvesting stem cells are used in the research, and in the process the embryos get destroyed. The use of human embryos for research purpose raises ethical concern. In this context, the religious leaders play the role to be the moral compass and "reality check" to engage with the public. In Malaysia, the Ministry of Health has outlined the Guidelines for Stem Cell Research and Therapy, reflecting on Islamic principles. Since there has not been much focus on the viewpoints of other faiths in Malaysia, this study attempts to (i) explore the ethical guiding principles deliberated by religious leaders from the Buddhist, Hindu and Catholic traditions and (ii) identify if there is a common ground between the mainstream religious views and principles of medical ethics, in relation to hESC research. Eleven religious leaders representing the Buddhist, Hindu and Catholic traditions were interviewed. Interestingly, though reasoning of religious leaders came from different angles, their underlying concerns revolve around the values of "do no harm" and "intention to save lives". These values are also the key principles in medical ethics. The findings are applied to answer the question as to whether religious and medical guiding principles can co-exist and complement in ethical decision-making, without compromising the values.

Matched MeSH terms: Buddhism
Knowledge, Attitude, and Practice of General Population toward Complementary and Alternative Medicines in Relation to Health and Quality of Life in Sungai Petani, Malaysia

Mohiuddin SG, Aziz S, Iqbal MZ, Naqvi AA, Ahmed R, Mahmoud MA, et al.

J Pharm Bioallied Sci, 2020 01 29;12(1):57-63.
PMID: 32801601 DOI: 10.4103/jpbs.JPBS_182_19

Purpose: The demand of complementary and alternative medicine (CAM) has increased drastically over the past few decades. The perceptions about CAMs among general population are positive. However, the literature highlights that effectiveness and acceptance of alternative therapies among the general population is still a subject of debate.
Materials and Methods: This is a cross-sectional study and the response along with demographic details was collected through a validated questionnaire; the results were analyzed by using a validated data collection tool. The results were concluded based on good, moderate, and poor responses, which were evaluated through data analysis by using the Statistical Package for the Social Sciences software version 20.0., SPSS Inc., Chicago, III, USA. A value of P < 0.05 was considered statistically significant.
Results: In total, 182 (44.4%) of male and 228 (55.6%) of female respondents were selected for this study. Studies showed that a greater knowledge level was observed among female respondents (15.55 ± 2.7, P < 0.001). The selected Chinese population had relatively good knowledge (i.e., 15.63, P = 0.006). People practicing Buddhism had also good knowledge. Rural population had lesser family income and showed a good practice pattern and understanding (P = 0.006). The positive attitude was identified among women ( P < 0.001) with a mean score of 15.55 ± 2.7. Postgraduate participants were found to have diverse results with SD ± 6.23, and 77.1% had a good attitude. A statistically significant association was observed between religion and attitude of respondents (P < 0.001).
Conclusion: Although a better practice was noticed in Malaysian population, more awareness is required and knowledge should be disseminated among the population to improve the overall health and quality of life in Malaysia.

Matched MeSH terms: Buddhism
The Tzu Chi Silent Mentor Program: Application of Buddhist Ethics to Teach Student Physicians Empathy, Compassion, and Self-Sacrifice

Santibañez S, Boudreaux D, Tseng GF, Konkel K

J Relig Health, 2016 Oct;55(5):1483-94.
PMID: 26311054 DOI: 10.1007/s10943-015-0110-x

The Buddhist Tzu Chi Silent Mentor Program promotes the donation of one's body to science as a selfless act by appealing to the Buddhist ethics of compassion and self-sacrifice. Together, faculty, families, and donors help medical students to learn the technical, spiritual, emotional, and psychological aspects of medicine. Students assigned to each "Silent Mentor" visit the family to learn about the donor's life. They see photos and hear family members' stories. Afterwards, students write a brief biography of the donor which is posted on the program website, in the medical school, and on the dissection table. In this paper, we: (1) summarize the Silent Mentor Program; (2) describe findings from an assessment of medical students who recently completed a new version of the program in Malaysia; and (3) explore how healthcare settings could benefit from this innovative program.

Matched MeSH terms: Buddhism/psychology*
Use of Traditional Chinese Medicine in Malaysia: A Knowledge and Practice Study among General Population toward Complementary and Alternative Medicine in Relation to Health and Quality of Life in Malaysia

Mohiuddin SG, Aziz S, Ahmed R, Shaikh Ghadzi SM, Iqbal MZ, Iqbal MS

J Pharm Bioallied Sci, 2020 12 21;13(1):102-107.
PMID: 34084055 DOI: 10.4103/jpbs.JPBS_258_20

Purpose: There is a wide range of use of complementary and alternative medicine (CAM), which has increased drastically and affected treatments overall. The knowledge and practice of Chinese herbal medicine among the general population is considered as positive. Literature shows that the effectiveness and acceptance of alternative therapies is still debatable among the general population.
Materials and Methods: Study design was cross-sectional, in which sociodemographic data of respondents were collected through a validated questionnaire; results were analyzed by using validated data collection tool. The results were concluded on the basis of good, moderate, and poor response, which was evaluated through data analysis by the Statistical Package for the Social Sciences (SPSS) software, version 20.0. A P < 0.05 was considered as statistically significant.
Results: Respondents were 182 (44.4%) males and 228 (55.6%) females; better knowledge was recognized among the females (P < 0.001) with mean knowledge of 15.55 ± 2.7. Chinese population had good knowledge with statistically strong correlation with mean knowledge of 15.63 (P = 0.006). Likewise, Buddhism was reported to have good knowledge among all the religions. Rural population was underlined with lesser family income and they showed good practice and understanding (P = 0.006). Comparatively positive attitude was noticed among the females (P < 0.001) with mean attitude of 15.55 ± 2.7. The highest level of education in this study was postgraduate, which showed 77.1% good attitude. Postgraduate participants were having varied results with standard deviation of ±6.23. Statistically highly significant association was seen between the religion and attitude of respondents with the P < 0.001. Chinese medicine is widely used, but religious difference was found among the races. Similar difference was found in knowledge and practice among the population of rural side and low family income compared to urban population with higher income and access to allopathic medicine.
Conclusions: Despite having better practice among the Malaysian population, still the knowledge needs to be disseminated among the population for the overall use of traditional Chinese medicine with safety to improve health and quality of life in Malaysia.

Matched MeSH terms: Buddhism
Religious scholars' attitudes and views on ethical issues pertaining to pre-implantation genetic diagnosis (PGD) in Malaysia

Olesen A, Nor SN, Amin L

J Bioeth Inq, 2016 Sep;13(3):419-29.
PMID: 27365102 DOI: 10.1007/s11673-016-9724-2

Pre-Implantation Genetic Diagnosis (PGD) represents the first fusion of genomics and assisted reproduction and the first reproductive technology that allows prospective parents to screen and select the genetic characteristics of their potential offspring. However, for some, the idea that we can intervene in the mechanisms of human existence at such a fundamental level can be, at a minimum, worrying and, at most, repugnant. Religious doctrines particularly are likely to collide with the rapidly advancing capability for science to make such interventions. This paper focuses on opinions and arguments of selected religious scholars regarding ethical issues pertaining to PGD. In-depth interviews were conducted with religious scholars from three different religious organizations in the Klang Valley, Malaysia. Findings showed that Christian scholars are very sceptical of the long-term use of PGD because of its possible effect on the value of humanity and the parent-children relationship. This differs from Islamic scholars, who view PGD as God-given knowledge in medical science to further help humans understand medical genetics. For Buddhist scholars, PGD is considered to be new medical technology that can be used to save lives, avoid suffering, and bring happiness to those who need it. Our results suggest that it is important to include the opinions and views of religious scholars when it comes to new medical technologies such as PGD, as their opinions will have a significant impact on people from various faiths, particularly in a multi-religious country like Malaysia where society places high value on marital relationships and on the traditional concepts of family.

Matched MeSH terms: Buddhism
Predictors of sociocultural adjustment among sojourning Malaysian students in Britain

Swami V

Int J Psychol, 2009 Aug;44(4):266-73.
PMID: 22029555 DOI: 10.1080/00207590801888745

The process of cross-cultural migration may be particularly difficult for students travelling overseas for further or higher education, especially where qualitative differences exist between the home and host nations. The present study examined the sociocultural adjustment of sojourning Malaysian students in Britain. Eighty-one Malay and 110 Chinese students enrolled in various courses answered a self-report questionnaire that examined various aspects of sociocultural adjustment. A series of one-way analyses of variance showed that Malay participants experienced poorer sociocultural adjustment in comparison with their Chinese counterparts. They were also less likely than Chinese students to have contact with co-nationals and host nationals, more likely to perceive their actual experience in Britain as worse than they had expected, and more likely to perceive greater cultural distance and greater discrimination. The results of regression analyses showed that, for Malay participants, perceived discrimination accounted for the greatest proportion of variance in sociocultural adjustment (73%), followed by English language proficiency (10%) and contact with host nationals (4%). For Chinese participants, English language proficiency was the strongest predictor of sociocultural adjustment (54%), followed by expectations of life in Britain (18%) and contact with host nationals (3%). By contrast, participants' sex, age, and length of residence failed to emerge as significant predictors for either ethnic group. Possible explanations for this pattern of findings are discussed, including the effects of Islamophobia on Malay-Muslims in Britain, possible socioeconomic differences between Malay and Chinese students, and personality differences between the two ethnic groups. The results are further discussed in relation to practical steps that can be taken to improve the sociocultural adjustment of sojourning students in Britain.

Matched MeSH terms: Buddhism
Psychiatric sequelae to a civil disturbance

Tan ES, Simons RC

Br J Psychiatry, 1973 Jan;122(566):57-63.
PMID: 4509384
Matched MeSH terms: Buddhism

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