Health among the Japanese people has been faltering since the ‘bubble’ economy burst in the early 1990s. The consequences of the recession are now visible. A middle-aged man committed hara-kiri, a ritual form of suicide often committed in the name of honour. In the past, samurai were willing to kill themselves to maintain the oie (the family which governed the territory inherited from the ancestor). The man appealed, at the expense of his life, to the company for which he had worked for decades, one of the most successful companies in Japan.

To survive the competitive business world, many Japanese companies have now embarked upon restructuring. It is those middle-age men, who contributed to the economic success of Japan since the Second World War, who are now, ironically, the target for restructuring. They have devoted almost all of their lives and often sacrificed their own family life for their companies. People have had the aisha-seisin (a deep spiritual attachment to their own company) exactly akin to that held by the samurai for the oie. The man who commited hara-kiri had trusted the company and believed that the company would not abandon the business warriors. He killed himself when he felt betrayed by the company.

There is evidence that the poor economic performance of Japanese business has affected the health of the nation. The number of deaths from suicide reached 31 734 (25.2 per 100 000 people) in 1998 (Statistical Information, Department of Health, Japan; further information available from the first author upon request); Japan's highest rate since statistics were first recorded in 1899. The rate of suicide has also risen after the end of the economic ‘bubble’, notably for middle-aged men, approaching 50 per 100 000 people (Reference Taniguchi, Ishikawa and IinoTaniguchi et al, 1998). An increase in the suicide rate, especially among middle-aged men, affected the estimate of life expectancy downward; as a consequence, the gap in expected longevity between men and women in Japan has become wider (6.85 years: Department of Health, Japan, August 6, 1999 (further information available from the first author upon request)).

Karoshi (early death due to overwork) (Reference LawlisLawlis, 1995) is also a result of aisha-seisin. These deaths can be avoided. People should realise that a strong worker—company bond and becoming a ‘business warrior’ is hazardous to health.