Abstract
Suicide is a significant form of unnatural death and must be differentiated as such from other violent manners of death (homicide, accident), but also from unexpected deaths due to natural causes. The distinction is made on the basis of a careful collection and correct interpretation of post-mortem forensic findings on the one hand, the general background of the case and the criminal investigation at the scene on the other. For competent assessment by the post-mortem medical examiner and/or forensic pathologist, a thorough knowledge of the numerous methods of committing suicide and their pathomorphological correlates is indispensable. This not only includes the constellation of findings and injury patterns typical of suicide, but also unusual manifestations. Highly conspicuous are complex suicides, in which several methods are applied simultaneously, or one after the other, as well as joint suicides and homicide–suicides involving several persons. Certain settings also deserve special attention. Moreover, simulated or dissimulated suicide is a possibility that must always be borne in mind in forensic practice.
References
Brinkmann B, Banaschak S, Bratzke H, Cremer U, Diese G, et al. Errors resulting from the external examination of corpses in Germany: results of a multicentre study. Arch Kriminol. 1997;199:1–12, 65–74.
Henderson JP, Mellin C, Patel F. Suicide—a statistical analysis by age, sex and method. J Clin Forensic Med. 2005;12:305–9.
Schmidt P, Müller R, Dettmeyer R, Madea B. Suicide in children, adolescents and young adults. Forensic Sci Int. 2002;127:161–7.
Madea B, editor. Die Ärztliche Leichenschau. 2nd ed. Heidelberg: Springer; 2006. p. 24–32.
Ringel R. Der Selbstmord. Abschluss einer krankhaften psychischen Entwicklung. Wien Düsseldorf: Maudrich; 1953.
Kölves K, Värnik A, Tooding LM, Wasserman D. The role of alcohol in suicide: a case–control psychological autopsy study. Psychol Med. 2006;36:923–30.
McGirr A, Tousignant M, Routhier D, Pouliot L, Chawky N, Margolese HC, et al. Risk factors for completed suicide in schizophrenia and other chronic psychotic disorders: a case–control study. Schizophr Res. 2006;84:132–43.
Shields LBE, Hunsaker DM, Hunsaker JC. Trends of suicide in the United States during the 20th century. In: Tsokos M, editor. Forensic pathology reviews, vol. 3. Totowa: Humana Press; 2005. p. 305–35.
Pollak S. Statistics and phenomenology of combined suicides and other multiple suicidal injuries in the urban area (I, II), with 2 case reports. Arch Kriminol. 1978;161:20–30, 68–81.
Bohnert M, Pollak S. Complex suicides—a review of the literature. Arch Kriminol. 2004;213:138–53.
Bohnert M. Complex suicides. In: Tsokos M, editor. Forensic pathology reviews, vol. 2. Totowa: Humana Press; 2005. p. 127–43.
Racette S, Sauvageau A. Planned and unplanned complex suicides: a 5-year retrospective study. J Forensic Sci. 2007;52:449–52.
Törö K, Pollak S. Complex suicide versus complicated suicide. Forensic Sci Int. 2009;184:6–9.
Pollak S. Joint suicides. Beitr Gerichtl Med. 1978;36:53–9.
Jensen LL, Gilbert JD, Byard RW. Coincident deaths: double suicide or murder-suicide? Med Sci Law. 2009;49:27–32.
Pollak S. Erscheinungsformen des erweiterten Selbstmordes. Forensia. 1979;2:67–78.
Byard RW. Murder-suicide: an overview. In: Tsokos M, editor. Forensic pathology reviews, vol. 3. Totowa: Humana Press; 2005. p. 337–47.
Travis AR, Johnson LJ, Milroy CM. Homicide–suicide (dyadic death), homicide, and firearm use in England and Wales. Am J Forensic Med Pathol. 2007;28:314–8.
Schröer J, Püschel K. Special aspects of crime scene interpretation and behavioural analysis—the phenomenon of “undoing”. In: Tsokos M, editor. Forensic pathology reviews, vol. 4. Totowa: Humana Press; 2006. p. 193–202.
Guddat SS, Schalinski S, Püschel K, Tsokos M, Schulz F. An extreme case of undoing and posing in a case of murder-suicide. A forensic pathological approach to crime scene investigation. Arch Kriminol. 2007;220:20–4.
Schmidt PH, Padosch SA, Madea B. Occupation-related suicides. In: Tsokos M, editor. Forensic pathology reviews, vol. 2. Totowa: Humana Press; 2005. p. 145–65.
Pollak S. Forensic aspects of suicide. Rechtsmedizin. 2005;15:235–49.
Tsokos M, Türk EE, Madea B, et al. Pathologic features of suicidal deaths caused by explosives. Am J Forensic Med Pathol. 2003;24:55–63.
Schwark T, Severin K, Grellner W. “I am flying to the stars”—suicide by aircraft in Germany. Forensic Sci Int. 2008;179:e75–8.
Grellner W, Kukuk M, Glenenwikel F. About suicide methods of physicians, medical personnel and related professions. Arch Kriminol. 1998;201:65–72.
Edirisinghe PA, Busuttil A. Suicide by severing the arterio-venous subclavian dialysis catheter. J Clin Forensic Med. 2006;13:86–8.
Gill JR, Marker E, Stajic M. Suicide by cyanide: 17 deaths. J Forensic Sci. 2004;49:826–8.
Saukko P, Knight B. Knight’s forensic pathology. 3rd ed. London: Arnold; 2004. p. 379–94, 566–9.
Aggrawal A. Agrochemical poisoning. In: Tsokos M, editor. Forensic pathology reviews, vol. 4. Totowa: Humana Press; 2006. p. 261–327.
Thierauf A, Gnann H, Bohnert M, Vennemann B, Auwärter V, Weinmann W. Suicidal poisoning with mercaptodimethur—morphological findings and toxicological analysis. Int J Legal Med. 2009;123:387–94.
Chan P, Duflou J. Suicidal electrocution in Sydney: a 10-year case review. J Forensic Sci. 2008;53:455–9.
Krauland W. Evaluation of fatal gunshot injuries (the weapon in the hand). Arch Kriminol. 1984;174:1–22.
Betz P, Tutsch-Bauer E, Eisenmenger W. “Tentative” injuries in a homicide. Am J Forensic Med Pathol. 1995;16:246–8.
Böhmer K. Tötung durch Erhängen. Dtsch Z Ges Gerichtl Med 1939/40;32:449–53.
Große Perdekamp M, Nadjem H, Weinmann W, Pollak S. Plastic bag as the method in suicide and homicide. Arch Kriminol. 2001;207:33–41.
Thomsen AH, Gregersen M. Suicide by carbon monoxide from car exhaust-gas in Denmark 1995–1999. Forensic Sci Int. 2006;161:41–6.
Wirth I, Schulz R, Schmeling A. Suicide by means of a charcoal grill. Casuistic report with review of the literature. Arch Kriminol. 2008;221:129–37.
Hartwig S, Tsokos M. Suicidal and accidental carbon monoxide poisonings due to charcoal fires in closed spaces. Arch Kriminol. 2008;222:1–13.
Auwärter V, Große Perdekamp M, Kempf J, Schmidt U, Weinmann W, Pollak S. Toxicological analysis after asphyxial suicide with helium and a plastic bag. Forensic Sci Int. 2007;170:139–41.
Grassberger M, Krauskopf A. Suicidal asphyxiation with helium: report of three cases. Wien Klin Wochenschr. 2007;119:323–5.
Trübner K, Püschel K. Fatalities in the bathtub. Arch Kriminol. 1991;188:35–46.
Wyatt JP, Beale JP, Graham CA, Beard D, Busuttil A. Suicidal high falls. J Clin Forensic Med. 2000;7:1–5.
Türk EE. Fatal falls from height. In: Tsokos M, editor. Forensic pathology reviews, vol. 5. Totowa: Humana Press; 2008. p. 25–38.
Crombie IK, Pounder DJ, Dick PH. Who takes alcohol prior to suicide? J Clin Forensic Med. 1998;5:65–8.
Bilban M, Skibin L. Presence of alcohol in suicide victims. Forensic Sci Int. 2005;147:9–12.
Püschel K, Schmoldt A. Drogennot- und -todesfälle. In: Madea B, Brinkmann B, editors. Handbuch gerichtliche Medizin 2. Berlin, Heidelberg, New York, Tokyo: Springer; 2003. p. 689–736.
Madea B, Käferstein H, Sticht G. Drug fatalities with cadaver dumping. Arch Kriminol. 1994;193:1–9.
Händel K. Suizid am Steuer. Lebensversicherungsmedizin. 1982;34:153–4.
Kammal M, Schulz F, Püschel K. Suicidal gunshot to the head while driving a car. Arch Kriminol. 2007;219:124–30.
Lasczkowski G, Röhrich J, Bratzke H. Suicidal excess—presentation of an unusual case. Arch Kriminol. 1998;202:100–8.
Rupp W, Scheithauer R, Pollak S. Ungewöhnliche Selbst- und Fremdtötungen in Kraftfahrzeugen. Unfall Sicherheitsforsch Straßenverkehr. 1993;89:176–9.
Pollak S, Missliwetz J. Suicides in hospitals of Vienna. Z Rechtsmed. 1979;83:233–44.
Schmidt P, Freudenstein P, Bonte W. Suicide in prison and police custody. Rechtsmedizin. 1991;2:16–9.
Grant JR, Southall PE, Fowler DR, Mealey J, Thomas EJ, Kinhock TW. Death in custody: a historical analysis. J Forensic Sci. 2007;52:1177–81.
Vennemann B, Brinkmann B. Death occurring in water. Rechtsmedizin. 2003;13:201–15.
Rothschild MA, Raatschen HJ, Schneider V. Suicide by self-immolation in Berlin from 1990 to 2000. Forensic Sci Int. 2002;124:163–6.
Thierauf A, Strehler M, Schmidt P, Madea B. Suicide by self-immolation. Arch Kriminol. 2007;220:103–14.
Bohnert M, Rothschild MA. Complex suicides by self-incineration. Forensic Sci Int. 2003;131:197–201.
Türk EE, Anders S, Tsokos M. Planned complex suicide. Report of two autopsy cases of suicidal shot injury and subsequent self-immolation. Forensic Sci Int. 2004;139:35–8.
Madea B, Schmidt P, Banaschak S, Schyma C. Homicide by fire. Arch Kriminol. 2001;208:1–9.
Bohnert M, Lehmann R, Simon KH, Wehner F. Reconstruction of a fire homicide after pouring spirit on the victim. Arch Kriminol. 2009;223:185–94.
Pollak S, Saukko P. Atlas of forensic medicine. CD-ROM, Amsterdam: Elsevier; 2003.
Seidl S. Accidental autoerotic death: a review on the lethal paraphiliac syndrome. In: Tsokos M, editor. Forensic pathology reviews, vol. 1. Totowa: Humana Press; 2004. p. 235–62.
Vennemann B, Pollak S. Death by hanging while watching violent pornographic videos on the Internet—suicide or accidental autoerotic death? Int J Legal Med. 2006;120:110–4.
Püschel K, Holtz W, Hildebrand E, Naeve W, Brinkmann B. Hanging: suicide or homicide? Arch Kriminol. 1984;174:141–53.
Maxeiner H, Bockhold B. Homicidal and suicidal ligature strangulation—a comparison of the post-mortem findings. Forensic Sci Int. 2003;137:60–6.
Herbst J, Hoppe B, Haffner HT. Criteria for homicide or suicide in fatalities due to sharp force injury. Rechtsmedizin. 1999;10:14–20.
DiMaio VJM. Gunshot wounds: Practical aspects of firearms, ballistics and forensic techniques. 2nd ed. Boca Raton: CRC Press; 1999. p. 355–77.
Karger B. Penetrating gunshot to the head and lack of immediate incapacitation. Int J Legal Med. 1995;108:53–61, 117–26.
Große Perdekamp M, Faller-Marquardt M, Kleck A, Pollak S. Suicide with multiple graze shots. Arch Kriminol. 2005;216:150–9.
Pollak S. Typology of suicides with more than one gunshot wound. In: Strauch H, Pragst F, editors. Beiträge des Wissenschaftlichen Symposiums Rechtsmedizin/Festschrift für Gunther Geserick anlässlich seines 60. Geburtstages. Heppenheim: Helm; 1999. p. 102–20.
Karger B, Billeb E, Koops E, Brinkmann B. Autopsy features relevant for discrimination between suicidal and homicidal gunshot injuries. Int J Legal Med. 2002;116:273–8.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Große Perdekamp, M., Pollak, S. & Thierauf, A. Medicolegal evaluation of suicidal deaths exemplified by the situation in Germany. Forensic Sci Med Pathol 6, 58–70 (2010). https://doi.org/10.1007/s12024-009-9120-x
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12024-009-9120-x