suicide classification - clues and their use
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Suicide classification-c lues and their use
A study of 1 2 2 case s of suicide and undete
rmined manner of death
P. Lindqvist, L. Gustafsson / Forensic Science International 128 2002 136 14( ) –
Yuthapaisan
The purpose of this study is t o analyse which clues that ap
pear most determinant for fo rensic pathologists in certifyi
ng suicide.
Guidelines to support the pol ice investigation as well as t - he medico legal examination
can probably reduce the num ber of undetermined cases in
cases of possible suicide.
Objective
C lassification of manner of death is important- - - next of kins- insurance issues- research and public h
ealth policies
C lassification i n Sweden-natural- -self intended- intentionally cau
sed by another- accidental or undetermined
Factors of study- age and gender
- previous suicide attempts- mental disorder - -alcohol dependency- suicidal communication - suicide intent- blood (BAC) and urine- alcohol concentr
ations - toxicological
Group of study- autopsied at the Institute ofForensic
Medicine in Umea° from September 1 9 8 3 through De
cember 1 9 8 5
- residing in Va¨sterbottens Coun ty (2 4 5 ,1 8 1 inhabitants in
1984)
- who’s death was certified as sui cide (n = 100) or as undetermined
manner of death (n = 22).
-The term alcohol dependency- the forensic pathologistused the ter
m ‘‘chronic alcoholism’’ in the death certificate.
- the deceased was diagnosed or described as an alcoholic in
medical records and/or police reports.
- hepatic cirrhosis and/or steatosi s was found and no other
explanation than high alcohol co nsumption was at hand.
A ge and gender122 subjects
males
females
sui ci des undetermine
sui cides
undetermine
91 (75%)
31 (25%)
45 yea rs (1 8 –87)
AAA48rs (3163– )
39 year s (1 8 –66)
56 yea ( 4 1 –70)
Blood alcohol test : positive
blood alc ohol test
undetermine
sui ci des
positive
negative
positive
negative
31 (mean 17. g/l; 0range .
3 59– . )
69 16 (mean 2.7 g/l; range
0.3–5.0)
6
100 22
12Cause of death related to manner of death in 2 cases of suicide and undetermined death
Three clues with the highest explanatory value in determining manner of death among 122 cases of suicide and undetermined deaths
a - Cases that deviated from the found decision making pattern of the forensic pathologists.
Greater uniformity, consistency and t ransparency in the classification of su
icide is thus desirable and we support the efforts to construct internationall
y applicable guidelines for certifyingsuicide.
A good teamwork between the police and forensic pathologists is thus of cr
ucial importance not only to reduce th e number of undetermined cases but
also to secure that the subsequent sp ecified classification of manner of dea
th is correct
Validity• autopsied at the Institute ofForensic
Medicine in Umea° from 1983September through Dec
ember 1 9 8 5• the problems of death by poisoni
ng with illegal drugs have increased, especially in urban areas.• the pathologists used an indirectmet
hod in order to understand the classification.
Conclusion
The difficulties in determining m anner ofdeath in possible suicides ar
e linked to certain causes of death, in particular poisoning.
Operational criteria for designati ng a death ‘‘suicide’’ can be helpful g
iven that the quality of the primary d ata collection is good.
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