Death certification of "suicide by cop"

Death certification of "suicide by cop" is controversial among some medical examiners and coroners. We present five such deaths that were certified as suicides and discuss the medico-legal issues involved with these certifications. To certify such a death as a suicide, certain criteria should be met. Suicide by cop is a circumstance that involves competing intentional acts that may result in dichotomous determinations of the manner of death. Despite the absence of direct self-infliction, there is overwhelming evidence that these five individuals intended to end their own lives. Their use of an unusual method to accomplish this goal may inappropriately result in a reflexive certification of homicide. All of the decedents possessed weapons or a facsimile of a weapon. We present five instances of suicide by cop and contend that these types of deaths are best certified as suicides.     

Police officers who commit suicide by cop: a clinical study with analysis

Suicide by cop has become a familiar topic among members of law enforcement, mental health professionals, and the general public. This paper presents two cases where police officers chose to commit suicide by getting other police officers to kill them. The two police officers studied, by examination of closed case files, were found to be similar to civilians who committed suicide by cop on several demographic (gender, age, history of mental illness, and suicide attempts), and situational (stress factors, trigger) variables. The cases help us to understand possible motives and management for individuals who choose to end their life in this manner.     

Attempted suicide by cop: a case study of traumatic brain injury and the insanity defense

Over the years, there have been a number of well-publicized incidents involving persons who seemingly maneuver police officers into shooting them. Such cases, while relatively rare compared with most forms of violence, nevertheless pose difficult challenges to law enforcement agencies. Relatively little is known about persons who engage in suicide by cop incidents. To our knowledge, there has been no published indepth research on instigators of suicide by cop who survived. In this paper, we present a case study of an individual who engaged in and lived through three separate "attempted suicide by cop" incidents. After describing relevant history as well as events of the most recent incident, we compare the case with the extant literature on suicide by cop and analyze commonalities and differences. Finally, we examine the legal considerations involved, with particular attention devoted to the role the individual's traumatic brain injury played in applying the insanity defense.     

History "lite" in modern American bioethics

This article explores a disconcerting phenomenon. In recent years, in writing on the subject of assisted suicide, several bioethicists have made extraordinary historical claims. The history of Western moral theories that exhibit disapproval of all forms of suicide is well known. Nevertheless, the bioethicists have claimed that some of Europe's most prominent early modern moral philosophers never believed in the inalienable right to life. This claim is quite controversial because this right is an important basis for secular moral opposition to assisted suicide. Irrespective of whether or not opposition to assisted suicide is philosophically justified, the philosophers the bioethicists write about did in fact believe in the inalienable right to life. Bioethicists can only come to their conclusions concerning the philosophers by employing an improper historical methodology.     

Suicide by Cop Among Officer-Involved Shooting Cases

Abstract: The frequency and characteristics of suicide by cop cases (SBC) among a large (n = 707) nonrandom sample of North American officer-involved shootings (OIS) were investigated. “Suicide by cop” is when a subject engages in behavior which poses an apparent risk of serious injury or death, with the intent to precipitate the use of deadly force by law enforcement against the subject. Thirty-six percent of the OIS in this sample were found to be SBC with high interrater agreement (intraclass correlation coefficient = 0.93) for category classification. SBC cases were more likely to result in the death or injury of the subjects than regular OIS cases. Most SBC cases were spontaneous, but had clear verbal and behavioral indicators that occurred prior to, and during the event. Findings confirm the trend detected in earlier research that there was a growing incidence of SBC among OIS. SBC individuals had a high likelihood of possessing a weapon (80%), which was a firearm 60% of the time. Half of those with a firearm discharged it at the police during the encounter. Nineteen percent simulated weapon possession to accomplish their suicidal intent. Other findings highlight the histories and commonalities in this high risk group.     

More history "lite" in modern American bioethics

This article revisits a disconcerting phenomenon. The history of prominent 17th and 18th century moral theorists who exhibited disapproval of all forms of suicide is well known. Nevertheless, there are many bioethicists who continue to claim that either these moral theorists never actually opposed suicide, or that they never believed in the inalienable right to life and liberty that is an important basis for secular moral opposition to assisted suicide. These erroneous claims evince an improper historical methodology. They originate from the bioethicists' inaccurate quotation of the moral theorists and also from the bioethicists' unwillingness to understand the moral theorists in their relevant historical context. The author concludes that this attempt to obfuscate the true history of 17th and 18th century moral theory may also be removing a line of inquiry from originalist constitutional analysis that Federal Courts have a duty to engage in.     

"Insanity" in civil law

The issue of "insanity" is rarely alluded to in the area of civil law. As a consequence, the legal standard for insanity is not clearly understood by many psychiatrists. The standard derives from case law and is based upon statutory law in the criminal sector. A civil case will be presented where the question of "insanity" was raised. In this case an individual committed suicide and his insurance company refused to pay the beneficiaries of his life insurance policy based upon a provision in his policy that excluded payment in situations of suicide. His beneficiaries sued, claiming that the deceased was insane at the time of his suicide and therefore not responsible for his actions. The standard for insanity in New Jersey and the reasoning of the psychiatrists will be presented.     

Judicial Murder‐Suicides in Van Diemen's Land

On the morning of December 17, 1827, nine convicts were executed by public hanging in Hobart Town, the capital of the British colony of Van Diemen's Land (now the Australian state of Tasmania). Two months previously they had drowned senior Constable George Rex on Small Island, which was part of the penal settlement at Macquarie Harbor, in front of five bound and gagged witnesses. They offered no defence at their trial. Examination of the Tasmanian colonial convict records shows that “suicide by lottery” involved convicts choosing two men, one to die and the other to kill him. The witnesses would earn a respite when taken away for the trial, and the murderer would be executed. “Death by gallows” could be considered a nineteenth‐century version of an orchestrated suicide reminiscent of more modern “death by cop.” This category of “judicial” murder‐suicide expands the range of contemporary classifications of dyadic deaths.     

Prison structure, inmate mortality and suicide risk in Europe

Suicide presents a major complication during imprisonment and greatly contributes to the high mortality rate of prisoners. All international studies have found increased suicide rates among prisoners compared to the general population. This study examines risk factors for suicide and mortality in prisoners using supranational data from the Council of Europe Annual Penal Statistics (Statistiques Penales Annuelles du Conseil du L'Europe or SPACE) from 1997 to 2008. Macrostructural risk factors for prison suicide are analyzed from this supranational data set and the identified indicators are further evaluated on the single country level. Sexual offenders, offenders charged with violent crimes and prisoners sentenced for short- and long-term imprisonment are considered to be at an elevated risk for suicide. In addition, prison mortality is associated with overcrowding.     

Patent Related Indicators for Assessing Knowledge-Generating Institutions: Towards a Contextualised Approach

This contribution aims at examining the extent to which patent related indicators are relevant for shedding light on the notion of excellence within knowledge-generating institutions. Traditionally, excellence has been looked upon as the ability to create interesting and valuable new scientific concepts, theories and data. From such a perspective, scientific excellence can be assessed through scientometric measures of publication output and impact. The recent interest in the entrepreneurial phenomenon within knowledge-generating institutes justifies efforts to examine the relevancy of broadening the set of indicators used to assess such institutions into the direction of entrepreneurial excellence. In this paper we will examine the relevancy of using patent data in order to delineate such additional, more entrepreneurial oriented, indicators. The arguments and findings presented in this respect will lead us to a plea for the use of these indicators in a contextualized manner.     

"Legal highs"-Toxicity in the clinical and medico-legal aspect as exemplified by suicide with bk-MBDB administration

The easily available "legal highs", which are products containing psychoactive substances, such as cathinones, piperazines and synthetic cannabinoids, are abused by adolescents in Poland and in the world as alternatives to classic drugs, such as amphetamines or marijuana. The majority of these potentially dangerous substances are still legal and they are associated with a risk of severe poisoning or even death, and provide new challenges in clinical and forensic toxicological practice. Investigations in the field of "designer drugs" may be well illustrated by the case of a suicide of a 21-year old male who ingested a specified dose of a preparation called "Amphi-bi-a" that contains bk-MBDB, chemically 2-methylamino-1-(3,4-methylenedioxyphenyl) butan-1-one, which belongs to the cathinone group, as a synthetic euphoric empathogen and psychoactive stimulant that is chemically similar to MDMA. It is one of more common components of "legal highs" examined in Poland and other countries. The documentation of the case includes a clinical assessment of the patient's health status performed during his almost 4-h hospitalization before death, autopsy and histological examinations supported by toxicological findings revealing bk-MBDB at extremely high concentrations (at 20mg/l in the blood and 33mg/kg in the liver); hence, this body of evidence contributes to knowledge in the field of "designer drugs". Inventions of designers of new psychoactive xenobiotics, which are much in demand, especially in view of the dynamic Internet marketing, which drums up narcobusiness, must be balanced by a national strategy developed by medical, legal and educational circles in the modern civilized world in order to prevent the spreading of the phenomenon.     

The descriptive epidemiology of unnatural deaths in Oregon's state institutions: a 25-year (1963-1987) study. I. A preliminary analysis of recent incidence rates of suicide in mental and correctional facilities

This paper presents for the first time the annual suicide incidence rates of residents from four Oregon state institutions for a 5-year (1983-1987) period of time. The suicide rate for inmate-patients of the Forensic Psychiatric Program (for the care and treatment of individuals who have been found guilty of serious crime and to be mentally ill) is 820/100,000. This represents a suicide rate 51 times higher than the rate for Marion County or the state of Oregon. This is also one of the highest annual suicide rates ever reported. The suicide rate for patients of the Oregon State Hospital is 289/100,000, which is similar to other reported suicide rates in hospitalized mentally ill populations. This rate is approximately 18 times higher than the rate for Marion County or the state of Oregon. The suicide rate for inmates of Oregon's four correctional institutions is approximately 29/100,000, which is similar to other reported rates for prisoners. This rate is approximately 1.8 times higher than the rate for Marion County or the state of Oregon. The suicide rate for residents of the Fairview Training Center (for care of the mentally retarded and developmentally disabled) is zero.     

"Magical thinking," suicide, and malpractice litigation

Prospective clinical assessment of suicidality differs significantly from that used retrospectively in malpractice litigation. In the latter context, the judge or jury may be susceptible to hindsight reasoning and a disproportionate emphasis on the specific method of suicide, exaggerating its foreseeability and "magically" linking the means of death to the treating clinician, especially in the case of suicide by an overdose of prescribed medication. Such magical thinking, moreover, is rooted in the clinical context of suicide: The errors of reasoning observed in the courtroom exhibit striking parallels with the mind-set of the suicidal patient. An understanding of these dynamics suggests appropriate precautions for the clinician and thus contributes to the prevention both of suicide and of malpractice litigation.     

Change is the Only Constant: The Evolving Role of Women in the Islamic State in Iraq and Syria (ISIS)

In the past, women in the Islamic State in Iraq and Syria (ISIS) were known to serve as homemakers (i.e., wives, mothers). However, in recent times there has been a shift in their roles, as more women are starting to emerge on the front lines as suicide bombers, recruiters, or a part of ISIS's official women police brigade. This article investigates this phenomenon by performing a thematic analysis on open-source material, namely research reports, media reports, and propaganda material produced by ISIS. In doing so, it presents the evolution of the roles of women in ISIS from past to present and highlights key reasons that motivate women to join ISIS, which include ideology, alienation, romance, peer influence, and a sense of security. Implications for research on women in terrorism have also been identified.     

Frontloading Mitigation: The "Legal" and the "Human" in Death Penalty Defense

The bifurcation of capital trials into determinations of guilt and sentencing presents defense advocates with what seem to be two distinct domains of knowledge—one apparently "legal" in character, the other "human." But this epistemological division is actually not so clear in practice. This article dissects the procedural and strategic mechanisms through which these two domains unsettle and reconstitute the other. I provide a historical, empirically grounded account that explicitly articulates the connections between developments in legal procedure, prevailing standards of care concerning the need to conduct humanistic investigations of mitigating factors, and the on-the-ground trial practice of "frontloading" as a defense strategy. Drawing from documentary research, interview data with leading capital defense practitioners, and analytical observations based on my own experience as a mitigation specialist, this article presents itself as a case study of the processes of mutually constitutive rupturing that reconfigure the categories of the legal and the human.     

Asphyxial suicide with helium and a plastic bag

Suicide by helium inhalation inside a plastic bag has recently been publicized by right-to-die proponents in "how to" print and videotape materials. This article reports a suicide performed according to this new and highly lethal technique, which is also a potentially undetectable cause of death. Toxicology information could not determine helium inhalation, and drug screening did not reveal data of significance. The cause of death could be determined only by the physical evidence at the scene of death. Helium inhalation can easily be concealed when interested parties remove or alter evidence. To ensure that their deaths are not documented as suicide, some individuals considering assisted suicide may choose helium methods and assistance from helpers. Recent challenges to Oregon's physician-assisted suicide law may increase interest in helium instead of barbiturates for assisted suicide.     

Exploring the Impact of Child Sex Offender Suicide

This paper explores the issues and widespread impact surrounding child sex offenders (CSO) who commit suicide after learning they are under criminal investigation. This phenomenon, which has received scant attention in the literature, affects family, friends, and victims of offenders who may experience a range of conflicting emotions including anger, guilt, confusion, betrayal, and loss. Involved law enforcement may, likewise, experience a range of complex reactions. Law enforcement personnel are neither trained nor required to assess offenders’ suicidality. However, awareness of how CSOs are impacted by an investigation may mitigate the risk of suicide and enhance operational strategies, including officer safety.     

Suicide disguised as murder: a dimension of Munchausen syndrome

This case study reports on a suicide made to look like murder. The case highlights the issue of false claims of criminal victimization and suggests the need for a reexamination of the dynamics of factitious allegations of criminal victimization. Factitious complaints of mental or physical illness are typically self-reported to psychiatric or medical authorities. This paper illustrates a different kind of phenomenon: one in which an injury or disorder is brought to medical attention by way of the police, who report the death or injury as arising from criminal victimization.     

Suicide by fire in a car trunk: a case with potential pitfalls

We present an unusual case in which an adult female committed suicide by fire while enclosed in the trunk of her vehicle. A finding of suicide was reached only because several key investigative facts were uncovered. Without these discoveries the case may still remain open as a suspicious death. Fire is rarely used as a mechanism of suicide in Western culture, and, as such, similar cases should be reported to advance our recognition of this phenomenon.