Medicolegal aspects of witnessed suicide due to gunshot to the head. Part 1: Circumstances and psychopathology

In the USA the frequency of witnessed suicide, i.e. suicide committed in the presence of at least one further individual, is reported to range between 5 and 15%. As up to now no detailed analysis of this special issue has been given in the medicolegal literature, this article presents and discusses a number of cases including 8 males and 1 female (age 19-58 years, mean 41.2 years) who had all committed suicide by inflicting a gunshot to the head. In 3 cases post-mortem blood alcohol concentrations of 1.73, 1.88 and 2.23 g/kg respectively were observed. Toxicological tests produced negative results. 5 cases had a medical history of psychiatric disorder with endogenous depression in 3, chronic alcohol abuse and drug abuse with concomitant psychosis in one case each. As far as the motives were known, domestic arguments were of prevailing importance. With one exception the suicides were committed at home. In 6 cases one witness was present, in 2 cases 2 individuals and in one case 22 persons witnessed the suicide. The reported cases are discussed in comparison with the psychiatric-psychological classification according to McDowell et al. with the aim to provide a solid and comprehensive medicolegal method to distinguish between homicide and suicide. Furthermore aspects of psychiatric sequelae and psychological support of the witnesses, which are also of importance for the forensic pathologist called to the scene, are discussed.     

Psychological factors in the determination of suicide in self-inflicted gunshot head wounds

Self-inflicted contact gunshot wounds to the head have usually been considered presumptive of suicide. This study evaluates whether sufficient psychological data are gathered in such cases to support a manner of death determination of suicide. We suggest that law enforcement agencies and coroner's departments do not fully explore the decedent's state of mind at the time of death. We studied the first 50 consecutive deaths in 1993 in a major metropolitan county due to self-inflicted gunshot wounds to the head. The sample consists primarily of unmarried, white males, with a median age of 35 years, who displayed psychiatric disturbance, primarily depression, before their death. Younger individuals were often under the influence of alcohol and/or drugs at the time of death. Stressors, such as the loss of a loved one, are common among young and middle-aged persons, while serious health problems are found among the majority of middle-aged and elderly individuals. Many of the findings of this study are consistent with the literature regarding individuals who commit suicide. Although data on many important psychological risk factors are missing in most cases, sufficient psychological material is gathered about the decedent's mental condition at the time of death to support a suicide determination.     

Characteristics of firearms and gunshot wounds as markers of suicide.

Data from a total of 1,200 cases that the Medical Examiner of Dallas County, Texas, ruled as suicide with a firearm have been compared with the results of forensic laboratory examinations and tests; 75% are with handguns and 25% are with long guns. The incidence of suicides by gender yields 82% males and 18% females, with the most common entrance site being the head. With regard to racial distribution of persons committing suicide, > 88% are white in the study population group, which is 76% white. Data are presented for the incidence of blood detected inside and on the muzzle end of the barrel of the firearm, and for the persistence of blood inside the barrel even after the weapon was discharged to obtain test bullets. The analysis of handwipings for primer residues shows that "positive" results are obtained for approximately 50% of the revolvers and approximately 32% of the pistols when the caliber is > 22. Other projects such as transfer of gunshot residues to the hand by simply handling the weapon, the incidence of single-contact wounds in homicide versus suicide cases, and the percent of positive identification of bullets with weapons submitted are described.     

Planned complex suicide by self-poisoning and a manipulated blank revolver: remarkable findings due to multiple gunshot wounds and self-made wooden projectiles

A remarkable case of complex suicide with poisoning and multiple self-inflicted gunshot wounds to the head is reported. After ingestion of a liquid insecticide, the victim shot himself twice in the head, once in each temple. Self-manufactured wooden dowels were used as projectiles in combination with conventional blank cartridges. The dowels had been glued on top of the blank cartridges and expelled by propellant gases. Moreover, the blank revolver used had been extensively manipulated in a rarely observed manner. Several occlusive devices had been removed from the barrel and the cylinder chamber to enable the expulsion of the wooden projectiles. The investigation of the methods used and the circumstances found at the scene pointed towards a planned complex suicide. A remarkable case with unusual projectiles, i.e., wooden dowels, fired by an extensively manipulated blank gun is reported, emphasizing the importance of close collaboration between the police firearm laboratory and forensic pathology in practical casework.     

Comparison of the battles at the Little Bighorn and at Isandhlwana. Medicolegal and forensic aspects.

Compared are two great and remarkably similar battles that occurred less than 3 years apart: the U.S. Cavalry versus the Plains Indians in the battle at the Little Bighorn in Montana Territory of the United States, and the British-Zulu battle at Isandhlwana in the Natal Province of South Africa. Computer evaluation, which was especially helpful in evaluating artifacts at the Montana site, could be an excellent tool to use in other such large-scale investigations.     

Suicidal contact gunshot wounds to the head with .38 Special Glaser Safety Slug ammunition

Glaser Safety Slug TM ammunition is a uniquely designed, essentially prefragmented ammunition. Tests performed by the U.S. Justice Department demonstrated that the ammunition possesses high kinetic energy, high relative incapacitation index (RII) and poses a very low risk to bystanders because of its total loss of kinetic energy in the target. Despite having been manufactured since 1974, no deaths from this ammunition have been previously reported. The authors herein describe the first three reported human deaths.     

Suicidal gunshot wounds to the head: a retrospective review of 406 cases

A retrospective review of 406 suicidal gunshot wounds to the head, investigated at the Medico-Legal Laboratory of Pretoria, between 1997 and 2000 was performed. Fifty-seven percent of fatal suicidal firearm injury to the head occurred in the 21- to 40-year age range in both male and female victims. Eighty-two percent of all these victims of suicidal firearm fatalities to the head were male. Of the 406 cases, 63% were white, 31% were black, and 6% were of mixed ethnic and/or Asian decent. There was a slight increase in incidence around spring and autumn. Handguns were used in the majority of cases with shoulder weapons being used in 18 of the 406 cases. Ninety-two percent of the suicidal gunshot wounds to the head occurred indoors. A positive blood alcohol concentration was seen in 40% of cases. Of those examined, 81% were contact gunshot wounds. The trajectory was upward in 51% of cases and horizontal in 24% of cases. The right temple was the most common entrance gunshot wound site. Findings are in keeping with previously published literature.     

Criteria for homicide and suicide on victims of extended suicide due to sharp force injury

This report is about the findings in association with the extended suicides of nine victims killed by sharp force. All victims were killed by sharp force. The perpetrators were predominantly the parents, the victims their children. Regarding the criteria for differentiating self-inflicted injuries from injuries inflicted by another person, the victims' injuries presented patterns usually found solely in suicides. Thus eight of nine cases presented tentative and hesitation injuries, in three of five cases areas of injury covered by clothing had been exposed beforehand. Despite extremely narrow intercostal spaces in children, injuries to the bones in thoracic stabbing were avoided more often than not (four of seven cases). Only the criterion "defence injury" occurred nearly as often as in homicide victims (three of nine cases). The psychopathology of extended suicide can explain this pattern. The perpetrator's motive is characterised by his pseudoaltruistic belief to save the loved ones from a world that is in his opinion unacceptable. A fusion or integration of the victim into the perpetrator's own self is based on an identity problem. Physical interrelation of forces between perpetrator and victim restricts the victim in his defence and presents an important prerequisite for acquiring the patterns of described injuries.     

Multiple self-inflicted gunshot wounds to the head: report of a case and review of the literature

Multiple self-inflicted gunshot wounds to the head are rare and usually present a challenge to the pathologist and to the police in determining the manner of death. We report a case of two suicidal gunshot wounds to the head. The literature is reviewed, and the pertinent findings, including location of the wounds, location of the brain injuries, types of weapons used, and criteria important to determine the manner of death, are discussed.     

Suicide by double bolt gunshot wound to the head: case report and review of the literature

Suicidal gunshot wounds from a livestock stunner with infliction of two shots against the head are extremely rare events. A case with these characteristics is presented and the corresponding literature is reviewed. A 61-year-old butcher was found dead with two entry wounds of the forehead on the right side and in the centre being typical for captive bolt pistols (symmetrically localized powder burns). The issues of the sequence of shots and the capacity of action are discussed on the basis of morphological findings and pathophysiological considerations. A literature review revealed only 4 case reports with double gunshot wounds of the skull caused by "humane killers" (Tovo 1956, Wolff and Laufer 1965, Schiermeyer 1973, Pollak 1977).     

Backspatter on the firearm and hand in experimental close-range gunshots to the head

The deposition of backspatter on the firearm or person shooting can greatly assist the reconstruction of shooting incidents. Backspatter was investigated in experimental transverse gunshots (9-mm Luger) to the heads of calves (n = 9) from shooting distances of 0 to 10 cm. The firearms were examined with a magnifying glass; the surgical gloves and the right sleeve worn by the person shooting were examined with a stereomicroscope. On the firearms, backspatter of blood was found in five of the nine cases, and one or both gloves showed bloodspatter deposits in six and the right sleeves in four cases. Most droplets were 1 to 3 mm and circular or elongated. In addition, a fine spray of tiny blood deposits was present on the firearm and textiles in four cases. The distribution of the droplets on the firearms varied: the areas included regions shielded by prominent parts, and the droplets were predominantly located on the extensor side of the fingers and the radial aspect of the hands and sleeves. Backspatter of tiny bone fragments was recovered from the firearm and sleeve in only one case, but tissue (bone, fat, muscle, skin) was present on the ground in front of the entrance wound in seven cases. A careful investigation, including appropriate lightning and magnification, is necessary for reliable statements concerning the absence of backspatter or the extent of backspatter present.     

病毒性心肌炎猝死心肌MCP-1表达及其法医学意义

目的探讨单核细胞趋化蛋白1（monocyte chemoattractant protein-1,MCP-1）在病毒性心肌炎（viral myocarditis,VMC）所致猝死者心肌组织中的表达及其意义。方法运用改良的免疫组织化学方法,观察VMC猝死组和对照组心肌组织中MCP-1的表达情况,应用统计学处理,比较两组间的表达差异。结果20例VMC猝死组中有17例MCP-1染色阳性;而20例非VMC猝死对照组仅4例局部散在MCP-1弱阳性表达,其余均阴性。VMC组MCP-1阳性表达率明显高于对照组（P〈0.01）。结论MCP-1的免疫组织化学检测可作为法医病理学诊断VMC所致猝死较为客观的病理形态学指标之一。     

根据创口射击残留物推断“5.4”式手枪射击距离的研究

目的利用环境控制扫描电镜/能谱仪（SEM/EDX）研究枪弹创射入口周围射击残留物与射击距离的关系,探讨其能否用于射击距离的判断。方法采用＂＂5.4＂＂式手枪分别在5、10、15、20、30、40、50、60、70、80、90、120cm处射击乳猪皮肤,利用SEM/EDX观察创口周围GSR的分布和成分,并建立回归方程。结果射击距离和GSR颗粒数量之间总体表现为直线关系,并建立了相应的回归方程。当射击距离为10~90cm时,用该方程推断射击距离效果较好。结论检测创口周围GSR可望用于判断“5.4”式手枪的射击距离。     

Early post-mortem animal bites after suicidal gunshot wound to the head of a police dog handler]

A 41-year-old police officer committed suicide in his office by firing a contact shot to the left temple. When the body was found 12 hours later, the German shepherd dog the officer had been in charge of had caused considerable damage on the lower half of the face and the adjacent parts of the neck. The clothing of the suicide was undamaged. Blood traces in the shape of paws were found at the place of death. The wound margins of the postmortem animal injury were nicked and jagged by the canine teeth. The entrance and exit wounds were not affected by the soft tissue defect. The findings gathered are discussed in reference to the relevant literature.     

The application of anodic stripping voltammetry to forensic science. II. Anodic stripping voltammetric analysis of gunshot residues

Non-destructive analysis of gunshot residues on hands was studied by anodic stripping voltammetry using a low-cost home-constructed polarograph. The washing solution was 0.5 M HCl. Antimony was first analyzed in 4 M HCl solution; and zinc, lead and copper were then simultaneously analyzed in 0.2 M acetate buffer (pH 5.9 ± 0.1).     

论不能犯与不能犯未遂问题

大陆法系国家刑法理论中关于不能犯的学说异常复杂,存在主观说和客观说的基本对立。进而基于对危险的判断基准的理解不同,又有"纯粹主观说"、"抽象危险说"、"具体危险说"、"客观危险说"等的论争。承认能犯未遂与不能犯未遂的分类具有合理性,区分二者对于刑事司法实践中正确量刑具有一定的意义。对于不能犯未遂的种类及其称谓,宜采纳"工具不能犯"与"对象不能犯"的观点。不能犯未遂的成立范围应当按照具体危险说的标准来确定。不能犯未遂负刑事责任的根据,在于其具备了主观罪过和客观犯罪行为这两个犯罪构成中最基本的要素,并且进而决定了其具有相当严重程度的社会危害性。迷信犯与不能犯之不同,在于其缺乏犯罪行为。     

Complex suicide by two gunshots to the chest and consecutive hanging: circumstances and aspects of reconstruction

In cases of suicidal gunshots, the capacity to act may be preserved for a certain period of time, so that the suicide may be completed with another method. In the presented case a 74-year-old man was found hanged on the first floor of his house with two gunshot wounds in the chest. Both on the ground and the upper floor traces of suicidal acts were detected. As shots to the precordial region suggest rapid incapacitation, a suicide extending over two floors seemed almost impossible without knowledge of the cause of death and evaluation of the ability to act. The autopsy findings confirmed vital signs of hanging. Moreover, a through-and-through gunshot wound of the chest and abdomen affecting the spleen and a shot lodged in the body without injuring the lung were found. The injury findings thus sufficiently explained the preserved ability to act. The presented case shows characteristics of a complex suicide not yet described so far, but could be clearly classified as suicide in congruity with the pertinent literature.     

Fatal thrombosis of the basilar artery due to a minor head injury

A case is reported where a 20-year-old alcohol-intoxicated man was admitted to the hospital after a minor head injury. Initially there was no neurologic disturbances or complaints but after a few hours he became comatose, and he died 4 days later without regaining consciousness. The autopsy revealed no lesions of the upper cervical spine or the vertebral arteries, but the basilar artery was occluded in its entire length. No traumatic lesions could be seen by naked eye examination of the artery, and there was no accompanying subarachnoid haemorrhage. A thorough microscopic examination, however, using step-sectioning technique revealed a significant incomplete arterial rupture with an occluding luminal thrombosis superimposed, consisting predominantly of aggregated platelets. Only the very thin adventitia separated the vascular lumen from the subarachnoid space preventing the more well known fatal complication to a minor head injury: A subarachnoid haemorrhage. To the best of our knowledge, fatal thrombosis of the basilar artery due to a minor head injury has not previously been reported. The pathogenetic mechanism seems to be identical to that underlying fatal subarachnoid haemorrhage following a similar trauma apart from the resulting arterial rupture being incomplete instead of complete.     

Student tragedy. Forensic-psychiatric and legal medicine aspects of an unusual crime

The unusual circumstances of the violent killing of an 18-year-old girl by her 18.8-years-old schoolfriend led us to undertake a forensic-psychiatric analysis of the offence action as well as a presentation of legal-medical points of view. The crime, which can be classified as a collective lover crime for which there is no parallel in the literature, was only solved 9 months later when one of the two delinquents confessed a further offence. The killing was planned and prepared, the victim being buried hurriedly in a previously made hole in a wood after she had been strangled.