Wrapped to death. Unusual autoerotic death

Despite the large population of New Orleans, including many homosexual and transsexuals, there have been relatively few cases of autoerotic deaths. The case reported here is an interesting one as it includes a bizarre form of autoerotic behavior from the standpoint of the method used. There have been no deaths reported in the literature in which the victim died as a result of jeopardizing himself by enclosing his body into plastic with an airway out of his "cocoon" in the form of a snorkel tube. He was engaged in masturbation when he apparently lost his mouth piece or airway. He attempted to use a knife to cut himself out.     

Cocaine-related death

Cocaine use and abuse, an ancient custom, is once again commonplace. While severe toxicity appears to be rare, overt poisoning including death can occur. This report documents nine cases of death associated with cocaine use; in three of these cocaine appears to be causative. Toxicologic analysis of body fluids and tissues was affirmative and levels are reported. Cocaine should be considered in serious drug overdose-reactions, especially after illicit injection.     

Examining death qualification

The biasing effects of the death-qualification process are structured into the very nature of the procedure, and may be intensified by variations in the manner in which the process is actually conducted. This article illustrates the process as it unfolds in court, discusses the manner in which its basic features can be exacerbated, and analyzes some of the nonobvious consequences of the process for the participants. It also discusses the treatment afforded some analogous “process effects” in law, and evaluates several proposed remedies to the biasing effects of death qualification.     

Autonomy and death

In this Article, Professor Clark explores the contours of the current debate over physician-assisted death. She beings by focusing on the legal issues raised by statutory attempts to either legalize or criminalize physician-assisted death, with particular emphasis on the constitutional questions that are currently before the United States Supreme Court. She then examines physician-assisted death from both medical and societal perspectives. Professor Clark uses a thought experiment in which assisted death is facilitated by persons other than physicians, and in doing so, questions whether physicians are the proper persons in whom to rest power over assisted death. She points out the irony in a process that would set up physicians as protectors of individual autonomy, and ultimately concludes that by deferring to the medical profession in this process, we risk losing the very autonomy that assisted death is designed to effectuate.     

Variability in cancer death certificate accuracy by characteristics of death certifiers

Death certificates are the source for mortality statistics and are used to set public health goals. Accurate death certificates are vital in tracking outcomes of cancer. Deaths may be certified by physicians or other medical professionals, coroners, or medical examiners. Idaho is one of 3 states that participated in a Centers for Disease Control and Prevention-funded study to assess the concordance between cancer-specific causes of death and primary cancer site among linked cancer registry/death certificate data. We investigated variability in the accuracy of cancer death certificates by characteristics of death certifiers, including certifier type (physician vs coroner), physician specialty, years of experience as death certifier, and number of deaths certified. This study showed significant differences by certifier type/physician specialty in the accuracy of cancer mortality measured by death certificates. Nonphysician coroners had lower accuracy rates compared with physicians. Although nonphysician coroners certified less than 5% of cancer deaths in Idaho, they were significantly less likely to match the primary site from the cancer registry. Results from this study may be useful in the future training of death certifiers to improve the accuracy of death certificates and cancer mortality statistics.     

Nonnatural death masquerading as SIDS (sudden infant death syndrome)

This article relates our experiences with accidental and homicidal deaths in reported sudden infant death syndrome (SIDS) cases. Our intent is to alert personnel in medical and health-related professions as well as death investigators (coroners, law enforcement officials, etc.) that a thorough scene investigation and history need to be obtained when a child's death has been reported, since this may modify the type of autopsy to be performed. It should not be assumed that all children less than 1 year of age who die suddenly die from SIDS.     

Use of rectal temperature-time of death nomograms at the scene of death

The application of the rectal temperature time of death nomogram at the scene of death by 11 authors from 6 lego-medical institutes resulted in a standard deviation of the differences between nomographic and real death time of +/- 1.3 h in 46 cases (group I) with met requirements and clearly defined points of contact, nevertheless, including 9 cases with a more progressive cooling (0.5 greater than Q greater than or equal to 0.2). In cases with a real death time of more than 4h (N = 26) the standard deviation was +/- 1.0 hours corresponding to permissible variation of 95% of +/- 2.0 hours. Consequently, the permissible variation of 95% was much smaller than that suggested by the nomogram. The nomographic death time interval did not agree with the real one in 5 cases out of additional 30 cases with recognizably unsure points of contact (group II).