The chain saw: an uncommon means of committing suicide

A suicide committed with a power saw is an uncommonly reported incident: and the use of a chain saw in particular has been extremely rare. We report two cases of suicide that were committed by using chain saws. In each case the victim had a history of depression or of a prior suicide attempt, and applied the chain saw to his neck to kill himself. We summarize the findings of the two death investigations and the world literature pertaining to suicide committed with power saws.     

Child abuse reporting trends: an unprecedented threat to confidentiality

Some recent interpretations of the child abuse laws are creating serious and unprecedented erosions of therapist/patient confidentiality. In contrast to the Tarasoff decisions and laws, the child abuse statutes introduced a new element of mandatory reporting which permits no discretionary alternatives and presents prospects of criminal penalties for failure to report. A recent development suggests a possible requirement for therapists to violate confidentiality for the sole purpose of punishing perpetrators. Overinterpretations of the laws by some child protective services have led to recommendations that long past child abuse must be reported, even when no current child is in danger. The California Attorney General's Office has issued a clarification stating that the child abuse statute refers to children and not to adults molested as children. A survey of forensic psychiatrists and psychologists shows that most perceived an ethical problem in reporting adults molested as children when no child is presently in danger, and the purpose of the report is solely for maximal legal self-protection. The survey indicates that fears induced by rigid and intimidating child abuse laws can influence therapists to act in ways most consider unethical. Recommendations are made for improving the current child abuse laws so that they accomplish their goals more effectively.     

Planned complex suicide: an unusual case

Abstract:  We report an unusual case of planned complex suicide. The victim was a woman aged 67 years, who was found dead in her bath in a state of advanced putrefaction. A plugged-in hairdryer was submerged in the water and the electrical fuses in the room had short-circuited. A kitchen knife lay below the body of the victim, whose left forearm bore incisions suggestive of wrist-cutting. At autopsy, no sign suggesting electrocution could be observed because of the advanced state of putrefaction of the body. Toxicological analysis revealed massive ingestion of tianeptine (blood concentration 15.5 mg/L). Although the exact cause of death could not be determined because of the state of the corpse, meticulous examination of the scene and information obtained from the victim's relatives led to the conclusion of suicide.     

Deradicalization: not soft,but strategic

The present article considers deradicalization programs. It is observed that deradicalization is primarily a strategic tool, that it was already used in the 1970s, that it can occur spontaneously, and that is should be differentiated from physical disengagement. An evaluation of existing deradicalization programs lead to the propositions that 1) deradicalization programs in the area of right-wing extremism primarily focus on changing behavior not thoughts, that 2) currently there is insufficient insight in what motives people to deradicalize, and 3) that insights from psychology are still insufficiently used to increase effectiveness of deradicalization. Research can make an important contribution to optimize efficiency of deradicalization for counterterrorism purposes.     

Complex suicide: an unusual case with six methods applied

Complex suicides (CSs) are committed by using more than one method. They account for 1.5-5% of all suicides. We present a case of CSs of a 44-year-old man, found dead in the vicinity of his car, in a deserted frozen field. Police investigation excluded homicide, and no medical data confirmed mental illnesses. Autopsy revealed wrist cuts, neck cuts, acid burns in the GI tract, multiple stab wounds to the head by a screwdriver, and several uncertain signs of hypothermia. Toxicology analysis (gas chromatography-mass spectrometry) confirmed ingestion of insecticide. We concluded that stab wounds to the head were the cause of death, while external hemorrhage and hypothermia were contributing factors. This is the first case of CSs reviewed in the literature where six suicide methods were applied. This particular case is interesting because the victim used a screwdriver as a tool for inflicting stab wounds to the head, which is a rare suicidal method.     

State sovereign standing: often overlooked, but not forgotten

Critics of Virginia's challenge to the constitutionality of the Patient Protection and Affordable Care Act have asserted that Virginia lacked standing to even raise the issue. Such criticism is inconsistent with foundational understandings of the role of states in providing a check on federal power and with the modern standing jurisprudence of the Supreme Court, especially as reflected in the Court's decisions regarding a state's sovereign interest in defending its code of laws. This Article demonstrates that, as a matter of constitutional design and history, as well as under relevant precedents, Virginia clearly had and has standing to bring its challenge.     

Depressed but not legally mentally impaired

This article examines the mental impairment (insanity) defense in the Australian state of Victoria and argues that the defense is successful only when offenders suffer from psychotic mental illnesses. This raises the question about how non-psychotic offenders are dealt with by the courts when they claim ‘mental impairment’ for serious acts of violence such as homicide, particularly when a relatively large number of perpetrators involved in homicide suffer from non-psychotic illnesses like depression. The analysis shows that depressive illnesses do not reach the threshold for mental impairment (legal insanity) such that they mitigate violent criminal behavior, although they can, arguably, diminish culpability. This article draws upon existing literature, qualitative analysis of two court cases and semi-structured interviews with four legal representatives to make its conclusions.     

An uncommon delayed sequela after pressure on the neck: an autopsy case report

Delayed sequelae after pressure on the neck are rare. Awareness of such sequelae as well as a high degree of suspicion is essential for early detection and proper clinical management. Injuries to the common carotid artery and pseudo aneurysm formation leading to fatal hemorrhage are still rare occurrences after attempts of manual strangulation. When such cases are presented to the forensic pathologist, he has to establish the link between the cause and effect, excluding other possible causes for such complications. In addition, he may have to give opinions in possible medical negligence charges.     

Plastic bag as the method in suicide and homicide

The report describes a suicide and a homicide by suffocation in a plastic bag. Both cases were copy-cat acts. The suicide copied the method--taking medicines and pulling a plastic bag over his head from a personal model. In the homicide the perpetrator followed the example of a film sequence from the US feature film "Charade".     

Study of an economic issue as a possible indicator of suicide risk: a discussion of stock prices and suicide

There were more than 30,000 suicides in 1998 in Japan, and since then, the numbers have remained high. In 2009, the number of suicides per a day was c. 90. This phenomenon constitutes a major social problem. One of the major reasons for the rapid increase in the number of suicides appears to be the worsening economic problems. It is therefore necessary to research the relationship between economic issues and suicide. In this study, we examined the relationship between the value of the Nikkei Stock Average and suicide rates in Japan. The value of the Nikkei Stock Average may be related to suicide among men. On the basis of the results, relevant researchers and organizations should understand the factors that relate to suicide to better carry out specific suicide prevention measures.     

The psychiatrist's role in retrospective determination of suicide: an uncertain science

Psychiatrists have made significant contributions to our understanding of the phenomenon of suicide and are generally regarded as experts in all matters relating to suicide. When a legal determination must be made as to whether an individual has died as a result of suicide or by accidental (or any other) means, psychiatrists are often called upon to proffer their expert opinion to assist the courts to resolve the matter. Two case illustrations are presented and analyzed in which psychiatrists were called upon to make such retrospective determinations of suicide. The question is raised as to whether psychiatrists may sometimes exceed the limits of their scientific expertise in making such determinations.     

Seen but not heard: Native people in four Canadian inner cities

This essay provides an overview of research on Native people in the inner core of four cities. This research was funded by the Aboriginal Justice Directorate, Department of Justice as part of the Aboriginal Justice Initiative. The objective of the research was to elicit information along a number of dimensions including: background, coming to the city, life in the city, experiences with the criminal justice system, and aspirations for the future. The information was used to compare east/west differences in Aboriginal incarceration levels, to explore urban and rural/reserve offences, and social stratification within the inner-city population. The findings revealed that social stratification exists in the inner-city Native population and that the more marginal the position, the greater the involvement with the criminal justice system. The findings also showed the relationship between childhood and adult experiences. East/west variation in Native incarceration levels can be explained by the findings that more people in the west belonged to the most marginal group in terms of education, employment, skills, and childhood disruption and violence. The findings argue for policy and program attention to be directed to those whose needs are greatest. When ‘broad brush’ solutions are applied, those with the most and least needs are treated equally. This essay is an overview of research contained in a three part volume,Seen but not Heard: Native people in the Inner City. Ottawa: Justice Canada. The views expressed are solely those of the author and do not necessarily reflect the views of Justice Canada or of the people involved in the project.     

Case reports of suicide with an electric drill

In this report, three cases of suicide by an electric power drill are described. In the first case, a man aged 51 was found with four penetrating wounds of the head and chest. The second case involves a 56-year-old man who suffered a penetrating craniocerebral injury and the third case involves a 53-year-old man who suffered one head injury and two chest injuries. In the first two cases, the victims were found dead. In the third case, the victim survived his injuries for 28 hours. The case histories and the post-mortem examinations revealed no evidence of homicide.     

Consumer beliefs and health plan performance: it's not whether you are in an HMO but whether you think you are

Surveys that rate how persons enrolled in HMOs and other types of health coverage feel about their health care are used to bolster claims that HMOs provide inferior quality care, providing justification for patient protection legislation. This research illustrates that the conventional wisdom regarding inferior care in HMOs may color how people assess their health care in surveys, resulting in survey findings biased toward showing HMOs provide inferior care and reinforcing existing stereotypes. Using merged data from the Community Tracking Study Household and Insurance Followback surveys, we identify privately insured persons who correctly and incorrectly know what kind of health plan they are covered by. Nearly a quarter misidentified their type of health coverage. Differences between responses by HMO and non-HMO enrollees to questions covering satisfaction with health care and physician choice, the quality of the last physician's visit, and patient trust in their physician shrink or disappear when we control for beliefs about what type of plan they are covered by. Results suggest that researchers and policy makers should be cautious about using consumer surveys to assess the relative quality of care provided under different types of health insurance.