Are there environmental factors influencing the choice of death by drowning as a means of suicide in the Geneva canton?

123 out of 850 suicides that occurred in the Canton of Geneva between 1980 and 1989 were suicides by submersion. 75 women and 48 men committed this kind of suicide. 89 victims (57 women and 32 men) were older than 40 years. In all cases the spatial distance between the residence of the suicides and the nearest river or lake was determined; a correlation with the tendency to commit suicide by drowning was not evident. More than geographical factors, the psychological influences have to be considered.     

Suicides by fall from height in Geneva,Switzerland, from 1991 to 2000

Suicides due to fall from height in Geneva from 1991 to 2000 were reviewed. Scene investigations, autopsy findings, psychiatric histories, and toxicology results were examined. There were 197 of these suicides, an incidence of five cases per 100,000 inhabitants per year or one fourth of all suicides in Geneva per year. Autopsies were performed on 33%, the rest had external examinations. Of the victims, 56% were female and 44% were male. The age distribution peaked at 20-29 years in men and 60-69 years in women. Most of the victims jumped from their home, the range of 2 to 7 stories being the most frequent height. Major injury sites, in decreasing frequency, were the thorax, abdomen, skull, vertebrae, pelvis and limbs. Psychiatric illness was reported in 38% of the cases. Toxicological analysis was performed in 25% of the cases and showed that the main drugs present were benzodiazepines, cannabis and antidepressant.     

Defined contusion marks caused by the knife handle]

If in inflicting a stab wound the knife is vigorously pushed in up to the end of the blade, this does not only cause cutting of the tissue, but also a blunt traumatization. The resulting abrasions can correspond with the respective construction parts (handle, handguard, devices for fixing the open blade) as to position, shape and size, thus allowing conclusions as to the shape of the instrument used. Incomplete, one-sided marks of the handle suggest an oblique-angled stab. The presence of a contusion mark shows that the blade penetrated completely, which makes it easier to draw conclusions as to the length of the blade from the depth of penetration. The reconstruction possibilities are demonstrated on the basis of three autopsies (homicide cases with different types of knives).     

Sudden, unexpected death due to undiagnosed frontal glioblastoma in a schizophrenic patient

The incidence of sudden death due to undiagnosed primary intracranial tumor is low in forensic autopsy. We report a case of a 48-year-old white male, known to be a schizophrenic patient for several years, and in whom a medico-legal autopsy disclosed a large, previously undiagnosed, bilateral frontal glioblastoma infiltrating the genu of corpus callosum. We emphasize the importance of performing complete autopsy, including a thorough neuropathological examination, in all cases of sudden unexpected death, especially in those cases in which no extracerebral cause of death had been established and whose clinical history was primarily of a psychiatric nature.     

Suicides in the young people of Geneva, Switzerland, from 1993 to 2002

Suicides in Geneva in those less than 25 years old, from 1993 to 2002, were reviewed. Scenes investigations, autopsy findings, toxicology results, and psychiatric history (when available) were examined. There were 65 cases. The average annual suicide rate was 11/100,000. Seventy-seven percent were male, and 23% were female. The youngest was 12 years old and most of the victims were 18 years old and over (89%). For men, the use of firearms was the most common method (38%), followed by fall from height (16%) and drowning (10%). For women, fall from height was the most frequent (40%), followed by firearms and medication overdoses (20% each), hanging (13%), and drowning (7%). Toxicological analysis was performed in 41% of the cases and showed that alcohol was present in 26% and other drugs in 67% of these cases. The most common drugs present were benzodiazepines, cannabis, and cocaine.     

Sexual assaults in Geneva between 2006 and 2010

In Geneva, all sexual assault victims are examined both by a gynaecologist and a forensic pathologist with special training in clinical forensic medicine. Between 2006 and 2010, 473 victims were examined following such an assault. Over the years, the number of sexual assaults rose steadily. Most victims were aged between 15 and 30 years. The majority of the assaults occurred at night and on the weekend and often happened at the place where the perpetrator or the victim lived. Usually, the offender acted alone and was known to the victim. Many victims hesitate to present for an examination, which makes it difficult to collect evidence. Penetration was usually vaginal and without the use of a condom. Injuries on the body or genitals were seen in only half of the cases for the first ones and in less than one third for the second ones. Quite often (at least in 42 % of the cases), the victim consumed alcohol before the assault and the use of drugs--especially cannabis--was not uncommon either.     

Factors Influencing the Filing of Complaints,Their Investigation,and Subsequent Legal Judgment in Cases of Sexual Assault

In Geneva, examination of victims of sexual assault is performed by a gynecologist and a medical examiner. 48% of the victims file a complaint and we wanted to investigate the factors leading to file a complaint, those leading the Prosecutor to go to trial, and those influencing a conviction. Between 2006 and 2012, 676 victims of sexual assault were investigated (averaged age 26 year, mean 22). Information on injuries, perpetrators, and circumstances of the assault was collected and analyzed. The attacker being the ex‐spouse or a friend and the presence of semen were factors leading to file a complaint. The assailant being a family member or ex‐spouse and the presence of genital/anal lesions were factors influencing the Prosecutor. The presence of nongenital lesions, the assailant being known by the victim, influenced conviction. This study shows that the medical examiner plays a vital role in the investigation of cases of sexual assault.     

Perpetrator related analysis of intentional homicides in the Genf canton (1971-1990)

A retrospective offender-related analysis was conducted on all deliberate homicides committed in the canton of Geneva between 1971 and 1990. The cases analyzed included 97 convicted single perpetrators or accomplices and 93 victims. 21 further homicides remained unsolved. 86.6% of the offenders were male; foreigners were over-represented in comparison with Swiss citizens. The average age was 35 years. In a majority of the cases the offender and the victim were partners, came from the same family or were acquainted with each other. Guns or knives were the most frequently used weapons. The criminal offences tried in Geneva were evaluated also with regard to their legal qualification.