Sleep violence--forensic science implications: polygraphic and video documentation

During the past century, infrequent, anecdotal reports of sleep-related violence with forensic science implications have appeared. Recent rapid developments in the field of sleep-disorders medicine have resulted in greater understanding of a variety of sleep-related behaviors, and formal sleep-behavior monitoring techniques have permitted their documentation and classification. Sleep-related violence can be associated with a number of diagnosable and treatable sleep disorders, including (1) night terrors/sleepwalking, (2) nocturnal seizures, (3) rapid eye movement (REM) sleep-behavior disorder, (4) sleep drunkenness, and (5) psychogenic dissociative states occurring during the sleep period. Potentially violent automatized behavior, without consciousness, can and does occur during sleep. The violence resulting from these disorders may be misinterpreted as purposeful suicide, assault, or even homicide. Sleep-related violence must be added to the list of automatisms. A classification system of both waking and sleep-related automatic behavior is proposed, with recommendations for assessment of such behavior.     

Are codes of professional ethics ethical?

This essay reviews and situates codes of professional ethics within the general field of ethics and considers the specific characteristics of such codes. In the process, the author argues against the view that one's professional role and code take precedence over other roles or codes. One's personal value system, once clarified and criticized, provides the appropriate basis from which to continuously assess our codes of professional ethics.     

Potentially Lethal Behaviors Associated With Rapid Eye Movement Sleep Behavior Disorder: Review of the Literature and Forensic Implications

Abstract:  Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by loss of the muscle atonia of REM sleep, with release of complex and violent behaviors that are often attempted dream-enactments. This study reviewed the literature on RBD with regard to potentially lethal behavior. A total of 39–41 clinical cases of RBD associated with potentially lethal behaviors to self and/or others were found, involving a child and adults of all age groups, that manifested as choking/headlock ( n  = 22–24), defenestration/near-defenestration ( n  = 7), and diving from bed ( n  = 10). A total of 80.8% ( n  = 21) were males; 19.2% ( n  = 5) were females; mean age was 65.6 ± (SD) 13.8 years (range: 27–81 years, and a child). (Gender/age data were not listed in the remaining cases.) An etiologic association of RBD with a neurologic disorder (or with pharmacotherapy of psychiatric disorders, n  = 4) was present in 21–23 patients. Thus, RBD carries well-documented, potential forensic consequences during RBD episodes that could possibly have been misinterpreted as suicidal or homicidal behavior.     

Parasomnia pseudo-suicide

Complex behaviors arising from the sleep period may result in violent or injurious consequences, even death. Those resulting in death may be erroneously deemed suicides. A series of case examples and review of the pertinent literature are provided to increase awareness of the possibility that some apparent "suicides" are the unfortunate, but unintentional, consequence of sleep-related complex behaviors and therefore are without premeditation, conscious awareness, or personal responsibility. The correct cause-of-death determination in such cases may have profound social, religious, and insurance implications for surviving friends and family members.