Suicide classification-c lues and their use

A study of 1 2 2 case s of suicide and undete

rmined manner of death

P. Lindqvist, L. Gustafsson / Forensic Science International 128 2002 136 14( ) –

Yuthapaisan

The purpose of this study is t o analyse which clues that ap

pear most determinant for fo rensic pathologists in certifyi

ng suicide.

Guidelines to support the pol ice investigation as well as t - he medico legal examination

can probably reduce the num ber of undetermined cases in

cases of possible suicide.

Objective

C lassification of manner of death is important

- - - next of kins

- insurance issues

- research and public h ealth policies

C lassification i n Sweden-natural

- -self intended

- intentionally cau sed by another

- accidental or undetermined

Factors of study- age and gender

- previous suicide attempts

- mental disorder - -alcohol dependency

- suicidal communication - suicide intent

- blood (BAC) and urine- alcohol concentr ations - toxicological

Group of study- autopsied at the Institute of Forensic

Medicine in Umea° from September 1 9 8 3 through De

cember 1 9 8 5

- residing in Va¨sterbottens Coun ty (2 4 5 ,1 8 1 inhabitants in

1984)

- who’s death was certified as sui cide (n = 100) or as undetermined

manner of death (n = 22).

-The term alcohol dependency- the forensic pathologistused the ter

m ‘‘chronic alcoholism’’ in the death certificate.

- the deceased was diagnosed or described as an alcoholic in

medical records and/or police reports.

- hepatic cirrhosis and/or steatosi s was found and no other

explanation than high alcohol co nsumption was at hand.

A ge and gender122 subjects

males

females

sui ci des undetermine

sui cides

undetermine

91 (75%)

31 (25%)

45 yea rs (1 8 –87)

AAA48

rs (3163– )

39 year s (1 8 –66)

56 yea ( 4 1 –70)

Blood alcohol test : positive

blood alc ohol test

undetermine

sui ci des

positive

negative

positive

negative

31 (mean 17. g/l; 0range .

3 59– . )

69 16 (mean 2.7 g/l; range

0.3–5.0)

6

100 22

12Cause of death related to manner of death in 2 cases of suicide and undetermined death

Three clues with the highest explanatory value in determining manner of death among 122 cases of suicide and undetermined deaths

a - Cases that deviated from the found decision making pattern of the forensic pathologists.

Greater uniformity, consistency and t ransparency in the classification of su

icide is thus desirable and we support the efforts to construct internationall

y applicable guidelines for certifyingsuicide.

A good teamwork between the police and forensic pathologists is thus of cr

ucial importance not only to reduce th e number of undetermined cases but

also to secure that the subsequent sp ecified classification of manner of dea

th is correct

Validity• autopsied at the Institute of Forensic

Medicine in Umea° from 1983September through Dec

ember 1 9 8 5• the problems of death by poisoni

ng with illegal drugs have increased, especially in urban areas.• the pathologists used an indirectmet

hod in order to understand the classification.

Conclusion

The difficulties in determining m anner of death in possible suicides ar

e linked to certain causes of death, in particular poisoning.

Operational criteria for designati ng a death ‘‘suicide’’ can be helpful g

iven that the quality of the primary d ata collection is good.