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Chapter: Forensic Medicine: Firearm injuries

Accident, suicide or homicide?

The medical examiner is often called upon to assist the court in determining whether the manner of death in a particular gunshot fatality was accidental, suicidal or homicidal.

Accident, suicide or homicide?

The medical examiner is often called upon to assist the court in determining whether the manner of death in a particular gunshot fatality was accidental, suicidal or homicidal. While a number of helpful features pointing to a specific manner of death may be present, few areas in forensic medicine provide as much opportunity for misinterpretation as gunshot wounds. There are nevertheless a number of well-recognised patterns that can be of help in determining the manner of death.

 

Accidental shootings

These usually result from careless handling of firearms, and children, hunters and inebriated persons are the most common victims. The wound sites and firing ranges vary a great deal, depending on the circumstances of death, and are therefore of paramount importance in determining whether the shooting incident was truly accidental.

 

Suicide wounds

Suicide wounds, on the other hand, are usually contact or close-range wounds and are found in classic locations, most often the temple area (right temple in right-handed persons and left temple in left-handed persons), anterior left chest, roof of mouth and center of forehead. Occasionally the epigastric (upper middle region of the stomach) and submental (below the chin) areas are chosen. Suicide gunshot wounds of the limbs are extremely rare but may occur, and multiple suicide gunshot-wounds, although uncommon, may be encountered, including wounds to the head.

The number of entry wounds in the body is not an important factor when distinguishing between suicide and homicide, especially when the gun is in the automatic firing mode. Because the safety-catch is usually set on a selected mode, its position is significant in any firearm investigation. In a reported case a person who committed suicide fired eight bullets with one pull of the trigger. Perhaps he did not intend to fire that number of bullets, but spasmodic movements, which usually accompany such a violent death, might have caused continuous depression of the trigger until the victim's muscle tone was lost completely. (If this is true, a case of suicide with as many as 24 entry wounds should be possible, since the maximum capacity of a magazine is usually 24 bullets.) In fact, the number of entry wounds is more likely to be dictated by chance than by any other force. Even when the safety-catch is set on the self-loading, single-shot mode, the number of shots alone, without taking other factors or features into account, is not pathognominic (indicative of the exact cause) because multiple suicide injuries still occur, however rarely. An additional feature indicative of suicide rather than homicide is that the clothing surrounding the wound may have been drawn back and neatly arranged prior to infliction of the wound in order to avoid its being soiled by blood. Finally, a suicide note may be found at the scene.

 

Homicide gunshot wounds

Homicide gunshot wounds are found on any part of the body and are mostly inflicted from a distance beyond arm's reach (intermediate or distant). Contact and close-range wounds are also found in homicide cases. These wounds, if found in the classic suicide sites, may be very difficult to interpret. Wounds found on the face, back or any inaccessible part of the body should be presumed to be homicide wounds, until accidental infliction is definitely ruled out.

 

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