Barranco Rosario, Diana Carole, Ventura Francesco
Department of Legal and Forensic Medicine, University of Genova, Via De Toni 12, 16132, Genova, Italy.
Department of Legal and Forensic Medicine, University of Genova, Via De Toni 12, 16132, Genova, Italy.
J Forensic Leg Med. 2019 Jul;65:5-8. doi: 10.1016/j.jflm.2019.04.007. Epub 2019 Apr 16.
Generally, the term complex suicide refers to a form of suicide in which more than one traumatic method is applied, simultaneously or consecutively, through multiple self-injurious actions using different methods and involving various bodily sites. A distinctive feature of complicated suicides is the failure of the initial attempt of the self-suppressive method that, nonetheless, results in death due to a subsequent accidental occurrence. In such cases, forensic pathologists and coroners are faced with the challenging differential diagnosis that generally includes homicide as well as suicide. We retrospectively analyzed autopsies from complex and complicated suicides registered at the Medicolegal bureau of Genoa (Italy) from 2006 to 2017. In the considered period, nineteen cases of complex suicides were identified and with only one case of a complicated suicide. In our series, the most frequent method of complex suicide was the cutting of the wrists followed by (unplanned) hanging for a total of eight cases (42.1%). The next most common cause (21% of cases) involved the jumping from a height after wrist cutting. In each case, it was necessary to meticulously examine the crime scene, reconstruct the chain of events, confirmed by the testimonies of relatives or eyewitnesses, review any medical history, particularly for psychiatric conditions, and perform a thorough autopsy so as to firmly establish the methods and causes of death.
一般来说，复合性自杀是指通过多种不同方法、涉及身体多个部位的多次自我伤害行为，同时或相继采用不止一种创伤性手段的自杀形式。复杂性自杀的一个显著特征是最初的自我抑制手段尝试失败，但随后因意外事件导致死亡。在这种情况下，法医病理学家和验尸官面临着具有挑战性的鉴别诊断，通常包括他杀和自杀。我们回顾性分析了2006年至2017年在意大利热那亚法医学局登记的复合性和复杂性自杀案例的尸检情况。在该时间段内，共确定了19例复合性自杀案例，仅有1例复杂性自杀案例。在我们的系列案例中，复合性自杀最常见的方式是割腕，其次是（意外的）上吊，共有8例（42.1%）。第二常见的死因（占案例的21%）是割腕后从高处跳下。在每一个案例中，都有必要细致地勘查犯罪现场，重建事件链，并通过亲属或目击者的证词加以证实，审查任何病史，尤其是精神疾病史，并进行全面的尸检，以便确切地确定死亡方法和死因。
