Asphyxia-related deaths

Abstract

Among fatalities that are subjected to medico-legal autopsies, asphyxia-related deaths account for a significant number of cases: according to experiences at the Institute of Legal Medicine in Hamburg, Germany, one third of all suicides, a one-fourth of all homicides and a significant number of all fatal accidents can be attributed to asphyxia. Qualitatively, the forensic pathologist often has to face sophisticated questions regarding these fatalities. The investigating officers expect quick answers to questions like ‘‘is this a suicidal or a homicidal manner of death?’’, ‘‘was the victim hanged after strangling him or her to fake suicide?’’, ‘‘could the fatality be accidental, e.g. in an autoerotic accident?’’, ‘‘can a natural death be assumed in cases with suspicious death scene findings, e.g. deaths in connection with sexual intercourse?’’, or ‘‘if instantaneous neurogenic cardiac arrest is diagnosed, was it the result of manual strangling or a short hit against the neck?’’. Answering these questions may be especially difficult if—as it is often the case, where there are no objective, witnesses and the forensic pathologist has no information on the deceased’s history, and has to give his expertise on the basis of the autopsy findings alone. 3. Definition