Complex Suicides

Abstract

The term “complex suicide” refers to suicides in which more than one suicide method is applied. In this context, a distinction can be made between planned and unplanned complex suicides. In planned complex suicides, two or more methods are employed simultaneously in order to make sure that death will occur even if one method fails. In unplanned complex suicides, several other methods of suicide are tried after the first method chosen failed to gain one’s end or when it proved to be too painful. In planned complex suicides, typically two of the generally common methods of suicide (e.g., ingestion of hypnotics or other medicaments, hanging, use of firearms, drowning, jumping from a height) are combined. However, unusual combinations have been described also, such as the simultaneous firing of several guns, self-immolation, jumping from a height, or shooting oneself while driving a car. In unplanned complex suicides, injuries by sharp force, especially cutting the wrists, are often found as the primary act of suicide. In some cases, the suicidal changes from the infliction of cut wounds to the infliction of stab wounds (most often located in the heart region). Other frequently used methods after failure of the first method are hanging and jumping from a height. A further characteristic feature of unplanned complex suicides is the application of more than two methods of suicide. The literature has reported the use of up to five suicide methods applied one after the other. From the criminological point of view, the presence of several injuries of different origin strongly suggests infliction by another person. Differentiation is possible only if autopsy including toxicological analysis is performed and the traces at the death scene are thoroughly investigated, so that the sequel of events can be reconstructed.