Homicide or Suicide: The LNC’s Impact on Legal Battles

Homicide or suicide: the LNC’s impact on legal battles is tremendous.

Gunshot Wounds

As healthcare providers and LNCs, we consider factors when examining the documentation available. Reports provided by the police, investigators, or medical professionals who examine a body.

What are some of those factors that we should consider?

Gunshot is one of the more common methods of suicide, especially in men versus women. However, when looking at that information, the injury location is one of the critical things. Obviously, with suicide, the injury has to be in a manner and an area that is accessible to the victim.

Most commonly, you get suicides that include gunshot wounds to the side of the head, in the mouth, or maybe the front of the chest.

Are there gunshot wounds to the abdomen, the side, or the back?

If so, those are more likely to be associated with a homicide versus a suicide—also, the number of shots. If there are multiple numbers of shots, unless that was a very strong-willed person, chances are it’s going to be a homicide.

You can’t rule suicide out entirely because there may have been suicides where somebody did shoot themselves multiple times. Still, chances are it’s going to be more consistent with a homicide rather than a suicide.

Then, the entrance wound must be somewhere the victim could logically reach it, where their handling of the gun would be logical for them.

For instance, if they’re a right-handed person but they have a gunshot wound to the left temple. Then, they don’t generally shoot with their left hand, so I would consider that suspicious if they have a gunshot to the back unless they set up a mechanism to shoot themselves in the back, such as tying.

You can tell from looking at entrance wounds in some cases whether that bullet entered the body from a great distance or a close-up.

How does that factor into this consideration of homicide versus suicide?

It’s by the distance based upon the entrance and exit wounds can be estimated logically with their arm’s length. So, if you have a gunshot entrance exit wound, there are no traces of gunshot residue on there.

Then, there is no bruising or burning from the muzzle mark on that area. Chances are it was a distant shot. And is it logical that somebody would hold the gun that far from them and shoot? More likely, you’re going to see those gunshot entrance and exit wounds, mainly the entrance wounds.

If they hold it up to their temple, you’ll see a burn mark. If they’re just a few inches away, you’ll see some. There is some gunshot residue and maybe some stippling, depending on how close it is.

So that is one of the key things about a gunshot, because if it is not a close, up to the skin or very close range, then the likelihood is that it’s probably not a suicide.

Understanding how to interpret gunshot wounds, the entrances, and the exits is vital in this.

A Knife or Sharp Object

What about the type of death that involves an injury from a knife or a sharp object?

What should we be thinking about as legal nurse consultants in helping to differentiate that type of death from a suicidal death?

Knife and sharp force deaths as suicides are less common than shootings, but they are one of the more common methods.

The most common is on the wrists and generally cutting upward on the wrists to get as much of that artery opened as possible to exsanguinate a little bit faster.

But some people might stab themselves in the heart to hope for a quick death with a sharp stab.

But in those, you would also look for prior cut marks.

Do they have a history of cutting, especially if the fatal injuries are on the wrist?

Do they have other cut marks on the wrists or the legs?

Those are common areas for people who are cutting and may consider slashing their wrists as a form of suicide. But if you’re talking about a stab wound specifically in the heart area, then you would want to look for the number of wounds in the locations. So, if it was a murder,  you might have more stab wounds.

You might have different lengths of stab wounds in a suicide, but you wouldn’t have a lot.

You may not have a lot of hesitation marks in the stab wounds, meaning very superficial stab wounds instead of the long, deep ones.

In suicide, when you’re looking at stabbing yourself, you might see some hesitation stab wounds. Those would be very shallow. Maybe they should test the knife to see how much force they need to put it in and how they’ll tolerate it to, you know, just kind of practice.

You might see some shallower ones and then that one fatal wound. It is more common to find multiple deep stabs or completed to the hilt of the knife on murder victims than it is in suicide victims.

Death by Drowning

In the United States, we recently had a case of a billionaire woman who was driving home at night onto her Texas property. She made a turn, maneuvering the car to back up.

The allegation is that her Tesla didn’t function appropriately or she didn’t use it appropriately. She ended up in the car, going backward into a pond on her property.

Initially, the allegations were that they thought there was a criminal act. But she called a friend and said,” I’m trapped in my car,” and told her or him what happened and asked for help, and they couldn’t get there in time.

She was found in her car. So, that was not a suicide. It was not a homicide. It was an accidental death.

Perhaps, in this case, she was retrieved within an hour. But sometimes people are found dead in a car 30 years later.

Most drowning deaths are related to accidents and often involve drugs and alcohol. But certainly, there could be a suicide via drowning.

Distinguishing or proving a drowning is problematic because it’s essentially a diagnosis by exclusion. Are the injuries due to as asphyxiation, being smothered, being strangled, or being drowned? These are things that remove the ability of the brain and the body to get oxygen.

There’s no blow to the body to identify; there’s no specific injury to identify. Investigators rely on the circumstances of the incident to help them determine if it was a drowning because this is usually it’s a diagnosis of exclusion when there’s no other explanation.

They look at what happened.

Where was it?

Was there water in the lungs showing the person was alive when they got into the water?

If there’s no water in the lungs, then they may have been dead before they got into the water.

This is one of the more difficult things for a forensic pathologist to identify and distinguish. And again, with the others determining homicide, suicide, and accidents, they look for defensive wounds.

Are there any signs of a struggle or an attack or an assault of some sort before getting into the water?

Is there a presence of drugs or alcohol in the victim’s system?

And go back to that suicide note. Is there a suicide note present there, too? So, this is not one of the more common methods of suicide, but it is undoubtedly a challenge for forensic pathologists to distinguish.

Death by Hanging

Finally, the last type of death that we would raise in terms of homicide or suicide is when somebody is found hanging.

What should we be thinking about as legal nurse consultants with that type of death?

One way to stage a scene is for someone to be strangled with a ligature, a rope, a TV cord, or a belt.

Then, to stage the scene to look like a suicide, they hang the person over their balcony on the house, or they hang them from the ceiling in their living room, or over the banister from their first and second floors.

You will get a V shape from the rope because the body weight pulls the rope taut.

Then our head is still pretty weighted, and the head goes down, and you get a V shape that way. However, if you are strangled with another object or a mechanism by another person, say you’re strangled from behind, you would still have potentially that ligature mark on the skin.

But in most cases, this would depend on the person’s height doing the strangling. Depending on how much struggle there was versus that V ligature mark, you will either have a horizontal ligature mark or marks.

That one telltale way to distinguish whether this crime scene was maybe staged is whether they hanged themselves or if somebody strangled them and then staged it to look like a hanging.

Are there bruises on their neck?

Because for the ligature marks, whether it’s from the hanging or a ligature, for those bruises to show up, the body needs to have blood flowing to cause those bruises.

If somebody strangles somebody with a ligature to death, you’ll have those ligature marks. Probably. But then, when they hang them, and they’re no longer living, you won’t have the shape. So that’s pretty easy to distinguish.

If there are defensive wounds from some struggle before that, that would be another sign it isn’t suicide.

You might find different scratches or bruises where the victim tried to get that ligature off their neck.

You might find broken nails, the assailant’s DNA underneath the fingernails, or scratching them. Looking at all that evidence is key in these cases.

Conclusion

An LNC has a big responsibility to review all of the information for each case. 

Are you interested in my direct role in his case? Click here to read all about it.

 

 

Pat Iyer is president of The Pat Iyer Group, which develops resources to assist LNCs in obtaining more clients, making more money, and achieving their business goals and dreams.

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