The rationale behind suicide, which is defined as the intentional taking of one's life, can be as simple or as complex as life itself. The person who commits suicide may see his or her actions as some sort of solution to a severe physical or psychological dilemma. Often, a police investigator will find a note indicating that the victim had suffered psychological torment or was severely depressed. The note might even suggest that he or she believed that suicide was the last resort. Many of the suicide notes I have seen over the years indicate the acute depression of persons who have taken their lives. Depression does not discriminate. It affects the young and old alike.

According to the 2004 statistics from the Centers for Disease Control in Atlanta, suicide took the lives of 31,655 persons in 2002, and 132,353 individuals were hospitalized following suicide attempts.1 The overall rate of suicide among youth has declined slowly since 1992. However, rates remain unacceptably high.

Adolescents and young adults often experience stress, confusion, and depression from situations occurring in their families, schools, and communities. In 2001, 3971 suicides were reported in the 15- to 24-year-old age group. Of these, 86% were male and 14% were female.1 Suicide rates increase with age and are very high among those 65 years and older. In 2001, 5393 Americans over age 65 committed suicide; 85% were male and 15% were female.1

Periodically, the nation's newspapers and television networks may cover this phenomenon by reporting a series of events including "teenage suicide pacts." Ironically, the media attention often results in further teenage suicides. The course of action would be to seek out professional assistance and create programs within the school system to deal with this problem.

Risk Factors2

• Previous suicide attempts

• History of mental disorders, particularly depression • History of alcohol and substance abuse 383

• Family history of suicide

• Family history of child maltreatment

• Feelings of hopelessness

• Impulsive or aggressive tendencies

• Barriers to accessing mental health treatment

• Loss (relational, social, work related, or financial)

• Physical illness

• Easy access to lethal methods

• Unwillingness to seek help because of the stigma attached to mental health and substance abuse disorders or suicidal thoughts

• Cultural and religious beliefs — for instance, the belief that suicide is a noble resolution to a personal dilemma

• Local epidemics of suicide

• Isolation, a feeling of being cut off from other people

Depression: A Clinical Perspective

The primary motivation for suicide is depression. Depression is a mood disturbance characterized by feelings of sadness, despair, and discouragement resulting from and normally proportionate to some personal loss or tragedy. Depression can become an abnormal emotional state, which exaggerates these feelings of sadness, despair, and discouragement out of proportion to reality.

There are four major clusters of depressive symptoms: emotional, cognitive, motivational, and somatic. Each of these clusters of depressive symptoms dependently and independently affects the depressed individual. In fact, as one set of clusters begins to affect the individual, another affects and reinforces the depressive effect. Eventually, the emotional and cognitive clusters affect the motivational symptoms causing what clinicians refer to as a "paralysis of the will" and/or psychomotor retardation (psychomotor pertaining to or causing voluntary movements usually associated with neural activity). In severe depression, the depressed person may actually experience a slowing down of his or her movements and may even have trouble walking and talking. The depressed individual experiences physical changes, which further exacerbate the depressive symptoms. The physical changes are referred to as the somatic symptoms.

Emotional Symptoms

Sadness is the most conspicuous and widespread emotional symptom in depression. Depressed people may even articulate their depression by statements such as "I feel sad." This emotional symptom is worse in the morning, usually as a result of not having been able to sleep. Feelings of anxiety are also present along with a loss of gratification and a loss of interest. The loss of interest may start with work and extend into practically everything the individual does (hobbies, recreational activities, etc.). Finally, even biological functions such as eating and sex lose their appeal.

Cognitive Symptoms

The term cognitive refers to the mental process characterized by knowing, thinking, learning, and judging. It is an intellectual process by which a person perceives or comprehends. The depressed individual thinks or perceives of himself in a very negative way. His future is viewed with despair. The individual may feel that he has failed in some way or that he is the cause of his problems. He believes that he is inferior, inadequate, and incompetent. His depressed cognitive functioning causes him to have intense feelings of low self-esteem. This sows the seeds for eventual hopelessness and pessimism. The depressed individual actually believes that he is doomed and there is no way out.

Motivational Symptoms

These particular symptoms are first noticed by those who are close to the depressed person. Depressed persons generally have trouble "getting started." Most of us are able to function by getting up in the morning, going to work, interacting with one another, and engaging in routine activities. The depressed individual is marked by passivity or lack of activity. This passivity and lack of normal response undermine the individual's ability to engage in important life functions and general socialization. In its extreme form, there may even be a "paralysis of will," whereby the individual does not even feel like doing what is necessary for life, such as attending properly to nourishment.

Somatic Symptoms

These are the biological manifestations of depression. They are perhaps the most insidious set of symptoms due to their impact. As depression worsens, every biological and psychological joy that makes life worth living is eroded. Loss of appetite, loss of interest in sex and sexual arousal, weight loss, and sleep disturbances lead to weakness and fatigue. Depressed individuals physically feel the depression. They are more susceptible to physical illness because the depression, as it becomes more severe, erodes the basic biological drives.

Clinical Scenario

An individual begins to feel sad and sustains a restless sleep. He begins to feel sad in the morning and experiences a lack of interest in work (emotional symptoms). He then begins to question his ability to perform at work and starts to feel inadequate. This adds to his anxiety and low self-esteem (cognitive symptoms). He then discovers that he just cannot get started in the morning and cannot bring himself to go to work and loses interest in life (motivational symptoms). As the depression deepens, the individual loses his appetite and experiences weight loss, which leads to weakness and fatigue. He then slips deeper and deeper into depression and becomes ill (somatic symptoms). The cycle of depressive symptoms will continue to evolve and the depression will worsen. At this point, the individual is in dire need of assistance.3

(A)

(B)

Figure 13.1 SUICIDE BY .308 RIFLE. (A) This suicide victim's locale, the interior of a vehicle, shows the devastating effect of the blast from a .308 rifle. Note the brain matter on the interior roof as well as the back seat of the car. (B) This photo depicts a close-up of the victim and the extensive damage inflicted by the high-velocity blast. The victim committed suicide by placing the barrel of the .308 rifle into his mouth and pulling the trigger. (Courtesy of Detective Lieutenant Raymond Krolak, commander, Investigative Division, Colonie, New York, Police Department.)

(A)

(B)

Figure 13.2 SUICIDE BY HANDGUN. (A) This photo depicts a suicide victim with gun still in hand. The woman had shot herself in the head with a .357 magnum revolver. The gun should be checked for any blowback. (B) This is a close-up shot illustrating the devastating effect of the .357 and the type of head wound the victim received. (Courtesy of Detective Steve Shields, Klickitat County, Washington, Sheriff's Office.)

Other Motives for Suicide

Although depression may be the primary motive for the suicide, other factors frequently play a part. Alcohol, drugs, stress, frustration, fear, anger, hostility, and guilt may lay the groundwork for suicide. In fact, motivations may range from the clinical to the bizarre. Some persons may actually take their life in order to punish the survivors, i.e., their family, coworkers, or even society in general, for some perceived wrongdoing.

I have a case on file that was reported in a Daily News story and actually aired on television. It was a particularly bizarre case in which the victim had planned his death for approximately 7 months. He had promised reporters that his story would be "the story of the decade."4 The victim was a state official who had been found guilty of bribery earlier in the year. On the day of his death, he called for a news conference, ostensibly to resign from public office. As he read his statement, he urged the reporters and camera crews to keep their lenses on him. He then pulled a .357 magnum handgun from a manila envelope and placed it into his mouth, pointing the barrel of the gun up toward his brain. He fired and effectively blew his brains out for the viewing audience.

(A)

Figure 13.3 SUICIDE BY MULTIPLE STABBING. (A) The body has been turned over by the arriving paramedics. Note the extreme violence to the body with the clustered stabbing wounds. (B) This photo illustrates the extensive stab wounds to the body as well as the presence of "hesitation" type wounds. The woman had stabbed herself 31 times. Only one wound penetrated the heart. (C) The knife the victim used was recovered at the scene. The blade was approximately 7 in. long. The blood on the blade indicated that the knife had been plunged into the chest at least 5 1/2 in. (Courtesy of Dr. Leslie I. Lukash, former chief medical examiner, Nassau County, New York.)

(B)

(C)

Figure 13.3 Continued.

In addition, some people feel that they have a right of self-determination and take their lives rather than suffer with an illness or disease. These types of suicides will be discussed later in the section "Final Exit Suicide Investigations." Also, some people wish to end their lives but do not want to do it themselves. They create a confrontational situation in order to force the police to shoot them. These types of suicides will also be discussed later in the section "Suicide-by-Cop."

The Investigation

Investigatively speaking, all death investigations should be handled as homicide cases until the facts prove differently. The resolution of the mode of death as suicide is based on a series of factors that eliminate homicide, accident, and natural causes of death.

Remember: Do it right the first time. You only get one chance.

It has been my experience that suicide cases repeatedly cause more problems for the investigator than homicide investigations. There is the possibility that suicide notes may have been taken or destroyed. In addition, the weapon and/or other evidence may have been removed prior to the arrival of the police. Also, it is not surprising to encounter misdirected grief and/or anger. The surviving family grieves the loss of a loved one and is faced with the psychological uncertainty of whether or not they could have prevented the act. These relatives frequently suffer a deep

Figure 13.4 BIZARRE SUICIDE — SUICIDE BY CHERRY BOMB. This individual decided to commit suicide with a large firecracker. He duct-taped a roll of pennies to a cherry bomb and placed the contraption into his mouth with the fuse extending through his lips. He lit the fuse and blew up his head. (From the author's files.)

Figure 13.5 MULTIPLE GUNSHOT SUICIDE. Victim had attempted suicide by shooting himself in the face with a rifle, blowing part of his face off. However, when this did not work, he placed the barrel of the rifle into his mouth and fired a second time, creating this effect.

(From the author's files.)

sense of guilt about the death, anger at the deceased, and feelings of shame because of the social stigma attached to a suicide incident.

I remember one case in which an 84-year-old woman was found with a gunshot wound to her head. A daughter of the deceased had notified the police of the death. Unknown to the police, the deceased had been suffering from terminal cancer and had been very depressed. Her daughter, who had unsuccessfully attempted to call her mother at home, went to the mother's house.

She opened the door with a key and discovered her mother's body. She saw a .32 caliber handgun, which she immediately recognized as an old family heirloom. The daughter removed the gun from the premises, along with some personal papers and a codicil she found in her mother's dresser drawer. She went home, got rid of the gun, and then called the police to report that she had not been able to get through to her mother. She requested the police to respond to her mother's apartment and she would meet them there.

Needless to say, when we arrived, we were looking at a burglary/homicide case and not a possible suicide. Later that week, we were called by the family's priest, who advised us of what had taken place. The case was properly reclassified as a suicide.

Case History

One of the more problematic cases of suicide I investigated involved the suicide death of an attractive 27-year-old woman. She was discovered in her sister's fiancé's apartment with a cut throat and three stab wounds to the chest. She had been hiding at the apartment from a boyfriend, who at first was our primary suspect. However, upon a complete and thorough death investigation, it was soon discovered that the circumstances of her death, as well as the evidence obtained by investigators during the crime scene search, indicated this death to be suicide. The cutting to the throat was superficial, with a stigma of hesitation. The stabbing to the chest was self-inflicted. The weapon came from the scene. The premises were locked from inside. Her palm prints were found on the blade of the kitchen knife. A note found at the scene, although not a classic suicide note, did indicate the victim's depression. A handwriting analysis revealed that the deceased had written the note.

A background check of the deceased indicated drug and alcohol abuse. Interviews of family and friends were conducted. Additional evidence was discovered that indicated the deceased had first tried to kill herself with a rifle found in the apartment. There were no signs of a struggle or forced entry into the locked apartment. The medical examiner who responded to the scene agreed with the investigative hypothesis and confirmed that the death was suicide.

(A)

Figure 13.6 STABBING SUICIDE — MULTIPLE WOUNDS. EQUIVOCAL DEATH — CASE

HISTORY. (A) The victim in her original position when police arrived. She had incised wounds to her neck and blood emanating from her mouth and nose. (B) Close-up of victim's face. (C) The kitchen knife in situ between her legs and a large bloodstain on the carpet. (D) Close-up of the incised wound to the victim's neck indicating a stigmata of hesitation. (E) Close-up of the victim's chest after the blood was removed. The first two stab wounds hit the sternum. Only one wound was fatal; the wound, which is anatomically to the left, pierced the victim's heart and lungs.

(From the author's files.)

(B)

(C)

Figure 13.6 Continued. (D)

(E)

Figure 13.6 Continued.

However, the following day an associate medical examiner, who lacked the expertise of the medical examiner at the scene and the homicide detectives involved in the case, reclassified the case as a homicide. Her rationale was that she had never seen a body with three stab wounds into the chest and that the victim's throat had incised wounds. The associate medical examiner made this determination without consulting the "tour" doctor, who had been at the scene. She disregarded his official notes, refused to discuss the case with the detectives or me, and adamantly insisted that this case was a homicide. As a result of her arrogant incompetence and the family's insistence, this case was subject to review by the State Attorney General's Office, the New York City Department of Investigation, and the NYPD Internal Affairs Division.

I would later have the pleasure of conferring with the chief medical examiner to make an official complaint against the associate medical examiner for her inappropriate and unprofessional behavior. The case was properly reclassified as suicide. However, the damage was done; to this day, the parents of that girl are convinced that their daughter was killed by the boyfriend. It was easier for them to believe that their child was killed than to accept the fact that she had killed herself.

Remember: Suicide cases can cause more problems for detectives than homicide investigations.

In fact, in my present capacity as a homicide and forensic consultant, many of the inquiries I receive concern death investigations that had originally been classified as suicides. Many of these cases raise serious questions about the actual cause of death (homicide, suicide, accident, or natural). These cases have been inadequately investigated, or there has been inappropriate interference in the investigative process due to political or other personal considerations beyond the control of the investigator.

However, in some situations, the police have been too quick to classify a case as suicide based on their initial observations at the scene. The death might have looked like a suicide; however, the presentation of the circumstances was created by a clever offender who staged the scene to make it appear to be a suicide. I have investigated many such cases and the truth of the matter is that initially, the cases did look like suicides. (See Chapter 22, "Equivocal Death Investigation.")

Staging a Scene

Staging a scene occurs when the perpetrator purposely alters the crime scene to mislead the authorities and/or redirect the investigation.

The term staging should not be used to describe the actions of a surviving family member who covers or dresses a loved one who is found nude or has died in an embarrassing situation.

Staging is a conscious criminal action on the part of an offender to thwart an investigation.

(A)

(B)

Figure 13.7 STAGED CRIME SCENE. (A) Homicide made to look like suicide by hanging. The victim was discovered hanging from a piece of construction equipment. (B) Close-up of victim's head area. Closer examination indicated that the victim had been "strung up" after death and the scene staged to look like a suicide. However, a piece of vegetation that did not come from the crime scene was caught in the victim's hair. This trace evidence indicated that he had been killed elsewhere and transported to this site. (From the author's files.)

Investigative Considerations

The investigator should be aware of three basic considerations to establish if a death is suicidal in nature:

1. The presence of the weapon or means of death at the scene

2. Injuries or wounds that are obviously self-inflicted or could have been inflicted by the deceased

3. The existence of a motive or intent on the part of the victim to take his or her life

It should be noted that the final determination of suicide is made by the medical examiner/coroner after all the facts are evaluated. However, the investigation at the scene and an inquiry into the background of the deceased may indicate the presence of life-threatening behavior or activities that suggest suicidal intent. Of course, the medical examiner/coroner is supposed to avail himself or herself of the input of the investigators who were present at the scene and conducted the death investigation.

The Weapon

The weapon or means of death should be present in cases of suicide. However, the absence of a weapon does not necessarily indicate that death was due to a homicide. The weapon could have been stolen or otherwise disposed of prior to the arrival of the authorities (as seen in the case of the heirloom handgun). Furthermore, family members have been known to conceal weapons and/or suicide notes in order to collect on an insurance policy. In many recorded cases, the suicide victim has arranged to make his or her death appear to be a homicide for a number of reasons.

If the weapon is observed in the hands of the deceased, the investigator should examine the hand to see whether the weapon is clutched tightly due to cadaveric spasm (instantaneous rigor mortis). (See "Body Changes after Death" in Chapter 9.) In some instances, the firearm or knife will be tightly clenched in the victim's hand at the time of death due to an intense muscular contraction of the hand. Some victims of suicide have been found tightly grasping their weapon in death. It is important to note such clutching of weapons because you can be sure that the person held this weapon at the time of his death. A person attempting to place a weapon in the deceased's hand after death would not be able to recreate the same grasp. This is especially important in cases involving firearms. Usually, when a person shoots himself in the head with a handgun, the weapon will fall from his hand. Long-barrel rifles and shotguns may be found cradled in the arms of the suicide victim, depending on the original position of the victim when the firearm was discharged.

In all suspected suicidal gunshot wound cases, an examination of the hands should be made for the presence of soot or powder. The weapon should be examined for evidence of discharge and operability. In addition, the weapon should be examined for the presence of any blow-back materials, including blood from the victim. A ballistics test should also be conducted. It should be noted that the weapon need not be in the hand of the deceased in order for the death to be a suicide. It is important to note the survival time factor — time between injury and death — which may have enabled the deceased to perform any number of activities, including disposal of the weapon or leaving the original location where he first attempted suicide.

Wounds

Injuries and wounds in suicides may be very similar to those observed in homicides. However, certain observations that the wounds found on the body are consistent with homicide or suicide should be made. For example, a person found dead from multiple stab wounds of the back would certainly not be considered a victim of suicide. Likewise, in suicide cases, there appear to be preferences and avoidances for certain parts of the body.

If the victim used a knife to commit suicide, the wounds will usually be on the throat or wrists. If the injury is a stab wound, it will generally be through the heart. Most suicidal stab wounds involve the mid- and left-chest areas and are multiple in nature.

The investigator should closely examine any slashing types of wounds for evidence of hesitation marks, which appear as parallel slashes alongside the mortal wound and are indicative of suicide. The investigator should not jump to any conclusions based on hesitation marks because an assailant knowledgeable about these factors might leave similar markings to cover up a homicide.

If the victim uses a handgun, the target will likely be the head, followed by the chest into the heart, followed by the abdomen. Head shots with handguns are usually found in the temple (consistent with the handedness of the victim), followed by the forehead or directly into the mouth. The wounds will be close range as opposed to long range. There should be evidence of powder burns and/or smudging.

In some instances, there may even be evidence of hesitation gunshot wounds or evidence of other shots fired prior to the fatal shot. The investigator should also examine the hands of the deceased for evidence of any blood or tissue splattering. In suicides with rifles and shotguns, the preferred sites are the head (81%), chest (17%), and abdomen (2%).5

It is important to remember that wounds are never too painful to a person determined to take his or her life. Deranged persons may inflict several extensive wounds on themselves before they collapse and die. I reviewed one case in which the deceased had attempted to hang himself with an electrical cord, but the cord broke under his weight. He then cut open his stomach with an 8-in. knife and systematically removed his intestines, which he cut into pieces using a pair of tin snips. Investigators at the scene recovered an 8-in. knife, a pair of tin snips, scissors, and towels containing blood and intestines.

Remember: It is not the number of self-inflicted wounds that is important, but rather the lethality of these wounds and what particular organs have been affected.

(A) (B)

Figure 13.8 HESITATION MARKS. (A) This photo illustrates the dynamic of hesitation marks on the throat of the victim. Note the hesitation cuts surrounding the fatal wound. STRAIGHT RAZOR WITH FINGERPRINTS. (B) The man had used a straight razor to cut his neck. He had gripped the weapon tightly in his hand. As a result of cadaveric spasm, a perfect set of fingerprint impressions were left in blood on the handle of the razor. (Courtesy of Dr. Dominick J. DiMaio, former chief medical examiner, City of New York.)

Figure 13.9 CLASSIC EXAMPLE OF SLASHING OF WRIST. This photo illustrates the classic cut-wrist pattern observed in suicides where the victim cuts across the wrist. Also note the hesitation marks. (Courtesy of Dr. Leslie I. Lukash, former chief medical examiner, Nassau County, New York.)

Figure 13.10 OLD INJURIES FROM SUICIDE ATTEMPT. The photo depicts the presence of old injuries from a prior suicide attempt in which the victim slashed his wrist. Investigators should note these injuries for predisposition towards suicide as well as victimology information. (Courtesy of Dr. Leslie I. Lukash, former chief medical examiner, Nassau County, New York.)

Case History: Suicide with Multiple Stab Wounds

Las Vegas Metro Homicide was called to a suspicious death case involving a 61-year-old male with multiple stabbing wounds found in a residence. The man had an apartment in the residence, which was separated by a dead-bolted interior door; he shared the residence with another male, who reported finding the body and calling 911.6

The victim's body was lying in a water feature, which consisted of a tiled sunken basin/pool with a rock formation to the side. Detectives observed the victim lying in a pool/basin. The basin was devoid of water and had been plumbed shut. Detectives also observed a half empty bottle of Drano® drain cleaner liquid lying on the floor of the basin/pool beneath the victim's right knee. Later, it was determined that the victim had ingested this caustic substance.

There was a black leather knife sheath lying on the dining room floor. Resting between the victim's left hand and his left chest was a bloody Buck folding knife, with a 4-in. blade. The knife was open, blade extending downward from the victim's hand.

It was learned that both men, who came from Bulgaria, were good friends over the last 35 years. In fact, the victim had lived in a separate apartment in the residence for the last 4 years. Reportedly, the victim had problems with drinking and gambling, which led to money problems. In addition the victim had recently seen a doctor for depression.

Las Vegas Metro detectives interviewed a female friend of the victim. She stated she had been a friend of the deceased for the last four years and knew him to be left-handed. She also told detectives that the victim had been depressed since his mother died and she had taken him to see a doctor. The doctor had advised the victim go into The Mojave Mental Clinic; however, the victim refused. She stated that, when she drove the victim home, he had given her his $2000 gold chain, cash, and credit cards and instructed her that these items should be given to his sister in Bulgaria.

Figure 13.11 SUICIDE — MULTIPLE STAB WOUNDS. This photo depicts a victim lying in a pool basin indoors. There is a Buck knife still in the victim's hand. He suffered multiple self-inflicted stab wounds. (Courtesy of Detective Sergeant Mike Thompson, Las Vegas Metropolitan Police Department Homicide, Las Vegas, Nevada.)

Figure 13.12 AUTOPSY — MULTIPLE STAB WOUNDS. This photo depicts the victim's chest area at autopsy. There were 83 stab wounds into the torso, with incised wounds to his wrist. (Courtesy of Detective Sergeant Mike Thompson, Las Vegas Metropolitan Police Department Homicide, Las Vegas, Nevada.)

Detectives noted that all of the blood was contained within the lower half of the basin/pool, primarily on the flooring around the victim and on the step or ledge. There were no footprints in blood and there was no blood anywhere else in the residence. Detectives noted the apparent stab wounds through the shirt into the chest and the bloody clothing. There were numerous apparent knife wounds of the abdomen and some internal organs were protruding from the victim's lower left abdomen. The victim was removed from the basin/pool; a cursory examination revealed slashing injuries to both wrists. The death was ruled a suicide.

It should be noted that there were 83 stab wounds to the torso, multiple incised wounds to both wrists, and the ingestion of Liquid Drano.

The cause of death was exsanguination due to multiple stab wounds of the torso. The wounds were largely concentrated on the left side; four penetrated the heart muscle. One penetrated the full thickness of the right ventricle of the heart. In addition to the stabbing wounds into the torso, there were multiple incised wounds to the wrist. The esophagus was edmatous (abnormal accumulation of fluid). The mucosa was edmatous and hemorrhagic with coagulated blood. Gastric mucosa similar with chunks of granular coagulated blood was found within the stomach. The Drano caused hyperemia and hemorrhage. Blood flow was increased due to inflammatory response.

Medicolegal Analysis

It is important to note that, although four stab wounds penetrated the heart, only one wound penetrated the full thickness of the right ventricle. According to medicolegal opinion, if that one wound had penetrated the left ventricle, the man could not have continued to stab himself because one wound penetrating the left ventricle of the heart would have incapacitated him. The left ventricle of the heart supplies the pressure recorded in blood pressure (BP) measurement, e.g., 130/70. The left ventricle of the heart is under pressure. The right ventricle is under less pressure than the left. The right ventricle of the heart is the collection system before the blood is transferred to the left ventricle for pressured release to the arteries.

Summary

Just as investigators should not presume homicide based merely on the extent of injury, they should not be fooled by the method. Although suicide by fire is extremely rare, gasoline is readily available and can provide a convenient method of self-immolation. Ironically, I have found more women resorting to death by fire than men. I presume that the reason for this situation is that men are perhaps more likely to obtain firearms.

Bizarre Suicides

Suicide by Blasting Cap

The badly decomposed body of the victim was discovered in his trailer. He had been dead 6 or 7 days. Detectives found a surge protector with several wires protruding under the victim's hand with his thumb above the ON/OFF switch. Interviews with family and friends indicated that the victim's family had a history of suicide. The victim had recently bragged about "going out in style" after finding "something" in a mineshaft. When investigators examined the victim's computer, they discovered several visits to www.suicide.com.

The windows of the trailer had been blown out and the head area had suffered extreme trauma. No facial features remained. His ball cap was shredded from an apparent blast. Further investigation revealed that the decedent had wired two blasting caps into the surge protector and had placed a blasting cap into each ear. At some point, he pressed the ON/OFF switch and blew himself up. Reconstruction of the victim's skull revealed that it had been blown out in the region of the ear.7

Suicide by Fireplace

An emotionally disturbed woman decided to end her life by stripping off her clothing and climbing into her fireplace. Most people would assume that crawling into a hot fireplace would be excruciatingly painful and a person could not actually sit on a fire. However, the victim left a note describing her suicide intentions and the fact that she chose her fireplace as a way out.

Attempted Suicide — Self-Mutilation

One of the most bizarre cases I ever investigated was a self-mutilation event, which was first thought to be a bizarre suicide attempt. We later determined it to be a

(A)

(B)

Figure 13.13 SUICIDE BY BLASTING CAP. (A) This photo depicts what is left of the victim's head as a result of the blasting caps in each ear and the effects of decomposition. (B) The effect of the blast inside the skull. This photo shows the right side of skull; the left side was also blown out. (Courtesy of Lt. Jim Ezzell and Investigator Pat Downs, La Plata, Colorado, Sheriff's Department.)

brief psychotic episode, which was the consequence of ingesting a large amount of PCP, or "angel dust."

We had received two calls simultaneously — one from the administrator at the hospital where the victim had been transported and another from a patrol sergeant requesting detectives. We stopped at the hospital first, where emergency room doctors briefed us as to the injuries. I examined the victim, a black male in his late 20s, who was being stabilized by doctors. I observed that the victim's entire face was missing. At this point in the investigation, we were not sure whether the victim had self-inflicted these injuries or had been the victim of an assault.

(A) (B)

Figure 13.14 SUICIDE — VICTIM SITTING IN FIREPLACE. (A) This victim actually sat in her fireplace with the fire to end her life. Remember: do not assume that something may have been too painful for a person desiring to commit suicide to endure. (B) The same suicide victim when the body was removed from the fireplace. Note the pugilistic attitude. (From the author's files.)

We then headed for the crime scene, which had been secured by the first officers. We were told that the police officers had to secure some "wild" dogs in a bedroom in the apartment so that the EMTs could approach and treat the blood-soaked victim, who was then transported to the hospital.

I ordered Emergency Service officers to respond to the location to control the dogs before we entered the apartment to examine the crime scene and requested that our Crime Scene Unit process the scene. The ESU officers shot the dogs with tranquilizer darts to render them harmless. As we examined the scene, I was surprised that we could not find any flesh or skin. I had examined the victim at the hospital and his entire face was "shaved" from his skull. I then remembered the dogs. I surmised that the dogs had, in fact, eaten the flesh. I ordered the dogs to be brought to the ASPCA and instructed the veterinarians to pump the dogs' stomachs. This procedure resulted in the recovery of pieces of the man's face, lips, and nose. These pieces were rushed to the hospital for possible reattachment. However, a medical decision concluded that this would not be possible.

We later determined that the victim had smashed a mirror while sitting in a chair and under the influence of PCP, or angel dust. He then apparently peeled his face from his skull with the broken pieces of mirror. He dug out an eye and rendered the other eye useless by severing the optic nerve. He cut off his ears, nose, and lips and fed the flesh to his pet dogs, which were a female shepherd and three pups. He survived this bizarre self-mutilation due to the large amount of drugs anesthetizing his system. However, the large amount of drugs had affected the victim's brain function. He became a ward of the state. This also required some intricate plastic surgery as doctors performed reconstructive surgery to recreate a face for the young man.

Apparently, this case so intrigued the author Thomas Harris that he "borrowed" the case information from my textbook without authorization. One of the creepier scenes in Thomas Harris' 1999 novel Hannibal involved a character named Mason Verger, who scraped off pieces of his face and fed them to his pet dog. I contacted Mr. Harris, who now properly cites his source. However, the folks at Urban Legends persist in debunking the facts of this case with their faulty interpretations at http://www.snopes2.com/horrors/drugs/facepeel.htm. The publisher of this textbook has warned them that the photos and information within this text are copyright materials.

Barrel of Gun in Suicide Victim's Head

A 14-year-old female was discovered in the bedroom of the family home with an apparent gunshot wound to the head. Several suicide notes were found in the scene, along with a Ruger .357 handgun, the apparent suicide weapon. The Ruger brand revolver was missing the barrel on the gun and the hammer was in the forward position. There was a pool of coagulated blood under the decedent's head. Her forehead had a large star-pattern open wound with tissue missing. This was a large entrance wound with no apparent exit wound. At autopsy, a 2-in. barrel for the

Ruger revolver was recovered inside the victim's head.8

(A)

(B)

Figure 13.15 SELF-MUTILATION — MIRROR MAN. (A) Victim at hospital. He had peeled his entire face from his skull while under the influence of "angel dust," or PCP. (B) Recovering victim being fed with a nasal gastric tube. His face is being reconstructed using a "pectoral flap" technique. (From the author's files.)

Figure 13.16 SUICIDE. An apparent suicide victim was found in her bedroom. There were several suicide notes found in the scene along with a Ruger .357 handgun. There was a gaping wound in the victim's forehead consistent with a contact type wound with no apparent exit wound. (Courtesy of Maria Weir, Crime Scene Analyst II, and Detective John Williams, Henderson, Nevada, Police Department.)

Figure 13.17 RUGER .357 FOUND AT SCENE. The apparent suicide weapon was found at the scene. There was no barrel on the gun and the hammer was in the forward position. There was one expended cartridge in the cylinder, located behind the hammer. The cylinder also contained four live cartridges. (Courtesy of Maria Weir, Crime Scene Analyst II, and Detective

John Williams, City of Henderson, Nevada, Police Department.)

Figure 13.18 BARREL OF THE RUGER. The victim's head was x-rayed at the medicolegal facility. The 2-in. barrel, which was observed in the x-ray, was removed from the victim's head. (Courtesy of Maria Weir, Crime Scene Analyst II, and Detective John Williams, City of Henderson, Nevada, Police Department.)

Equivocal Death Investigations

Equivocal death investigations are those inquiries that are open to interpretation. There may be two or more meanings and the case may present as a homicide or a suicide depending upon the circumstances. The facts are purposefully vague or misleading, as in the case of a "staged crime scene," or the death is suspicious or questionable based upon what is presented to the authorities. (See Chapter 22, "Equivocal Death Investigation.") I reviewed one particularly bizarre case in which a psychologically disturbed woman committed suicide under circumstances that made the case appear to be a sex-related homicide.

Investigators were called to the scene of a "possible homicide" in a secluded area near a canal. Upon arrival, they observed a vehicle, which had been completely burned, at the edge of a canal as if someone had pushed the car towards the water. In the rear hatchback of the auto, the detectives observed the badly burned and charred body of a white female, with her pants pulled down to her mid-thigh area.

The body was secured to the spare tire wheel-well bracket with a steel chain. Investigators found four 5-gal gas containers approximately 60 ft from the vehicle. It appeared that the victim had been sexually assaulted and killed by an offender who then secured the body by chain to the vehicle. The vehicle was doused with gasoline and pushed towards the canal. The car had been stopped from going into the river by a small tree.

However, upon closer examination, it was discovered that the chain was actually loose enough for someone to crawl into. The vehicle was registered to a woman who had a history of psychological problems and had just been released from a mental institution. Authorities went to her residence, where they found documents and letters indicating her intention to take her life, along with her will leaving her possessions to her son. The investigators were able to trace the gas cans to a WalMart, where the deceased had purchased them along with the chain and a cigarette lighter. She had paid with American Express checks. Detectives retrieved the sales slips and cancelled checks.

In addition, the detectives located the gas station where the deceased had filled her containers. At this gas station there was a 24-hour video. She was observed on the video making the purchase the day of the incident. She also paid for the gas with American Express checks.

Investigative reconstruction indicated that the woman had secured the chain to the spare tire wheel-well bracket beforehand. She had left it loose enough to crawl into after she doused herself and her automobile with the 20 gal of gasoline. After crawling into the chain, she lit a cigarette lighter and caused an explosion. The explosion caused the windows to blow out and the extreme heat caused the auto, which was in gear, to start up and move down towards the canal.

As she struggled and writhed in pain from the flames and fire, the victim's pants were pulled down to her mid-thighs by the chain, which was wrapped around her torso. The case was properly classified as a suicide.

Motives and Intent

The manner of death may be important in determining suicidal intent. For example, people who hang themselves or jump to their deaths from fatal heights have certainly indicated an intention to take their lives. Similarly, deaths that involve a combination of methods (poisoning, shooting, slashing, inhaling gas, etc.) show an extreme desire to die.

There are numerous motives to consider in suicide cases. I have found from my experience, however, that some people's motives never surface; the motive dies with the deceased. Some of the more common motivations are

Depression Marital or family crisis

Drugs Severe emotional trauma

Alcohol Psychological problems

(A)

(C)

Figure 13.19 EQUIVOCAL DEATH — SUICIDE CASE. (A) Victim's fire-damaged automobile at the edge of the canal. The fire department had responded to a reported brush fire at this location by the St. Jude Canal in Plaquemines Parish. (B) The fire department discovered the badly burned body of a female victim wrapped in chains in the rear of the hatchback auto. Police were notified of a possible homicide. (C) View of the victim's body when it was removed from the auto. (D) Evidence of gas containers. Four 5-gal cans were found 60 ft west of the burned auto. They were brand new and recently purchased. (Courtesy of Detective James "Skip" Wright and the Jefferson Parish Sheriff's Office, Gretna, Louisiana.) Continued.

(C)

(D)

Figure 13.19 Continued.

Stress Physical deterioration

Frustration Loss of a loved one

Fear The death of a child

Anger Financial situations

Hostility Teenage problems

Guilt Loss of employment

Terminal illness Despair

Illness in the family General inability to cope with life

I remember working a case in which the body of the deceased was found at the base of a high drop. There was evidence of some cutting on the wrists and it was apparent that he had jumped or fallen from the ledge approximately 70 feet above. An examination of the body, however, indicated that his wallet was missing. A further examination of the area on the ledge failed to locate the wallet or any type of blade that could have been used to cut the wrists. The deceased had been at work the previous day and seemed to have been fine. Friends and family of the deceased had not noticed any suicidal tendencies. The case was definitely shaping up into a real mystery.

Later in the day, we received a call from a neighboring jurisdiction. The police had recovered the wallet belonging to the deceased in a motel room. The room was very bloody and it appeared that there had been an assault in the premises. Further examination, however, disclosed a suicide note, an empty bottle of pills, and a bloody razor blade. Apparently, the deceased had gone to the motel room to take his life. He had cut both wrists, consumed the contents of the prescription bottle, and bled all over the place. When death did not occur, he left the motel, got into his car, and drove approximately 10 miles back to New York City. He then selected a relatively high building in the area and jumped to his death. The suicide note, which was recovered by police, indicated that the deceased was extremely upset with his life and had planned to kill himself at the motel.

Suicide Notes

Suicide notes are direct communications indicating intent to commit suicide. Letters and notes that indicate severe depression and/or anger may be addressed to relatives and friends and left at a death scene. The notes are often coherent and legible. They may be instructional and/or admonishing. Suicide notes often have mixed emotional content, including "positive" and "negative" feelings. Many notes reveal what are referred to as "suicide ideations." These are the formation and conception of ideas in the mind of a person that present suicide as a viable option. References to an "afterlife," once again being with a loved one, or "looking down" are quite common.

The presence of a suicide note certainly suggests suicide. However, the investigator should conduct a further inquiry to ascertain whether the note is genuine. Was it written by the deceased? Was it written voluntarily? The investigator should collect the note in a manner that will preserve any latent fingerprints. In any event, known writings of the deceased (exemplars) should always be collected for comparison. Remember: even when you are sure that the deceased has written the note and you are not anticipating doing a handwriting analysis, you should still collect exemplars. This could become an issue at a later date and you will not have an opportunity to obtain such exemplars.

Excerpts from a few suicide notes from cases I have investigated and consulted on over the years are provided next in order to add some insight into the thinking of a person who has chosen suicide as the final solution to a real or imagined problem.

The psychology of suicide becomes an integral part of the professional investigation; often the note provides the detective with a basis of inquiry into the background of the victim for a later psychological autopsy.

Dear Mom and Dad, I guess the past ten years escapades have finally paid off — with my Life...I'm sorry I'm letting a lot of people down, who had faith in me, but I no longer had any faith in myself...

This above case involved a young man who had a serious alcohol problem. The actual note was two pages and contained his telephone number and home address. The note was found in his vehicle, which had been parked on the George Washington Bridge in New York City. The note also contained a drawing that indicated he had jumped into the waters of the Hudson River. His body was found approximately 5 days later.

To my family, I just got a little tired. It's not your fault, but I want you to know I love YOU very much...Love always Dad.

This case involved the suicide of a police officer. I knew this man for some 15 years and would never have suspected that he would take his life. I remember interviewing his wife, who told me, "This was not the [Jack] you or I knew. He changed. There was a drastic change during the week. I think it was the medication he was taking." Jack (not his real name) had been prescribed drugs for an infection. The prescription had put him into a deep depression.

Last will and testament, Everything goes to [Jim] with the exception of the things that belong to [John]. I love you all.

This case involved a young woman who had moved to New York City from the Midwest and become depressed with her life. Although she had a good job as a nurse in a hyperbaric center, her real goal was to be in fashions. She decided to kill herself in front of her place of work. She probably decided that no one would miss her and she did not want to die alone, so she took her pet dog with her. She hooked up a vacuum cleaner hose, which she taped to the exhaust pipe of her car, and ran the hose into her vehicle. She was found by her fellow employees the next morning.

Now, [Eva] doesn't have to say Oh she a pain now I'm dead. Now everybody is happy. I hope I wasn't a problem to nobody but if I was now I am not...I hope I didn't cause so much trouble. Tell everybody I say goodbye. Have a Happy Thanksgiving.

This was an extremely sad case involving a 12-year-old girl, who took her life rather than risk being sexually abused any further by her father. The young girl,

(A)

(B)

Figure 13.20 SUICIDE VICTIM'S AUTO. (A) The victim's auto. Note how the vacuum hose has been taped to the exhaust pipe. The victim had placed the hose inside the front door of her vehicle to allow the fumes to flow inside. (B) The victim's face presented with a cherry-red complexion, which is consistent with the inhalation of carbon monoxide poisoning. (From the author's files.)

who was staying with relatives, believed that her father, who had recently been released from prison, might take her back to live with him. Investigation indicated that she had been abused since she was 5 years old. She shot herself with an unlicensed .38 caliber handgun after swallowing a number of pills.

Brother and sister, we didn't have anything else in this world. Please put our bodies in the same coffin...We love you all...Don't be sad about us. Everything is in God's hands...

This was a classic "lovers' suicide pact." The two bodies were found in a motel; both of them had been shot through the head. The male was found with the gun by his hand. They were both lying in bed. The note was found on a lamp table next to a Chinese symbol that meant eternity.

I reviewed an investigation for a detective who wanted me to analyze the suicide notes left by the victim. The series of notes were classic examples of suicide cognition. These notes contained a combination of intense feelings. There was anger, rage, and revenge. There were classic suicide ideations of a better afterlife to be shared with loved ones. There were acceptance, hope, and a plea to God for forgiveness. There were instructions to her best friend on burial arrangements. There was an expression of gratitude to her friend, whom she thought of as family, and there were admonitions.

The notes indicated an intense anger and rage toward the victim's granddaughter, whom she accused of stealing her money. The victim blamed her granddaughter for all of her depression. There was even a suggestion of revenge as the deceased wrote:

When you receive this letter from me, I will be gone and where you can not hurt me anymore.

The note then went on to list all of the money and gifts that the woman had given her granddaughter over the years, including the power of attorney, to assure her well-being in later life.

How could you rob a grandmother, who did all that...I hope that you shed as many tears as I did. Any person, that can do what you did to me, is a person lost...God can see you for what you are...Before, I close I want you to know that no matter where you are day or night, I will follow you with my eyes...Remember, I am your shadow looking at you until you tell me why you robbed me, mistreated me, and then hated me. You will suffer as I have suffered.

In another note, the deceased asks for forgiveness and expresses her thanks to her best friend:

(A) (B)

Figure 13.21 SUICIDE PACT. (A) Two Vietnamese lovers made a pact to kill one another when their families objected to their relationship and pending marriage. Their bodies were discovered in bed in a motel room. Both suffered gunshot wounds to the head. (B) A Chinese symbol for eternity was found on the night table next to the bed where the two suicide victims ended their lives.

You have been a good friend, a sister, a mother God has sent to me. I love you like a daughter. I can't thank you enough for taking care of me...I will be looking down smiling at you and I hope that I will find peace...I will pray for you and will be at Joe's wedding. You won't see me, but I will be there. [classic ideation]

Dear God forgive me. I can't keep going on anymore. I don't want to live anymore, I want to be with my God. I want to go home and be with my beloved daughter and be with my Lord. [The daughter had predeceased the victim — another classic ideation.] I know that God will forgive me, because He knows that I have tried. I am so sorry...Christmas coming, just can't do it. I will be with God and my daughter and my husband. God loves me. Please think kindly of me and forgive me.

[instructional] [Name], maybe you should have this [note] copied just so it doesn't get lost in case you may need it.

I want to keep my little medal of the Blessed Virgin that I have around my neck on me. I want to take the medal with me. [ideation of going to heaven]

[instructional] Remember to check and see that I have all the underclothes on me when am layed [sic] out. [The deceased, who was elderly, was concerned about modesty.] Thank you for every thing and God will repay you some day...

Background Information

It is important to note that the deceased may have indicated an intent to commit suicide through activities and statements prior to death. The investigation should focus on any prior mental disease or defect. Was the deceased under any professional treatment? Consider obtaining this information via subpoena if necessary. The therapist–client relationship is terminated with the death of the client. Has the deceased ever attempted suicide in the past? Research has indicated that persons who have attempted suicide in the past are likely to repeat these behaviors under similar circumstances. Has anyone in the family ever committed suicide? There may be underlying pathological or psychological dynamics to consider. Any diaries, unmailed letters, or similar writings should be examined for information that may explain the death. Many suicide deaths are preceded by verbal threats of selfdestruction and other indications of despondence. In some instances, these threats are made to people whom the deceased respects or highly regards. In other instances, sudden change in behavior is shown by subtle actions, such as increasing life insurance, giving away prized possessions, disregarding doctor's advice, or abuse of alcohol or drugs.

Psychological Autopsy

The psychological autopsy is a collaborative procedure involving law enforcement and mental health experts who attempt to determine the state of mind of a person prior to the fatal act. By examining the victim's lifestyle and interviewing the friends and relatives, they determine whether the death was accidental or involved suicide. Warning Signs

1. A change in sleeping habits — sleeping more than usual or staying up much later — followed by sadness

2. A change in eating habits — weight loss or lack of appetite

3. A lack of interest in sex — loss of sex drive

4. A sudden drop in grades or school attendance (young people); loss of work interest (adults)

5. Loss of interest in favorite activities, hobbies, or sports

6. Loss of interest in friends, family, etc. — isolation

Extreme Danger Signs

1. Suddenly becoming cheerful or calm after a depression — a sudden euphoria or burst of activity. This could mean that the person has resolved the inner conflict by deciding to take his or her life. The decision is made.

2. Giving away prized possessions.

3. Speaking of life in the past tense — e.g., saying, "I've loved you" or "You've been a good mother."

Investigative Considerations

Evaluation of the Wounds

1. Could the deceased have caused the injuries and death?

2. Was the person physically able to accomplish the act?

3. Are the wounds within reach of the deceased?

4. Are the wounds grouped together?

5. Is there more than one cause of death?

6. Describe the nature and position of the injuries.

7. Are there any hesitation marks?

Psychological State of the Victim

1. Obtain a background of the victim from family and friends. This background should include medical as well as social information

2. Were there any warning signs indicated by the victim?

3. Were there any recent deaths in the family?

4. Is there any indication of a recent upset or stress?

5. Did the victim leave any notes? Request a sample of the victim's handwriting for analysis in case a note is later discovered.

6. Did the decedent have any close personal relationships, close friends, etc.?

Interview as soon as possible.

Any Prior Mental Disease or Defect

1. Had the deceased been under any professional treatment?

2. Had the deceased attempted suicide in the past?

3. Has anyone in the family committed suicide?

4. Was the deceased a heavy drinker?

5. Was the deceased on any medication?

6. Was there a history of drug abuse?

7. Was there a history of physical or psychological abuse to the deceased?

Final Exit Suicide Investigations

Introduction

This section addresses the phenomenon of victim-facilitated suicide and victimassisted suicide events in which the individual has followed instructions provided in the book Final Exit. In my capacity as a homicide consultant, I have had the opportunity to interact with many investigators from a number of different agencies within the United States and Canada. As a result of an informal survey conducted among attendees at my Practical Homicide Investigation® programs, I have discovered an increase in these types of suicides. I selected the city of St. Louis for my case illustrations; however, my research indicates that a significant number of Final Exit suicides occur throughout the country. In an article appearing in The New York Times on November 6, 1993, medical authorities in New York City reported an increase in the number of suicides since the publication of the book. The article also referred to statistics from the National Center for Health Statistics, which reported that plastic bag asphyxiation types of suicides increased 30.8% between 1990 and 1991.9

In 1991, Mr. Derek Humphry wrote a very controversial book entitled Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying.10 Ironically, this book about suicide and death actually topped The New York Times bestseller list in 1991. In 1992, it was published in many languages and made available

Figure 13.22 FINAL EXIT. This book is often found at the scene of a "Final Exit suicide" with notations in or highlighting of pertinent chapters. (From the author's files.)

in a revised and updated paperback version. Published as an informational aid to end life, this book actually provides detailed instruction and guidance to the reader on how an individual can effectively terminate his or her life.

The initial impassioned debates over whether this book should have been published have since diminished. The moral implications of such a treatise rightly remain the subject of theology and personal religious beliefs. However, Mr. Humphry does make a statement early in his book: "If you consider God the master of your fate, then read no further. Seek the best pain management available and arrange for hospice care" (p. 4).10

However, once Mr. Humphry gets that "God" question out of the way, he further states, "If you want personal control and choice over your destiny, it will require forethought, planning, documentation, friends, and decisive, courageous action from you. This book will help" (p. 4).10

In my professional opinion, this book provides someone predisposed to suicide the wherewithal and step-by-step guide to terminate his or her life. It is not my intention to debate the moral implications of this book or to impose my theology and belief in God on the reader. Instead, I wish to focus on the investigative considerations that this book presents in suicide investigations. Investigators need to be cognizant of the concept of self-deliverance and the methodologies presented in Final Exit in order to conduct professional death inquiries — particularly, if the deceased was assisted in the suicide by another person. At the risk of increasing Mr. Humphry's book sales, I do recommend that investigators secure a copy of Final Exit for their research library as a reference source in the event that they encounter such cases.

Synopsis of Contents

Final Exit is composed of two major sections. Part 1 is entitled "Self-Deliverance for the Dying Person" and comprises 23 brief chapters. Each of these sections addresses substantive issues in the dynamics of suicide and euthanasia. Contents include

"The Euthanasia Decision"

"Shopping for the 'Right Doctor'"

"Beware of the Law"

"The Hospice Option"

"The Cyanide Enigma"

Ways to die (presenting a number of options and case scenarios)

Going together

"Self-Deliverance via the Plastic Bag"

Recommendations of medications and how to obtain the drugs

How to avoid the medicolegal autopsy

Insurance considerations

What letters need to be written

Sample legal forms

Documentation

A final exit checklist

Part 2, "Euthanasia Involving Doctors and Nurses," comprises five chapters, which address the medical profession and the law, including a section on Dr. Jack Kevorkian's "suicide machine." Final Exit includes a drug dosage table (with footnotes to drug dosage), which identifies the most effective drugs for self-deliverance by generic and trade names. In addition, there a listing of recommended readings, information on the Hemlock Society (a group formed in 1980 to campaign for the right of a terminally ill person to choose voluntary euthanasia), and four appendixes dealing with the Death and Dignity Act, pain control, suicide hot lines, and a living will and durable power of attorney for health care.

Investigative Considerations

Specific instructions within Final Exit will indicate that the deceased intended to commit suicide and was guided by the rationale of self-deliverance. The presence of the book at the crime scene as well as the dynamics of the suicide event should be properly documented. In addition, certain items at the scene as well as the circumstances of the death might suggest the possibility of victim assistance.

Letters to Be Written

In Chapter 17, Mr. Humphry explains the importance of the "suicide note":

It must clearly state why you are taking your life, that you accept sole responsibility, and that nobody else persuaded you. In the event you are discovered before death has taken place, you must demand that you are not to be disturbed but allowed to die. Using the law of informed consent, you cannot be touched or treated without your permission. If you were revived you could, technically, sue for battery (p. 81).10

Mr. Humphry also states that the person can use a tape recorder to make the suicide statement, clearly marking the cassette, "My Final Statement" (p. 83).10

In addition, the reader is advised to attach to the suicide note copies of a living will and durable power of attorney for health care. (The reader is provided with an address and telephone number for information where to obtain these items.) The reader is also advised to make two copies because the police and/or coroner will take a copy.

Case History

St. Louis Police were called to an apartment to "check the well-being" of the occupant. Upon arrival, the officers met the concerned friend, who had called the police after being unable to make contact. The police were admitted to the secured apartment by the building manager and discovered the deceased. The victim was discovered nude, face down. There was a syringe and a large amount of prescription drugs at the scene.

Police Investigation

P.O. Daniel Chitwood conducted a preliminary investigation for follow-up by Detective Sergeant Joseph Beffa, St. Louis Homicide. The investigation revealed that the deceased was HIV positive and terminally ill with the AIDS virus. According to his close friend, the deceased had talked of committing suicide on several occasions. There were three letters found at the crime scene indicating the deceased's suicidal intention as well as a copy of the book Final Exit. The case was classified as suicide

The three letters were written according to the recommendations in Final Exit, one of which used the "Law of Informed Consent":

"To whom it may concern:

I [name deleted] have decided to end my life because of my AIDS DISEASE. I have seen too much pain and been through alot! I am tired of trying and no longer wish to continue life as I know it and as I know my body will become...

This decision is known to no other and has been mine alone in a normal state of mind. No one helped or persuaded me to take my life.

If I am discovered before I stop breathing. I will certainly sue anyone who attemp [sic] to revive me. Do not touch me until I'm dead. [signed by the deceased]

Self-Deliverance via the Plastic Bag

In Chapter 19, Mr. Humphry makes reference to the use of a plastic bag as an aid in self-deliverance. He states, "If you don't have the help of a physician to aid the dying, then a plastic bag as well as drugs is highly advisable" (p. 91).10 Mr. Humphry states that it is important that the bag be firmly tied around the neck in order to prevent any air from coming through. He also makes reference to the use of an icebag to avoid the distress of breathing hot air, which may create an unpleasant hot and "stuffy" feeling.

The author makes reference to "devoted couples" wanting to handle the process themselves and also instructs the reader on the law relative to assistance in suicide:

The actual helping of the person constitutes the crime by demonstrating intent. Intent is necessary for successful prosecution. So it is preferable if the person wanting deliverance does it alone. There is no legal risk in removing the bag once the person stops breathing. Removal also reduces the chance of police or medical examiners suspecting suicide (p. 95).10

Mr. Humphry points out that the two best methods of self-deliverance are from the use of selected prescription drugs, aided by a plastic bag (p. 109);10 he also recommends barbiturate drugs such as secobarbital (Seconal) and pentobarbital (Nembutal) as first choice, followed by Valium and Darvon, which are nonbarbiturates. He asserts that drinking alcohol will hasten the drug's effect by 50% (p. 110)10 and that vodka is extremely effective (pp. 112).10

Case History

St. Louis Homicide detectives were dispatched to a call of "suspicious sudden death." Upon arrival at the location, they observed a female victim lying on her bed with an ice-pack under her neck and a plastic bag covering her head. The detectives also observed 11 bottles of various prescription medication bearing the deceased's name.

Police Investigation

Detective Sergeant Alfred Adkins and Detective Dave Calloway conducted the police investigation. Their analysis of the circumstances and facts surrounding this incident revealed that the deceased had numerous medical problems and was seeing a

Figure 13.23 FINAL EXIT SUICIDE VICTIM. The victim was discovered with a plastic bag over her head and evidence that she had taken an overdose of prescription drugs. (Courtesy of Lieutenant Alfred Atkins and Detective David Calloway, City of St. Louis, Missouri, Metropolitan Police Department.)

psychiatrist. She had recently been despondent and, according to a close friend, had stated that she was going to get all of her affairs in order and leave the world. The deceased often spoke about suicide and had bought several books on the subject including Final Exit.

The detectives seized the book as evidence. In their police reports, they referenced Chapter 19, "Self-Deliverance via the Plastic Bag," and Chapter 22, "The Final Act," due to the similar circumstances of the decedent's death. The victim had apparently followed the instructions in Final Exit. Their investigation indicated that she was not assisted in her death and the case was classified as suicide.

In Chapter 22, Derek Humphry presents the reader with the following "selfdeliverance" procedure:

The Final Act

1. An hour beforehand have an extremely light meal — perhaps tea and a piece of toast — so that the stomach is nearly vacant but not so empty that you would feel nauseous and weak.

2. At the same time, take a travel sickness pill such as Dramamine, which will ward off nausea later.

3. When the hour has elapsed, take about ten of your chosen tablets or capsules with as large a drink of spirits or wine as you are comfortable with. Vodka is extremely effective. If you cannot drink alcohol, use your favorite soda drink.

4. Have the additional powdered tablets already mixed into a pudding and swallow that as fast as is possible.

5. Throughout, keep plenty of alcoholic drink or soda at your side to wash this all down. It will also help dilute the bitter taste.10

Case History

The body of a 38-year-old male was discovered in a warehouse in St. Louis, Missouri, by two members of a rock band that used the building for band practice. The deceased was found lying on his back. A cylinder of compressed gas and an empty bottle of vodka were lying next to the body. The label on the cylinder indicated that the gas was carbon monoxide. Several handwritten notes, apparently written by the deceased, were found near the victim, which indicated his intention to take his life by inhaling the carbon monoxide gas along with "what to do" instructions to whoever found his body. Also found next to the victim's body was the book Final Exit.

Police Investigation

Detective Sergeant Joseph Beffa and Police Officer Daniel Chitwood conducted the death scene investigation. The deceased left four notes. The first note was addressed to "Young Rockers" and dated the day before. The victim instructed them (1) to turn off the gas and (2) not to smoke. He then explained that he got into the "Rock Warehouse" and hid in the corner while the band rehearsed. He stated, "I enjoyed it — Thanks." He then added, "Sorry for the hassal [sic]" and signed his name.

In Chapter 17, Mr. Humphry states, "If you are unfortunately obliged to end your life in a hospital or motel, it is gracious to leave a note apologizing for the shock and inconvenience to the staff" (p. 82).10 Although not in a hospital or motel, the deceased took the advice and left this note apologizing for any inconvenience he caused by taking his life at the warehouse.

There were two suicide notes. One stated, "I have committed suicide," and provided the name of a police official from his hometown to contact. The second note was a three-page handwritten letter in which the deceased discussed his rationale for ending his life.

The fourth note was attached to a gas company receipt. This receipt indicated that the deceased had put a $100 deposit down for the carbon monoxide cylinder. In his note, he apologized to the company representative for "tricking" her into providing him with the gas. He then requested that they help his parents get the deposit money back.

On pages 152 and 153 in the Final Exit book found at the crime scene, the investigators noticed that the deceased had underlined and circled those passages relevant to the use of carbon monoxide gas; on page 153, he had written "how many cubic feet?" The authorities seized the book and photocopied this reference for their file on this case. The death was classified as suicide.

(A)

(B)

Figure 13.24 FINAL EXIT CASE. (A) Victim used a canister of carbon monoxide to end his life. The Final Exit book was found at the scene. (B) Suicide notes and book with some entries marked were found at the scene just as described in Final Exit. (Courtesy of Lieutenant Joe

Beffa, Homicide Squad, City of St. Louis, Missouri, Metropolitan Police Department.)

Investigative Checklist for Final Exit Cases

Is the book Final Exit at the crime scene?

Check the book for any entries, highlighting, or writing relative to what is observed in the crime scene and how this relates to what is observed in the crime scene or any evidence of "acts of self-deliverance." Are there any suicide notes at the scene?

Seize these notes as evidence for fingerprint and handwriting analysis.

Obtain a handwriting exemplar (writings of the deceased when he or she was alive).

Compare the contents of the notes with the "Letters to Be Written" chapter recommended in the book Final Exit.

Take "major case" prints of the deceased. These include not only fingerprints, but also palmar (hand) prints.

Request "major case" prints from all persons present or who are considered close to the deceased.

The plastic bag: Presence of a plastic bag at the scene is highly suggestive of a Final Exit type of suicide. The investigator should note and document the following:

Is there a plastic bag over the victim's head or present at the crime scene? Submit the entire plastic bag for an examination of latent fingerprints. Check the plastic bag for any fingerprints for comparison with/elimination of the deceased's prints.

Seize all prescription drugs/medication at the scene for subsequent toxicological examination

Note trade name, doctor, pharmacist, and date.

Compare these with the drug dosage chart in Final Exit.

Remember: There is a presumption of possible victim assistance in these types of suicides based upon the information in Final Exit.

Recommendations

I recommend that investigators be cognizant of the concept of self-deliverance and the methodologies presented in Final Exit in order to conduct professional death inquiries. At present, no empirical study of these cases has been conducted due to the lack of an identifiable population of cases. The informal sampling that I conducted tends to support the hypothesis that these events are occurring with some regularity. Therefore, I recommend that investigators who encounter these events make an appropriate reference to the case as a "Final Exit suicide."

Conclusion

Final Exit types of suicides are distinctively unique from other suicide cases. They are planned events, with possible victim assistance. Law enforcement personnel who investigate sudden and violent deaths have a responsibility to document and classify these events properly.

Staged Crime Scenes Involving Final Exit

Investigators should be aware that a clever perpetrator could mislead the police by committing a homicide and making it appear to be a Final Exit suicide. The author reviewed a case in which the scene had been staged as a Final Exit suicide. The victim, who had been on chemotherapy after an operation to remove ovarian and liver cancer, had recently been informed that the cancer tumors had started to grow. She was found in her bed with a gun by her right hand. There was a typed note at the scene stating, "I can't take it anymore, no more, no more." The book Final Exit was found next to the victim. The death appeared to be a suicide, especially considering the victimology of the deceased.

However, the woman's death was in fact a cleverly disguised murder. The son of the victim had purchased Final Exit with the mother's credit card. He had shot her in the head while she was sleeping. He then wiped off the gun and placed it near her hand. He typed the suicide note and placed it on the night table next to the book and then called police to report that his mother had killed herself. (See "The Staged Crime Scene" in Chapter 1.)

Suicide-by-Cop

Introduction

The term "suicide-by-cop" is a police colloquialism used to describe incidents in which individuals, bent on self-destruction, engage in life-threatening and criminal behavior in order to force the police to kill them.

Example

A 27-year-old male, identified as Tim Sebastian, called the Butler County Sheriff's Department, in Hamilton, Ohio, to report that a man (himself) was prowling around his home and that the man was armed and dangerous. He then cut his telephone lines so that his wife could not call back. When the officers arrived, Sebastian approached them despite their instructions for him to remain still. The officers attempted to discourage Sebastian from making any further threatening motions. He then pulled a shiny metallic object from his belt and pointed it at one of the officers. Both officers fired, hitting the man in the chest. The object turned out to be a pair of vice grips. A review of the incident indicated that the subject had given a farewell birthday gift to his son before calling police and had made a prior suicide attempt earlier in the month by swallowing rat poison. This is an example of suicide-by-cop.

This phenomenon confronting law enforcement appears to have begun in the mid-1980s. These events are seemingly on the increase. However, because they are not classified as suicide-by-cop, the actual number of these incidents is unknown. To date, no empirical study of these events has been undertaken. Historically, there have been many justifiable homicide events resulting from the imminent use of deadly physical force against law enforcement officials. Most of these police shootings occur during the commission of a violent crime or in connection with an independent police action resulting in a confrontation between the offender and the police.

However, there has been a growing number of justifiable homicides, in which police officers have shot and killed an apparently armed individual who threatened the officer or others with the immediate use of deadly physical force. The subsequent homicide investigation, assessment, and review of the circumstances reveal many of these events to be victim precipitated.

The dynamics of such victim-precipitated homicides is that the police officer is confronting an individual who has a death wish and intends to force the police into a situation where the only alternative is for the police to kill him. The motivations of these people bent on self-destruction range from the clinical to the bizarre.

Early Example

An example of one such bizarre circumstance was played out in Jasper, Arkansas. Keith "FOU" Haigler and his wife, Kate, took a busload of hostages in order to force a confrontation with the police. They were members of a religious cult called the Foundation of Ubiquity (FOU) also known as the Father of Us. Keith Haigler stated, "I am the spiritual son of the long awaited Messiah." The entire episode was based on a delusional belief that they would be resurrected after the police killed them. The media covered the event, during which Haigler made the following statements:

We are the two witnesses spoken about in the Book of Revelations...We want you [the media] to put this nationwide. The long awaited Messiah is here. The proof is that we are going to be shot by the police officers. We have the consent of my father to have our bodies placed on his land for 3 1/2 days. After the 3 1/2-day period, the spirit of life and God enters. They stand on their feet...It's all in the Book of Revelations.

As the police were attempting to negotiate with Haigler, the media advised that they had to get their film to the local T.V. station in time for the evening news. At this point, Haigler stated, "I want you to get the shooting in." A short time later, Keith and Kate "FOU" Haigler exited the bus with their guns in hand. The police fired at their right shoulders to immobilize and save them from themselves. However, both parties turned the guns on each other in a homicide/suicide ending. It should be noted that on the third day neither one of them rose from the dead.

Clinical Interpretations

I interviewed Dr. Harvey Schlossberg, former director of Psychological Services of the New York City Police Department and presently chief consulting psychologist for the Port Authority of New York and New Jersey.11 I asked him whether he recognized the phenomenon of "suicide-by-cop" scenarios. He stated, "Absolutely. It is crystal clear. These type incidents represent clear-cut suicides in which the offender is inviting the police to kill him." Dr. Schlossberg described an incident involving two police officers. They had responded to a "man with a gun" call and were confronted by an individual who took up a barrier position and pointed his weapon at the police. The police ordered the man to drop his gun. He refused and made actions as if he were about to fire the pistol. The man was shot and killed by the police. His pistol was actually a toy gun. This case is an example of a clear-cut intention to die by police gunfire.

Dr. Schlossberg has testified as an expert witness in many such cases in New York City and across the U.S. He states:

The motivational elements in such incidents illustrate the person's desire, oftentimes unconscious, sometimes conscious, to commit suicide. Determining the motive is based on the type of weapon, which includes unloaded or imitation guns; the threat to shoot, which forces the police to fire; and the discovery of an intent on the part of the subject to commit suicide. In other situations, the individual may be seriously psychiatrically disturbed and there will be an extensive psychiatric background.

I asked Dr. Schlossberg why people selected police officers as a vehicle of their deaths. He replied:

It's the most obvious and easiest way to die. Suicide by jumping from a tall building, suicide by running your car into a tree, and suicide by blowing your own brains out requires a decision on the part of the person bent on self-destruction. If you can get someone else to do it for you, you are "writing-off the sin" or avoiding the stigma or social taboos associated with suicide. The police are a good object for this. Police symbolically represent the social conscience. Sometimes, suicidal people feel guilty about something real or imagined. They seek punishment. In other cases they just don't have the guts to end it all.

The Psychopathology of Suicide-by-Cop Scenarios

I interviewed Dr. Ronald Turco, a psychiatrist and police detective from Beaverton, Oregon, who stated that suicide-by-cop scenarios may take several forms:12

1. Individuals simply are depressed to the extent that they wish to die, but do not want to take their own lives. There may be a degree of grandiosity associated with the act of a public display of their difficulty and having the supreme authority figure take their lives.

2. In other instances and possibly at the root of all such occurrences is the identification that the individual has with a parent figure or substitute that

has been rejecting and critical. In such an instance, the parent may have harbored an unconscious wish for the destruction of the offspring. It is as if the individual is asking the police officer to kill him or her because this represents the ultimate hostility toward the original parent. It is as if he or she is saying, "You want me dead. Go ahead and kill me. This is what you want. To hell with you."

3. In some cases of terrorists' activity, the individual has identified with a "super cause" and desires to die at the hands of the hated enemy in a show of defiance. Usually, this type of suicide-by-cop comes at the end of a hostage negotiation that has gone sour or under circumstances in which the member or members of the terrorist group do not wish to capitulate to the "enemy" and therefore choose to be blown up, shot, etc. and go down "in a blaze of glory."

According to Dr. Turco,

The most commonplace police officer–assisted suicide is that of a mentally ill person who is simply depressed, is acting out a rage toward a parent or parent substitute (in psychiatric terms, an introjected object), and has basically cast the police officer in the role of despised parent. Therefore, the individual accomplishes his own destruction, but flaunts it in the face of authority. Police officers in such instances experience various degrees of guilt, sometimes necessitating treatment.

Hostage Situations

Many suicide-by-cop scenarios involve hostage taking. This requires that police personnel on the scene be effectively able to diffuse the situation and/or dissuade the hostage taker from harming the hostages or himself. Hostage negotiation skills are of paramount importance in such incidents. Dealing with hostage incidents requires setting up communications, establishing a command post and support personnel for the negotiator, and effective intelligence gathering in order to formulate a negotiating strategy and cooperative team effort with the tactical unit.

I interviewed retired Detective Captain Frank Bolz, Jr.,13 who was one of the founders of the New York City Hostage Negotiation Team and is presently a crisis management consultant. Frank Bolz is the author of The Counterterrorism Handbook: Tactics, Procedures, and Techniques, second edition — one of the textbooks in my Practical Aspects of Criminal and Forensic Investigations series. Bolz states, "The perpetrator of a hostage situation has four perceived options: escape, surrender, suicide, or homicide. For two of these options, suicide and surrender, there seems to be a ritual that a subject will go through. These are difficult for the police to differentiate." Some suicide indicators are

1. The subject sets a deadline for his or her death.

2. The subject mentions names of people who are dead and talks about them as if they are still alive or indicates that he or she will soon be with them.

3. The subject makes verbal statements or arrangements for the disposition of "worldly goods," giving away "prized possessions," which includes items he or she has at the time of negotiations — i.e., wrist watch, rings, etc.

4. The subject may create a confrontational face-to-face negotiating posture with the police.

5. The subject makes an announcement or declaration of intent to die.

6. The subject makes biblical references, specifically as they relate to the Book of Revelations and resurrection.

According to Bolz, who is a recognized authority on hostage negotiations,

The resolve to commit suicide many times fades or is diminished if the person is contained and allowed to articulate and ventilate his or her problems. Many times, in hostage/barricade situations, the tactical people inadvertently contribute to the success of the perpetrator committing suicide by police because they do not have good cover and are forced to respond with fire power in order to save their own lives.

However, when one sets his or her mind to commit suicide-by-cop, police negotiations and tactics will probably not dissuade their intentions. The Jasper, Arkansas, incident in which two religious cult members wanted to die at the hands of the police is an example of such intent.

Classic Case History Involving a Retired Police Officer

On August 6, 1992, at approximately 6:57 P.M., Richard Raymond Segura entered a retail store in a shopping mall located at 3329 E. Bell Road in Phoenix, Arizona. He approached the clerk and asked her to call the police, stating that there was a man in the parking lot waving a gun around. The clerk called 911 and was asked for a description by the police operator. The clerk went outside and contacted Mr. Segura. When the clerk asked about the man with the gun, Segura told her it was him and showed her a gun. The clerk returned to the store and notified the 911 operator.

Phoenix police officers Gregory Sargis, Dean Flaherty, Ben Leuscher, and James Collins were among the first officers to arrive at the parking lot of the shopping complex. The officers had received a description of the "man with the gun" and his vehicle from the police radio and spotted their suspect on the north side of the parking lot. As Officer Collins drove towards the subject's vehicle, he saw the man get out of the car with a gun in his hand. The man held his weapon up for Collins to see and "worked the action." Officer Collins exited his vehicle and drew his service weapon. The man then reached back into his auto and removed a red colored book. He held his weapon in his right hand and the red book in his left hand and began to move towards Collins. In the meantime, Officers Sargis, Flaherty, and Leuscher had positioned themselves behind their police vehicles. Officer Collins yelled to the man to drop his gun and Segura stated, "I can't do that" and kept advancing. Segura then stated, "Shoot me, but don't mess up my face."

As the suspect got closer, Collins retreated to the rear of his car. At this point, all four of the officers were yelling to the man to drop his gun, but he repeatedly yelled, "Shoot me." During this confrontation, Segura was facing Collins and Flaherty. Officers Sargis and Leuscher were south of the suspect. As Segura made a movement of his right arm towards Officer Collins, Officer Sargis fired two shots, one of which hit the suspect in the chest. The suspect Segura died at the hospital. His weapon was a .380 caliber semiautomatic pistol, which was unloaded but with the hammer cocked.

Richard Raymond Segura was a 42-year-old male Hispanic who had been a deputy with the Pima County Sheriff's Office. He had retired in 1989 due to injuries he had received on the job. Investigation revealed that approximately 2 weeks before this incident, Segura and his wife had become involved in a domestic altercation. Richard Segura was reportedly despondent over the break-up of his marriage and apparently decided to take his life by forcing the officers to kill him. Among the items that Segura held in his left hand during the confrontation was a handwritten note stating, "I love you my dear wife. To live without you and Krystal is not to live at all." The note had his address and telephone numbers and was signed, "Love, Chiquito." At the bottom of the piece of paper Segura had apparently left a message for the police officers who were forced to fire upon him. It stated, "Thanks guys, always trust your own to do the job."

Psychological Ramifications for Police Officers Involved in Suicide-by-Cop Incidents

Suicide-by-cop scenarios psychologically traumatize the officers involved in such incidents. According to psychiatrist Ronald Turco and psychologist Harvey Schlossberg (forensic experts in the field of police-related stress), officers will be depressed and angry upon discovering that they were used for an execution. They need to vent and get in touch with their anger. Both recommend intervention strategies.

According to Dr. Schlossberg, who has treated a number of officers for shootingrelated stress, the effects of a suicide-by-cop incident can be devastating. It amounts to a psychological assault on the officer. He or she is basically shattered as a result of the incident.

As a general rule, people tend to feel guilty about their actions. It is part of human nature to feel guilty. We are basically governed by guilt — you should do this, you should not do that, etc. The officer finds himself or herself second-guessing the incident: Maybe I should have held fire until I could get a better look at the gun. Maybe I should have tried to physically disarm him, etc. The officer begins to relive the incident over and over again. All of these thoughts are psychologically damaging and parallel post traumatic stress disorder (PTSD). Some of the most common symptoms are depression coupled with anxiety, an inability to sleep, hypersensitivity, irritability, nightmares, and flashbacks.

In addition, civil suits will probably be filed by lawyers for the family of the deceased against the police, and the sympathies will generally be for the surviving family. This seems to reinforce the guilt the officer is already experiencing. According to Dr. Schlossberg, critical incident stress debriefings and intervention are a must. Ironically, the officer finds himself or herself in a moral dilemma based on role conflict. The messages police receive are twofold: Shoot to kill. Defend yourself. You are supposed to shoot the bad guy. The media, T.V., and movies — e.g., Dirty Harry, Out for Justice, Lethal Weapon — all support the concept of the police shooting the offender. At the same time, the other message being driven home by many police administrators is "You are not supposed to shoot your gun. Shoot only as a last resort. You will be suspended and placed under investigation, etc." According to Dr. Schlossberg, these dual messages amount to the "double-bind" concept where the individual receives contradictory messages as portrayed by the schizophrenogenic mother who tells the child, "You have to drink your milk" and then adds, "You're putting on too much weight, don't drink so much milk."

The Racial Component in Police-Related Shooting Incidents

A police-related shooting incident in which a minority subject is killed by police can cause community unrest and in some instances major civil disturbances. The shooting may be justifiable; however, many times the potential for civil violence can be exacerbated by certain individuals, who can best be described as racial racketeers. I refer to them as the racial PEP squad: the provocateurs, entrepreneurs, and prevaricators, who have made a business of racism in this country. In the case cited in the following case history, some members of the black community alleged that the police shooting was unnecessary. There were demonstrations against the police and a suggestion that the death was racially motivated.

Case Histories — Racial Incidents

Incident: St. Louis, Missouri. A 17-year-old black male was shot and killed by police. A hostile crowd gathered and surrounded the police, who called for assistance. The allegation by some members of the community was that the police shot an unarmed youth for no reason.

Facts: The police officers had attempted to pull the suspect over for a series of traffic violations. There was a pursuit when he failed to comply. The suspect drove onto a front yard. When the police approached the suspect, he reached for a gun in the back seat and pointed it at the officers. The officers yelled twice to the suspect to "drop the gun." The suspect shouted, "You'll have to kill me." He then turned toward one of the officers with a gun in his right hand. The officer fired four shots at the suspect. As the suspect was being handcuffed, he stated, "Please kill me, please kill me." The gun was unloaded.

Investigation: The investigation revealed that the suspect, who was upset with his girlfriend, had told his grandmother that he was going to kill himself or someone else. Other relatives confirmed that the subject was "acting and talking crazy" and had made statements that he was going to kill himself. He had last been seen by a friend who saw him run out of the house, enter his jeep, and speed away.

Investigative Considerations

Practically speaking, incidents of suicide-by-cop should be investigated as homicide and suicide. The investigative procedures employed should not only focus on the homicide aspect but also on the clinical considerations and dynamics of suicide. The reality of police-related shootings is that the onus is on the police agency involved to articulate and explain exactly how and why the incident took place. In addition, most police-related shootings become matters of civil litigation. Therefore, it is imperative that the police agency's investigation take into account the legal justification aspects of the shooting and indicate whether the incident and police actions were consistent and in conformance with that agency's department policy. In cases where the elements and facts indicate victim precipitation, I would recommend a specific reference to the incident as "suicide-by-cop," with official reports and witness statements supporting this classification based on the dynamics of the event.

References

1. National Center for Injury Prevention and Control, Centers for Disease Control. "Suicide: Fact Sheet." http://www.cdc.gov/ncipc/factsheets/suifacts.htm.

2. Department of Health and Human Services. The Surgeon General's Call to Action to PreventSuicide. Washington, D.C. Department of Health and Human Services, 1999. www.surgeongeneral.gov/library/calltoaction/ default htm.

3. Rosenham, D.L. and M. Seligman. Abnormal Psychology, 2nd ed. New York: W.W. Norton & Co., 1989.

4. Daily News, January 24, 1987, p. 6.

5. DiMaio, V.J. Gunshot Wounds: Practical Aspects of Firearms, Ballistics, and Forensic Techniques, 2nd ed. Boca Raton, FL: CRC Press, 1999, p. 357.

6. Thompson, M., detective sergeant, Las Vegas Metro Police Department. Personal interview,February, 2005.

7. Ezzell, J. Personal interview, November, 2004.

8. Weir, M., crime scene analyst II, City of Henderson, Nevada, Police Department. Personalinterview, March 2005.

9. The New York Times, November 6, 1993, p. A12.

10. Humphry, D. Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying. New York: Dell Publishing Group, Inc., 1991.

11. Schlossberg, H. Personal interview, February 20, 1993.

12. Turco, R., M.D. Personal interviews, February, 1993, and November, 2004.

13. Bolz, Jr., F., retired captain, NYPD. Personal interviews, March, 13, 1993 and November,2004.

Selected Reading

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., rev. Washington, D.C.: Author, 1994.

Coleman, J.C., J.N. Butcher, and R.C. Carson. Abnormal Psychology and Modern Life. 7th ed. Glenview, IL: Scott, Foresman and Company, 1984.

DiMaio, D.J. and V.J. DiMaio. Forensic Pathology, 2nd ed. Boca Raton, FL: CRC Press, 2001.

DiMaio, V.J. Gunshot Wounds: Practical Aspects of Firearms, Ballistics, and Forensic Techniques, 2nd ed. Boca Raton, FL: CRC Press, 1999.

Geberth, V.J. Practical Homicide Investigation: Tactics, Procedures, and Forensic Techniques, 3rd ed. Boca Raton, FL: CRC Press, 1996.

Geberth, V.J. "The Racial Component in Suicide-by-Cop Incidents." Law and Order Magazine, 42, 1994.

Geberth, V.J. "Final Exit Suicide Investigations." Law and Order Magazine, 41, 1993.

Geberth, V.J. "Suicide-by-Cop." Law and Order Magazine, 41, 1993.

Humphry, D. Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying. New York: Dell Publishing Group, Inc., 1991.

Rosenham, D.L. and M. Seligman. Abnormal Psychology, 2nd ed. New York: W.W. Norton & Co., 1989.