Forensic Features of Clothing-Related Deaths: Historical and Cultural Aspects

Non-Fatal accidental strangulation in a stroke patient

Non-fatal strangulation poses a significant concern in clinical forensic medicine. Indeed, surviving victims often present a diverse array of signs and symptoms. In rare instances, acute pathological events that manifest with symptoms similar to those secondary to neck compression (e.g., stroke with subsequent neurological symptoms, etc.) can lead to loss of consciousness, inadvertently resulting in strangulation. Therefore, in this context, forensic investigation plays a crucial role in interpreting the signs and symptoms presented by the victim and determining whether they are the cause or consequence of neck compression. This report presents a case of a middle-aged previously healthy woman who was found by her husband on the bathroom floor and then brought to the medical attention exhibiting signs of neck compression in combination with neurological symptoms. Since a previous episode of domestic violence involving the husband has been recorded in the hospital database, a medico-legal investigation was initiated at the behest of the prosecutor. The integration of all clinical, radiological, forensic pathological findings and circumstantial data allowed the exclusion of homicidal strangulation by ligature perpetrated by the husband, as well as suicidal hanging; instead, it classified the case as an accidental hanging, with a stroke being the underlying cause of the accident. The case provides valuable insights into the complexity of interpreting injuries associated with neck compression and emphasizes the need for comprehensive investigative approach in such cases.

Ligature Strangulation in a Vehicular Accident Due to the Entanglement of a Shirt: An Autopsy Case

Among the various types of asphyxial deaths, strangulation is one of the commonly encountered cases as structures in the neck make it vulnerable to fatality. In most such cases, ligature material, usually cloth, is used for the commission of the offense. Clothing may be associated with a wide range of both accidental and deliberately induced deaths. Accidental strangulation due to entrapment of the neck in clothing, especially in relation to vehicular accidents, has also been described in the literature, but these cases are mostly associated with long scarf-like clothing. Loose clothing and intoxication act as critical factors in entrapping the person in such an event. This case report highlights the rare occurrence of accidental strangulation due to the entanglement of clothing other than a long scarf consequent upon road traffic incident.

Delayed familial self-immolation: A rare memorial event

Self-immolation suicides refer to lethal situations where a victim has intentionally set themselves on fire using an accelerant, or has deliberately stepped into a fire. These are rare events in Western countries accounting for only 0.6-1% of suicides. Two cases are described of familial self-immolation with features of an anniversary/memorial event: Case 1: The charred body of a 66-year-old woman was found beside a suburban waterway with evidence of self-immolation using methylated spirits. Death was attributed to incineration; Case 2: Twenty five years later the charred body of another 66-year-old woman was found on the banks of a nearby suburban river. Analysis of clothing revealed ethanol, a major component of methylated spirits. Death was due to the combined effects of inhalation of products of combustion and incineration. Review of the history revealed that the decedent in case 2 was the daughter of the victim in case 1. This, therefore, represents an extremely rare event, that of familial self-immolation suicides with the daughter choosing the same method that had been used by her mother, at an identical age and in a similar location. These cases add to the potential complexities of familial suicides.

Bride burning: A unique and ongoing form of gender-based violence

Despite legislation, dowry is still widespread in many parts of India and adjacent countries. It refers to the transfer of goods, money, and property to a bridegroom, his parents, or his relatives from a bride's family as a condition of the marriage. One of the consequences of the dowry system has been the murder or abetted suicide of young wives, either because more dowry goods were not provided to her husband or his family, or to secure the goods after marriage. In 2015 7634 women died due to dowry harassment, representing approximately 21 cases per day in India. The majority of dowry deaths occur within the first three years of marriage. Common types of dowry death homicides involve fire ('bride burning', drowning, poisoning and hanging/strangulation. In addition to legislation, an organized and multipronged approach is need by investigating police officers, women's' welfare organizations, responsible public servants, and the judiciary with consistent applications of deterrent penalties. Full and properly conducted medicolegal investigation is mandatory which must include scene examinations, full autopsies with photographic documentation and ancillary investigations such as headspace analyses. Significant burns in young Indian women living in traditional circumstances should raise the possibility of dowry-related crime.