1
|
Kiryakova T, Mileva B, Timonov P, Fasova A, Goshev M, Alexandrov A, Tsranchev II. A Case of Accidental Autoerotic Death by Hanging Linked to Erotic Photography. Cureus 2024; 16:e65087. [PMID: 39171049 PMCID: PMC11337238 DOI: 10.7759/cureus.65087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2024] [Indexed: 08/23/2024] Open
Abstract
Autoerotic death, as a subtype of mechanical asphyxia, refers to a person's fatal outcome while engaging in solitary sexual activity using various devices and methods to reduce oxygen supply and induce cerebral hypoxia, leading to increased sexual gratification. These asphyxial deaths are accidental and sporadic. In cases of sexual asphyxia, especially when strangulation methods such as hanging or ligature are used, thorough crime scene investigation is crucial to determine the type of asphyxia and the manner of death. Inadequate information about specific crime scene findings can lead to significant errors in determining the manner of death and the type of strangulation, potentially leading to cases being mistaken for ligature strangulation in a homicidal manner or hanging in a suicidal manner.
Collapse
Affiliation(s)
- Teodora Kiryakova
- Department of Forensic Medicine, Medical Institute of the Ministry of Internal Affairs, Sofia, BGR
| | - Biliana Mileva
- Department of Forensic Medicine and Deontology, Medical University, Sofia, Sofia, BGR
| | - Pavel Timonov
- Department of Forensic Medicine and Deontology, Medical University of Plovdiv, Plovdiv, BGR
| | - Antoaneta Fasova
- Department of Anatomy, Histology, and Embryology, Medical University of Plovdiv, Plovdiv, BGR
| | - Metodi Goshev
- Department of Forensic Medicine and Deontology, Medical University, Sofia, Sofia, BGR
| | - Alexandar Alexandrov
- Department of Forensic Medicine and Deontology, Medical University, Sofia, Sofia, BGR
| | - Ivan I Tsranchev
- Department of Forensic Medicine and Deontology, Medical University of Plovdiv, Plovdiv, BGR
| |
Collapse
|
2
|
Štěpánka PK, Dalibor K, Tomáš V, Lenka Z, Martin J, Rizwana R, Petr H. Electrocuted to death: A case of an autoerotic fatality with body wrapping, anal masochism, and low abdomen mechanical stimulation. Leg Med (Tokyo) 2023; 63:102265. [PMID: 37150122 DOI: 10.1016/j.legalmed.2023.102265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/14/2023] [Accepted: 04/27/2023] [Indexed: 05/09/2023]
Abstract
Autoerotic paraphilic manipulations may be not only incredibly unusual but also hazardous and possibly fatal. Autoerotic experimenters sometimes combine several paraphilic mechanisms, both potentially lethal and non-lethal. A tragic outcome is usually a direct consequence of the life-threatening paraphilic mechanism(s); however, it may also result from an accidental complication arising from the constellation of the paraphilic realization. In this report, we present a case of an autoerotic death of a 30-year-old man who applied two potentially lethal paraphilic mechanisms-body wrapping and foreign body anal insertion-together with two other non-lethal paraphilic activities, autofetishism and transvestitism. However, the man's death ultimately occurred due to another associated autoerotic activity-stimulation of the lower abdomen with an electric massager, which accidentally short-circuited and caused fatal electrocution. Such autoerotic fatalities constitute a distinct subcategory of accidental autoerotic death.
Collapse
Affiliation(s)
- Pohlová Kučerová Štěpánka
- Department of Forensic Medicine, Faculty of Medicine, Charles University, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic.
| | - Kovařík Dalibor
- Department of Forensic Medicine, Faculty of Medicine, Charles University, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Vojtíšek Tomáš
- Department of Forensic Medicine, Faculty of Medicine, Masaryk University, Brno, St. Anne's Faculty Hospital Brno, Tvrdého 562/2a, 662 99 Brno, Czech Republic
| | - Zátopková Lenka
- Department of Forensic Medicine, Faculty of Medicine, Charles University, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Janík Martin
- Department of Forensic Medicine, Jessenius Faculty of Medicine, Comenius University, Kollárova 10, 036 59 Martin, Slovakia
| | - Riaz Rizwana
- Department of Forensic Medicine, Faculty of Medicine, Charles University, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| | - Hejna Petr
- Department of Forensic Medicine, Faculty of Medicine, Charles University, University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic
| |
Collapse
|
3
|
Curtice M. The Mental Capacity Act 2005 and autoerotic asphyxiation: pleasure versus the risk of harm. BJPSYCH ADVANCES 2022. [DOI: 10.1192/bja.2021.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
There has been a series of judgments in recent years emanating from the Court of Protection in England and Wales involving sexual relations. One such judgment is unique in that it is the first time the court has assessed capacity in the sexual practice of autoerotic asphyxiation in a person with a diagnosis of autism spectrum disorder. This article reviews the judgment and specifically the key section of the Mental Capacity Act 2005, section 27, which applies to capacity decisions in the context of family relationships, including sexual relationships. The practice of autoerotic asphyxia can be a complex and emotive subject and dangerous to individuals undertaking it. The judgment provides guidance and a framework for applying the Act to assess the capacity of someone practising autoerotic asphyxia that can be used in clinical practice for people with any mental disorder.
Collapse
|
4
|
Schori A, Jackowski C, Schön CA. How safe is BDSM? A literature review on fatal outcome in BDSM play. Int J Legal Med 2022; 136:287-295. [PMID: 34383118 PMCID: PMC8813685 DOI: 10.1007/s00414-021-02674-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/20/2021] [Indexed: 11/14/2022]
Abstract
A noteworthy number of people are interested in BDSM (bondage and discipline, dominance and submission, sadism, and masochism). Fatal outcomes while participating in BDSM activities occur. The aim of this literature review is to give a better insight into potential dangerous BDSM play by summarizing published data on BDSM fatalities. A literature search was conducted. It was searched for non-natural death related to BDSM activity. Seventeen cases were found. The age of the deceased ranged between 23 and 49 years (mean age 34.9 years). Strangulation in the course of erotic asphyxiation was the most common cause of death (88.2%). In 13 cases, a toxicology report for the deceased was mentioned, of which in eight cases (61.5%) toxicology analysis was positive. In four of these cases, the BDSM partner was also tested positive with the same substance. Drugs or alcohol was involved in 64.3% of fatal BDSM play. In nine cases, the level of experience in BDMS activity of the deceased and the partner was described, and in all of them, the deceased and the partner were not new to BDSM play. Fatal outcomes of BDSM plays are rarer than autoerotic fatalities and natural deaths related to sexual activities. Safeguards and education on medical aspects exist in the BDSM communities. If they are followed by the practitioners, the risks of BDMS play can be reduced. Cases of non-natural death connected to BDSM are rare incidents and can be prevented.
Collapse
Affiliation(s)
- Anouk Schori
- Institute of Forensic Medicine, University of Bern, Bühlstrasse 20, 3012, Bern, Switzerland.
| | - Christian Jackowski
- Institute of Forensic Medicine, University of Bern, Bühlstrasse 20, 3012, Bern, Switzerland
| | - Corinna A Schön
- Institute of Forensic Medicine, University of Bern, Bühlstrasse 20, 3012, Bern, Switzerland
| |
Collapse
|
5
|
Čakš Golec T, Balažic J, Kavalar R. Accidental autoerotic death. Rechtsmedizin (Berl) 2021. [DOI: 10.1007/s00194-021-00507-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
6
|
Fatal strangulation during consensual BDSM activity: three case reports. Int J Legal Med 2020; 135:347-353. [PMID: 33106895 DOI: 10.1007/s00414-020-02449-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022]
Abstract
Autoerotic accidents are well-known occurrences in forensic casework. Reports about unintentional deaths in a sexual context involving other persons are much rarer. Three cases of fatal incidents related to asphyxiophilia during consensual BDSM activity are reported. Two men died while visiting a dominatrix, the third one in the presence of a male casual sexual partner. Paraphernalia associated with BDSM/fetishism were found at the scene in all cases. Autopsy findings were compatible with death by strangulation. The cases are compared with published autoerotic accidents and similar unintentional deaths involving other individuals. The difficulties concerning the forensic assessment and reconstruction of the cases are discussed.
Collapse
|
7
|
Lohner L, Sperhake JP, Püschel K, Schröder AS. Autoerotic Deaths in Hamburg, Germany: Autoerotic accident or death from internal cause in an autoerotic setting? A retrospective study from 2004-2018. Forensic Sci Int 2020; 313:110340. [PMID: 32497993 DOI: 10.1016/j.forsciint.2020.110340] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/10/2020] [Accepted: 05/12/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Autoerotic deaths are rare events. The death scene is often bizarre and the death unexpected, thus often requiring forensic autopsies. Our analysis will provide an overview of the expected range of causes and manners of death in cases of autoerotic deaths. METHODS A retrospective analysis was carried out on all scientific and forensic autopsies and postmortem examinations performed at the Department of Legal Medicine in Hamburg, Germany, over the period of 2004-2018. RESULTS 25 cases of autoerotic fatalities were identified over this 15-year-period or one to two cases per year, respectively. Autopsies were carried out on 23 of these cases. 16 (64%) of the cases involved autoerotic accidents and 7 (28%) from internal causes of death during an autoerotic act. Two cases had not undergone an autopsy. On average, those who were involved in autoerotic accidents had been younger in age (average age: 37 years) than the individuals who died from internal disease (average age: 61 years). Only one woman was involved. The most common cause of death in autoerotic accidents was strangulation (hanging: 8 cases, ligature strangulation: 1 case), followed by smothering of the respiratory tract (4 cases). Fatal intoxication was diagnosed in three of the cases. Fatalities with natural cause of death solely involved cardiovascular causes of death. CONCLUSIONS Autoerotic deaths involved a wide range of natural and non-natural causes of death. The reconstruction of such unusual cases and detection of non-natural fatalities requires thorough investigation of the scene of death as well as a postmortem external and internal examination including a chemical toxicological and blood alcohol analysis.
Collapse
Affiliation(s)
- L Lohner
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld, 34, 22529, Hamburg, Germany.
| | - J P Sperhake
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld, 34, 22529, Hamburg, Germany
| | - K Püschel
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld, 34, 22529, Hamburg, Germany
| | - A S Schröder
- Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld, 34, 22529, Hamburg, Germany
| |
Collapse
|
8
|
Bunzel L, Koelzer SC, Zedler B, Verhoff MA, Parzeller M. Non-Natural Death Associated with Sexual Activity: Results of a 25-Year Medicolegal Postmortem Study. J Sex Med 2019; 16:1547-1556. [PMID: 31447384 DOI: 10.1016/j.jsxm.2019.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 06/24/2019] [Accepted: 07/07/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Non-natural deaths associated with sexual activity may occur either with or without the involvement of other persons. AIM The present study provides an overview of cases of non-natural death related to sexual activities as well as recommendations of how to handle these cases and to identify potentially dangerous pleasure-enhancing techniques. METHODS This medicolegal, postmortem, retrospective, and prospective study is based on data of autopsies performed at the Institute of Legal Medicine at University Hospital, Goethe University, Frankfurt, Germany. MAIN OUTCOME MEASURE Identification of circumstances, sexual practices, and gender distribution of cases of non-natural death in this context. RESULTS Between 1993 and 2017 (25 years), 16,437 medicolegal autopsies were performed, of which 74 cases (43 males, 31 females) of non-natural death were found to relate to sexual activities (0.45%). One female and 21 males had died in the course of autoerotic practices (group I, n = 22). Nine males and 14 females had performed sexual practices with mutual consent (group II, n = 23), and 13 males and 16 females without mutual consent (group III, n = 29). The average age in group I was 45.4 years; in group II, 40.6 years; and in group III, 39.2 years. Most of the deceased were found in their own apartments. Forms of stimulation included vaginal, anal, and oral intercourse; insertion of foreign bodies; use of chemical substances; and tools for respiratory depression/hypoxia. Three cases of death occurred during sexual activities involving bondage and discipline, sadism, and masochism (BDSM). Death due to strangulation was the main cause in group I, whereas intoxications were predominant in group II. Sharp force (eg, knife) was mainly responsible for death in group III. Anogenital injuries were documented in all groups in approximately equal percentages. CLINICAL IMPLICATIONS The cases presented show a high variety of circumstances in which non-natural death connected to sexual activity may occur. STRENGTHS & LIMITATIONS This study presents a large postmortem collection of non-natural death cases with associated sexual activity. As the main limiting factor, it must be stated that mutual consent for a sexual practice or consumption of substances was presumed based on the information provided and a lack of evidence against this assumption. CONCLUSION In cases of death associated with sexual activity, medical staff should perform thorough unbiased examinations and documentations. Strangulation and the consumption of stimulants should be classified as life-threatening, pleasure-enhancing techniques. Patients and young people should be informed about these risks. Bunzel L, Koelzer SC, Zedler B, et al. Non-Natural Death Associated with Sexual Activity: Results of a 25-Year Medicolegal Postmortem Study. J Sex Med 2019;16:1547-1556.
Collapse
Affiliation(s)
- Lena Bunzel
- Institute of Legal Medicine at University Hospital, Goethe University, Frankfurt, Germany.
| | - Sarah C Koelzer
- Institute of Legal Medicine at University Hospital, Goethe University, Frankfurt, Germany
| | - Barbara Zedler
- Institute of Legal Medicine, Justus Liebig University of Gießen, Gießen, Germany
| | - Marcel A Verhoff
- Institute of Legal Medicine at University Hospital, Goethe University, Frankfurt, Germany
| | - Markus Parzeller
- Institute of Legal Medicine at University Hospital, Goethe University, Frankfurt, Germany
| |
Collapse
|
9
|
Idota N, Nakamura M, Tsuboi H, Ichioka H, Shintani-Ishida K, Ikegaya H. Autoerotic asphyxia using a plastic bag loosely covering the head over a gas mask. Leg Med (Tokyo) 2019; 38:69-72. [DOI: 10.1016/j.legalmed.2019.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/06/2019] [Accepted: 04/14/2019] [Indexed: 10/27/2022]
|
10
|
Echterdiek F, Kitterer D, Schwenger V, Latus J. Severe acute kidney injury due to violent sadomasochistic play. BMJ Case Rep 2018; 2018:bcr-2018-224813. [DOI: 10.1136/bcr-2018-224813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
11
|
Female autoerotic asphyxial death – features and issues. Forensic Sci Med Pathol 2016; 13:107-109. [DOI: 10.1007/s12024-016-9832-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2016] [Indexed: 10/20/2022]
|
12
|
|
13
|
Bugeja L, Ibrahim JE, Ferrah N, Murphy B, Willoughby M, Ranson D. The utility of medico-legal databases for public health research: a systematic review of peer-reviewed publications using the National Coronial Information System. Health Res Policy Syst 2016; 14:28. [PMID: 27067413 PMCID: PMC4828834 DOI: 10.1186/s12961-016-0096-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 03/24/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medico-legal death investigations are a recognised data source for public health endeavours and its accessibility has increased following the development of electronic data systems. Despite time and cost savings, the strengths and limitations of this method and impact on research findings remain untested. This study examines this issue using the National Coronial Information System (NCIS). METHODS PubMed, ProQuest and Informit were searched to identify publications where the NCIS was used as a data source for research published during the period 2000-2014. A descriptive analysis was performed to describe the frequency and characteristics of the publications identified. A content analysis was performed to identify the nature and impact of strengths and limitations of the NCIS as reported by researchers. RESULTS Of the 106 publications included, 30 reported strengths and limitations, 37 reported limitations only, seven reported strengths only and 32 reported neither. The impact of the reported strengths of the NCIS was described in 14 publications, whilst 46 publications discussed the impacts of limitations. The NCIS was reported to be a reliable source of quality, detailed information with comprehensive coverage of deaths of interest, making it a powerful injury surveillance tool. Despite these strengths, researchers reported that open cases and missing information created the potential for selection and reporting biases and may preclude the identification and control of confounders. CONCLUSIONS To ensure research results are valid and inform health policy, it is essential to consider and seek to overcome the limitations of data sources that may have an impact on results.
Collapse
Affiliation(s)
- Lyndal Bugeja
- />Health Law & Ageing Research Unit, Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, 3006 Australia
- />Coroners Court of Victoria, 65 Kavanagh Street, Southbank, Victoria 3006 Australia
| | - Joseph E. Ibrahim
- />Health Law & Ageing Research Unit, Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, 3006 Australia
| | - Noha Ferrah
- />Health Law & Ageing Research Unit, Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, 3006 Australia
| | - Briony Murphy
- />Health Law & Ageing Research Unit, Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, 3006 Australia
| | - Melissa Willoughby
- />Health Law & Ageing Research Unit, Department of Forensic Medicine, School of Public Health and Preventive Medicine, Monash University, 65 Kavanagh Street, Southbank, 3006 Australia
- />Coroners Court of Victoria, 65 Kavanagh Street, Southbank, Victoria 3006 Australia
| | - David Ranson
- />Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, 3006 Australia
| |
Collapse
|
14
|
Lynch-Aird J, Moffatt C, Simmons T. Decomposition Rate and Pattern in Hanging Pigs. J Forensic Sci 2015; 60:1155-63. [DOI: 10.1111/1556-4029.12796] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 05/14/2014] [Accepted: 08/21/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Jeanne Lynch-Aird
- School of Forensic and Investigative Sciences; University of Central Lancashire; Preston PR1 2HE U.K
| | - Colin Moffatt
- School of Forensic and Investigative Sciences; University of Central Lancashire; Preston PR1 2HE U.K
- Zayed University; Dubai United Arab Emirates
| | - Tal Simmons
- Department of Forensic Science; Virginia Commonwealth University; Richmond VA 23284 U.S.A
| |
Collapse
|
15
|
Traumatologie und gewaltsamer Tod. Rechtsmedizin (Berl) 2015. [DOI: 10.1007/978-3-662-43500-7_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
16
|
Sens MA, Koponen MA, Meyers S. Other Pediatric Accidental Deaths. FORENSIC PATHOLOGY OF INFANCY AND CHILDHOOD 2014. [PMCID: PMC7123499 DOI: 10.1007/978-1-61779-403-2_30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
|
17
|
|