By: Darren Dake D-ABMDI, CI, CCI
No matter your initial opinion of the title question, give me a minute to break down a few thoughts. I was recently a part of an online forum conversation where this question was posed, and there were mixed opinions. Many were hardline Suicide-no discussion, and others were more on the accident side, giving some reasons for their position. But as with any controversial topic, lines seem to have been drawn in the sand.
To get things started off right, I stand more on the accident side of the question. However, not without cause and consideration. During the conversation I mentioned earlier, some cited the Guide for Manner of Death Classification published by the National Association of Medical Examiners. Many in the field of death investigation use this guide as Holy Scriptures not to be questioned. However, like with actual Holy Scriptures' some people take parts and pieces to fit an argument and not the text as a whole.
The latest edition of the NAME guide I could find was the first edition written in 2002- this is the copy NAME has on their website. Some very smart folks put this publication together, and in their wisdom, they understood that manner of death is not always a defined line. They even start by saying the publication is a guide and manners are based upon opinions supported by facts. To quote NAME; It must be realized that when differing opinions occur regarding manner-of-death classification, there is often no “right” or “wrong” answer or specific classification that is better than its alternatives.
So, with the foundation set, let me get to my argument. To begin with, let's look at the definition of Suicide.
- Suicide is death caused by injuring oneself with the intent to die. *CDC.gov
- The act or an instance of taking one's own life voluntarily and intentional *Merriam Webster Dictionary Online
- Suicide is defined as death caused by self-directed injurious behavior with the intent to die as a result of the behavior *National Institute of Mental Health
- The death results from the intentional action of the decedent, who anticipates, expects, or is at a high risk for death (e.g, ligature hanging, intentional drug overdose). *ABMDI – Medicolegal Death Investigator 1996 by Occupational Research and Assessment, Inc.
Using the NAME guide
To classify a death as Suicide, the burden of proof need not be “beyond any reasonable doubt,” but it should exceed “more likely than not” (that is, the burden of proof should be more compelling than 51%, which barely exceeds chance). In general, requiring a “preponderance of evidence” is a reasonable practice when deciding whether to classify a death as Suicide. In some states, case or other law requires that a preponderance of evidence exist to classify death as Suicide. In short, if classification as Suicide is little more than an informed guess or mere speculation, accident or undetermined are deemed to be better options. NAME Guide page 8
- Preponderance of medical/investigative evidence (For practical purposes, let's say about 70% or greater certainty) NAME- digress of certainty. Page 4
With these definitions in mind, two things are clear. First, the person committing the act must have the clear intent to die, and second, the classifier must be 70% sure or higher that this was an intentional act to die before the death can be ruled a suicide.
Here is where the foundation of my stance comes in; without a complete investigation into the actions and intent of the deceased, how can we generically assign the manner of Suicide to the death. If we look at the intent and inherent danger as NAME uses it, what is the actual percentage of possible death?
If we assume the roulette game is played as “normal,” meaning one round in the cylinder, spun and closed, placed to the head, and the trigger pulled, what is the percentage of death or serious injury?
- 5 Round Cylinder = 20%
- 6 Round Cylinder = 17%
- 9 Round Cylinder = 11%
These are certainly not the odds I would want to play, but where is the intent? As an investigator, I believe it is our basic duty to investigate the case and, as much as possible, determine the state of mind and intent of the subject pulling the trigger. Suppose we are going to stand only on the act itself, stating that the person “should have known” the danger. Then we could just as easily assign that notion to the Fentanyl drug user. Every user knows the odds will catch up to them at some point, maybe not the first time or even the tenth time, but the odds will catch up to them. In these deaths, we classify them as accidents, if not homicide, in some instances, but never would we rule them Suicide unless we had a clear and convincing reason to believe the person overdosed on purpose with the intent to die. Thus, why do we not use the same thinking in the roulette case? I believe it is because a gun is involved, and whenever that scary word (gun) is used, everything gets intensified.
Here is an example, a person at a party, drunk and “acting the fool,” wants to show how tuff he is. He produces a gun puts one bullet in the cylinder, and spins it. All the while laughing, joking, and showing his bravery. He places the pistol to his head and pulls the trigger. The gun fires, and he dies. No one at the party, in his personal life, or during any conversation throughout your investigation indicate even the slightest suicide ideation.
Using the preponderance of the evidence rule, how is this a suicide when every definition of Suicide states that intent must be present to make the ruling, and if you cannot meet the 70% threshold, the death should be ruled an accident. Of course, if there were three rounds in the gun, or if he pulled the trigger multiple times before it fired, I would lean more to the intent side as his actions increase the percentage of discharge.
The one area I disagree with NAME on is the sentence, “Classification of such deaths as suicide provides for a consistent approach and reflects the most common practice”. Used to give guidance in ruling roulette cases. This seems to contradict their previous statements that these deaths “may” be classified as Suicide, not shall. Further, with this wording, investigators are not taking any investigation findings into the ruling and basing their entire ruling on this sentence and ignoring all other guidance in NAME guidelines.
To summarize, I believe each death should have an appropriate level of investigation and not be classified solely on an event. To further quote the NAME guidelines, “All agree, however, on the fundamental premise that manner of death is circumstance-dependent, not autopsy-dependent.” page 4. Thus, not doing so would be a direct contradiction to the holy scriptures of the NAME guidelines.
In discussions such as this, these words are evermore true. We can “agree to disagree– but to not be disagreeable,” to quote New York City Medical Examiner Charles Hirsch.
A Guide for Manner of Death Classification First Edition 2002 – National Association for Medical Examiners
Suicide definitions as cited on each