Prevention and future issues of karoshi and suicide by overwork in Japan

Since death from overwork became a social problem, the enactment of laws and the establishment of standards for certification, as well as improved actions on both the company and worker sides have  been made. However, there is rarely a day in which news reports on death from overwork, suicide by overwork, power harassment (bullying in […]

Suicide classification–clues and their use: A study of 122 cases of suicide and undetermined manner of death

In order to identify clues to forensic pathologist’s classification of suicide, the forensic files of 100 consecutive cases of suicide, and 22 cases of undetermined manner of death, were analysed. Some specific causes of death, suicidal communication and other circumstantial evidence suggesting suicidal intent explained all but three classifications. Problematic cases concerned death by poisoning […]

Why do we agree to disagree? Agreement and reasons for disagreement in judgements of intentional self-harm from coroners and a suicide register in Queensland, Australia, from 2001 to 2015

Suicides are likely to be underreported. In Australia, the National Coronial Information System (NCIS) provides information about suicide deaths reported to coroners. The NCIS represents the findings on the intent of the deceased as determined by coroners. We used the Queensland Suicide Register (QSR) to assess the direction, magnitude, and predictors of any differences in […]

Homicide, suicide, or accident? Complex differential diagnosis. A case series

Distinguishing between homicides, suicides, and accidental deaths remains a challenging task. The examination of actual cases, which involve a multitude of variables, significantly contributes to our understanding of these matters. In this context, we present three distinct cases that required the involvement of various specialists to conduct a thorough analysis of the manner of death. In the […]

Gendered patterns in manifest and latent mental health indicators among suicide decedents: 2003-2020 US National Violent Death Reporting System (NVDRS)

Objectives. To investigate differences in the documentation of mental health symptomology between male and female suicide decedents in the 2003-2020 US National Violent Death Reporting System (NVDRS). Methods. Using information on 271 998 suicides in the 2003-2020 NVDRS, we evaluated precoded mental health-related variables and topic model-derived latent mental health themes in the law enforcement and coroner or […]

A report on suicide deaths in Ontario

Coroners in Ontario – along with the Ontario Forensics Pathology Service – are tasked with ensuring that no death will be overlooked, concealed, or ignored. While not all deaths require investigation, coroners are charged with investigating all non-natural deaths as well as natural deaths that occur in certain circumstances, including: deaths that occur suddenly and […]

Using real-time suicide monitoring systems to inform policy and practice

Many countries have now established, or are establishing, suicide monitoring systems (Baran et al., 2021). These systems typically use data from police reports and death certificates to identify suspected suicides,  with key information about the deceased entered into a register soon after death. Information entered into the register may include the location of death and […]

Substances detected during coroner postmortem toxicology analyses in poisoning- and nonpoisoning-related suicides

Importance  Determining the association between drug use and suicide is complicated but can help to inform targeted suicide prevention strategies. Objective  To examine the substances prevalent in poisoning- and nonpoisoning-related suicides in Australia. Design, Setting, and Participants  This was a multiple-year, cross-sectional study of suicides from July 2013 to October 2019 in Australia with toxicology data available in […]

Homicide or suicide? A probabilistic approach for the evaluation of the manner of death in sharp force fatalities

The role of forensic science can be defined as providing relevant opinions to assist investigators and courts of law in answering questions. The Likelihood Ratio (LR) provides a quantitative and logical approach to communicating the strength of expert evidence. We reviewed existing forensic literature on sharp force fatalities, focusing on studies reporting the manner of […]

It is official, they are different: Discrepancies between national statistical agency and register-based state suicide mortality statistics in Australia

Background: In Australia, most state-based suicide registers now publicly release suicide mortality data alongside those the Australian Bureau of Statistics (ABS) releases annually. Aims: This study compared ABS’s recorded suicides with three state-based suicide registers (Queensland, Victoria, and Tasmania). We compared their case definitions and coding approaches to assist users in choosing the most suitable […]

Are false positives in suicide classification models a risk group? Evidence for “true alarms” in a population-representative longitudinal study of Norwegian adolescents

Introduction: False positives in retrospective binary suicide attempt classification models are commonly attributed to sheer classification error. However, when machine learning suicide attempt classification models are trained with a multitude of psycho-socio-environmental factors and achieve high accuracy in suicide risk assessment, false positives may turn out to be at high risk of developing suicidal behavior or […]

Suicide trends in Jordan in correlation with the COVID-19 Pandemic: A forensic medicine perspective

Background: This study aimed to examine the suicide trends among Jordanians who died by suicide before and during the coronavirus disease 2019 (COVID-19) pandemic and assess their correlation with demographic data, including gender, age, marital status, and the method used for suicide, from a forensic medicine perspective. Methodology: This was a retrospective, observational, autopsy-based study. […]

Arranging the death of a king

King George V provides an example of a direct medical killing worthy of consideration within the context of the euthanasia debate. Polemicists in the euthanasia debate, and those who argue to and fro over end-of-life morality questions, may find much to support their divergent viewpoints in this example. Who should be part of medical decision-making […]

Why there is a need for an international nomenclature and classification system for suicide

There is no internationally agreed-upon set of terms, definitions, or classifications for the range of thoughts, communications, and behaviors that are related to self-injurious behaviors, with or without the intent to die. Nor is there an agreed taxonomy that encompasses the full spectrum of what are often clinically defined as suicide-related behaviors. There also are […]

Suicide rates in the Slovak Republic in 2011–2020

Purpose: Suicide is a serious public health problem leading to premature mortality. The aim of the present study is to describe and analyze the trends of suicide rates in the Slovak Republic in 2011-2020. Methods: Trends of age-standardized suicide rates were described and incidence rate ratios of suicide were analyzed by negative binomial regression. The age-standardized rates […]

Training death investigators to identify decedents’ sexual orientation and gender identity: A feasibility study

There is growing impetus within mortality surveillance to identify decedents’ sexual orientation and gender identity (SOGI), but key personnel to this effort (eg, death investigators) are not currently trained to collect SOGI information. To address this gap, we developed a training for death investigators on this topic and tested its feasibility with 114 investigators in […]

Robin’s Wish and the complex causal web of death by suicide

The documentary film Robin’s Wish aims to reclaim the media scrutiny around Robin Williams’ death, fixating on causation being solely attributed to a postmortem diagnosis of which Williams was unaware-Lewy Body Dementia. The film and other sources as well defined and animated the view that Williams’ death by suicide was fully a result of this medical condition, […]

Factors related to childhood suicides: Analysis of the Queensland Child Death Register

Background: Suicide among children under the age of 15 years is a leading cause of death. Aims: The aim of the current study is to identify demographic, psychosocial, and psychiatric factors associated with child suicides. Method: Using external causes of deaths recorded in the Queensland Child Death Register, a case-control study design was applied. Cases were suicides of children (10–14 […]

A proper, fitting explanation? Suicide bereavement and perceptions of the coroner’s verdict

Background: As in several other countries, inquiries after a suspected suicide in England and Wales now routinely seek to include both medico-legal and family perspectives on the character and motivations of the person who died. Little research attention, however, has been paid to the reactions of the bereaved to the coroner’s verdict. Aims: To explore people’s accounts of […]

Investigating official records of suicides for research purposes: Challenges and coping strategies

In many countries worldwide the circumstances of unnatural deaths, including suicides, are subject to official investigations, usually by medical examiners or coroners. In England and Wales, where our experience is based, investigations into sudden or unexplained deaths are conducted by a coroner, an independent officer appointed by the local government authority, who usually has a […]

Integrating medical examiner and police report data: Can this improve our knowledge of the social circumstances surrounding suicide?

Background: Recently, suicide in the United States has begun to be viewed as a preventable public health issue. This has led to the creation of a National Violent Death Reporting System that collects and integrates data on the social circumstances surrounding suicides. Aims: The study examines data on social circumstances surrounding suicides as collected by the medical […]

Counting suicides and making suicide count as a public health problem

Relatively few countries credibly count their dead (Mathers, Fat, Inoue, Rao, & Lopez, 2005). Thus, differential sophistication as well as sociopolitical and economic support of healthcare and systems to  investigate deaths inevitably leave a large gulf between richer and poorer countries in accurately registering manner and cause of death. And when suicide is in question, […]

Australia revises its mortality data on suicide

The accuracy of suicide statistics is far from being just an obsession for epidemiologists: It directly influences policy-making in mental and public health, planning and funding of preventative strategies,  and research reports. Community awareness and support services depend on reliable reporting, and determining the extent and costs of suicide is important for combating stigma and […]