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Concept: Hanging


BACKGROUND: Suicide rate trends for Poland, one of the most populous countries in Europe, are not well documented. Moreover, the quality of the official Polish suicide statistics is unknown and requires in-depth investigation. METHODS: Population and mortality data disaggregated by sex, age, manner, and cause were obtained from the Polish Central Statistics Office for the period 1970-2009. Suicides and deaths categorized as ‘undetermined injury intent,’ ‘unknown causes,’ and ‘unintentional poisonings’ were analyzed to estimate the reliability and sensitivity of suicide certification in Poland over three periods covered by ICD-8, ICD-9 and ICD-10, respectively. Time trends were assessed by the Spearman test for trend. RESULTS: The official suicide rate increased by 51.3% in Poland between 1970 and 2009. There was an increasing excess suicide rate for males, culminating in a male-to-female ratio of 7:1. The dominant method, hanging, comprised 90% of all suicides by 2009. Factoring in deaths of undetermined intent only, estimated sensitivity of suicide certification was 77% overall, but lower for females than males. Not increasing linearly with age, the suicide rate peaked at ages 40-54 years. CONCLUSION: The suicide rate is increasing in Poland, which calls for a national prevention initiative. Hangings are the predominant suicide method based on official registration. However, suicide among females appears grossly underestimated given their lower estimated sensitivity of suicide certification, greater use of “soft” suicide methods, and the very high 7:1 male-to-female rate ratio. Changes in the ICD classification system resulted in a temporary suicide data blackout in 1980-1982, and significant modifications of the death categories of senility and unknown causes, after 1997, suggest the need for data quality surveillance.

Concepts: Death, Demography, Suicide, The Complete Manual of Suicide, Hanging, Suicide methods


From the eighteenth century through to the abolition of public executions in England in 1868, the touch of a freshly hanged man’s hand was sought after to cure a variety of swellings, wens in particular. While the healing properties of corpse hands in general were acknowledged and experimented with in early modern medicine, the gallows cure achieved prominence during the second half of the eighteenth century. What was it about the hanged man’s hand (and it always was a male appendage) that gave it such potency? While frequently denounced as a disgusting ‘superstition’ in the press, this popular medical practice was inadvertently legitimised and institutionalised by the authorities through changes in execution procedure.

Concepts: Medicine, Therapy, Science, Capital punishment, Hanging, New England, Decapitation, Gallows


While suicide attempt history is considered to robustly predict completed suicide, previous studies have limited generalizability because of using convenience samples of specific methods/treatment settings, disregarding previous attempts, or overlooking first-attempt deaths. Eliminating these biases should more accurately estimate suicide prevalence in attempters.

Concepts: Death, Suicide, Hanging


Despite great advances in forensic sciences in the last decades, our knowledge of the pathophysiology of ligature strangulation is still largely based on old writings from the 19th and beginning of the 20th century. The study of filmed hangings by the Working Group on Human Asphyxia has contributed to a better understanding of the agonal responses to strangulation by hanging, and judo-related studies have given some insight into the pathophysiology of manual strangulation, but the pathophysiology of ligature strangulation has remained largely unexplored so far. Three nonlethal strangulations filmed by an autoerotic practitioner are here presented. In these 3 ligature strangulations, the 35-year-old man is sitting on a chair. A pair of pajama pants is rolled once around his neck, with the extremities of the pants falling down on each side of his chest. The man is pulling the extremities of the pants with both hands to apply compression on his neck. After losing consciousness, he ceases to pull on the ligature, and the pants slowly loosen around the neck. A few seconds later, he regains consciousness and gets up from the chair. In the 3 nonlethal ligature strangulations presented in this study, the loss of consciousness occurred in 11 seconds. The loss of consciousness was closely followed by the onset of convulsions (7-11 seconds). These results are compared with the early agonal responses documented in filmed hangings and judo studies.

Concepts: 20th century, The Loss, Hanging, The Onset, Suicide methods, Strangling, Execution methods, 20th Century Fox


Hanging is known not only as a common method of suicide but also as a capital punishment method in some countries. Although several cases have been reported to survive after the attempted suicidal/accidental hanging, to the extent of our knowledge, no modern case of survival after judicial hanging exists. We reported a case of an individual who revived after modern judicial hanging despite being declared dead. The case was admitted with poor clinical presentations and the Glasgow Coma Scale of 6/15. The victim received all the standard supportive intensive care and gained complete clinical recovery.

Concepts: Scientific method, Death, Intensive care medicine, Capital punishment, Hanging, Glasgow Coma Scale, Coma, Plato


When a body is found in suspended position, not only suicidal hanging has to be considered but also an accident or homicide. These alternatives and the criteria to be applied for their differentiation were already extensively discussed in the old medico-legal literature. Nevertheless, it is still a challenge for detectives and forensic experts to prove a homicidal assault when a suspended body is found. In the presented case, the findings collected at the scene and during autopsy seemed to be consistent with the assumption of suicide at first and the case has only been elucidated by supplementary inquiries and a secondary evaluation of the photos taken at the scene and during the autopsy. The victim, a 47-year-old woman, had been manually strangled in her flat. Subsequently, the perpetrator took her up to the attic and tried to hang her in order to simulate suicide.

Concepts: Critical thinking, Death, English-language films, Suicide, Homicide, Hanging, Suicide methods, Nelson Erazo


The distinction between self-inflicted blade wounds and blade wounds inflicted by another can be difficult in situations where there is little available history or context. We reviewed homicides and suicides in the past 10 years at the Vermont Office of the Chief Medical Examiner to define the characteristics of homicidal and suicidal blade wounds. All homicides and suicides involving blade wounds, not just those in which blade wounds were the cause of death, were included. Information regarding victim demographics, location and type of injuries, toxicology, and evidence of suicidality was gathered. Blade wounds were the cause of death in 85.7% of homicides but only in 36% of suicides. Hanging and gunshot wounds were the cause of death in 28% and 24% of suicides, respectively. Multiple stab wounds were found in 10% of homicides and in 0% of suicides, whereas multiple incised wounds were found in 60% of suicides and only 10% of homicides. However, several unusual instances of suicide were found, including suicides with clothing damage or bone or cartilage injury from blade wounds. No characteristics of blade wounds were definitive for homicide or suicide. History and circumstances of the scene are thus crucial in determining the manner of death.

Concepts: Death, Injuries, Injury, Wound, Suicide, Homicide, Hanging, Coroner


This study describes the psychometric properties of the Inventory of Motivations for Suicide Attempts (IMSA). The IMSA was designed to comprehensively assess motivations for suicide emphasized by major theories of suicidality. The IMSA was administered to two samples of recent suicide attempters, undergraduates (n = 66) and outpatients (n = 53). The IMSA exhibited a reliable two-factor structure in which one factor represented Intrapersonal motivations related to ending emotional pain, and the second represented Interpersonal motivations related to communication or help-seeking. Convergent validity and divergent validity of IMSA scales were supported by expected patterns of correlations with another measure of suicide motivations. In addition, the IMSA scales displayed clinical utility, in which greater endorsement of intrapersonal motivations was associated with greater intent to die, whereas greater endorsement of interpersonal motivations was associated with less lethal intent and greater likelihood of rescue. Findings suggest the IMSA can be of use for both research and clinical purposes when a comprehensive assessment of suicide motivations is desired.

Concepts: Death, Assessment, Psychometrics, Psychiatry, Suffering, Suicide, The Complete Manual of Suicide, Hanging


If capital punishment is constitutional, as it has long been held to be, then it “necessarily follows that there must be a means of carrying it out.”(1) So the Supreme Court concluded in Baze v. Rees, a 2008 challenge to Kentucky’s lethal-injection protocol, in which the Court held that the means used by Kentucky did not violate the Eighth Amendment’s prohibition against cruel and unusual punishment. Lethal-injection procedures have changed significantly since 2008, and that fact coupled with Oklahoma’s recent botched lethal injection of Clayton Lockett, the latest in a long series of gruesome and error-ridden executions, has raised questions . . .

Concepts: Supreme Court of the United States, Capital punishment, Hanging, Lethal injection, Capital punishment in the United States, Electric chair, Baze v. Rees, Execution by firing squad


The incidence of cervical spine injuries in suicidal hangings with a short-drop has been reported to be extremely low or non-existent. The aim of this study was to determine the frequency and pattern of cervical spine injuries in suicidal hanging.

Concepts: Lumbar vertebrae, Vertebral column, Cervical vertebrae, Thoracic vertebrae, Physical trauma, Suicide, Hanging, Hangman's fracture