Two hundred twenty-six suicides by firearms were analyzed to determine the entrance wound site. Overall, the head was the most favored site, accounting for 74% of the wounds; specifically, the right temple accounted for 39% of the wounds. The data were further examined in terms of specific weapon types. In the case of handguns, the preference for the temple was even more prominent, with this site accounting for nearly two thirds of the wounds. With long guns the predominance of head wounds was less pronounced but still present. Correlations with sex and age showed no significant differences in choice of site but did show differences in selection of gunshot as the means of suicide. Correlations of site with handedness showed that most individuals held true to form but that a significant proportion (8%) inflicted their wounds on the other side. Finally, three cases of suicide by multiple gunshots are presented.

The extent and distribution of injuries differed markedly in the two cases. The first case involved loss of consciousness probably from subarachnoid hemorrhage or cerebral hypoxia, followed by death due to cerebral anoxia. The second case involved a major spinal cord injury with subarachnoid hemorrhage.

No abstract

Fifty-three suicides using plastic bags were identified in a review of cases within the jurisdiction of the King County Medical Examiner's Office, Seattle, Washington from 1984 to 1993. We found that this method was used at a greater frequency by individuals older than 50 in comparison with other methods. The most commonly identified stressor leading to the suicide in this population was failing health. The use of this method as a means of "self deliverance," as advocated by the Hemlock Society, could be inferred in only a small minority of cases where terminal illnesses were identified. This method may be preferred by those older than 50 years because of the ready availability of plastic bags and the relative nonviolence of the death. Analysis of the autopsy findings showed no specific features for this method of suicide. In particular, petechiae, which are often considered a marker of asphyxia, were present in only a small minority of cases (3%). Furthermore, the scene investigation rarely revealed specific features, other than the plastic bag in place. Thus, if the plastic bag were removed after death, the cause and manner of death would be obscure.