When a Hanging Isn’t a Suicide: The hidden truths behind strangulation and equivocal deaths

Adapted from: Ferguson, C., & Brooks, N. (2024). “A scoping review of strangulation and hanging: Determining suicide from concealed homicide in equivocal death cases.”

The examination of deaths believed to be from ligatures around the neck presents many investigative challenges. Initial assessments may lead to the seemingly straightforward conclusion of suicide, particularly in controlled environments devoid of indications of forced entry. Nevertheless, as research has demonstrated, such superficial appearances can occasionally obscure an orchestrated facade of homicide.

A recent scoping review by Ferguson & Brooks highlighted the intricate dynamics of hanging and strangulation, prompting the question: under what circumstances should a death initially perceived as a suicide be reconsidered as a concealed homicide?

Both hangings and strangulation involve compression of the neck. In a forensic investigation, distinguishing between suicide and homicide is crucial. Investigators must thoroughly examine the crime scene, conduct an extensive victimology, and meticulously analyse medical findings before considering a potential suspect.

Scene Evidence: Key Indicators

Investigators should carefully examine the area around the body and consider the position in which the deceased is found. For instance, hair, clothing, or jewelry caught in the ligature may indicate foul play. In genuine suicide cases, individuals usually apply the ligature themselves, resulting in minimal tangling. If there is evidence of a struggle or indications that someone else fastened the ligature, this warrants thorough investigation.

Additionally, missing items and signs of cleanup can suggest staging. Perpetrators might remove evidence or tidy the scene, whereas genuine decedents might leave personal belongings behind. Unusual clothing for the time of day is also significant, such as being discovered in work clothes instead of nightwear when the death supposedly occurred late at night. The position and type of knot used, along with access to the hanging point, are crucial aspects that investigators should assess and test.

Several notable cases have underscored instances where staging was overlooked. For example, in Australia, a woman was initially thought to have died by suicide in her garage. It was later revealed that her partner had assaulted her and staged the scene to look like a suicide.

Victimology: Contextual Considerations

Grasping the deceased's background is essential to differentiate between suicide and homicide. Studies indicate that typical profiles for suicidal hangings often involve males, those with previous suicide attempts, or individuals with mental health histories. Conversely, profiles suggesting staging may include female decedents who have faced abusive intimate partner relationships or recent separations. However, caution is necessary, as there are no absolute rules or conclusive research findings. Each case requires careful examination, and it must be acknowledged that perpetrators might fabricate evidence to mislead investigations. Therefore, investigators should verify claims with independent sources and assess whether the deceased had future-oriented plans, which could indicate a lower probability of suicide.

This evaluation involves reviewing personal diaries, social media activity, and communications that reveal the individual's mindset and intentions. For instance, if the deceased had made specific plans for upcoming events or showed enthusiasm for future projects, these signs might suggest a desire to live rather than an intention to end their life. Additionally, interacting with family members, friends, and colleagues can provide crucial context regarding the individual's emotional state and the circumstances leading up to their death. A vital aspect of this process is also examining medical records and consulting with their treating doctor.

By gathering thorough information from various perspectives, investigators can develop a clearer understanding of the deceased's mental health and intentions.

Medical Findings: Clues with Limitations

Autopsy results can provide valuable insights but have specific limitations. The overlapping findings from neck compression caused by hanging or strangulation make interpretation difficult. Traditional indicators of strangulation, like fractures of the hyoid or thyroid bones, may not always appear and can differ due to various factors. Additionally, soft-tissue injuries and other signs might indicate assault rather than suicide, but these findings are not always dependable.

Notably, some manual techniques, such as suffocation or physical neck restraint, can cause death with minimal external signs of trauma. These methods are often used in a way that leave very few, if any, visible marks on the body, complicating the detection and identification of the cause of death. The subtlety of these methods can result in fatalities that initially seem to be due to natural causes or accidents, making it particularly difficult for investigators to determine the true circumstances of the death.

Given these complexities, it is crucial to adopt a comprehensive approach that considers all available evidence. This approach should not only focus on the physical examination of the body but also include forensic analysis, toxicology reports, and a thorough investigation of the surrounding circumstances. By integrating various strands of evidence, such as witness statements, the deceased's behavioral patterns, and any relevant historical context, investigators can construct a more complete picture of the events leading to death. Such a multifaceted strategy is essential for accurate determinations, ensuring that covert homicides can be identified.

Implications for Decedents, Families, and Investigators

The central message is that no single indicator can definitively determine whether a death is staged. A comprehensive investigation that incorporates scene evidence, decedent profiles, witness statements, and medical findings is essential for accurate conclusions. Investigators should avoid rushing to conclusions, especially in cases involving female decedents found by intimate partners, where scene details may not match initial accounts.

Police must be thorough when responding to hangings and ensure a systematic examination and response from the outset. It should not be assumed to be a suicide simply because it appears to be one. To improve investigative outcomes, meticulous scene preservation, early collaboration with forensic experts, and verification of the decedent's history are necessary. Establishing standardised protocols for hangings is a crucial step toward developing better practices.

Concluding Thoughts

The intersection of hanging and strangulation deaths presents significant challenges for forensic investigations, primarily because of the complexities in distinguishing the specific circumstances of each case. Although these two methods may seem similar, they can arise from very different contexts, motives, and situations. Forensic investigators must navigate these subtle differences while considering the psychological and emotional factors involved.

Research from various forensic studies emphasises that initial appearances can be deceptive, highlighting the need for meticulous examination of evidence. Elements such as ligature marks, body positioning, and scene-related factors must be carefully evaluated to determine whether a death was accidental, suicidal, or the result of foul play. This involves not only physical evidence but also witness testimonies, psychological profiles, and the historical context of the individual's life and relationships. Additionally, modern forensic technologies, including digital forensics and advanced imaging techniques, can offer deeper insights into the circumstances of the death, aiding investigators in their pursuit of the truth.

Given these complexities, it is crucial for professionals involved in death investigations to have the appropriate tools and resources. Developing resources such as checklists or decision-flow guides can assist forensic experts in the field, providing structured methodologies for navigating these cases. Moreover, ongoing training and education in the nuances of hanging and strangulation deaths are essential for forensic professionals.

Scene Evidence refers to the physical information found at the location of the incident. Elements such as the positioning of the body, the presence of weapons, and signs of a struggle or forced entry can provide crucial insights into the circumstances of the death. A comprehensive review of the scene is essential for establishing the context of the investigation and for determining what is present, what is absent, and what may align or not align with the situation.

Victimology involves examining the deceased's personal history, relationships, and any previous encounters with threats or violence. This investigation can reveal potential negative motives among those involved in the deceased's life. Understanding the deceased's background is vital for constructing the narrative of their life and identifying the events leading up to their death.

Medical Findings include autopsy results, toxicology reports, and various forensic analyses that can uncover important information about the cause and manner of death. While each element alone might not provide conclusive answers, the combination of this information offers a more comprehensive understanding of the case.