Forensic Science International 131 (2003) 197±201

Complex suicides by self-incineration

Michael Bohnerta,*, Markus A. Rothschildb
a
Institute of Forensic Medicine, University of Freiburg, Albertstrasse 9, D-79104 Freiburg, Germany
b
Institute of Forensic Medicine, University of Cologne, MelatenguÈrtel 60-62, D-50823 Cologne, Germany
Received 12 December 2001; accepted 26 November 2002

Abstract

Among the few cases of suicidal self-incineration primary or secondary complex suicides are a rarity. Accordingly the number
of reports on this subject in the forensic literature is small. In a retrospective analysis of the Freiburg and Berlin autopsy material,
four cases were found within an observation period of 11 years. These are described together with seven other cases reported in
the literature. Altogether most of these suicides are primary combinations, especially with falls from a height. Other
combinations include hanging or the in¯iction of stabs, cuts or gunshot injuries. The sex and age distribution is similar to
that found for suicide by self-incineration alone.
# 2002 Elsevier Science Ireland Ltd. All rights reserved.

Keywords: Complex suicide; Self-incineration; Fall from height

1. Introduction Self-incineration is rarely combined with other methods of

suicide. In a retrospective analysis of all suicides by self-
The term ``complex suicide'' is used for suicides using incineration occurring in Berlin within 11 years (46 cases) only
more than one suicidal method. In this context one has to 2 cases were found to be complex suicides [7]. Reports on
distinguish between primary complex suicide and secondary cases of this type are also rare in the forensic literature. In the
complex suicide. Primary complex suicide means the simul- following report, four cases are presented from the Freiburg
taneous application of more than one method of suicide in and Berlin autopsy material (period of observation: 1990±
order to ensure the fatal outcome. In contrast to this the term 2000, including all cases of death in connection with ®re).
``secondary complex suicide'' refers to a case in which more
than one method of suicide is applied in quick chronological
succession. This is usually done if the ®rst chosen method 2. Casuistics
failed to be fatal or did not lead to death fast enough.
Complex suicides account for 1.5±5.6% of all suicides in 2.1. Case 1: self-incineration with fall from a height
the forensic autopsy material [1±3]. In primary complex
suicides the most frequent combination is intoxication by 2.1.1. History
medicines with hanging followed by intoxication by med- A 17-year-old student climbed a 40 m high lookout tower
icines with drowning. Other comparatively frequent meth- on a late afternoon. Witnesses noticed at ®rst a cloud of
ods are the intake of medicines or illegal drugs combined smoke on the tower and shortly afterwards found the student
with pulling a plastic bag over one's head [4±6] and shooting in a lifeless condition lying at the bottom of the tower with
with consecutive hanging by means of a noose previously extensive burns. The emergency doctor could only con®rm
put around the neck (particularly in males) [2]. his death. On the platform of the tower the young man's
rucksack and a gasoline can were found. The police inves-
tigations did not reveal any motive for the suicide. No
*
Corresponding author. Tel.: ‡49-761-203-6854; farewell letter had been left. There were no clues pointing
fax: ‡49-761-203-6858. to homicide. The student was known to consume hashish and
E-mail address: bohnert@ukl.uni-freiburg.de (M. Bohnert). ecstasy occasionally.

0379-0738/02/$ ± see front matter # 2002 Elsevier Science Ireland Ltd. All rights reserved.
doi:10.1016/S0379-0738(02)00449-8
198 M. Bohnert, M.A. Rothschild / Forensic Science International 131 (2003) 197±201

2.1.2. Autopsy ®ndings mucosa of the upper respiratory tract. In the pharynx and
The body showed ®rst- to fourth-degree burns of about larynx there was only little soot.
80% of the body surface. Little soot was found in the oral The woman had hit the ground ®rst with the back and the
cavity, the pharynx, the trachea and the esophagus. The occiput. In the occipital region there was a large laceration
mucosa of the larynx was reddened with partial patchy with extensive bruising and an underlying stellate burst
detachment. fracture system. Both occipital poles of the brain showed
Further ®ndings were bilateral hemopneumothorax, rup- contusions with bilateral contrecoup lesions being located
ture of the right radix pulmonis, bilateral pulmonary con- at the frontal poles. The ®fth thoracic vertebral body was
tusions, cardiac contusion, multiple ruptures of the liver, broken. On both sides there were paravertebral serial rib
fracture of the left ®rst rib, fracture of the pelvic ring and fractures. The left lower pulmonary lobe was torn and the
extensive contusions of the dorsal soft tissue. There were left pleural cavity contained approximately 500 ml blood.
neither fractures of the extremities nor was there an aortic On the rear side of the heart were contusions and the
rupture. ascending part of the aorta showed an about 10 mm long
The cause of death was blunt polytrauma together with transverse tear leading to severe bleeding into the med-
extensive burn injuries. The mechanical lesions were con- iastinum.
sistent with a fall from a height. The soot in the respiratory According to the autopsy ®ndings the woman died of a
tract and the esophagus as well as the thermic lesion of the combination of acute extensive burns and mechanical poly-
laryngeal mucosa justi®ed the assumption that the burns trauma.
occurred while the victim was still alive and were brie¯y
survived. 2.2.3. Toxicology
Traces of diazepam were found in the blood. No other
2.1.3. Toxicology drugs could be detected. The alcohol tests were negative.
The spectrophotometric examination of the heart
blood showed a CO±Hb concentration of 6%. Toxicolo- 2.3. Case 3: self-incineration and shot to the head
gical tests for narcotic substances revealed 6.112 ng/ml with a livestock stunner [8]
amphetamine in the heart blood. The test for blood alcohol
was negative. 2.3.1. History
In a forest clearing almost completely calcined human
2.2. Case 2: self-incineration with fall from a height bone fragments without any soft tissue were found in the
ashes of a largely burned pile of wood. Moreover, a partially
2.2.1. History burned Kerner-type livestock stunner was found in the
Neighbors saw a 42-year-old woman standing at the open rubble of the ®re. A witness reported that he had heard
window of her apartment on the opposite side of the street for the noise of a shot from the direction of the clearing already
a prolonged period of time and behaving ``strangely''. Then the day before and had noticed black smoke rising from the
the woman poured a liquid from a big plastic bottle over site where the body was found later. At the edge of the
herself and suddenly caught ®re. Immediately afterwards she clearing a locked car was parked in which two farewell
climbed onto the window sill and, while burning, jumped out letters were detected.
of the window of her apartment on the third ¯oor. The body
thudded onto the pavement in front of the house and 2.3.2. Autopsy ®ndings
continued burning. Passers-by extinguished the ®re with From the remains of the burned-down pile of wood
coats. When the emergency doctor arrived at the scene he numerous, mostly small bones or bone fragments, which
could only con®rm the death of the woman. were all free of soft tissue and weighed about 3 kg, were
The police investigations revealed that the woman had recovered. Only a small number of intact bones were pre-
been under psychiatric out-patient treatment for depression served; mainly fragments were found. All of them showed
and had made two suicide attempts in the past 2 years (one marked calcination and a signi®cant reduction of their mass
by cutting her wrists and the other by dropping a hair dryer as well as numerous heat-induced tears. Obviously the
into the bath-tub ®lled with water). No farewell letter was skeletal material belonged to a single person. Due to the
found. The investigations showed that the in¯ammable dimensions and some preserved pelvic structures the
liquid had been spirit. assumption seemed justi®ed that the body was that of a
male of medium height.
2.2.2. Autopsy ®ndings Of the skull several irregularly shaped fragments were
At autopsy third-degree burns were found on about 50% preserved, which mainly belonged to the skullcap and the
of the body surface. The thermal lesions involved the entire base of the skull, respectively. On two matching parts of the
head, the neck, both the front and the back of the thorax as frontal squama parts of the right and left supraorbital margin
well as both arms. There was a marked inhalation trauma were discernible. The medial edges of the frontal bone
with strong reddening and membranous sequestration of the fragments matched exactly with a roundish punch-like bone
 M. Bohnert, M.A. Rothschild / Forensic Science International 131 (2003) 197±201 199

defect (diameter 9 mm) being localized in the center with forehead with suicidal intent after setting ®re to the pile of
several fracture lines radiating from it. wood near or on which he was standing.

2.3.3. Identi®cation and reconstruction 2.4. Case 4: wrist cuts, shot to the head and self-
At ®rst the police concentrated their investigations on the incineration
owner of the car parked not far from the place where the
body was found. The 71-year-old man had left his home after 2.4.1. History
a domestic argument and was missing since then. The pile of Without any warning a 33-year-old man shot himself in
wood on the clearing and the livestock stunner belonged to the head with a blank-cartridge pistol in the middle of the
the family. The missing man was known to be familiar with street near his home. Profusely bleeding from the head, he
the handling of such a device due to the slaughtering of ran towards his apartment and poured gasoline over himself
domestic animals. in front of the door. Shortly after he had entered his apart-
Because of the severe destruction of the body identi®ca- ment a de¯agration occurred. With his body burning he then
tion was neither possible by morphological methods nor by ran into the inner courtyard of the house where he warded off
DNA methods. Nevertheless, the overall circumstances of any attempts of his neighbors to extinguish the ¯ames. He
the case justi®ed the assumption that the bone remains was unconscious when a rescue helicopter took him to a
originated from the missing car owner. It had to be assumed hospital and died in the intensive care ward about 14 h later.
that the man had ®red a shot from the livestock stunner to his In the apartment a farewell letter was found in which the

Fig. 1. Case 4: complex suicide by wrist cuts, shot to the head with a blank cartridge pistol and self-incineration. Stellate gunshot entrance
wound on the right temple. Singeing of the hair and burns of the face.
200 M. Bohnert, M.A. Rothschild / Forensic Science International 131 (2003) 197±201

man gave as reasons for his suicide his alcoholism as well as Table 1
the separation from his wife. Overview of the own cases and the cases from the literature

Sex Age (years) Other suicide method Reference

2.4.2. Autopsy ®ndings
The body showed ®rst- to third-degree burns of about Primary complex suicide
85% of the body surface. Only on the lower legs and the feet Male 17 Fall from height Own case no. 1
there were no signi®cant thermal lesions. A substantial Female 42 Fall from height Own case no. 2
Male 29 Fall from height [9]
amount of soot was found in the pharynx and the tracheo-
Male 30 Fall from height [9]
bronchial system reaching as far as the peripheral bronchial Male 71 Shot to the head Own case no. 3
sections. The organs were markedly congested and the brain with livestock
showed edematous swelling. stunner
On the right temple a stellate gunshot entrance wound Female 54 Cuts of the neck [12]
penetrating the entire epicranium was found (Fig. 1). The Male Unknown Hanging [13]
periosteum above the outer table was also torn while the Secondary complex suicide
skullcap itself and the brain were intact. Male 33 Shot to the head Own case no. 4
On the ¯exor side of the left wrist a singular, transverse, with blank cartridge
2 cm long cut wound was localized which reached down into pistol; wrist cuts
the subcutaneous fatty tissue. No major blood vessels were Male 37 Stabbing of the chest [10]
affected. Male Unknown Hanging [11]
According to the autopsy ®ndings the man died of car- Male 43 Wrist cuts [12]
diovascular failure due to extensive burns of the body sur-
face.
also injuries in¯icted by sharp force (Table 1). One of the
2.4.3. Toxicology victims was a 54-year-old woman who was found dead
Apart from the medication administered for post-trau- beside a burned-out car with second- to third-degree burns.
matic treatment the results of the toxicological analyses Apart from the thermal lesions the body also showed six
were negative. parallel cuts on the front of the neck, which were partly deep
enough to sever the trachea and the right carotid artery.
Together with the aspiration of blood and the burns these
3. Discussion injuries were responsible for death. From the anamnesis she
was known to suffer from depression and had repeatedly
In the literature complex suicides combining self-incin- threatened to commit suicide.
eration with one or more other methods of suicide are a rarity Cingolani and Tsakri [13] recently reported on three
[9±13]. Lignitz and Strauch [9] found only 2 cases of this primary complex suicides. One case referred to a man
type among more than 33,000 autopsies within an observa- who hanged himself on a tree after piling up branches under
tion period of 19 years (Table 1). Some publications on the tree and setting them on ®re (Table 1). There were
suicidal self-incineration do not even mention complex extensive burns, especially on the head, the upper part of
suicides [14±17]. the chest and the legs.
The cases reported by Lignitz and Strauch [9] referred to a These four cases reported in the literature as well as our
29-year-old man who jumped from a ®re escape on the 11th own case nos. 1±3 can be classi®ed as primary complex
¯oor of a high-rise building after pouring linseed oil over suicides. Secondary complex suicides, like our case no. 4,
him and setting ®re to his clothing. The man was known to have also been reported occasionally, e.g. by Leth and Hart-
suffer from diabetes mellitus and schizophrenia, but had not Madsen [11] and by Grimm and Sigrist [12] (Table 1).
attempted suicide before. No farewell letter was found. In their survey of suicides by self-incineration covering a
The other case referred to a 30-year-old man who period of 10 years Leth and Hart-Madsen [11] mentioned the
poured spirit over himself, set ®re to it and then jumped case of a man who burnt himself after his original plan to
from the fourth ¯oor of his house. The man died 8 weeks hang himself had failed, because the rope broke.
later from the consequences of the burns and polytrauma- Among the four cases of suicide by self-incineration out
tization. From his medical history a personality change in the open described by Grimm and Sigrist [12] was a 43-
was known, which had started approximately 5 years year-old man whose body was found in a forest with severe
before and was characterized by withdrawal, termination burns. On the left wrist super®cial parallel cuts in¯icted in
of social contacts and a growing interest in religious the ®rst phase of the suicide were detected. No farewell
topics. He had made a suicide attempt by self-incineration letter was found. The man was said to have been heavily
2 years before. indebted.
Grimm and Sigrist [12] described four suicides by self- Among 32 suicides by self-incineration within a period of
incineration out in the open. In two of these cases there were 3 years Shkrum and Johnston [10] mentioned the case of a
 M. Bohnert, M.A. Rothschild / Forensic Science International 131 (2003) 197±201 201

37-year-old man who showed stab wounds on the chest in References

addition to the burns. However, no further details are told
with regard to the circumstances of the case. [1] G. Dotzauer, H. Goebels, H. Legewie, Selbstmord und
Most of the suicides who killed themselves by self- Selbstmordversuch, MuÈnch. Med. Wschr. 105 (1963) 973.
incineration in combination with other methods were young [2] S. Pollak, Statistik und PhaÈnomenologie kombinierter
to middle-aged. An exception was our own case no. 3, which SelbsttoÈtungen und anderer suizidaler MehrfachschaÈdigungen
refers to a 71-year-old man. The case reports by Cingolani im urbanen Bereich, Arch. Kriminol. 161 (20±30) (1978)
68±81.
and Tsakri do not indicate the age of the victims; the same
[3] K. Scheib, Kriminologie des Suizids, Karl Scheib, Groû-
applies to the publication by Leth and Hart-Madsen [11].
Gerau, 2000.
The other suicides were aged between 17 and 54 years and [4] M.J. Bullock, D. Diniz, Suffocation using plastic bags: a
thus essentially younger than suicides in general (highest retrospective study of suicides in Ontario, Canada, J. Forensic
incidence in the seventh decade of life [2]). According to the Sci. 45 (2000) 608±613.
literature the highest incidence of suicides by self-incinera- [5] M. Groûe Perdekamp, H. Nadjem, W. Weinmann, S. Pollak,
tion is found in middle age [7,10]. As regards the sex ratio of Plastikbeutel als Mittel der Selbst- und FremdtoÈtung, Arch.
our own cases and those reported in the literature there is a Kriminol. 207 (2001) 33±41.
predominance of the male sex which corresponds to that [6] E. Lignitz, H. Strauch, Tod durch PlastikbeutelÐBeitrag zum
found for suicides by self-incineration alone [7,10]. akzidentellen und suizidalen Ersticken, Kriminalistik und
Forensische Wissenschaften 63 (1986) 36±49.
Among the primary complex suicides self-incineration
[7] M.A. Rothschild, H.-J. Raatschen, V. Schneider, Suicide by
was most frequently associated with a jump or fall from a
self-immolation in Berlin from 1990 to 2000, Forensic Sci.
height (®ve of seven cases). A feature generally noticeable Int. 124 (2002) 163±166.
both with primary and secondary complex suicides is that [8] M. Bohnert, U. Schmidt, M. Groûe Perdekamp, S. Pollak,
self-cremation is usually combined with other ``hard'' meth- Diagnosis of a captive-bolt injury extremely destroyed by ®re,
ods of suicide like hanging, in¯iction of stabs, cuts or Forensic Sci. Int. 127 (2002) 192±197.
gunshot wounds. As in suicides by self-incineration gener- [9] E. Lignitz, H. Strauch, Kombinierter Suizid durch Verbren-
ally, the medical histories contain an increased percentage of nen und Sturz aus der HoÈhe, Arch. Kriminol. 178 (1986)
psychiatric disorders. If there was a special psychopatholo- 51±53.
gical constellation or a speci®c motive in the cases described [10] M. Shkrum, K. Johnston, Fire and suicide: a 3-year study of
self-immolation deaths, J. Forensic Sci. 37 (1992) 208±221.
above which would allow differentiating them from the
[11] P. Leth, M. Hart-Madsen, Suicide by self-incineration, Am. J.
group of suicides committed by self-incineration alone,
Forensic Med. Pathol. 18 (1997) 113±118.
cannot be answered in view of the small number of cases. [12] U. Grimm, T. Sigrist, Verbrennen im Freien, Arch. Kriminol.
For the same reason it is not possible to differentiate the 201 (1998) 137±145.
cases of complex suicides with self-incineration from other [13] M. Cingolani, D. Tsakri, Planned complex suicide. Report of
forms of complex suicides. No doubt the choice of the three cases, Am. J. Forensic Med. Pathol. 21 (2000) 255±260.
method of suicide depends not only on personal reasons, [14] A.R. Copeland, Suicidal ®re deaths revisited, Z. Rechtsmed.
but also on the availability of the means of suicide [10]. 95 (1985) 51±57.
For differential diagnosis cremation to cover up a homi- [15] O. Hadjiiski, P. Todorov, Suicide by self-in¯icted burns,
cide should always be taken into consideration when exam- Burns 22 (1996) 381±383.
[16] A.R. Mabrouk, A.N.M. Omar, K. Massoud, M.M. Sherif,
ining ®re victims showing additional injuries, such as
N.E. Sayed, Suicide by burns: a tragic end, Burns 25 (1999)
gunshot wounds (our case nos. 3 and 4) or sharp force
337±339.
injuries [10,12]. In the individual case differentiation [17] J.M. O'Donoghue, J.L. Panchal, S.T. O'Sullivan, M.
between suicide and homicide may be dif®cult, especially O'Shaughnessy, T.P.F. O'Connor, H. Keeley, M.J. Kelleher,
if the body is found in the open with additional injuries being A study of suicide and attempted suicide by self-immolation
(co-)responsible for death and there are no independent in an Irish psychiatric population: an increasing problem,
witnesses who are not involved in the case. Burns 24 (1998) 144±146.