Fomwic Science International, 57 (1992) 181- 191 Elsevier Scientific Publishers Ireland Ltd.
181
FIREARM DEATHS IN YORKSHIRE AND HUMBERSIDE
J. CHAPMAN and C.M. MILROY Departmmt of Forensic Pathology, University of Sh@ield, Medico-Legal Centre, Watery Street, Sh@ie.!d SS 7ES (UK) (Received September 9tb, 1992) (Accepted September 22nd, 1992)
Summary Firearm fatalities occuring in Yorkshire and Humberside between 1975 - 1991 were examined; 130 cases were found, 64 were homicides, 55 suicides and 11 were accidental or unclassifiable. Ail but two of the suicides were men. Shotguns were the most frequent weapon used in both suicides and homicides. Of the 55 suicides, 17 were by men who had murdered before committing suicide. In 15 of these cases the assailants knew their victims. The other two cases involved murder of police officers. These cases were mostly with shotguns. In both homicide and suicide, rifled weapons and handguns were infrequently used. Most suicides and homicides occurred at home. Alcohol was again shown to be a significant factor in suicides. Overall firearms account for less than 10% of homicides in England and Wales and less than 5% of suicides in men and is most unusual in women. Key wordx Firearms;
Homicide; Suicide
Introduction
In the United States, the most frequent method of killing in homicides and suicides is by firearms [l]. In England and Wales they accounted for 8.59% of homicides [2] and 3.54% of suicides between the years 1975 and 1990 [3]. Firearm fatalities have been studied in a number of countries but similar studies are lacking from the United Kingdom. This paper reports on firearm fatalities seen in Yorkshire and Humberside between 1975 and 1991. Methods
Information was collated from autopsy reports and, where available, forensic science laboratory reports on cases involving gunshot fatalities seen by the Departments of Forensic Medicine of Leeds University and of Forensic Pathology at Sheffield University between the years 1975 and 1991 inclusive, Correspondence to: C.M. Milroy, Department of Forensic Pathology, University of Sheffield, MedicoLegal Centre, Watery Street, Sheffield S3 7ES, UK. 0379-0738/92/$05.00
0 1992 Elsevier Scientific Publishers Printed and Published in Ireland
Ireland Ltd.
182 TABLE 1 TOTAL NUMBERS AND PERCENTAGES OF HOMICIDES, SUICIDES AND UNKNOWNS 4%x
Homicides No.
M F
35 29
Total
64
SUtiS %
Accident w unclassifiable
No.
54.7 45.3
96.4 3.6
53 2
100
No.
%
9 2
100
55
% 81.8 18.2
11
100
that occurred in Yorkshire and Humberside. This area is a mixed urban and rural area and has a population of approximately five million people. All cases of suspicious death will have been seen by the departments, though not all suicide cases. The data collated from each case consisted of: (i) sex; (ii) age; (iii) the firearm used (whether shotgun, handgun, rifle or other); (iv) the site of the entrance wound; (v) the number of shots an individual received; (vi) the range at which an individual was shot (excluding suicides) (vii) the location where the body was discovered; (viii) blood and urine alcohol levels where available; (ix) the month in which the body was found; (x) whether death was due to homicide, suicide or was deemed to be accidental or unclassifiable from the information available. Results
A total of 130 gunshot cases were found. Of these, 64 were classified as homicides, 55 as suicides and 11 were accidental or unclassifiable.
sexofwicti?ns The sex of the individuals is shown in Table 1. The vast majority of gunshot
TABLE 2 HOMICIDES, SUICIDES AND HOMICIDE-SUICIDES
ssx
Homicides
HonCcide-suicides
SUtib
Homicide No
%
No
M F
26 14
65 35
36 2
Total
40
100
38
% 94.7 5.3 100
No 9 15 24
Suicide
% 37.5 62.5 100
No
95
17 -
100 -
17
100
183
suicides were by males and the ratio of male to female firearm homicide victims was approximately 11:9. A separate subgroup, the ‘homicide-suicides’(so called dyadic death), was identified. The results are shown in Table 2. All perpetrators of homicide-suicides were male. Victims in this group had a sex ratio of approximately 2 females to 1 male. Even with homicide-suicides divided into a distinct group, 19 out of 20 suicides were by males, but, in the homicide group, the ratio of female to male victims was 2:l. Of the 29 female homicide victims, 12 (41.4%) were killed by their spouse (or cohabitee). In this study, 32% of firearm homicides were followed by the suicide of the assailant. Age
ofvictim
The mean age of male homicide victims was 39.04 years (range 11 - 71) and of females 29.92 years (range 3-46 years). The mean age of male suicides was 44.92 years (range 17-88 years). Since there were only 2 female suicides, their mean age was not calculated. The homicide and suicide cases were split into
TABLE 3 A. AGE GROUPS OF HOMICIDES AND SUICIDES (INCLUDING HOMICIDE-SUICIDES) WHERE KNOWN Age (years)
Homicides % Suicides %
Total
c.80
21-30
51-40
u-50
>50
10 16.95
16 27.12
16 27.12
7 11.86
10 16.95
59
3 5.6
9 16.6
11 20.4
8 14.8
23 42.6
54
B. AGE GROUPS OF HOMICIDES, SUICIDES AND HOMICIDE-SUICIDES WHERE KNOWN Homicides %
3 a.3
12 33.3
12 33.3
4 11.1
5 13.9
36
Suicides %
3 7.9
7 18.4
6 15.8
6 15.8
16 42.1
38
Homicides of homicide-suicides %
7
4
4
3
5
23
30.5
17.4
17.4
13.1
21.6
0
2
5
2
7
0
12.5
Suicides of homicidesuicidesa YO
BInsufficientdata on one case.
31.25
12.5
43.75
16
184 TABLE 4 A. FIREARM USED IN HOMICIDES AND SUICIDES Shotgun
Ri&
Handgun
Total
Homicides %
40 62.50
4 6.25
15 23.44
5 7.81
64 100
Suicides %
36 65.50
3 5.45
14 25.45
2 3.60
55 100
Total
76
I
29
7
119
B. FIREARM USED IN HOMICIDES, SUICIDES AND HOMICIDE-SUICIDES Homicides %
22 55.0
3 7.5
10 25.0
5 12.5
40 100
Suicides %
22 57.9
2 5.32
12 31.5
2 5.3
38 100
Homicide-suicides %
32 78.0
2 4.9
7 17.1
0 0
41 100
Total
76
7
29
7
119
various age groups (Table 3A); 42.6% of suicides were over 50 years of age, whilst over 50% of homicide victims were between the ages of 21 and 40 years. Further analysis (Table 3B) revealed that nearly one third of homicide victims of homicide-suicides were under 20 years of age compared to less than 10% of other firearm homicide victims. TABLE 5 SITES OF PRINCIPAL INJURY Head (inc. neck)
Chest
Abdmnen
>One site
Total
Homicides %
13 32.5
14 35
5 12.5
8 20
40
Suicides %
45 81.8
5 9.1
2 3.6
3 5.5
55
Homicides of homicide-suicide %
19
3
1
1
24
4.15
4.15
79.2
12.5
185 TABLE
6
NUMBER OF SHOTS FIRED INTO INDIVIDUAL
Number of shots
1
2
3 or more
Total
Homicides %
44 68.75
9 14.05
11 17.2
64 100
Suicides %
53 96.4
2 3.6
-
55 100
In the suicide group, approximately one sixth of individuals were between the ages 31 and 40 compared to nearly one third of suicides in the homicide-suicide group. The percentage of suicides over 50 years of age was similar in both subgroups of suicide. Type of firearm
Firearms were classified as shotgun, rifle or handgun. The results are shown in Table 4A. Approximately two thirds of all homicides and suicides were by shotguns and one quarter by handguns. Further examination (Table 4B) showed that of homicide-suicides, four fifths were carried out by shotguns. In over half of other homicides and over half of all suicides, the firearm used was also a shotgun. One individual committed suicide using a ‘humane killer’ powered by a O.Z2-cartridge, and one used a ‘home-made’ gun. Four homicides were due to a rifled projectile, but whether the source was a longarm or handgun could not be ascertained. Sites of injury and numbers of shots The sites of the principal injury are shown in Table 5. The percentage distribu-
TABLE
7
SITE OF ENTRANCE
WOUNDS OF SUICIDES
Mouth
Lefl side
Shotgun %
15 55.5
3 11.1
Handgun %
2 16.6
-
Rifle
-
-
%
ofhmo!
BY TYPE OF FIREARM
Right side ofhead
Forebad
under chin
5 18.6
3 11.1
1 3.7
7 58.3
3 25
-
-
-
3 100
186 TABLE 8 SITES OF INJURY FOR ALL FIREARMS Al Ragheb 141
Hirsh and Ao!.ehm [s]
Thom.wnand Albrekkm [6]
Present studya
Head and neck %
24 60
349 77.5
220 73
45 84.9
Chest %
9 22.5
83 18.4
54 17.9
6 11.3
Abdomen %
7 17.5
18 4.0
21 7.0
2 3.8
BExcludestwo suicide cases with two sites of injury.
tion of injuries between homicides of homicide-suicides and suicides was very similar (approximately 80% being to the head in both groups). The number of shots fired (Table 6) indicates that most homicide victims in the study died due to one shot. In the vast majority of suicides only one shot was used, but there were two cases when more than one shot was fired by the individual (3.7% of all suicides). Further analysis revealed that of all suicidal shots to the head, shotgun suicides showed a predilection for firing into the mouth and handguns into the right side of the head (Table 7). Comparison with other published series is shown in Tables 8 and 9. Range of shots The range of the shot was determined by reference to the ballistics reports
where available and by the characteristics of the entrance wounds in the pathologists’ reports. Four categories: contact, near-contact, intermediate and
TABLE 9 SITES OF INJURY FOR SHOTGUN SUICIDES Eisele et al. [?‘j
Mitchell [8] and Milvtrnun
Present study
Head and neck %
12 51
53 50.5
28 77.8
Chest %
8 35
38 36.2
5 13.9
Abdomen %
3 13
14 13.3
3 8.3
187 TABLE 10 RANGE OF FIREARM FROM VICTIM; HOMICIDES AND HOMICIDE-SUICIDES Range
contact
Near-contact
Intermediate
Distant
Unstated or
othf?r Homicides % Homicides of homicide-suicides %
-
10 25
7 17.5
14 35
9 22.5
4
9
6
4
1
16.6
37.5
25
16.6
4.3
distant were recorded. Cases of homicide and suicide were compared. The results are shown in Table 10. From this table it can be seen that over half of the homicide victims of homicide-suicide were shot at either contact or near-contact ranges compared to one quarter of other homicides. Location whm-e the body was discovered The location of the body (where the information was available) was noted. This was divided into those found at home and away from home. The results are shown in Table 11. Most suicides and homicide-suicides occurred at home. The majority of homicides also occurred at home, but not as frequently as in the previous groups. Further examination of where the body was found within the home (including gardens, pathways, outhouses and garden sheds, etc.) revealed that the most common room where the deceased was discovered was the bedroom (Table 12).
TABLE 11 LOCATION OF BODY (WHERE KNOWN) HOme
Away from home
Homicides %
22 62.9
13 37.1
Suicides %
20 71.4
8 28.6
Homicides of homicide-suicide %
17
Suicides of homicide-suicide %
77.3 11 78.6
5 22.7 3 21.4
188 TABLE 12 LOCATION OF BODY WITHIN THE HOME Bedroom
Living-room
Homicide %
7 31.8
5 22.7
Suicides %a
9 47.4
Homicides of homicide-suicides %
10
Suicides of homicidesuicides %
Bathroom
outsid4?
other
1 4.6
4 18.2
5 22.7
3 15.8
2 10.5
2 10.5
3 15.8
4
1
1
1
5.9
5.9
5.9
58.8
23.5
5
2
2
-
2
45.5
18.1
18.1
-
18.1
BOnecase exact site in home unknown.
Approximately one third of homicides occurred within the bedroom compared to nearly three fifths of homicides in homicide-suicides. Out of all suicides at home, 46.6% were found within the bedroom. Blood and urine alcohol
Blood and/or urine alcohol (BA; UA) results were available for twenty-five homicide victims and twenty-three suicides (Table 13). Of the twenty-five homicides, nine (36%) were found to have alcohol detectable (mean BA 141.5 mg per 100 ml; range 2- 249 mg/lOO ml; UA 221.3 mg/lOO ml; range 19-310 mg/lOO ml). Thirteen out of twenty-three suicides (56.5%) had detectable levels of alcohol (mean BA 145.8 mg/lOO ml; range 79 - 258 mg/lOO ml; mean 184.5 mg/lOO ml; range 92 - 334 mgllO0 ml).
TABLE 13 BLOOD AND ALCOHOL LEVELS IN HOMICIDES AND SUICIDES Homicide
suicide
Alcohol detected %
9 36
13 56.5
Alcohol not detected %
16 64
10 43.5
Total
25
23
189 TABLE 14 SEASONAL VARIATIONS IN HOMICIDES, SUICIDES AND HOMICIDE-SUICIDES BY EPISODE Dec. -Feb.
Mar. -May
June-Aug.
Sep. -NOV.
Homicides %
8 22.2
7 19.4
13 36.1
8 22.2
Suicides %
13 34.2
8 21.0
11 28.9
6 15.9
Homicide-suicides %
7 41.2
5 29.4
4 23.5
1 5.9
Seasonal variations Seasonal variation in homicides, suicides and homicide-suicides was considered. The year was divided into 3-month blocks. The results are shown in Table 14. From these results it can be seen that 41.2% of homicide-suicides occurred between December and February. Nearly two thirds of suicides occurred within the months December to February and June to August. The peak incidence for homicides was during the months of June to August (highest incidence of homicide being in June). Unusualcases As mentioned previously, one individual committed suicide using a humane killer powered by a 0.22~cartridge. Another unusual suicide involved an improvised firearm consisting of a piece of steel tubing, a turned steel breechblock, a nail for a firing pin and a steel block as an improvised hammer. This fired a 0.22 cartridge. Another case of note involved the individual being shot in the chest by a shotgun. He survived for 16 days but died due to emboli of shotgun pellets to his small bowel, thus leading to infarction and peritonitis. At post mortem, a pellet was found in the left coronary artery, four pellets in the ileum and one pellet in the right anterior cerebral artery. Pellets were demonstrated on X-ray in the left lung. Healing punctures of the aorta and pulmonary arteries were demonstrated during the autopsy. Amongst the homicide-suicides, there was one case which involved the deaths of three persons. One of the murdered victims was shot and the other asphyxiated by manual strangulation. In all the other homicide-suicides, all the victims were shot. Discussion
In England and Wales between 1975 and 1990, there were 7833 offences of homicide (as currently recorded) of which 725 (8.59%) were by firearms [2]. Be-
190
tween 1975 and 1990 there were 65 762 recorded suicides, of which 2330 (3.54%) were by firearms and explosives, of which the vast majority were male suicides t31.
In this study the vast majority of suicides were men (96.4%). The over 50’s were the commonest age group. Shotguns were the most frequent weapon used. In all but two suicide cases, only one shot was delivered and was nearly always to the head. However, the chest was the site of injury in approximately 15% of cases and in two cases the abdomen. In two suicides there were two shots fired. With respect to homicide, shotguns were again the most frequent weapon used, handguns being used in less than 2.5% of cases and rifles in less than 10% of cases. Men were more frequently victims of homicide (55%) but women formed a significant proportion (45%). The chest was a more frequent site of injury in homicides (35%) than in suicides, with the head being involved with a similar frequency to the chest (32.5%) A third pattern was identified, namely homicide followed by suicide of the assailant, so called dyadic death. In all the cases the perpetrator was a man and with two exceptions, the victims were known to the assailant and were usually members of the same family. The two exceptions were men who shot police officers and then committed suicide. These cases were both with handguns. In homicide-suicides shotguns were by far and away the most frequent weapon, being used in over 80% of cases. Excluding the two murders of police officers, only one case of homicide-suicide was not with a shotgun. A high proportion of homicide victims under 20 were in the homicide-suicide episodes. These were children of the assailant. The head was a more frequent site of the gunshot wound than in other homicides. When the location of the body within the home is taken into account, nearly 60% were in the bedroom. The position of the body indicated most of the victims were asleep, thus making it easier to shoot at the head. Of all the suicides in this study (where information was available) 56.5% had detectable levels of alcohol in their blood. Selway reported 31% in his study [9], Freytag 35% [lo] and Hudson 40% [ll]. A study in Alaska showed that of 169 suicides, 99 had detectable levels [12]. In Denmark 31% of firearm suicides had a history of chronic alcoholism and/or drug abuse and alcohol was present in 55% at necropsy [6]. In this series, the highest incidence of firearm suicides occurred between December and February. In contrast, Jordan displayed a peak incidence of firearm suicides between June and August [4]. In the UK, May to July are stated to be the most frequent months for suicide [13]. Comparing international rates, most homicides and suicides in the USA are by firearms, with handguns being the most frequent weapon [1,5,10,11,14]. In Jordan, 7.1% of all unnatural deaths (which included road accidents which accounted for 44% of unnatural deaths) are by firearms [4]. Handguns were the most frequent firearm used in suicides in Jordan (72.5%). In comparison, rifles were the most frequent weapon used in suicides (66%) in Australia [9]. In Iceland [15], 22.2% of homicides were with firearms whilst in Singapore it was only 2% [16]. In Auckland, New Zealand, 13.8% of homicides were with
191
firearms, with a similar frequency of shotguns and rifles [17]. In Victoria, Australia, one third of homicides were with firearms, with rifles being the most common weapon [ 181.Shotguns were the most frequently used firearm in suicide in Denmark (50%), with handguns (44%) the most frequent firearm in homicide followed by shotguns (28%) [6]. In conclusion, in England and Wales shotguns are the most frequent firearm used in both homicides and suicides, but firearms are a less frequent method of killing than in many other countries. This paper, however, once again illustrates that the type of firearm used and the frequency with which they are used relate to the availability of the weapon. Acknowledgement
We wish to thank Mrs A. Cooper and Mrs J. Rutter for secretarial assistance. References 1
G.J. Wintemute, S.P. Teret, J.F. Kraus and M.W. Wright, The Choice of Weapons in Firearm Suicides. Am. J. Publ. Health, 78 (1988) 824-826. 2 Criminal Statistics in England and Wales 1975 - 1990, HMSO, London. 3 Office of Population Censuses and Surveys Mortality Statistics: Cause, Series DH2 1975 - 1990, HMSO, London. 4 S.Y. Al Ragheb, Firearm fatalities in Jordan. Med. Sci. Law, 24 (1984) 213-221. 5 C.S. Hirsch and L. Adelson, A suicidal gunshot wound of the back. J. Forensic Sci., 21(1976) 659 - 666. 6 J.L. Thomsen and S.B. Albrektsen, An investigation of the pattern of firearms fatalities before and after introduction of new legislation in Denmark. Med. Sci. Law, 31 (1991) 162 - 166. 7 J.W. Elsele, D.T. Reay and A. Cook, Sites of suicidal gunshot wounds. J. Forensic Sci., 26 (1981) 480-485. 8 J.S. Mitchell and J. Milvenan, Shotgun suicides. Forensic Sci. Gaz., 8 (1977) 3. 9 R. Selway, Gunshot suicides in Victoria, Australia, 1988. Med. 5%. Law, 31 (1991) 76-80. 10 E. Freytag, Autopsy findings in head injury from firearms. Arch. Path&. , 75 (1963) 402 - 413. 11 P. Hudson, Multishot firearm suicide examination of 58 cases. Am. J. Forensic Med. Pa&Z., 2 (1981) 239-242. 12 W.G. Hlady and J.P. Middaugh, Suicides in Alaska: Firearms and alcohol. Am. J. Publ. Health, 78 (1988) 179- 180. 13 M. Geider, D. Gath and R. Mayon, Suicide and deliberate self-harm. In Ozford Textbook of Psychiatry, Oxford Medical Publications, Oxford, 1989, pp. 478-489. 14 I.G. Stone, Observations and statistics relating to suicide weapons. J. Foreneic SC%.,32 (1987) 711-716. 15 G.H. Gudjonsson and H. Petursson, Some criminological and psychiatric aspects of homicide in Iceland. Med. Sci. Law, 22 (1982) 91-98. 16 E.H. Kua, A.F. Yuan and A.L. Ang, Homicide in Singapore. Med. Sci. Law, 25 (1985) 26 - 28. 17 M. Lo, J.C. Vuletic and T.D. Koelmeyer, Homicides in Au&and, New Zealand. A 14-year study. Am. J. Forensie Med. Path&., 13 (1992) 44-49. 18 R. Selway, Firearm fatalities in Victoria, Australia 1988. Med. Sci. Law, 31 (1991) 167- 174.
181
FIREARM DEATHS IN YORKSHIRE AND HUMBERSIDE
J. CHAPMAN and C.M. MILROY Departmmt of Forensic Pathology, University of Sh@ield, Medico-Legal Centre, Watery Street, Sh@ie.!d SS 7ES (UK) (Received September 9tb, 1992) (Accepted September 22nd, 1992)
Summary Firearm fatalities occuring in Yorkshire and Humberside between 1975 - 1991 were examined; 130 cases were found, 64 were homicides, 55 suicides and 11 were accidental or unclassifiable. Ail but two of the suicides were men. Shotguns were the most frequent weapon used in both suicides and homicides. Of the 55 suicides, 17 were by men who had murdered before committing suicide. In 15 of these cases the assailants knew their victims. The other two cases involved murder of police officers. These cases were mostly with shotguns. In both homicide and suicide, rifled weapons and handguns were infrequently used. Most suicides and homicides occurred at home. Alcohol was again shown to be a significant factor in suicides. Overall firearms account for less than 10% of homicides in England and Wales and less than 5% of suicides in men and is most unusual in women. Key wordx Firearms;
Homicide; Suicide
Introduction
In the United States, the most frequent method of killing in homicides and suicides is by firearms [l]. In England and Wales they accounted for 8.59% of homicides [2] and 3.54% of suicides between the years 1975 and 1990 [3]. Firearm fatalities have been studied in a number of countries but similar studies are lacking from the United Kingdom. This paper reports on firearm fatalities seen in Yorkshire and Humberside between 1975 and 1991. Methods
Information was collated from autopsy reports and, where available, forensic science laboratory reports on cases involving gunshot fatalities seen by the Departments of Forensic Medicine of Leeds University and of Forensic Pathology at Sheffield University between the years 1975 and 1991 inclusive, Correspondence to: C.M. Milroy, Department of Forensic Pathology, University of Sheffield, MedicoLegal Centre, Watery Street, Sheffield S3 7ES, UK. 0379-0738/92/$05.00
0 1992 Elsevier Scientific Publishers Printed and Published in Ireland
Ireland Ltd.
182 TABLE 1 TOTAL NUMBERS AND PERCENTAGES OF HOMICIDES, SUICIDES AND UNKNOWNS 4%x
Homicides No.
M F
35 29
Total
64
SUtiS %
Accident w unclassifiable
No.
54.7 45.3
96.4 3.6
53 2
100
No.
%
9 2
100
55
% 81.8 18.2
11
100
that occurred in Yorkshire and Humberside. This area is a mixed urban and rural area and has a population of approximately five million people. All cases of suspicious death will have been seen by the departments, though not all suicide cases. The data collated from each case consisted of: (i) sex; (ii) age; (iii) the firearm used (whether shotgun, handgun, rifle or other); (iv) the site of the entrance wound; (v) the number of shots an individual received; (vi) the range at which an individual was shot (excluding suicides) (vii) the location where the body was discovered; (viii) blood and urine alcohol levels where available; (ix) the month in which the body was found; (x) whether death was due to homicide, suicide or was deemed to be accidental or unclassifiable from the information available. Results
A total of 130 gunshot cases were found. Of these, 64 were classified as homicides, 55 as suicides and 11 were accidental or unclassifiable.
sexofwicti?ns The sex of the individuals is shown in Table 1. The vast majority of gunshot
TABLE 2 HOMICIDES, SUICIDES AND HOMICIDE-SUICIDES
ssx
Homicides
HonCcide-suicides
SUtib
Homicide No
%
No
M F
26 14
65 35
36 2
Total
40
100
38
% 94.7 5.3 100
No 9 15 24
Suicide
% 37.5 62.5 100
No
95
17 -
100 -
17
100
183
suicides were by males and the ratio of male to female firearm homicide victims was approximately 11:9. A separate subgroup, the ‘homicide-suicides’(so called dyadic death), was identified. The results are shown in Table 2. All perpetrators of homicide-suicides were male. Victims in this group had a sex ratio of approximately 2 females to 1 male. Even with homicide-suicides divided into a distinct group, 19 out of 20 suicides were by males, but, in the homicide group, the ratio of female to male victims was 2:l. Of the 29 female homicide victims, 12 (41.4%) were killed by their spouse (or cohabitee). In this study, 32% of firearm homicides were followed by the suicide of the assailant. Age
ofvictim
The mean age of male homicide victims was 39.04 years (range 11 - 71) and of females 29.92 years (range 3-46 years). The mean age of male suicides was 44.92 years (range 17-88 years). Since there were only 2 female suicides, their mean age was not calculated. The homicide and suicide cases were split into
TABLE 3 A. AGE GROUPS OF HOMICIDES AND SUICIDES (INCLUDING HOMICIDE-SUICIDES) WHERE KNOWN Age (years)
Homicides % Suicides %
Total
c.80
21-30
51-40
u-50
>50
10 16.95
16 27.12
16 27.12
7 11.86
10 16.95
59
3 5.6
9 16.6
11 20.4
8 14.8
23 42.6
54
B. AGE GROUPS OF HOMICIDES, SUICIDES AND HOMICIDE-SUICIDES WHERE KNOWN Homicides %
3 a.3
12 33.3
12 33.3
4 11.1
5 13.9
36
Suicides %
3 7.9
7 18.4
6 15.8
6 15.8
16 42.1
38
Homicides of homicide-suicides %
7
4
4
3
5
23
30.5
17.4
17.4
13.1
21.6
0
2
5
2
7
0
12.5
Suicides of homicidesuicidesa YO
BInsufficientdata on one case.
31.25
12.5
43.75
16
184 TABLE 4 A. FIREARM USED IN HOMICIDES AND SUICIDES Shotgun
Ri&
Handgun
Total
Homicides %
40 62.50
4 6.25
15 23.44
5 7.81
64 100
Suicides %
36 65.50
3 5.45
14 25.45
2 3.60
55 100
Total
76
I
29
7
119
B. FIREARM USED IN HOMICIDES, SUICIDES AND HOMICIDE-SUICIDES Homicides %
22 55.0
3 7.5
10 25.0
5 12.5
40 100
Suicides %
22 57.9
2 5.32
12 31.5
2 5.3
38 100
Homicide-suicides %
32 78.0
2 4.9
7 17.1
0 0
41 100
Total
76
7
29
7
119
various age groups (Table 3A); 42.6% of suicides were over 50 years of age, whilst over 50% of homicide victims were between the ages of 21 and 40 years. Further analysis (Table 3B) revealed that nearly one third of homicide victims of homicide-suicides were under 20 years of age compared to less than 10% of other firearm homicide victims. TABLE 5 SITES OF PRINCIPAL INJURY Head (inc. neck)
Chest
Abdmnen
>One site
Total
Homicides %
13 32.5
14 35
5 12.5
8 20
40
Suicides %
45 81.8
5 9.1
2 3.6
3 5.5
55
Homicides of homicide-suicide %
19
3
1
1
24
4.15
4.15
79.2
12.5
185 TABLE
6
NUMBER OF SHOTS FIRED INTO INDIVIDUAL
Number of shots
1
2
3 or more
Total
Homicides %
44 68.75
9 14.05
11 17.2
64 100
Suicides %
53 96.4
2 3.6
-
55 100
In the suicide group, approximately one sixth of individuals were between the ages 31 and 40 compared to nearly one third of suicides in the homicide-suicide group. The percentage of suicides over 50 years of age was similar in both subgroups of suicide. Type of firearm
Firearms were classified as shotgun, rifle or handgun. The results are shown in Table 4A. Approximately two thirds of all homicides and suicides were by shotguns and one quarter by handguns. Further examination (Table 4B) showed that of homicide-suicides, four fifths were carried out by shotguns. In over half of other homicides and over half of all suicides, the firearm used was also a shotgun. One individual committed suicide using a ‘humane killer’ powered by a O.Z2-cartridge, and one used a ‘home-made’ gun. Four homicides were due to a rifled projectile, but whether the source was a longarm or handgun could not be ascertained. Sites of injury and numbers of shots The sites of the principal injury are shown in Table 5. The percentage distribu-
TABLE
7
SITE OF ENTRANCE
WOUNDS OF SUICIDES
Mouth
Lefl side
Shotgun %
15 55.5
3 11.1
Handgun %
2 16.6
-
Rifle
-
-
%
ofhmo!
BY TYPE OF FIREARM
Right side ofhead
Forebad
under chin
5 18.6
3 11.1
1 3.7
7 58.3
3 25
-
-
-
3 100
186 TABLE 8 SITES OF INJURY FOR ALL FIREARMS Al Ragheb 141
Hirsh and Ao!.ehm [s]
Thom.wnand Albrekkm [6]
Present studya
Head and neck %
24 60
349 77.5
220 73
45 84.9
Chest %
9 22.5
83 18.4
54 17.9
6 11.3
Abdomen %
7 17.5
18 4.0
21 7.0
2 3.8
BExcludestwo suicide cases with two sites of injury.
tion of injuries between homicides of homicide-suicides and suicides was very similar (approximately 80% being to the head in both groups). The number of shots fired (Table 6) indicates that most homicide victims in the study died due to one shot. In the vast majority of suicides only one shot was used, but there were two cases when more than one shot was fired by the individual (3.7% of all suicides). Further analysis revealed that of all suicidal shots to the head, shotgun suicides showed a predilection for firing into the mouth and handguns into the right side of the head (Table 7). Comparison with other published series is shown in Tables 8 and 9. Range of shots The range of the shot was determined by reference to the ballistics reports
where available and by the characteristics of the entrance wounds in the pathologists’ reports. Four categories: contact, near-contact, intermediate and
TABLE 9 SITES OF INJURY FOR SHOTGUN SUICIDES Eisele et al. [?‘j
Mitchell [8] and Milvtrnun
Present study
Head and neck %
12 51
53 50.5
28 77.8
Chest %
8 35
38 36.2
5 13.9
Abdomen %
3 13
14 13.3
3 8.3
187 TABLE 10 RANGE OF FIREARM FROM VICTIM; HOMICIDES AND HOMICIDE-SUICIDES Range
contact
Near-contact
Intermediate
Distant
Unstated or
othf?r Homicides % Homicides of homicide-suicides %
-
10 25
7 17.5
14 35
9 22.5
4
9
6
4
1
16.6
37.5
25
16.6
4.3
distant were recorded. Cases of homicide and suicide were compared. The results are shown in Table 10. From this table it can be seen that over half of the homicide victims of homicide-suicide were shot at either contact or near-contact ranges compared to one quarter of other homicides. Location whm-e the body was discovered The location of the body (where the information was available) was noted. This was divided into those found at home and away from home. The results are shown in Table 11. Most suicides and homicide-suicides occurred at home. The majority of homicides also occurred at home, but not as frequently as in the previous groups. Further examination of where the body was found within the home (including gardens, pathways, outhouses and garden sheds, etc.) revealed that the most common room where the deceased was discovered was the bedroom (Table 12).
TABLE 11 LOCATION OF BODY (WHERE KNOWN) HOme
Away from home
Homicides %
22 62.9
13 37.1
Suicides %
20 71.4
8 28.6
Homicides of homicide-suicide %
17
Suicides of homicide-suicide %
77.3 11 78.6
5 22.7 3 21.4
188 TABLE 12 LOCATION OF BODY WITHIN THE HOME Bedroom
Living-room
Homicide %
7 31.8
5 22.7
Suicides %a
9 47.4
Homicides of homicide-suicides %
10
Suicides of homicidesuicides %
Bathroom
outsid4?
other
1 4.6
4 18.2
5 22.7
3 15.8
2 10.5
2 10.5
3 15.8
4
1
1
1
5.9
5.9
5.9
58.8
23.5
5
2
2
-
2
45.5
18.1
18.1
-
18.1
BOnecase exact site in home unknown.
Approximately one third of homicides occurred within the bedroom compared to nearly three fifths of homicides in homicide-suicides. Out of all suicides at home, 46.6% were found within the bedroom. Blood and urine alcohol
Blood and/or urine alcohol (BA; UA) results were available for twenty-five homicide victims and twenty-three suicides (Table 13). Of the twenty-five homicides, nine (36%) were found to have alcohol detectable (mean BA 141.5 mg per 100 ml; range 2- 249 mg/lOO ml; UA 221.3 mg/lOO ml; range 19-310 mg/lOO ml). Thirteen out of twenty-three suicides (56.5%) had detectable levels of alcohol (mean BA 145.8 mg/lOO ml; range 79 - 258 mg/lOO ml; mean 184.5 mg/lOO ml; range 92 - 334 mgllO0 ml).
TABLE 13 BLOOD AND ALCOHOL LEVELS IN HOMICIDES AND SUICIDES Homicide
suicide
Alcohol detected %
9 36
13 56.5
Alcohol not detected %
16 64
10 43.5
Total
25
23
189 TABLE 14 SEASONAL VARIATIONS IN HOMICIDES, SUICIDES AND HOMICIDE-SUICIDES BY EPISODE Dec. -Feb.
Mar. -May
June-Aug.
Sep. -NOV.
Homicides %
8 22.2
7 19.4
13 36.1
8 22.2
Suicides %
13 34.2
8 21.0
11 28.9
6 15.9
Homicide-suicides %
7 41.2
5 29.4
4 23.5
1 5.9
Seasonal variations Seasonal variation in homicides, suicides and homicide-suicides was considered. The year was divided into 3-month blocks. The results are shown in Table 14. From these results it can be seen that 41.2% of homicide-suicides occurred between December and February. Nearly two thirds of suicides occurred within the months December to February and June to August. The peak incidence for homicides was during the months of June to August (highest incidence of homicide being in June). Unusualcases As mentioned previously, one individual committed suicide using a humane killer powered by a 0.22~cartridge. Another unusual suicide involved an improvised firearm consisting of a piece of steel tubing, a turned steel breechblock, a nail for a firing pin and a steel block as an improvised hammer. This fired a 0.22 cartridge. Another case of note involved the individual being shot in the chest by a shotgun. He survived for 16 days but died due to emboli of shotgun pellets to his small bowel, thus leading to infarction and peritonitis. At post mortem, a pellet was found in the left coronary artery, four pellets in the ileum and one pellet in the right anterior cerebral artery. Pellets were demonstrated on X-ray in the left lung. Healing punctures of the aorta and pulmonary arteries were demonstrated during the autopsy. Amongst the homicide-suicides, there was one case which involved the deaths of three persons. One of the murdered victims was shot and the other asphyxiated by manual strangulation. In all the other homicide-suicides, all the victims were shot. Discussion
In England and Wales between 1975 and 1990, there were 7833 offences of homicide (as currently recorded) of which 725 (8.59%) were by firearms [2]. Be-
190
tween 1975 and 1990 there were 65 762 recorded suicides, of which 2330 (3.54%) were by firearms and explosives, of which the vast majority were male suicides t31.
In this study the vast majority of suicides were men (96.4%). The over 50’s were the commonest age group. Shotguns were the most frequent weapon used. In all but two suicide cases, only one shot was delivered and was nearly always to the head. However, the chest was the site of injury in approximately 15% of cases and in two cases the abdomen. In two suicides there were two shots fired. With respect to homicide, shotguns were again the most frequent weapon used, handguns being used in less than 2.5% of cases and rifles in less than 10% of cases. Men were more frequently victims of homicide (55%) but women formed a significant proportion (45%). The chest was a more frequent site of injury in homicides (35%) than in suicides, with the head being involved with a similar frequency to the chest (32.5%) A third pattern was identified, namely homicide followed by suicide of the assailant, so called dyadic death. In all the cases the perpetrator was a man and with two exceptions, the victims were known to the assailant and were usually members of the same family. The two exceptions were men who shot police officers and then committed suicide. These cases were both with handguns. In homicide-suicides shotguns were by far and away the most frequent weapon, being used in over 80% of cases. Excluding the two murders of police officers, only one case of homicide-suicide was not with a shotgun. A high proportion of homicide victims under 20 were in the homicide-suicide episodes. These were children of the assailant. The head was a more frequent site of the gunshot wound than in other homicides. When the location of the body within the home is taken into account, nearly 60% were in the bedroom. The position of the body indicated most of the victims were asleep, thus making it easier to shoot at the head. Of all the suicides in this study (where information was available) 56.5% had detectable levels of alcohol in their blood. Selway reported 31% in his study [9], Freytag 35% [lo] and Hudson 40% [ll]. A study in Alaska showed that of 169 suicides, 99 had detectable levels [12]. In Denmark 31% of firearm suicides had a history of chronic alcoholism and/or drug abuse and alcohol was present in 55% at necropsy [6]. In this series, the highest incidence of firearm suicides occurred between December and February. In contrast, Jordan displayed a peak incidence of firearm suicides between June and August [4]. In the UK, May to July are stated to be the most frequent months for suicide [13]. Comparing international rates, most homicides and suicides in the USA are by firearms, with handguns being the most frequent weapon [1,5,10,11,14]. In Jordan, 7.1% of all unnatural deaths (which included road accidents which accounted for 44% of unnatural deaths) are by firearms [4]. Handguns were the most frequent firearm used in suicides in Jordan (72.5%). In comparison, rifles were the most frequent weapon used in suicides (66%) in Australia [9]. In Iceland [15], 22.2% of homicides were with firearms whilst in Singapore it was only 2% [16]. In Auckland, New Zealand, 13.8% of homicides were with
191
firearms, with a similar frequency of shotguns and rifles [17]. In Victoria, Australia, one third of homicides were with firearms, with rifles being the most common weapon [ 181.Shotguns were the most frequently used firearm in suicide in Denmark (50%), with handguns (44%) the most frequent firearm in homicide followed by shotguns (28%) [6]. In conclusion, in England and Wales shotguns are the most frequent firearm used in both homicides and suicides, but firearms are a less frequent method of killing than in many other countries. This paper, however, once again illustrates that the type of firearm used and the frequency with which they are used relate to the availability of the weapon. Acknowledgement
We wish to thank Mrs A. Cooper and Mrs J. Rutter for secretarial assistance. References 1
G.J. Wintemute, S.P. Teret, J.F. Kraus and M.W. Wright, The Choice of Weapons in Firearm Suicides. Am. J. Publ. Health, 78 (1988) 824-826. 2 Criminal Statistics in England and Wales 1975 - 1990, HMSO, London. 3 Office of Population Censuses and Surveys Mortality Statistics: Cause, Series DH2 1975 - 1990, HMSO, London. 4 S.Y. Al Ragheb, Firearm fatalities in Jordan. Med. Sci. Law, 24 (1984) 213-221. 5 C.S. Hirsch and L. Adelson, A suicidal gunshot wound of the back. J. Forensic Sci., 21(1976) 659 - 666. 6 J.L. Thomsen and S.B. Albrektsen, An investigation of the pattern of firearms fatalities before and after introduction of new legislation in Denmark. Med. Sci. Law, 31 (1991) 162 - 166. 7 J.W. Elsele, D.T. Reay and A. Cook, Sites of suicidal gunshot wounds. J. Forensic Sci., 26 (1981) 480-485. 8 J.S. Mitchell and J. Milvenan, Shotgun suicides. Forensic Sci. Gaz., 8 (1977) 3. 9 R. Selway, Gunshot suicides in Victoria, Australia, 1988. Med. 5%. Law, 31 (1991) 76-80. 10 E. Freytag, Autopsy findings in head injury from firearms. Arch. Path&. , 75 (1963) 402 - 413. 11 P. Hudson, Multishot firearm suicide examination of 58 cases. Am. J. Forensic Med. Pa&Z., 2 (1981) 239-242. 12 W.G. Hlady and J.P. Middaugh, Suicides in Alaska: Firearms and alcohol. Am. J. Publ. Health, 78 (1988) 179- 180. 13 M. Geider, D. Gath and R. Mayon, Suicide and deliberate self-harm. In Ozford Textbook of Psychiatry, Oxford Medical Publications, Oxford, 1989, pp. 478-489. 14 I.G. Stone, Observations and statistics relating to suicide weapons. J. Foreneic SC%.,32 (1987) 711-716. 15 G.H. Gudjonsson and H. Petursson, Some criminological and psychiatric aspects of homicide in Iceland. Med. Sci. Law, 22 (1982) 91-98. 16 E.H. Kua, A.F. Yuan and A.L. Ang, Homicide in Singapore. Med. Sci. Law, 25 (1985) 26 - 28. 17 M. Lo, J.C. Vuletic and T.D. Koelmeyer, Homicides in Au&and, New Zealand. A 14-year study. Am. J. Forensie Med. Path&., 13 (1992) 44-49. 18 R. Selway, Firearm fatalities in Victoria, Australia 1988. Med. Sci. Law, 31 (1991) 167- 174.
