Hesitation and Defense Injuries

Tentative or "hesitation" injuries are self-inflicted sharp-force injuries. They are characterized by superficial incised or stab wounds usually, but not always, near the deeper fatal injury (Figs. 19, 21, 23-26 and refs 6, 8, 13, 16, 17, 23, 85, and 86). Superficial cuts run parallel to each other and extend as deep as the subcutaneum (16,90). Small punctures can be clustered together near a stab wound and be associated with bruising (16). A stab wound can be associated with a linear abraded tail or deeper incision (Fig. 24) (16). A greater number of hesitation marks is seen when more than one site is involved (16). Superficial cuts can be seen on the fingers of a suicide victim and mimic defense wounds (5,6,9,16,27). They are the result of mishandling of a knife or other sharp instrument (e.g., razor [10,16]). Tentative wounds have been seen on the skin of murdered children and rarely adults, incapacitated by disease, intoxication, or other trauma (6,17,23,90). Hemorrhage, associated with tentative wounds, indicates that the injuries were inflicted while the victim was alive. Superficial or deep hesitation wounds are observed in self-inflicted wounds with power tools (e.g., band or circular saw; see Fig. 5 and refs. 65 and 69).

Defense wounds are sharp-force injuries typically of the extremities, usually involving the hands and arms, and they are consistent with the victim moving a part of the body between a sharp object and a potentially lethal body target, e.g., torso (Fig. 27; refs. 3 and 8). A knife can be grabbed by the victim (Fig. 28). A greater frequency of defense injuries is seen in women, because they may be more likely to be in protracted domestic disputes and ready to defend themselves (3).

Fig. 24. Self-inflicted abdominal wound. Deep wound has a "superficial" abraded tail (arrow). Note superficial incisions indicative of "hesitation" injuries (arrowheads).
Fig. 25. Superficial self-inflicted stabs of neck ("hesitation" wounds).
Fig. 26. Superficial "hesitation" incisions of neck. (Courtesy of Dr. E. Tweedie, London Health Sciences Centre, London, Ontario, Canada.)

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