In various series, the following information has assisted in the determination of suicide: witnesses; a suicide note and suicidal ideation; a history of cancer or terminal illness (known or perceived); recent bizarre behavior or depression; and associated self-inflicted wounds (see Table 1 and ref. 3). A scene finding supportive of suicide is the observation of clothes and personal effects found stacked neatly by the water (4,31). An individual's shoeprints or ski tracks in the snow at the water's edge suggest deliberate entry into cold water (3). There are unusual scene findings that are suspicious (e.g., weights attached to a body, a couple who were tied together at the waist; see Fig. 1 and refs. 4 and 37).
Identification of a submerged body assists in the determination of a suicide (1,5). Once identified, a psychiatric history is helpful (7). Even if there are findings suggestive of suicide (e.g., horizontal wrist scars, toxicological detection of certain medications), without a proper identification, access to additional information is not possible (see Subheading 8.1.). Caution is required in interpreting suicide-like circumstances and past history (e.g., suicide attempts, mental disorder) in assessing the manner of death (7). Suicide is the only manner of death that requires the demonstration of the victim's intent.
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