Hesitation wounds and suicide
Hesitation wounds are superficial, self-inflicted injuries that often precede fatal wounds in instances of suicide. Typically located on the wrists, neck, or other accessible areas, these wounds are characterized by their tentative, uneven appearance, reflecting the individual’s emotional turmoil and hesitation in the act of self-harm. The presence of hesitation wounds can provide forensic evidence indicating that a death is likely a suicide, rather than an accident or homicide, although not all suicides involve such wounds. These injuries may appear as cuts, stabs, or punctures and are generally found near the site of the fatal injury.
The term also encompasses self-inflicted wounds that occur during suicide attempts that do not result in death, often serving as a signal of distress and a cry for help. Such wounds may arise from various common household tools, highlighting the tragic reality that individuals in crisis may resort to available means to express their pain. Understanding hesitation wounds is crucial for mental health professionals and forensic experts in identifying the intent behind self-harm behaviors and providing appropriate support or intervention.
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Hesitation wounds and suicide
Definition: Tentative, superficial, self-inflicted wounds made before the final wounds that cause death by suicide.
SIGNIFICANCE: The presence of hesitation wounds made before fatal wounds were inflicted nearly always indicates death by suicide as opposed to death from another source, such as an accident or homicide. Not all deaths from suicide involve hesitation wounds, however.
The superficial, self-inflicted hesitation wounds sometimes seen in cases of death by suicide are usually found in the wrists or neck, although sometimes they may be found at the elbow or near the heart. These wounds may appear as cuts, stabs, or punctures. They are most often found near or at the same site as the wound that actually caused death and may appear as rough, jagged wounds that are more superficial than the fatal wound. They often appear tentative and uneven, as the person may have been trembling or may have had difficulty holding the weapon and inflicting the wounds with any strength because of shaking hands. These wounds occur when a person is getting up the courage to self-inflict a wound with enough damage to cause death, as it takes more effort than is generally thought to cause a deadly wound.
A forensic pathologist examines wounds in any death that appears to be a suicide but could potentially be a homicide. In such a case, the pathologist looks for evidence that the wounds were self-inflicted. As with any wound, the angles and directions of the injuries are helpful in determining whether the injuries were self-inflicted. Self-inflicted wounds have a distinctive downward direction that results from the angle of the arm in relation to the body as the wounds are inflicted. Hesitation wounds also have these distinctive patterns, often mimicking the final wound.
Hesitation wounds are commonly caused by the same instruments often used in suicides. They include objects generally found around the home, including knives (kitchen, garden, or pocket), razors, hatchets or axes, and screwdrivers.
The term “hesitation wounds” also applies to wounds that are self-inflicted in suicide attempts in which death does not actually occur. These types of wounds are also tentative, shallow, and superficial, and they occur near the places on the body where a suicidal person might attempt to inflict a fatal wound, such as the wrists or neck. These wounds sometimes are present when a person does not actually intend to commit suicide, in which case they should be viewed as a cry for help, or when a person does intend to commit suicide but the pain or injury caused by the hesitation wounds is too great to continue.
Bibliography
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