Woman Commits Suicide by Cutting off her Foot
The deceased was a 61-year-old unemployed woman who lived alone. The mother of the deceased person could not communicate with her, so she visited her residence and unlocked the door lock on the front door, but it was locked with a shackle from the inside of the door. She called 911, forced the door to open, and checked the scene.
The deceased was discovered in her bathtub and her left ankle was amputated, the bathtub was running with water. Her foot was cut off above the ankle following several incision wounds. A kitchen knife presumably used for cutting was next to the faucet in the bathtub. The house of the deceased is on the 9th floor of an apartment building, so it is not easy for outsiders to break in without entering through the front door. Her clothes were found in the bedroom, and there were no signs of burglary or ransacking.
There was not much distribution of bloodstains with a wide radius that could be easily observed at the scene from the knife, and there were no traces of bloodstains, cast-offs, spatters, falling bloodstains, or moving falling bloodstains. However, in the bathtub, within the arm's movement radius, bloodstains presumed to belong to the deceased and some bloodstains on the inside of the bathtub walls were observed. The deceased was diagnosed and treated for schizophrenia 35 years ago, and she often said, “I am not qualified and must die quickly,” and recently said, “A ghost is pulling my leg.”
On external examination, the face and body were pale. Six or more cuts were found in the left ankle region and an oblique cross-section in the bone was confirmed. The left foot was cut off above the ankle. The cut wound showed irregular edges. Several superficial incision wounds (hesitation wounds) could be seen. There were bloodstains and small body tissues on both hands and arms, and there were no other defense marks or other injuries. Internal examination revealed that the left tibia and the distal end of the calf bone were incised.
The cut surface was relatively flat, and multiple incisions were also found in the surrounding periosteum. There were no specific pathological lesions that could affect the cause of death. In the drug test, chlorpromazine, risperidone, and procyclidine were detected at sub-therapeutic concentrations. The cause of death was determined to be hypovolemic shock caused by amputation of the ankle.
Suicide is the biggest cause of reducing the life expectancy of schizophrenic patients, and in a study conducted by the World Health Organization on 1,056 mentally ill patients, suicide was the most common cause of death. It is known that about 20%-40% of patients with schizophrenia attempt suicide, and 10%-15% end their life by suicide.
Depression was found in almost 2 of 3 suicides with schizophrenia. Depression is the most important risk factor for suicide, and depressive syndrome is present in 66% of all suicide victims. The case is a very specific and rare case of suicide method selection. Common suicides are usually less painful, and they consider methods that are easy to take in their surroundings.
There are cases where alcohol and drugs are used together to reduce pain. However, in this case, a very extreme and violent method was performed, far outside the range of options for ordinary suicides. In addition, among suicide methods of schizophrenia patients, deaths by self-harm methods similar to the case are very rare.
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