Suicide in any of its form is a global health issue. The estimated annual burden of suicides each year is 14.5 suicides per 100,000 populations (Pompili et al. 2010). Prevalence of suicidal death in India is 10.6 per 100,000 population (Accidental deaths and suicides in India 2015). The common precipitating factors for suicide include marital and financial problems, unemployment, depression and social isolation, alcohol abuse, physical and mental illness, etc. In Indian scenario, financial burden, marital disharmony, and substance abuse are the major factors associated with suicidal deaths.
The term ‘dyadic death’ has often been used differently in the literature. While some authors propose that it is the course of events and relation of the events which are more important rather than the time interval, others consider that the term dyadic death should be used in relation to the time intervals between the fatalities. While some authors have proposed this time interval to be 24 h (Melez et al. 2014), a time period as long as 5 years has also been reported (Carson 2010).
Death scene reconstruction and exploring the sequence of events prior to the death are paramount in the investigation of dyadic deaths not only to conclude on the exact cause and manner of death but also to ascertain if the deaths were simultaneous or one after another. In case of the latter, it becomes important to estimate the time elapsed between the deaths. In the reported case, the body of the male was lying down with a ligature mark around the neck while the female was found hanging, and hence, a possibility of the husband being strangled by a wife prior to committing suicide was also explored.
In the reported dyadic deaths, the pattern of postmortem lividity, as well as the appearance of ligature mark distinctly, varied between the deceased males and female. The post mortem lividity was distributed in ‘glove and stocking’ pattern over the extremities and was fixed in the female victim while the lividity on the male body was present over the back of the body and was not fixed. Though the ligature materials used in both the cases were cotton cloth material, the appearance of ligature mark around the neck was significantly different too. The appearance of ligature mark around the neck is influenced by many factors including the type of ligature material, weight of the body, duration of suspension, etc. Distinct grooved ligature mark in the female was suggestive of prolonged suspension while an inconspicuous and faint ligature mark in male indicated the contrary. It is highly likely that the knot of the ligature noose in the male victim loosened and opened up after some time of the suspension due to the weight of the body, as suggested by the relative position of the male victim on the floor and the cloth material freely hanging from the roof above it. The effects of body weight on ligature material and suspension can be deceptive (Kanchan et al. 2010).
The injuries on the tongue of the female and finger tips of the male were inflicted by a razor that was recovered from the room. The ‘slashed off’ pattern of injuries on the fingertips of the left hand suggested that the husband had held the part of the tongue that was protruding between teeth with the fingers of his left hand while attempting to cut it off using his right hand. This act of post-mortem mutilation is indicative of the distressed state of mind of the husband who probably was upset with the frequent humiliations by his wife. Ante-mortem injuries to the fingertips in males and post-mortem injury to the tongue in female was also suggestive of the sequence of events in the reported dyadic deaths. It also ruled out the possibility that the husband was strangled by a wife prior to committing suicide. The possibility of the wife being hanged by the husband could only be ruled out considering the facts that the death scene did not show any signs of a struggle and that the only injury on the victim’s body was an obliquely placed ligature mark high on the neck.
Dyadic death episodes are reported from various parts of the world (Jena et al. 2009) and mostly seen in low socioeconomic, less educated, or illiterate families. Dyadic suicides are frequently associated with unsuccessful relationship or marriage, separation, divorce or extramarital affairs, etc. Most of the dyadic deaths are reported at the home of the perpetrator or the victim (Galta et al. 2010). The victims in the reported case belonged to the low socioeconomic background and resorted to suicide at their house owing to marital discord.
Most of the dyadic deaths are premeditated. Firearms, poisoning, hanging, and drowning are the preferred methods in suicide pacts (Sikary et al. 2016; Marcikic et al. 2011). Hanging and poisoning are reported as the preferred methods of suicide in India (Kanchan et al. 2009) and unsurprisingly both the victims resorted to hanging in the reported case. Alcohol and opioid abuse have been related to high risk behavior, suicidal tendencies, and suicidal deaths. Alcohol alone is believed to be an independent risk factor for suicidal behavior (Pompili et al. 2010; West et al. 2015). Presence of alcohol and opioid alkaloids in the blood and viscera of the deceased in the reported dyadic suicides is thus, in concurrence with that reported in the literature. Lack of facilities for quantification of opioid alkaloids at regional forensic science laboratory can be considered as a limitation of investigation as it would have completely ruled out the possibility of a female being drugged and hanged by the husband. Besides, the presence of multiple old healed linear scars on a ventral aspect of left forearm of both the deceased male and female was suggestive of their inclination to self-harm and even suicidal ideation.