The causes of death are always figured out by doctors. It can occur as a result of external or internal factors. In forensic medicine, one can find a classification of the reasons why a person died.
Accepted Terminology
Death is understood as a complete stop of life, in which physiological and biological processes cease. In medicine, there is a special area that studies the body in the final stages of the dying process. This science is called thanatology.
Death for most people at all times concealed the imprint of mysticism and mystery. It is inevitable, often unpredictable and unexpected. But the concepts of death in jurisprudence, medicine, philosophy, religion differ markedly.
Doctors separately distinguish several thermal conditions preceding direct death. This is preagony, agony, and clinical death. Resuscitation measures may still be successful at this time. If they were not carried out or were unsuccessful, then doctors diagnose biological death. In this state, in tissues and cells, an irreversible cessation of all physiological processes occurs.
Further, the decomposition process begins. This is the name of the destruction of the body, during which all nerve connections are damaged. Recovery from this becomes absolutely impossible. Specialists call this stage information death.
Until it comes, there is a theoretical possibility of maintaining the body in a state of suspended animation (using, for example, cryonics), which can prevent further destruction of the body. In this case, the theoretical possibility of its restoration in the future remains.
Classification of causes
Death can be violent and non-violent. In the first case, it occurs as a result of the influence of various factors from the outside. Various diseases lead to nonviolent death. It can also occur due to the appearance of deep age-related changes. Although at present it cannot be said that a person has died of old age, a specific reason is needed that led to this. Sometimes it happens that external and internal factors act simultaneously. In this case, it is difficult to determine the cause of death. After all, forensic experts should identify which factor played a decisive role.
Nonviolent death can be:
- physiological: from senility decrepitude or prematurity of a newborn baby;
- pathological.
The last kind of death is caused not only by progressive diseases. It can also be sudden, it is also called sudden.
Violent death occurs as a result of:
- suicides
- killings;
- an accident.
The study and determination of this is forensic medicine.
Factors Leading to Natural Nonviolent Death
Quite often, people die from problems with various organs and systems. Sudden or pathological death can occur as a result of diseases:
- of cardio-vascular system;
- respiratory organs;
- endocrine system;
- gastrointestinal tract;
- infectious lesions;
- central nervous system;
- genitourinary system;
- other organs and systems of the body.
Malignant neoplasms also lead to non-violent death. Sometimes it occurs as a result of pregnancy and subsequent childbirth. The exact reasons can be found only after pathological autopsy. According to its results, a death certificate is issued.It displays the reasons that led to the fact that a person died.
A sudden death is a non-violent dying that has occurred in a healthy person, according to others. It arises as a result of the onset of an acute form of the disease or a latent form of a chronic disease.
Prevalence of Nonviolent Dying
Analyzing the factors that led to the cessation of human activity, forensic experts can understand what causes of death are the most popular.
More than 75% of people die from circulatory system diseases. Moreover, most of them are diagnosed with chronic coronary heart disease. They may have acute or repeated myocardial infarction, cardiomyopathy. Cerebral infarctions, subarachnoid hemorrhages, arterial diseases occur slightly less frequently.
Less common causes of nonviolent death are respiratory diseases. Chronic obstructive pulmonary disease leads to death. In chronic bronchitis, the airways swell, the passages become narrow. Emphysema occurs when lung damage occurs. With these diseases breathing problems begin.
Stage 4 of cancer is not much less likely to die. Men often suffer from malignant neoplasms in the prostate, and women in the chest. But most of all deaths are caused by lung cancer. It is difficult to detect in the initial stages. They did not show itself. Problems begin only when metastases appear.
It is worth noting that smokers have a 12-fold higher risk of lung problems than those who do not smoke. Also, giving up this addiction reduces the likelihood of developing kidney cancer.
Also, almost a quarter of people die from infectious lesions, eating disorders, and neonatal diseases. In low-income countries and life, birth injuries, asphyxia, problems caused by prematurity are the leading causes of death in newborns.
Causes of Violent Death
People often die due to the influence of not internal, but external factors. The main types of violent death are:
- mechanical damage;
- asphyxia;
- extreme temperatures;
- poisonous substances, gas poisoning also applies here;
- exposure to electric current;
- radiation energy.
Mechanical damage includes falling from a height, traffic accidents, injuries caused by sharp and blunt objects. Any gunshot wound that caused the cessation of life can also be classified in this category.
Poisoning occurs as a result of exposure to toxic substances on the body. Poor or infected food, water, alcohol, and medications can lead to them. You can get poisoned with carbon monoxide in unventilated rooms, in factories or in houses heated by stoves.
Death from strangulation can occur due to the development of oxygen starvation, which was caused by mechanical causes. This can be strangulation, hanging, closing the respiratory tract with loose or liquid objects, closing the openings of the mouth and nose. Squeezing the abdomen and chest can also lead to asphyxiation.
It must be understood that the type of violent death and the reasons that led to it are different concepts. Their forensic experts determine. Even with the same influences, a person can die from various causes.
The type of death is established depending on what kind of impact on the person. But the reasons are determined by what changes have occurred in the body as a result of various influences on it. For example, it was found that blunt trauma to the skull led to death. This means that a person could die from a brain injury or squeezing of the resulting hematoma.
Gas poisoning can also be voluntary, accidental or intentional.But the kind of death is already established by law enforcement agencies.
The need for a forensic examination
It is possible to determine what exactly caused the person to die during a special medical event. It is called forensic medical examination. It is mandatory if it is obvious that the death was violent. Also, it must be done in cases where:
- sudden death occurred, but there is a suspicion that it could be violent;
- the cause of death is unknown, the person died outside the walls of the hospital;
- death occurred in the hospital, but the patient was not diagnosed;
- the person died in the hospital, but a complaint was received from the relatives by the investigating authorities.
Also, regardless of the place and alleged cause of death, forensic examination is carried out to all unidentified persons.
Examination of the corpse allows you to determine why a person died. Depending on this, the tactics of further actions are determined. If a forensic expert determines that death was due to poisoning, for example, with methyl alcohol, then law enforcement agencies will need to establish why this happened. It could be suicide: a person could pour himself methyl alcohol and drink it, wanting to end his life. He could also use it by mistake. In this case, death will be classified as an accident. But if it was arranged, and another person poured methyl alcohol into the glass, then we are already talking about murder.
Autopsy
In order to determine whether a natural or violent death has occurred, one must examine the corpse. An autopsy can be a routine pathologic or forensic examination. The first type is carried out in cases where death was non-violent. Such an autopsy can be carried out in several ways:
- Abrikosov's method;
- a cut along Leshka;
- Shore's method;
- Fisher's method.
But according to the instructions of the inquiry bodies, a forensic autopsy is carried out. In the process of its implementation establish:
- time of death;
- the presence and nature of the damage, establish whether they were caused during life or after death;
- mechanisms and methods for causing damage, their sequence;
- the reasons that led to death.
Also, a forensic medical examination can solve other issues of a biomedical nature. She can say what injuries, incompatible with life, were received in the first place, and how exactly a person died.
Forensic medical examination
To determine the causes of violent death, a special examination is carried out by doctors who have been trained in the field of forensic medicine.
The study begins with an examination of clothing, items that arrived with the corpse. The expert must identify possible damage, traces, impositions on them. After this, the body of the deceased is examined directly. The corpse is carefully inspected, all post-mortem changes are described. If damages were found, then their nature, features, and places of localization are established. Be sure to examine the soft tissues and internal organs.
If poisoning is suspected, the corpses are sent for a special forensic chemical study. But this is not the only possible additional examination. If necessary, bacteriological, physico-technical, histological examination is carried out. The list of additional examinations is determined by the expert, depending on what tasks were set before the forensic medical examination, and on what the alleged cause of death is.
According to the results of the study, not a death certificate is given, as with a conventional autopsy, but a conclusion or an act of forensic examination. It describes all the ongoing procedures with the corpse, the results of the examinations, establish a diagnosis and give a conclusion that contains answers to the questions posed to the forensic examination.
Stages of dying
Regardless of whether death has come from old age, violent or other non-violent causes, experts distinguish two types. Dying can be slow or fast. In the first case, a prolonged terminal state, agony, is observed. And with a quick death, which is also called acute, these stages are blurred.
The process of dying begins with a predagonal state. In some cases, it is completely absent. This is a protective reaction of the body. You can observe it in people who have stage 4 cancer. After all, they usually have severe and painful damage to the body. In the last hours, the processes of inhibition in the central nervous system are developing. This is accompanied by an appropriate psychological state. Indifference to what is happening around is observed, sensitivity disappears. Some completely or partially lose consciousness.
In a pre-agonal state, a person can fall into a coma or a stopper, his blood pressure decreases, centralization of blood circulation occurs. Breathing can become frequent, but superficial. At the same time, the lungs are not adequately ventilated.
If the patient does not undergo medical measures, or they are ineffective, then this state is replaced by a thermal pause. After that, agony begins. This is the name of the body’s attempt to use all the remaining opportunities to save life. In this state, pressure rises, heart function is restored, breathing becomes strong. But the lungs are not ventilated due to improper muscle function. It usually lasts about 5 minutes, in some cases it can reach half an hour. The agony is followed by clinical death.
Necessary diagnostics
Before establishing what exactly caused the cessation of human activity, physicians must make sure that the patient is really dead. Even if a gunshot wound is visible, a check is carried out. Perhaps it did not affect vital organs, and the person is alive.
They look at a complex of signs, the so-called vital tripod: preservation of the central nervous system functions, respiration and heart activity. But there are situations when doctors can make mistakes.
For example, the preservation of breathing can be checked using a mirror, fluff, auscultation, or Vinslov's test. But all of them can be erroneous. Any gust of wind, increased humidity in the room, passing vehicles can cause incorrect results.
More informative is a check of cardiovascular activity. Auscultation of heart contractions, palpation of the pulse, cardiac impulse is carried out. But very weak manifestations of vital activity may go unnoticed.
The most important indicator is the preservation of the functions of the central nervous system. One of the valuable signs is the absence or presence of a corneal reflex. The doctor checks how the pupils react to light. One of the first signs of death is the Beloglazov phenomenon, or “cat pupil”. The tone of the muscles narrowing the pupil disappears. When squeezing the eyeball, it becomes oval.
