吊縊屍體死因與死亡方式的分析與探討:屏東地方法院檢察署民國102至106年相驗案件之經驗

Abstract

在近幾年，吊縊是臺灣地區最常見之自殺死亡方式，本研究收集屏東地方法院檢察署102至106年共計188件吊縊自殺案件，經司法相驗後之偵查資料進行人口學特徵之差異性分析及探討，包括性別，年齡，婚姻狀況，教育程度，職業，索溝特徵，懸掛地點，吊縊工具的使用，是否留有遺書，自殺過往史，自殺原因，吊縊屍體的外觀表徵及解剖鑑定報告。結果顯示：男、女吊縊比為1.47：1；在25-44歲年齡層，女性吊縊比例(30.26%)高於男性(23.20%)；在45-64歲年齡層，男性吊縊比例(38.39%)高於女性(34.21%)；男女皆以房內(40.96%)為最常見之吊縊地點，其次依序為戶外(22.34%)、樓梯間(14.36%)；男性選擇戶外(32.14%)的比例顯著性的高於女性(5.36%)；女性使用布條或布繩(10.525%)、絲襪(9.21%)比例也顯著性高於男性(0%)，但男性使用繩索或尼龍繩(54.17%)、電線(10.71%)、和皮帶(8.92%)高於女性；在索溝表徵方面: 女性以單一索溝(63.15%)、男性以多條索溝(54.46%)、男女性索溝位置皆位於甲狀軟骨上方(54.25%)、斜向左右對稱或不對稱(54.78%)、繩結位於後枕部上方(63.29%)為最常見；而結膜點狀出血、顏面充血、軀幹及四肢皮膚點狀出血點、頸部指抓痕、舌頭外露於齒列間、耳道或肛門出血、脫糞、遺尿皆與性別不具有統計學上之顯著差異；女性留有遺書(51.32%)和生前有輕生念頭(63.15%)比例顯著性高男性；男、女性吊縊原因依序以身體疾病(27.13%)、精神健康(19.68%)及工作/經濟壓力(12.77%)為主要導因。 屏東地區吊縊案件司法解剖率僅有1.75%，冀望日後能提高司法解剖率和案發現場之證據調查，並藉由這些縊吊自殺死亡案件之分析與探討，以期能更精確的對吊縊自殺案件之死因及死亡方式之判定與參考有所助益。

In recent years, hanging was the most common method of suicide in Taiwan. This research collected of 188 suicide cases by hanging in the Jurisdiction of Pingtung Prosecution Office from 2013 to 2017. Then we analyzed the judicially testified data in order to find out the difference of demographic characters in those hanging cases which included gender, age, marital status, eduction, occupation, the features of ligature mark, hanging place, use of tools, leaving of suicide note or not, suicide history, suicide reason, esternal appearance of inspected corpse and the report of post-mortem examination. The result are as follows: male to female ratio was 1.47：1. In the 25-44 age group, the proportion of hanging in female (30.26%) was higher than in men (23.20%), but in the 45-64 age groupe, the proportion of hanging in men (38.39%) was higher than that in female (34.21%). Both Male and female preferred to hang themselves in their home (40.96%), followed by outside (22.34%) and staircase (14.36%). Male selection hanging outside ratio (32.14%) was significantly higher than that of female (5.36%). Female used cloth roping (10.52%) or stockings(9.21%) ratio was significantly higher than male(0%). But men used Nylon rope (54.17%), Electric wire (10.71%) and belt (8.92%) were significantly higher than female. The features of ligature marks usually single in female(63.15%), multiple in male(54.46%), both situated above the level of thyroid cartilage (54.25%), oblique and symmetric/asymmetric form on the both sides of neck to the occipital region(54.78%), with knots which located above the occipatial region were the most(63.29%). Conjunctiva petechiae, facial congestion, petechiae in trunk and limbs, finger scratches in neck, tongue exposed to teeth, ear and anal canal bleeding, defecation, enuresis were not statistically related to gender. Female has a significantly higher proportion of leaving a suicide note (51.32%) and suicidal thoughts (63.15%) than male (23.21%) / (41.07%). The cause of hanging related to Physical illness(27.13%), followed by mental illnes(19.68%) and work/economic status(12.77%). Finially, the forensic autopsy rate of hanging in Pingtung city was only 1.75%. This research has analyszed and statistics the trend of of these suicidal hanging cases and how to increase the autopsy rate and the associated evidence at the scene investigation which may provide more correct determination in cause or manner of death in the feature.