Criminal Poisoning: Investigational Guide for Law Enforcement, Toxicologists, Forensic Scientists, and Attorneys by John H. Trestrail Page B
Authors: John H. Trestrail
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become known as Munchausen Syndrome by Proxy . This condition was named after Baron von Munchausen, a famous German teller of fabulously unbelievable tales. This syndrome is a phenomenon in which a mentally ill parent administers poison to his or her child in order to draw attention to himself or herself. Such a parent enjoys being the center of attention, and by using a child as the object of a medical emergency, the parent in effect becomes the center of attention by proxy. The offender gets some personal psychological reward from having doctors listen and begins to exaggerate the symptoms. This type of poisoner is usually a mother, who may show many of the following characteristics (Levin & Sheridan, 1995):
• Comes from a background where she was ignored and unrecognized • Has a history of being abused herself
• May consider the relationship she had with her obstetrician the most intense, personal, and rewarding she had ever had and is attempting to transfer this role to the child’s pediatrician
• May have some nursing training
• May have a history of weaving false tales of medical problems.
This type of poisoning event is considered a form of child abuse. In most cases, the father is usually oblivious to the activities or may be in sub-conscious collusion with the perpetrator.
The timely issue of euthanasia of the elderly and terminally ill by homicidal poisoning, in private homes as well as in nursing homes, came to national attention in the last decade. Dr. Jack Kevorkian’s fight for doctor-assisted suicide brought this type of poisoning to the forefront of nightly news around the country. Its popularity is also evidenced by the publication of the euthanasia guidebook Final Exit , and the existence of the “Hemlock Society,” which provides instructions for committing suicide to those wishing to end their own lives because of terminal illness.
The emphasis of Criminal Poisoning concentrates mainly on intentional homicidal poisoning, which is always considered first-degree murder because of the element of premeditation.
Victims
65
4.2. INVESTIGATIVE CONSIDERATIONS
What indices might the homicide investigator utilize to help him or her determine that a poisoning murder may have occurred? Investigators should look for friends or relatives who arouse suspicion, as well as suspicious circumstances that surround the death. Indicators might include the sudden death of the victim after eating, drinking, or going into the bathroom; or poison containers found near the deceased. In a suicide, the latter might well be the case, although it could be a murder masquerading as a suicide.
The antemortem (before death) clinical course might indicate that the deceased exhibited symptoms consistent with a poisoning, but it is easy for an investigator to be misled. One would think that an autopsy of the body would clearly reveal that the cause of death was other than natural, yet in many localities autopsies are not performed, owing to either the cost or availability of such a service, and the coroner or medical examiner normally lists on the death certificate his or her best judgment as to the cause of death.
4.3. DISTINCTIVE PATHOLOGICAL FINDINGS
Following are pertinent questions that the medical examiner should ask: • Does the victim exhibit no morphological changes that can be attributed to direct chemical action by a toxic agent? Poisonous substances that might be considered in such cases include the following: acute central nervous system depressants (alcohols, ethers, sedatives, chloroform, hypnotics, and so forth), chemical asphyxiant gases (carbon monoxide, hydrogen cyanide), organophosphate insecticides (OPIs) (malathion or parathion), and alkaloidal compounds (strychnine, opiates).
• Are systemic lesions present without obvious injury at the site of entry? Poisonous substances that might be considered include arsine and nitrobenzene.
• Is an injury present at the site of entry that does not
• Comes from a background where she was ignored and unrecognized • Has a history of being abused herself
• May consider the relationship she had with her obstetrician the most intense, personal, and rewarding she had ever had and is attempting to transfer this role to the child’s pediatrician
• May have some nursing training
• May have a history of weaving false tales of medical problems.
This type of poisoning event is considered a form of child abuse. In most cases, the father is usually oblivious to the activities or may be in sub-conscious collusion with the perpetrator.
The timely issue of euthanasia of the elderly and terminally ill by homicidal poisoning, in private homes as well as in nursing homes, came to national attention in the last decade. Dr. Jack Kevorkian’s fight for doctor-assisted suicide brought this type of poisoning to the forefront of nightly news around the country. Its popularity is also evidenced by the publication of the euthanasia guidebook Final Exit , and the existence of the “Hemlock Society,” which provides instructions for committing suicide to those wishing to end their own lives because of terminal illness.
The emphasis of Criminal Poisoning concentrates mainly on intentional homicidal poisoning, which is always considered first-degree murder because of the element of premeditation.
Victims
65
4.2. INVESTIGATIVE CONSIDERATIONS
What indices might the homicide investigator utilize to help him or her determine that a poisoning murder may have occurred? Investigators should look for friends or relatives who arouse suspicion, as well as suspicious circumstances that surround the death. Indicators might include the sudden death of the victim after eating, drinking, or going into the bathroom; or poison containers found near the deceased. In a suicide, the latter might well be the case, although it could be a murder masquerading as a suicide.
The antemortem (before death) clinical course might indicate that the deceased exhibited symptoms consistent with a poisoning, but it is easy for an investigator to be misled. One would think that an autopsy of the body would clearly reveal that the cause of death was other than natural, yet in many localities autopsies are not performed, owing to either the cost or availability of such a service, and the coroner or medical examiner normally lists on the death certificate his or her best judgment as to the cause of death.
4.3. DISTINCTIVE PATHOLOGICAL FINDINGS
Following are pertinent questions that the medical examiner should ask: • Does the victim exhibit no morphological changes that can be attributed to direct chemical action by a toxic agent? Poisonous substances that might be considered in such cases include the following: acute central nervous system depressants (alcohols, ethers, sedatives, chloroform, hypnotics, and so forth), chemical asphyxiant gases (carbon monoxide, hydrogen cyanide), organophosphate insecticides (OPIs) (malathion or parathion), and alkaloidal compounds (strychnine, opiates).
• Are systemic lesions present without obvious injury at the site of entry? Poisonous substances that might be considered include arsine and nitrobenzene.
• Is an injury present at the site of entry that does not
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