HOME

On a sunny summer day eight centuries ago, in a remote province of rural China, a sinister event unfolded. While a farmer toiled in the rice patties, another man crept up behind him and struck him and stabbed him repeatedly with a large sickle and then threw his victim’s lifeless body into a watery grave in the rice pattie shallows. He confidently believed that since there were no eyewitnesses, his secret was safe. However, long before fingerprinting, blood typing, DNA, and other forms of modern forensic medicine, the Chinese killer found himself caught up in the centuries-old lesson that “blood will out.” The elders of the community quickly assembled all the local farmers and ordered them to lay their sickles on the grass. In a matter of moments, flies began to swarm around the killer’s sickle. Although the killer thought he had thoroughly cleaned his murder weapon, imperceptible traces of blood and tissue remained on the blade. His was the only sickle that attracted flies, a clear signification to the village elders of the man’s guilt. With this early form of forensic testing, the elders were convinced of the killer’s identity and he was taken away to immediate execution.

The thirteenth-century manuscript which survives that tells of this tale--the first recorded case where insect evidence trapped a killer--speaks of the “voice” of the dead man speaking out from his watery grave and, as it were, pointing his finger directly at the murderer, proclaiming that “this is the man.” Over the centuries, the incident (like many other similar examples drawn from past ages) has often been reduced to the level of a romantic anecdote; the story, in fact, often has been used as “testimony” to the difference between the exotic justice which existed in other periods of human history as opposed to the more hard-headed, scientifically-grounded evidence and procedures that form a linchpin to the modern notions of “sound science” and a fair trial. Such “evidence” as that demonstrated on that long ago day in China, one believes, would have difficulty passing muster in the post-Daubert era, with the requirements or relevance and reliability carrying considerable more weight than the “expertise” of swarming flies.

At the same time, however, recent years have seen stunning breakthroughs in forensic medicine and science for the courtroom with evidentiary results not terribly unlike those believed by men more knowledgeable of the natural, observable world than of the microscopic. The use of DNA testing, for example, has created a great supposition of certainty in the interpretation of scientific evidence in criminal cases as juries and judges try to determine who was (or was not) responsible for the perpetration of crimes. As the Journal of Forensic Science reported in November 2001, earmarks left behind at a crime scene were recently found by a court in the United Kingdom to be comparable in forensic credibility to fingerprints and the use of them in the prosecution of a homicide resulted in a conviction. The technology of DNA has also been responsible for the exoneration of individuals accused and even convicted of crimes such as rape and murder. In the past decade alone, under what is popularly known as the Innocence Project, more than sixty individuals have been proved innocent of crimes for which juries convicted them before DNA technology was readily available.

The use of DNA and other forensic technologies in legal cases is, of course, much more than a case of human ingenuity finally catching up to human insight. Though we might appreciate the perceptiveness and acuity of the elders in that Chinese village, the unique characteristics that we now understand each human being to have, from fingerprints and earmarks to the blood flowing underneath our skin and the genetic code that makes up the fabric of individual existence, have been demonstrated to be scientifically relevant and reliable to a higher degree than we would probably be willing to afford to the behavior of insects.

As effective and at times irrefutable as modern forensic science seems to be, however, there are some activities and procedures that still require the same kind of healthy skepticism as modern science and jurisprudence has to tales of justice from the pre-scientific-method era. One of these areas is in the realm of what is often called the “psychological autopsy.” This term, coined in 1958, describes an investigative analysis into an “equivocal death” and attempts to understand all the factors that might have made up a person’s psychology at the time of death. History, emotional health, relationships, incidents of stress, work and/or educational issues, family dynamics, substance abuse, and recent personal or financial losses are areas into which a “psychological autopsy” probes. Typically, these examinations into a death try to answer whether or not a suspicious death (i.e. Russian Roulette shootings, gun-cleaning accidents, unwitnessed drownings, etc.) was a homicide, accidental death, or suicide. In the medico-scientific community, these investigations, though specific and individual in nature, are often used to determine general suicide risk-factors that can be used as a means of preventing future suicides. In the legal arena, these “equivocal death analyses” are often employed to determine if a crime has been committed or whether or not a life-insurance policy on the deceased should be honored.

Recent psychological autopsies have resulted in a finding by the U.S. Army that the death of a Kentucky National Guardsman, whose body was found with 26 stab wounds, was a suicide; a report that resulted in a financial settlement for the family of a Maine man stricken with Mesothelioma but who had been misdiagnosed with treatable Tuberculosis and who, the family argued, would have lived his final months differently had he been correctly diagnosed; a defense brief filed to stay the execution of a man who was convicted for the murder of an elderly woman on the grounds that “he was made gravely vulnerable by war experiences in Vietnam and could not account for or remember what he had done”; and in a public defender case in Montana, an attempt by a convicted murderer to win an appeal of his conviction on the grounds that he had been denied funds for a psychological autopsy that would have shown the victim, his live-in lover, was “a confrontational woman who constantly badgered and berated him.” In this latter case, the defendant was, in effect, asking that an expert be allowed to speak from the stand in order to let the corpse speak from the grave “for the purpose of establishing the existence of mitigating factors in the causation of her death.” He was unable, however, to sway the Montana Supreme Court, which rejected his appeal.

This rejection is indicative of what frequently happens when psychological autopsies butt up against the dictums of Daubert v. Merrell Dow Pharmaceuticals (509 U.S. 579, 1993), the landmark Supreme Court ruling which lays out the parameters for expert witness testimony and gives judges “gatekeeper” authority. Lanny Berman, executive director of the American Association of Suicidologists, recently issued a clarion call to his colleagues to elevate both the perception and practice of psychological autopsies above the charges of “junk science” and “psycho babble” that have made it more difficult to get psychological autopsies admitted into evidence. Though psychological autopsies routinely met the old standard set in Frye v. United States (293 F. 1013, 1014, D.C. Cir., 1923), which stipulated only that expert opinion be generally accepted by the relevant scientific community, i.e., psychology and suicidology, Berman notes that Daubert “ups the ante and commands suicidologists to attend to the science of our profession.” How exactly has Daubert changed the admissibility of psychological autopsies?

The “principles and methodology” of “psychological autopsy,” when they are applied is, of course, different from the more familiar, physical autopsy. In the physical examination of the deceased, the body of the deceased is present, and, in some instances, “able” to provide the coroner or forensic specialist, who uses a systematic methodology in examining the physical body, a number of clues about the decedent’s demise, even if the corpse is not actually able to cry out from the grave. Unlike the physical autopsy, the “psychological autopsy” is usually not just one examination but a series of intensive interviews and investigations designed to reconstruct the social and physiological circumstances that may be brought to bear in determining why the person died. By performing these interviews it is hoped that psychological intent can be uncovered by reconstructing the decedent’s behavior and communication during his final days, supplemented by history, personal habits, personality traits, and character. A psychological profile is developed by poring over documents such as diaries and journals, letters, criminal records, physical and mental health files and other “speaking” documents, and by interviewing surviving family members, friends and associates, co-workers, physicians, and others who are able to provide relevant information about the personality and lifestyle of the deceased.

Diverging from the time-honored methodology of a physical autopsy with its painstaking and meticulous examination and dissection of the body, no set formula of procedures for the psychological autopsy interview exists. Furthermore, as a compilation (see Appendix 1) of some of the more common questions asked in “psychological autopsy” interviews suggests, the methodological starting point of the “psychological autopsy” also differs in that many questions appear to assume suicide at the outset of the investigation as the probable reason for the “equivocal death.” The physical autopsy, conversely, guards against preliminary suppositions.

For adherents of “psychological autopsies,” or as Dr. Frederick V. Malmstrom, a retired state prison psychologist, calls them, “a kind of FBI Profiler exercise in reverse,” these “autopsies” are akin to physical autopsies in their scientific precision in that they investigate the antecedents of death, revealing the “contributions” the dead make to their own demise. In spite of their inherent speculative nature, “psychological autopsies” are believed to perform a vital function in equivocal cases which provide limited information and require professional interpretive analysis. Some believe, in fact, that the psychological autopsy is preferable in the reconstruction of past human activity to having the actual person present--whether alive or dead. Psychologists Tony Byrne and Kathleen Maguire, for example, argue that “conclusions cannot be made from information given by those who attempt suicide but do not complete it,” but they can be drawn from psychological autopsies, “which study the behavior patterns and attitude change over a specified period of time before the suicide.” In these instances, psychologists and suicidologists assert that “psychological autopsies” help to form an understanding of the death from a combination of physical evidence, documented life events, and intangible psychological factors. In support of their view, they frequently point to a number of “equivocal deaths” in which the physical autopsies performed by coroners “agreed” with the conclusions culled from the “psychological autopsies.”

This very agreement, however, can suggest a problem with psychological autopsies. The intensive interviews, for example, bringing to bear a multitude of pieces of speculation or items of “hearsay” evidence, can often influence physical forensic personnel into assenting to a cause of death when the physical evidence might be lacking or could even be contradictory. But it is the fluidity of the science of “psychological autopsy” that is the most troubling to many. Malmstrom, for instance, argues that the process of psychological autopsies is a “bewildering” one for “what the psychologist is doing is attempting to recreate what was going through the victim’s mind,” and as such, it amounts to “an impossible task. Mind-reading is a lost art--if ever it existed--but imagine reading the mind of a dead person!” Perhaps not insignificantly, in most scientific and legal research involving psychological autopsies, even by professionals who assert considerable sympathy for the practice, the term is almost exclusively enclosed in quotation marks, signifying a process that still has considerable dubiety as a discipline. In a 1992 case in Mississippi, which attempted to determine whether the death of a man was homicide or suicide, a federal judge obviously had grave doubts as to the practice, throwing out a psychological autopsy and ruling that the procedure was nothing but “pure speculation” and did “nothing to assist the trier of fact in the least.”

At the heart of the process, whatever questions the psychological autopsy might answer in its collection of relevant information about the deceased and his mental, emotional and physical state in the days before his death, the real unanswered question often remains, to use the Daubert vocabulary, how reliable this amalgam of information actually is. University of South Florida forensic psychologist Randy Otto, who examined the reliability of “psychological autopsies” in 1993, has written that there is little, if any, consistency between one expert’s psychological autopsy and another one, a divergence of views which seldom occurs in physical autopsies. Otto and his co-author, James Ogloff, observed that “assessing the validity of psychological autopsies is difficult because of the problem of criterion validation. . .Because the ‘truth’ or actual outcome is unknown in many cases. . .it is difficult to identify a criterion against which to judge the accuracy of the mental health professional.” One of the decrees Daubert, which, interestingly, was handed down the same year in which Otto and Ogloff’s study was published, mandates is that the science which the court approves be replicable and verifiable. Another is that there be consensus in the scientific community for the scientific evidence under question and currently there is no agreement on what a psychological autopsy is, who should be selected to do them, or how they should be carried out. Though the term has had wide currency for over four decades, neither “psychological autopsy” nor its constituent elements have yet to achieve either consensual validation or operational standardization, thus calling into question issues of content validity and reliability. Though Otto finds some worth in interviewing those close to a deceased person, the claims made by many psychological autopsy practitioners are “pretty shaky” and “highly speculative.” So, while many in the field of psychology, psychiatry, and suicidology believe these investigations can be used to find closure to “equivocal deaths,” they are still questioned by many, particularly when attorneys attempt to transfer these scientific disciplines to the courtroom.

Speculation into how and why a life ended will always be irresistible to human beings inasmuch as everyone loves to solve mysteries and ferret out the solution to a puzzle. In February 2002, U.S. Senator Frank Murkowski of Alaska, for example, requested that the body of Meriwether Lewis (of Lewis and Clark fame) be exhumed to put an end to questions whether or not the famous 19th century American explorer committed suicide or was murdered--questions in large part raised by the practice of psychological autopsy. More sensationally, American novelist Patricia Cornwell--whose writing career has been comprised of constructing fictitious mysteries--recently attempted to solve, once and for all, the mystery of the identity of the infamous Jack-the-Ripper. She performed psychological autopsies on the unfortunate prostitutes of Victorian England who were the Ripper’s victims and also on her “prime suspect,” the nineteenth-century Impressionist artist Walter Sickert, who is best known for a series of macabre paintings of murdered prostitutes some years after the 1888 murders that transfixed the city of London. Cornwell, of course, is not the first to do this. Psychological autopsies of victims and possible suspects regarding this fascinating case are almost as old as the murders themselves. In fact, it is reputed by some “Ripperologists” that Sir Charles Warren, Metropolitan Police Commissioner at the time, asked a photographer to use a special lens in photographing the horribly mutilated body of one of the victims, hoping it would capture the image of what the victim saw just before she died, and provide police with a “picture” of the killer. Alas, the photograph provided no “mug shot” and likewise Cornwell’s investigation uncovered no “physical evidence” to link Sickert to the Whitechapel murders. Nevertheless, she believes that her psychological autopsy, which delved into Sickert’s life and work at a cost of over $4 million, obtaining 30 of Sickert’s paintings and his painting table and engaging forensic experts in a futile attempt to lift fingerprints from them nearly a century after his death, examining letters purportedly written by the Ripper for DNA trace evidence (again to no avail), and repeatedly visiting the streets of the east end of London and the graves of the Ripper’s victims, proves “100 percent that Walter Richard Sickert committed these serial crimes, that he is the Whitechapel murderer.” Though she formulates an interesting theory to her readers and aficionados of murder mysteries and conspiracies and provokes thought and conversation within popular culture, her musings have not prompted a call by Scotland Yard to reopen the case. As with many other “psychological autopsies” that have attempted to give corpses a “voice” and opportunity to speak from the grave, Cornwell’s foray would seem to be doomed, like the five London prostitutes who were the Ripper’s victims, to walk the back streets of admissible evidence.

Undoubtedly, as the scientific literature reveals, the use of “psychological autopsies” over the last four decades to uncover some of the risk factors of suicide have aided psychologists and suicidologists in their quest to prevent future incidents of self-destruction. That certainly makes the practice valuable in that limited sphere, as Otto and Ogloff’s study made clear, even as the authors criticized practitioners for their lack of methodological standards and scientific precision. But the continuing attempt to use “psychological autopsies” in the legal arena is fraught with problems. In his call to ground the practice with a greater reliance on the scientific method and validation, Lanny Berman suggested that the profession needs to formulate methodologies that would allow better answers to the questions of reliability, arguing psychological autopsies must define error rates, develop standardized operational procedures and come up with reasonable measures of validity--as all scientific disciplines must do in order to have expert testimony accepted by gatekeeper judges. Until such standards, procedures, and measures are developed and implemented, many judges will continue to treat the findings of “psychological autopsies” as “speculation,” intriguing, perhaps, as the thirteenth-century village elders found swarming flies over a sickle blade to be or as a contemporary mystery novelist finds the connection between art and violence, but speculation, nonetheless, not a body of facts or data grounded on scientifically informed principles and methodology.

What is the age, sex, race, marital status, occupation of the victim.

Was victim regularly seeing a physician? Had there been a recent appointment?

Who was the victim’s physician?

Had the victim been experiencing chronic pain?

Had the victim been diagnosed with a chronic, fatal, or disabling disease?

Was there a significant reduction in physical capabilities? If so, what, and how was the deceased adjusting?

What are the relatives’ responses to the death?

How supportive or close were the nuclear and extended families?

Was there a history of significant abuse (physical, sexual, emotional, etc.) Or a perception of abuse on the part of the decedent?

What is the health history of the family? (genetic diseases, cancer, fatal illnesses, ages at death, and other details)

What was the victim’s personality and lifestyle?

Was there a history of psychiatric disorder and suicidal behavior?

Did deceased routinely take risks considered unusual by most people?

What sort of childhood and adolescence did the victim have?

What education had the victim received?

What was the housing or living situation of the victim and the family?

What role, if any, did alcohol and/or drugs play in the death of the victim?

Did the victim have a history of substance abuse? If so, what was the degree of substance abuse at the time of death?

Did the victim’s family have a substance abuse history? (parents, siblings, relatives)

Did the victim make any recent attempts to discontinue substance abuse?

Did the pattern of substance abuse include abuse of more than one substance?

Had the deceased ever experienced an “accidental overdose?”

What was the victim’s psychiatric history?

Had decedent seen a therapist or psychiatrist in the recent past? Was he/she in therapy at the time of death? With whom?

Had there been any suicide attempts, or had the victim ever talked of suicide as a solution to problems or in response to interpersonal conflict?

Did the victim manifest any self-destructive behaviors (such as self-mutilation, routine substance abuse, drinking/driving, etc.) Did crisis situations occur on an unusually frequent basis?

Was the victim prescribed any psychiatric medications for anxiety, depression, or psychosis at any point?

Were there any psychiatric disorders? If so, what were their characteristics?

Was the victim ever hospitalized in a psychiatric setting? Where?

Did the victim have contact with clinical services prior to death?

Did the deceased ever express worry about “going crazy”?

Had the victim had fantasies, dreams, thoughts, premonitions or fears relating to death, accident, or suicide?

Had the decedent appeared depressed, sad, tearful, or moody recently? Had the victim recently appeared to have recovered from a depression?

Had the deceased appeared anxious or complained recently of anxiety or panic?

Had the deceased demonstrated perfectionistic tendencies?

Were there problems with insomnia?

Were there changes in the victim before death? Had the decedent shown a lack of interest or joy in life? (of habits, hobbies, sports, eating, sexual patterns, personal hygiene, and other life routines)

Did the deceased display a lower than usual energy level?

Had the deceased demonstrated slowed or preoccupied thinking?

Had the deceased discussed feelings of guilt?

Had the decedent appeared agitated recently?

Was there a tendency for the decedent to behave in an impulsive manner? Did the decedent appear to be confused, disoriented, or psychotic?

Did the deceased express feelings of hopelessness, helplessness, or worthlessness?

Did the deceased talk specifically about suicide, or of life not being worth living?

What was the nature of victim’s interpersonal relationships? (partner, family, friends)

To what degree was the decedent able to create and maintain close personal relationships?

Was the deceased able to express feeling as needed (i.e. grief and anger), or was there a pattern of holding within then “blowing a stack”?

Had decedent talked recently about feeling unsupported, uncared for, not important?

To what degree was decedent successful in relationships? (work, social, personal)

Was victim religious? Attend church services regularly?

Had the decedent experienced a significant loss or series of losses, relationships, job, finances, prestige, self-concept, family member moving? (anything of importance to the person)

Had there been a significant (or perceived significant) disruption of a primary relationship?

Were there any legal troubles or difficulties with police?

Were there occupational or employment difficulties?

Had the deceased experienced an event which was traumatic, or perceived to be traumatic?

Had there been a significant life change? (Negative as well as positive, i.e. marriage, birth of child, job promotion, etc.)

Had the deceased had exposure to suicidal behavior?

Had the deceased experienced the completed suicide or suicidal behavior of a family member or a loved one?

Had the decedent made preparations for death? (include updating wills, insurance policies, etc)

Had the deceased deviated from usual routine in any way just prior to death?

Is the date of death the anniversary of an important death, or important loss for deceased?