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Background: Switzerland is a highly developed country with a comparatively high rate of suicide but a rather low rate of violent crimes.Violent crimes are usually perpetrated in a domestic context, among these, Homicide-Suicide is of particular concern in the public.One particular spectacular case, when a prominent former sport star was killed by her estranged husband, had political consequences, as the worldwide unique rule to leave the personal weapon to each conscript was challenged by a referendum.Army weapons are often used as means in Homicide-Suicides and suicides in Switzer-land; victims of lethal domestic violence, however, were often women with a migrant background and hence the perpetrators migrants, too.Since migrants have no access to army weapons, they might use other means to kill their spouse and not commit suicide after the act.In this paper we examine the differences between perpetrators of Homicide-Suicide and perpetrators of lethal domestic violence without consecutive suicide.These possible differences might have some implications for preventive measures.Methods: The files of all cases of Homicide-Suicide (n=24) and all cases of lethal domestic violence without consecutive suicide (n=21), which occurred in the region of Basle, Switzerland, between 1987 and 2006 were examined in the Institute of Forensic Medicine of the University of Basle.The region of Basel is a mixed urban-rural one with a population of about 450000 inhabitants.We analyzed the forensic-psychiatric expertises, which are made as rule in Switzerland when a serious crime has occurred, of all perpetrators of lethal domestic violence without consecutive suicide and the surviving perpetrators of Homicide-Suicide.We compared the socio-demographic, clinical and criminological variables of the two groups by using the scheme of Marzuk which originally was introduced to classify Homicide-Suicide.We also considered the quality of the files in their ability to explain the background of Homicide-Suicide when there was no survivor.Results: Perpetrators of lethal domestic violence without consecutive suicide were significantly younger, they had a low educational and social background and were foreigners as a rule.Only one third of them used guns, mostly illegally acquired, the rest knives and blunt force.More than half of the perpetrators of Homicide-Suicide used guns, half of these were army-weapons.Whereas spousal dispute was the common cause of lethal domestic violence, we observed in one third of the Homicide-Suicides so called Suicide Pacts, some of them executed with the assistance of a "Right to die"-society.The contents of the police files of Homicide-Suicide without surviving perpetrator were sometimes scarce.Conclusion: Since lethal instruments like guns which are easily accessible in Switzerland are frequently used as means of Homicide-Suicide and "Right to Die"-societies up to now had easy access to lethal drugs like barbiturates, traditional measures like limiting the access to these means by changing the law could be effective from a preventive point of view.Since lethal domestic violence without consecutive suicide is often executed by blunt force and knives, preventive measures should focus on better integration and education of putative perpetrators.