高處墜落死之死亡方式探討-自殺或意外

The discussion of the manner of death in the victim of falling from height:Suicide or Accident

許逸文(Yi-Wen Hsu)

指導教授 ： 周明智 ； 蔡崇弘

中山醫學大學/醫學院/醫學研究所/碩士(2007年)

https://doi.org/10.6834/CSMU.2007.00040

摘要

在台灣，高處墜落死因及死亡方式的判定一直是法醫相驗實務上的難題，即使是在解剖率百分之百的新加坡，高處墜落的死亡方式也只有30%至40%能依照工作經驗、專業知識等做合理猜測。因此本研究綜合彰化地方法院檢察署2004年1月至2005年12月兩年內高處墜落案例總共73件-意外52件，自殺21件，根據法醫驗斷報告、相驗初步調查報告以及現場鑑識報告，冀望找出影響高處墜落的可能因子，面對未來相驗時，能採用研究結果來對死亡方式做初步的判斷。影響高處墜落的可能因子利用羅吉氏迴歸分析統計上有顯著意義的是性別、工作狀況、發生地點、報案人、與掉落地點的關係、墜落高度、掉落點與建築物距離、過去病史、自殺紀錄、自殺傾向、遺書、藥物、存活時間分析等十三項，再使用因子分析找出發生地點、墜落高度（公尺）、自殺紀錄、有自殺傾向以及死亡方式等五因子和高處墜落意外和自殺明顯有關。有自殺紀錄和有自殺傾向及墜落高度高於15公尺的人，可合理推判死亡方式為自殺；而發生墜落地點為工作地點的人，可合理推判死亡方式為意外。

關鍵字

高處墜落 ； 死亡方式 ； 意外或自殺

並列摘要

In Taiwan , it have become a hard challenging task for medicolegal expert in facing a victim of height fall to determination manner of death (suicide or accident). Similarly,even in Singapore, a country of 100% forensic autopsy rate, only 30 to 40% of such cases can be predicted by experts own work experience, expertise, etc. In fact, little attention has been paid to tackle this problem in a systematical approach. To determine factors that could contribute to the reason(s) for height fall, this research triesto sowe the problem by reviewing current literature and scrutinizing cases documented from Changhua District Court from January of 2004 to December of 2005: total 73 cases about height fall including accident 52,suicide 21 diagnosed a cording to coroner records、preliminary investigatory report and forensic scence report. The result of this research concludes following factors using logistic regression analysis play a significant role in the reason(s) for height fall and the manners of death, they are: gender, vocation, location, people who report a case to the police, occurring place, height of the fall, place of dropping and the distance to the building, medical history, history of attempting/uncommitted suicide, likelihood of committing suicide, the suicide-association letter or notes , ordinary drug history of the dead, and life expectancy. In addition, use factor analysis again and it is found that work condition, height of the fall, history of attempting/uncommitted suicide, tendency of committing suicide, and the manners of death have a significant relationship with height fall and suicide. Also, for those who used to try to committed suicide together with the height fall of over 15m we could infer the manner of death to be more in favor of suicide; and for cases that happen in job site to be casualty may be category in accident.

並列關鍵字

Fall from height ； manner of death ； accident or suicide

參考文獻

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