In a case of alleged suicidal incised wound to the wrist, which feature at autopsy is MOST consistent with homicide rather than self-infliction?

• A Multiple parallel 'tentative' or 'hesitation' cuts alongside the main wound
• B Incised wounds on the dorsal aspect of both hands and on the back of the neck ✓
• C The wound is located on the left wrist in a right-handed individual
• D Shallow superficial cuts parallel to the main deep wound

Explanation

Hesitation cuts (A, D) are multiple parallel shallow incised marks alongside a deeper wound — these are characteristic of suicide as the individual makes tentative attempts before the decisive cut. Wounds on the non-dominant wrist (C) are typical of self-infliction in right-handed persons. In contrast, incised wounds on the dorsum of hands, back of neck, or inaccessible areas that cannot be self-inflicted indicate homicide. A victim cannot easily inflict wounds on their own back of neck or dorsum of hands from a defensive position; such wounds result from an assailant's attack when the victim raises their hands in self-protection. The combination with absence of hesitation marks further supports homicide.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

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Written and medically reviewed by the StethoPrep medical team.