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Suicidal pacts seen among married, middle aged couples: Local case reports 

20 Dec 2021

BY Ruwan Laknath Jayakody  Suicidal pacts are an extremely rare phenomenon, seen however among married, middle aged couples, amongst others. This finding was made by the Consultant Judicial Medical Officer (CJMO) at the Anuradhapura Teaching Hospital, S.M.H.M.K. Senanayake in a case report on “Suicide pacts in a District of Sri Lanka between the years of 2001 and 2014”, which was published in the Medico-Legal Journal of Sri Lanka 4 (1) in December 2016.  A suicide pact, A.K. Sikary, R. Swain, S. Dhaka, S.K. Gupta and A. Yadav’s “Jumping together: A fatal suicide pact” noted, is an agreed plan between two or more individuals to commit suicide. The plan, according to “Can this be a suicidal pact or dyadic (an interaction between two things such as an interaction between a pair of individuals) deaths (a dyadic death refers to an incident where homicide is followed by the perpetrator’s suicide)?” by M. Vidanapathirana (Professor of Forensic Medicine at the Sri Jayewardenepura University’s Medical Sciences Faculty’s Forensic Medicine Department), H.K.R. Sanjeewa (Registrar in Forensic Medicine at the same latter Department), P.A.G.K. Niroshani (Senior Registrar in Ophthalmology at the National Eye Hospital, Colombo) and R.R.G.S. Amararatne, (CJMO at the Puttalam Base Hospital), may die together, or separately but in a closely timed manner.  A suicide pact is, Senanayake explained, a rare phenomenon, adding that in the 13 years of service in the North Western and North Central Provinces, in two Provincial general hospitals as the Medico-Legal Consultant in Charge for a District, only two such incidents of suicide pacts had been encountered, out of a total of 10,200 post-mortem examinations.  First case  In the Kurunegala District, a married couple (one spouse a 56-year-old and the other a 54-year-old) had committed suicide by way of the ingestion of cyanide. The reason, per a suicide note that was available, had been owing a large financial debt. The duo had first gone to a famous church and then into a jungle near the sea, and ingested cyanide.  Second case In the Anuradhapura District, a couple who were living together had hanged themselves, one week into their new life (the male was 40-year-old and unmarried, while the 36-year-old female was married and had a seven-year-old child). According to the suicide note that was available, the female had wanted the child but her husband had refused to hand over the child to the mother and therefore, she could not live with the new husband without her child and could also not wait until the divorce case was completed.  Suicide pacts are usually commonly reported, Senanayake, and Vidanapathirana et al. observed, in married couples, blood relatives/family members, lovers/romantic partners or friends. M. Rosenbaum observed in “Crime and punishment: The suicide pact” that of the members in the pact, survivors show and have depression. In Senanayake’s analysis, of the two aforementioned cases, one member had a very strong reason for depression where one had a large debt while the other faced the loss of a child. A British medical journal editorial on “Suicide pacts and the Internet” also noted the rare phenomenon where strangers get together through Internet websites and commit suicide in increased numbers. The causes of suicide pacts, as found by M. Brown and B. Barraclough in “Partners in life and death: The suicide pact in England and Wales 1988-1992”, were found to be mental disorders, the loss of a partner due to ill health, euthanasia and thwarted love. There are also several variables based on which victims of suicide pacts differed significantly from single suicides and according to “A controlled study of suicide pacts” by D.A. Fishbain, L. D’Achille, S. Barsky and T.E. Aldrich, they included a tendency to use guns, leave suicidal notes, have blood alcohol levels, be older, be less depressed and to commit suicide in the morning hours. The World Health Organisation (WHO) revealed in September 2014 that instances of suicide were most prevalent in Guyana, North Korea, South Korea, Sri Lanka, Lithuania, Suriname, Mozambique and Nepal. Suicides in Sri Lanka, Senanayake noted, are common, in particular among unmarried young persons and old persons; however, suicide pacts are very rare with a single incident being seen in a District after several years, where the percentage is about one such incident per approximately 5,000 autopsy examinations.  In the case report presented by Vidanapathirana et al., an Indian couple was found dead inside an air-conditioned room in a hotel in Sri Lanka. They had come to Sri Lanka on vacation, one week prior to the incident. Their bodies were found on a bed with whitish, coarse froth around the mouths. The female body was found longitudinally while the male body was found transversely; the male’s head on the lower limbs of the female body. The female body was neatly covered with a bed sheet up to the upper half. The scene was not disturbed and there was a half a bottle of soft drink on a table. White colour crystals were found inside a bag. The autopsy revealed that the female was pregnant. Both bodies had bright, pinkish colour hypostasis (the accumulation of fluid or blood in the lower parts of the body or organs under the influence of gravity, and which occurs in cases of poor circulation or after death). Early putrefactive changes were identified in the female body while rigour mortis was complete in the male body. Toxicological analysis revealed cyanide compounds in both the bodies, the bottle of soft drink and the white crystals in the bag. Vidanapathirana et al. explained that though the two bodies were exposed to the same environmental conditions, the fact that they showed different post-mortem changes may be due to individual factors or different time since the deaths. Therefore, based on the medical evidence alone, it was extremely difficult for Vidanapathirana et al. to differentiate the aspect of a suicidal pact from a dyadic death.  If you feel that you or someone you know may be affected by this content or may require help the following institutions would assist you:  The National Institute of Mental Health: 1926  Sri Lanka Sumithrayo: 0112 682 535  Shanthi Maargam: 0717 639 898  Courage Compassion Commitment (CCC) Foundation: 1333  Women In Need (WIN) 24-hour hotline: 077 567 6555  


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