|Year : 2021 | Volume
| Issue : 4 | Page : 111-116
The trend of homicides in South Kerala from 2002-2016: A retrospective forensic autopsy-based study
Nikhil Dileeph1, S Sharija2, Antony Stanley3, K Valsala4, SS Sujisha4, Nikita Prabhakaran4
1 Department of Forensic Medicine, Dr. SMCSI Medical College, Thiruvananthapuram, Kerala, India
2 Department of Forensic Medicine, Government Medical College, Thiruvananthapuram, Kerala, India, India
3 Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India
4 Department of Forensic Medicine, Government Medical College, Thiruvananthapuram, Kerala, India
|Date of Submission||24-Jul-2020|
|Date of Decision||14-Dec-2020|
|Date of Acceptance||17-Oct-2021|
|Date of Web Publication||30-Dec-2021|
Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala
Source of Support: None, Conflict of Interest: None
Aims: The aim was to analyze the homicide pattern in South Kerala from autopsies conducted between 2002 and 2016. Objectives: Exploring the age and gender distribution of death due to homicide, the type and distribution of injuries according to the region of the body, and trends of homicide. We also tried to study the pattern of defense wounds in homicidal cases and characteristics in dyadic deaths (homicide-suicide). Materials and Methods: It was a retrospective descriptive study. The setting was the Department of Forensic Medicine, State Medico-Legal Institute, Government Medical College (GMC), Thiruvananthapuram. All cases of autopsies with an alleged history of homicide, between 2002 and 2016, done at Mortuary of GMC, Thiruvananthapuram, were included in the study. Records of all cases of an alleged history of homicide from January 1, 2002 to December 31, 2016 were perused. Results: 957 cases were analyzed. The annual incidence of homicide is declining after 2012. Young adult males (31–40 years) are the most common group involved (24.97%). Head injury was the most common cause of death (43.68%). The head was the most common area to be affected in fatal blunt force injuries (49%) while the chest was involved commonly in fatal sharp force injuries (36%). Females were more often the homicide victims in murder-suicides. Husband–wife and father–child combination was the most common pairs in dyadic deaths. Conclusion: The characteristics which were associated with the homicides were generally in agreement with the existing forensic literature. The findings encourage examining the motives of homicide and potential sociocultural factors affecting the victims and possibly the assailants. We also found that the murder-suicide cases differed from the homicides requiring a separate domain of understanding and subsequent investigations.
Keywords: Death, homicide, homicide-suicide, Kerala, murder, Thiruvananthapuram
|How to cite this article:|
Dileeph N, Sharija S, Stanley A, Valsala K, Sujisha S S, Prabhakaran N. The trend of homicides in South Kerala from 2002-2016: A retrospective forensic autopsy-based study. J Forensic Sci Med 2021;7:111-6
|How to cite this URL:|
Dileeph N, Sharija S, Stanley A, Valsala K, Sujisha S S, Prabhakaran N. The trend of homicides in South Kerala from 2002-2016: A retrospective forensic autopsy-based study. J Forensic Sci Med [serial online] 2021 [cited 2022 Oct 2];7:111-6. Available from: https://www.jfsmonline.com/text.asp?2021/7/4/111/334487
| Introduction|| |
Though being rare, homicide is a high-impact event and captivates many including the victim, the offender, the kith, and kin of both parties as well as the media. Homicide also scars the lives of the victim's family and community, who may be termed as secondary victims. The average global homicide rate in 2017 was 6.1 per 100,000 population. In India, the overall homicide rate decreased by 10% over the period 2009–2015, from 3.8 to 3.4 per 100,000 population. Every day on an average 80 murders was reported across India in 2018.
The latest National Crime Records Bureau (NCRB) data shows that a total of 29,017 murders were reported in 2018, up by 1.3% over 2017. Based on the NCRB data, Uttar Pradesh recorded the most murders followed by Bihar and Maharashtra. Kerala was placed sixth from the bottom. Disparities not only occur with the geographical distribution but also with the type of activity and the amount of culpability. Earlier studies pointed out that the problematical socioeconomic life, caste-related violence, religious crimes, etc., were indirectly contributing to the rise of homicides in India. Modern times have shown rising trends of city-based organized crime rackets and their involvement in contract killing. There have always been debates and disagreements among researchers regarding the underlying factors for homicides whether it be financial, social or educational status.
There is a dearth of systematic research on the topic of homicides, typology, and patterns in Kerala. There is a growing belief among academics that the homicide patterns in Kerala is changing and is different from the Northern parts of India. To establish the point of difference, we needed to study the homicide pattern in Thiruvananthapuram, the capital city of Kerala, and adjacent districts and its evolution over the last 15 years; hence, a retrospective study of all homicidal deaths between 2002 and 2016 was undertaken.
| Materials and Methods|| |
This retrospective study was approved by the Institutional Review Board and was conducted at the Department of Forensic Medicine, Government Medical College (GMC), Thiruvananthapuram. The Ethics Approval Number for the study was IEC.No.03/03/2017/MCT dated 09/02/2017. All autopsy cases which were done at the Mortuary of Department of Forensic Medicine of GMC, Thiruvananthapuram from January 1, 2002 to December 31, 2016 for which the manner of death was homicide were retrospectively reviewed. The Forensic Department in GMC, Thiruvananthapuram provides autopsy service to the districts of Thiruvananthapuram, Kollam, and parts of Pathanamthitta.
The details of the homicidal cases from the period of January 1, 2002– December 31, 2016 were retrospectively analyzed from the archives (records department) in the Department of Forensic Medicine, GMC. The record included postmortem certificates, the requisition forms (Kerala Police Form-102), the clinical case sheets in case of treated patients (through the IP number available in the Postmortem certificate), details of the viscera sent for chemical examination, histopathology, and the postmortem certificate. Further doubts regarding any of the details in the pro forma were cleared accordingly over the phone in the respective police stations. These included sociodemographic data like sex, age, socioeconomic status, and other personal information. The details of the homicide like various aspects of injuries, the relationship of the accused, the fatality of the injuries, the time of survival, the efficiency of the treatment given were collected.
Data were analyzed using R software version 3.6.3. All tests were 2-tailed, and P values not greater than 0.05 were considered significant. Quantitative variables were reported as mean +-standard deviation. Qualitative variables are reported as proportions and percentages. The t-test was used to determine if there is a significant difference between the means of two groups and the Chi-square test was used to determine the association between categorical variables.
| Results|| |
Characteristics of the population
The majority of the victims belonged to the age group 31–40 years (24.97%) followed by 21–30 years (21.11%). Among the homicidal victims, there was a preponderance of male victims with 719 cases (75.13%) over female victims with 238 cases (24.87%), with a male:female ratio of 3:1. The lowest age among the female victims were 6 days and the highest was 84 years. The range of age among male victims was 1 day and the highest was 83 years. The age and sex distribution are shown in [Table 1].
Comparison of homicides year-on-year between male and female showed male preponderance in every year. The greatest difference was shown during 2009 when males victims contributed to 88% of the homicidal victims. The disparity between the genders was significant every year with the least being during 2007 where male victims comprised 66.2% and female victims formed 33.8%. When gender distribution is sought in each age group, it is found that the males are predominating in all age groups except in the age group <10 years.
Among the 17 cases which were <1 year, 9 cases were females and among the 20 cases between 1 and 10-year age group, 15 were females. Another focal observation was that in all the 9 cases <1 year, it was the mother who was the accused. The religion-wise split-up of the victims showed that 74.19% of the victims belonged to the Hindu religion followed by Christians (15.36%) and Muslims (9.61%). Most of the victims in the study were moderately nourished. Normal BMI was seen in 796 cases (83.18%) followed by overweight individuals (12.75%). Poorly nourished victims were only 37 cases (3.87%).
During the study period from 2002 to 2016, a total of 46232 medico-legal autopsies were conducted. Out of which 957 cases (2.07%) were homicidal deaths. The maximum number of cases were reported in 2012 (90 cases) followed by 2007 (77 cases) and 2010 (74 cases). The least number of cases were reported in 2016 (46 cases) (see [Figure 1]). As a percentage of homicides against the total number of autopsies in each year, 2012 (2.62%) reported the maximum and the least was in 2016 (1.49%).
|Figure 1: Annual trend of autopsies conducted for homicides and homicide-suicides in the Department of Forensic Medicine, Government Medical College, Trivandrum from 2002 to 2016|
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Survival time and place of death
Most of the homicide victims (758 cases) died within 1 day of the attack-constituting about 79.21%. The minimum category was that of those who survived more than 1 month (1.67%) which was extremely low. The number of cases which were seen dead constituted 595 (62.17%), 66 cases (6.9%) died on their way to the hospital, and the remaining 296 cases (30.93%) died after receiving first-aid, reaching casualty, post-admission or while undergoing treatment (inpatient + surgical care) in the hospital. One hundred and forty-four cases (15.05%) died despite getting some form of surgical intervention.
Distribution of traumatic and nontraumatic cause of death
An overwhelming majority of the homicidal victims, 907 (94.78%) suffered a traumatic cause of death. The trauma was caused by a sharp force trauma or a blunt force trauma or a combination of both. Seventeen (1.78%) cases were nontraumatic and were caused by either smothering, drowning, or poisoning. Only 33 (3.45%) suffered from both traumatic and nontraumatic injuries.
The pattern of traumatic injury: Out of the 940 traumatic cases, 350 cases (37.22%) were caused by sharp force, 484 cases (51.49%) were caused by blunt forces (see [Table 2]). Firearm were responsible for 9 (0.96%) cases. The least proportion was by burns combined with sharp or blunt force and burns in 6 cases (0.63%). In total, a blunt force was found to be employed in 578 cases (60.83%) among the cases of traumatic death.
|Table 2: Distribution of traumatic, nontraumatic patterns of injury and defense wounds|
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Defense wounds: Defense wounds were seen in 37.83% of the total cases. This was commonly seen in the right forearm (43.9%). This was followed by the right hand (32.6%) and right arm (29.8%). Males had more self-defense wounds 300/719 (41.7%), whereas only 62/238 (26.1) females exhibited defense wounds (P < 0.01).
Type of weapon: Among the traumatic cases, sharp weapons were predominant-446 (46.6%) compared to the blunt objects– 265 (27.7%). The sharp weapons included 227 single-edged weapons, 41 double-edged weapons, 98 heavy cutting weapons, 52 swords, 15 other sharp weapons, 7 rubber taper's knives and 6 cases of scissors. Firearms were used in 9 (0.96%) cases. Thirty-nine (4.14%) victims were also murdered by ligature strangulation.
Regions of the body involved
Considering all the traumatic cases, head and face were the region which sustained maximum injuries 520 (55.32%) followed by chest injuries 485 (51.6%), neck injuries 305 (32.45%), abdominal injuries 215 (22.87%), upper limbs 138 (14.68%) and lower limbs 138 (14.68%) (see [Table 3]).
|Table 3: Region-wise distribution of fatal injuries by blunt and sharp forces in traumatic homicidal cases|
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Skull fractures: Among 418 head injury cases with a skull fracture, the temporal bone was the most involved in 109 (26.07%) cases followed by frontal in 83 (19.85%) cases. The fractures involving the anterior cranial fossa, middle cranial fossa and posterior cranial fossa were 59 (14.11%), 68 (16.26%) and 11 (2.6%) respectively.
Intracranial bleed: Head injury cases with intracranial hemorrhages were of the following varieties-342 cases were associated with subarachnoid hemorrhages followed by subdural haemorrhages in 283 and the least was extradural hemorrhage in 19 of the cases.
Organs Injured: Internal organs most seen injured was the brain in 418 cases (45.09%) followed by lungs 183 cases (19.74%) while spleen (9), kidney (7), pancreas (3) and adrenal (1) were least injured.
Cause of death: The major cause of death was due to head injury (418, 43.68%) followed by chest (224, 23.41%) and neck injury (198, 20.69%). Injuries to more than three vital organs have been categorized as multiple organ injuries.
Region-wise distribution of fatal injuries by blunt and sharp forces in traumatic homicidal cases: The blunt force was commonly marked towards the head (49%) followed by the neck (25%). The majority of sharp force injuries were sustained to the chest (36%) (P < 0.001).
Assailant and victim relationship
Type of relationship: Analyzing 957 cases during the study period, the category of interpersonal relationship other than intimate partners or family members which includes friend, colleague and acquaintance were found to be the most common group involved-402/957 (42.01%), followed by those in which the relationship between the assailant and victim was unknown 176/957 (18.39%). In 146/957 (15.26%) of the homicides, the victim was a family member of the assailant. Intimate partners were involved in 98/957 (10.24%) homicide cases. Out of the 98 cases, the male partner was found to be the accused in 86 cases (8.99%) and the female partner in 12 cases (1.25%). In 17 cases (1.78%), the mothers were found involved in killing their children <10 years.
Time, place of occurrence of the incident and alcohol use in victims
Many of the cases– 502/957 (52.46%) occurred during the night (8 PM to 4 AM). This was followed by afternoon + evening (12 PM to 7:59 PM) 272/957 (28.42%). The exact time could not be ascertained in 66/957 (6.9%) of the victims. The most common place of incidence of the homicide was the victim's house itself 495 (51.72%). In 212 (22.15%) cases the victim was found on the road, and in 26 (2.72%) cases the victim was found in their workplace. Chemical analysis of the blood sample revealed the presence of ethyl alcohol in 224 (23.41%) victims in the present study.
Murder-suicides were seen in 44 (4.59%) cases. All were dyadic deaths, a third loss of life never happened in any of these cases. Females were more often the homicide victims in murder-suicides (see [Table 4]). Out of the 44 victims, 30 were females. Three of the victims were <1 year of age (infanticide). Neck injuries were the most common (21, 47.7%) and the least being drowning and injury to the thigh (1 each). Most smothered victims (4 out of 5) were below the age of <10 years.
Out of the total homicide victims, 12.6% of female victims were murder-suicide victims whereas only 1.9% of the male homicide victims were part of a murder-suicide. Less than 1 year, 1–10 and 11–20 age category had a higher proportion of victims (17.6%, 30.0%, 20%) due to murder-suicides than the higher age groups. In cases where the relationship between assailant and the victim was confirmed, it was seen that the husband– wife combination where the husband was the assailant, and the wife the victim was 14 out of 44. Father was the assailant in 11 cases, while mother was the assailant in 5 cases and siblings in 2 cases. The relationship between the assailant and the victim could not be ascertained in 12 cases.
| Discussion|| |
The homicide cases show a marked decrease year-on-year from 2012, although up until 2012, there was no uniform trend. This decline is not unique to Kerala. Homicide rates across the world have been decreasing in recent decades. This decrease is probably multifactorial. This could in part be attributed to the development of human society due to the advancing lifestyle changes through the years. It could also be related to the improvement in the law-and-order situation.
The age group that showed a maximum share of victims in the present study was the 31–40-year group (24.97%). Taking into consideration the young adult age group between 21 and 40-year age group, the total prevalence came to 46.08%. This finding is consistent with time and place. Pokorny et al. found that 47.5% of homicide victims were in the age group of 21–40-years. When gender distribution is sought in each age group, it is found that the males are predominating in all age groups except in the age group <10 years. Among the 17 cases which are <1 year, 9 cases were females and among the 20 cases between 1 and 10-year age group, 15 were females. The other important observation is that in all the 9 cases <1 year, it was the mother who was the accused.
We observed that 79.21% of the victims died within a day after the occurrence of the incident. They were either found dead/died in hospital. This is similar to other studies like Chimbo et al. where the majority of victims were found dead at the spot. It is directly pointing to the spontaneity of the action and the intense rage of the accused. This could also be that the intention to eliminate was so strong that he made an active effort to remove every chance of survival of the victim. This is also related to the fatality of the injuries and the number of injuries afflicted.
According to the present study, blunt force injuries commonly affected the head and neck region. The injury sustained to the head was the most common cause of death. The most common organ to be involved which resulted in a fatality was the brain. Vorada et al. stated that the psychology of an accused is to ensure the possibility of death in his victim. For this, the person might focus on inflicting the most fatal injury on the victim and head being the most vital, it is almost always chosen invariably. The spontaneity of the actions of an accused is what leads to blunt trauma being the most common among these. Thus, considering the most common of combinations, blunt injury to the head can be the most common mode. The sharp force was commonly sustained to the chest. This could be because the chest is more pliable to penetration than the hard-cranial vault. Access to a firearm is difficult in Kerala and hence such injuries are very few in the present study. In some cases, the weapons could not be recovered. This could be the result of the assailant trying to cover his tracks. To destroy the evidence, the assailant could have resorted to burying it, throwing it into water bodies, burning it or dismantling it to be undetectable.
The defense injuries showed a predominance in the right upper limbs showing the predominance of right-handedness in the population. When we analyzed the relationship between the victim and the accused-neighbors, friends, and acquaintances (categorized as other interpersonal relationships) was the most common. Family members and spouses were less common. If the victim is a female, the intimate partner has a greater chance to be the accused according to the present study. The most common place of occurrence of homicide was in the home of the victim. The predominant time of occurrence of homicides was also during the night hours. Our results showed that alcohol was frequently found in the blood of male homicide victims between the age group 21–40.
Murder victims in murder-suicides (dyadic deaths) were mostly females which were in contradiction to the usual homicide sex ratio. Over a period of 15 years, 44 cases of murder suicides were reported. Every year at least one case was reported, and none of it was a cluster, based on geography. The assailants (perpetrator) ranged from spouses, mother, father, and siblings. The reasons ranged from financial stressors, social stressor, amorous jealousy, angry impulse, and altruism (concern for the child). Notable missing patterns in murder suicides were instances of the wife being the perpetrator and the husband being the victim. Many studies from the developed nations report that the most common weapon used in murder–suicide was firearm, especially in the filicide-suicide type., However, in our experience, none of the murder-suicide cases reported the use of a firearm. The mental status of the assailants could not be assessed which is a limitation of this study.
| Conclusion|| |
The analysis of the characteristics (age and sex of the victims, the relationship between the victim and the assailant, methods used for homicide) which were associated with the homicides during the study period was generally in agreement with the existing forensic literature. The findings although not unique to the region, encourages examining the motives of homicide and potential sociocultural factors affecting the victims and possibly the assailants. We also identified a significant number of murder suicide cases in the region. The causes and the pattern of murder–suicide in our cases were slightly different from the western literature. These require a deeper understanding and subsequent specific investigation of individual cases.
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Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4]