Investigating Unnatural Deaths Linked to Sexual Assault: A Forensic Analysis

Background: Exploration of fatalities associated with sexual activity, encompassing both natural and unnatural occurrences, delving into elements such as physical strain and peculiar circumstances. Terminology like "dying in the saddle" is utilized to describe incidents during sexual intercourse. Although human sexuality is generally regarded as positive, it can, in some cases, result in fatal incidents. Natural deaths, often impacting males, are correlated with pre-existing medical conditions, including fatal cardiovascular events triggered by sexual exertion. Sexual violence, spanning from harassment to coerced penetration, remains a pervasive global issue. In Bangladesh, there are notable instances of sexual intimate partner violence against women.

Aim of the Study: The study aimed to represent the clinical characteristics and causes of unnatural death related to sexual assault.

Methods: This retrospective study, conducted at the Department of Forensic Medicine & Toxicology, Dhaka Medical College, Bangladesh, analyzed 15 autopsies over two years, from July 2021 to June 2023, focusing on suicides by hanging and poisoning. The research adhered to legal and ethical guidelines, obtaining informed consent from legal guardians. Inclusion criteria covered all ages and genders, with unnatural deaths related to sexual activities. Exclusion criteria included natural deaths. Cases were identified through autopsy records, additional examinations, police files, court proceedings, and input from witnesses. A team of five experienced forensic pathologists ensured an unbiased evaluation. Results were organized into tables and graphs, with statistical analysis using SPSS.

Results: This study analyzed 15 unnatural deaths, focusing on age distribution, gender, sexual assault patterns, locations, sexual activities, and causes of death. Victims aged 0-10 years constituted 46.67%, 11-20 years were 33.33%, and 21-30 years were 20.00%. Females comprised 93.33%. Sexual assaults occurred mainly by neighbors (40.00%), involved gang rape (20.00%), and stepfather rape (13.33%). Public places (33.33%) and other locations (40.00%) were common sites. The most prevalent type of injury was head trauma, accounting for 26.67%. Fatal injuries, burns, choking, and poisoning were equally significant, each contributing to 33.33% of cases. Falls from heights were identified as a major cause of death, comprising 20.00% of the reported incidents.

Conclusion: This research delves into the intricate aspects surrounding non-natural deaths occurring in the context of sexual activities, with a specific emphasis on suicides related to hanging and poisoning. It underscores the imperative for a nuanced comprehension of these incidents, drawing attention to possible misclassifications and advocating for precise forensic evaluations. The findings underscore the necessity for increased awareness, education, and preventive measures to confront the social and cultural determinants that contribute to sexual violence.