A case of suicide by double gunshot wounds to the head: the ability to act after the first shot

Interpol review of forensic firearm examination 2019–2022

“…That immediate and total incapacitation does not always occur after a bullet enters a human cranium is supported by a case report, in which a man died as a consequence of two bullets entering through the right temporal region of the head and stopping in the left occipital and left temporal lobe respectively [ 171 ]. The case circumstances convinced the authors that both shots were self-inflicted.…”

Suicide or Homicide? A Case of Self-Inflicted Triple Gunshot Wound by Double-Barrel Shotgun

“…If not rare, in fact, multiple suicidal gunshot wounds are very infrequent, with reported incidences ranging from 0% to 5% 7 . In most cases where more than 1 entrance wound is present, it is particularly difficult for the forensic pathologist to differentiate between homicide and suicide, with the evaluation of residual “ability to act” after all but the last gunshot playing a crucial role in the diagnosis of the manner of death 8,9 …”

“…7 In most cases where more than 1 entrance wound is present, it is particularly difficult for the forensic pathologist to differentiate between homicide and suicide, with the evaluation of residual "ability to act" after all but the last gunshot playing a crucial role in the diagnosis of the manner of death. 8,9 Different cases of suicide by multiple gunshot injuries have been described in the forensic literature, including unique suicides by 8 gunshot wounds to the head 10 and 14 shots at the thorax. 11 However, few cases exist describing multiple self-inflicted gunshot deaths with exclusive involvement of the so-called targets of secondary importance, meaning organs such as lungs, liver, kidneys, or spleen, whose injury can enable a survival time in the range of hours or even days depending on a slower rate of bleeding and activation of circulatory compensation mechanisms.…”