The Four Manners of Death

Male skull showing bullet exit wound on parietal bone, 1950s.

Male skull showing bullet exit wound on parietal bone, 1950s.

Have you ever wondered how many ways someone can die? The cause of death is the reason an individual dies. This means that a heart attack, any chronic disease, a gunshot wound or a skull fracture are causes of death. However, each cause can alter an individual’s physiology in different ways. For instance, a gunshot would may not be fatal to one person, but another person may died from that cause. The mechanism of death, then, would represent that actual change that causes a victim to die.

A gunshot wound, for instance, can cause exsanguination (bleeding to death) or sepsis (infection in the blood stream), which are two different death mechanisms. A person who falls and hits her head can die from a number of mechanisms of death, including cerebral contusion, intracerebral bleed (bleeding into the brain) or subdural or epidural meatoma (bleeding around the brain). All three types of injury can lead to brain compression and asphyxia. Therefore, a fall would be the cause of death, and asphyxia may be the mechanism of death.

The manner of death is the root cause of the sequence of events that lead to death. One way to learn the manner of death is through three questions:

  1. How and why did these events take place?
  2. Who or what initiated the events and with what intention?
  3. Was the death caused by the victim, another person, an accident or by Mother Nature?

The answers to the questions above would help determine the manner of death:

  • Natural – these deaths are the work of Mother Nature, including heart attacks, cancers, pnuemonias and strokes. Natural death is, by far, the largest category of death that the medical examiner sees, making up almost half of all investigated cases.
  • Accidental – Accidental deaths include any unplanned and unforeseen events such as car accidents, electrical shocks and falls.
  • Suicidal – The victim’s own hand is responsible for the cause of death, including gunshot wounds, drug overdoses and self-hangings.
  • Homocidal – Homicides are deaths that occur by the hand of someone other than the victim’s hand. The variety of deaths that occur under this manner are numerous.

Only natural deaths are caused by disease, and other categories usually lead to civil or criminal court proceedings. However, some diseases, which may be caused by man-made situations (such as cancers) have been taken to court in the past. Also, a natural death that occurs from another manner of death (such as a heart attack from a surgical error) is an example of a death that can fit two categories. When the death seems natural, but is caused by another manner of death (such as a robbery that results in the victim’s heart failure), then that death may be ruled as a homocide.

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