Suizidbeihilfe in der Schweiz

Direkte aktive Sterbehilfe, auch Euthanasie genannt, bezeichnet die von einem Patienten gewünschte Tötung zur Verkürzung seiner Leidensdauer und ist in den meisten Ländern der Erde gesetzlich verboten, so auch in der Schweiz. Die durch Artikel 115 des Strafgesetzbuchs (StGB) legitimierte Beihilfe zum Suizid ist demgegenüber ein Vorgang, bei dem die sterbewillige Person durch die Bereitstellung einer tödlichen Medikamentendosis, die sie selbständig aufnehmen muss, von Dritten unterstützt wird. Diese Assistenz muss allerdings frei von selbstsüchtigen Beweggründen geschehen. Jährlich sterben in der Schweiz etwa 700 Menschen nach assistiertem Suizid (AS), und ihre Anzahl nimmt stetig zu. Mittels einer retrospektiven Forschungsstudie an Akten aller in den Schweizerischen Instituten für Rechtsmedizin (IRM) archivierten AS-Fälle aus mehr als 30 Jahren wurden Daten zu insgesamt 3.666 Todesfällen erfasst und analysiert. Im Beitrag werden erste Ergebnisse sowie festgestellte Problemkonstellationen zur Veranschaulichung der Situation präsentiert

Trends in methadone-related deaths in Zurich

Methadone has a long and successful history in the treatment of opioid addiction. In recent years, it has become popular again—as potent and inexpensive analgesic in patients with chronic pain. Since methadone has been used fatalities have been reported. In our study all methadone-associated deaths in Zurich from 1998 to 2007 were analysed. Most of the 146 detected deaths of the past 10years occurred during substitution programmes or illicit intake of methadone while only three of them could be attributed to methadone used as an analgesic. Noticeable in our study was the high percentage of cases of combined drug intoxication (76%). The most frequent co-intoxicants were alcohol and cocaine. Mortalities attributed to methadone intoxication alone were a rare finding and could only be detected in five cases of deceased who had received methadone maintenance treatment. The aim of our study is to assess the trends in the number and nature of methadone-related fatalities in Zurich during the last 19years. For this purpose a previous study from Zurich (1989-1997) was included, whereby a very long observation period and large number of cases resulte

VIPSCAL: A combined vector ideal point model for preference data

In this paper, we propose a new model that combines the vector model and the ideal point model of unfolding. An algorithm is developed, called VIPSCAL, that minimizes the combined loss both for ordinal and interval transformations. As such, mixed representations including both vectors and ideal points can be obtained but the algorithm also allows for the unmixed cases, giving either a complete ideal pointanalysis or a complete vector analysis. On the basis of previous research, the mixed representations were expected to be nondegenerate. However, degenerate solutions still occurred as the common belief that distant ideal points can be represented by vectors does not hold true. The occurrence of these distant ideal points was solved by adding certain length and orthogonality restrictions on the configuration. The restrictions can be used both for the mixed and unmixed cases in several ways such that a number of different models can be fitted by VIPSCAL

Incidental occult gunshot wound detected by postmortem computed tomography

The body of a 59year old woman underwent postmortem computed tomography (PMCT) examination prior to forensic autopsy, using a 256 slice multidetector row computed tomography scanner. A large left tension pneumothorax detected on the PMCT was considered to be a likely cause of death and this was confirmed at autopsy. In addition there was an unsuspected PMCT finding of a probable gunshot injury traversing the right orbit, facial bones and frontal sinus. The autopsy technique was adjusted accordingly and PMCT findings confirmed. PMCT in this case was not only diagnostic of cause of death, but also revealed retained projectile fragments of an old gunshot wound to the face. Without prior imaging such findings would have been undetected at autopsy. This case further underscores the contribution of routine PMCT examination to forensic autopsy practic

Lethal Carbon Monoxide Poisoning in Wood Pellet Storerooms—Two Cases and a Review of the Literature

The installation of wood pellet heating as a cost-effective and climatically neutral source of energy for private households has increased steadily in recent years. We report two deaths that occurred within the space of about a year in wood pellet storerooms of private households in German-speaking countries and were investigated by forensic medical teams. This is the first report of fatalities in this special context as is shown in the literature review. Both victims died of carbon monoxide (CO) poisoning; one of the victims was a woman who was 4 months pregnant. Measurements at the scene detected life-threatening CO concentrations (7500 ppm, >500 ppm), which were not significantly reduced after ventilation of the storerooms as required by regulations. We carried out a series of experiments in order to confirm CO production by wood pellets. Thirty kilograms of freshly produced pellets from two different manufacturers were stored for 16 days in airtight containers at 26°C with different relative humidities. CO concentrations between 3100 and 4700 ppm were measured in all containers. There were no notable differences between the wood pellet products or storage at different humidities. Emission of CO from wood pellets has already been described, but fatal accidents have previously been reported only in association with pellet transport on cargo ships or storage in silos. It is therefore a new finding that fatal accidents may also occur in the wood pellet storerooms of private households. We show that significant CO concentrations can build up even when these rooms are ventilated in accordance with the regulations and that such levels may cause the death of healthy persons, as described in the following. As the safety recommendations from the wood pellet industry are inadequate, we consider that further fatal accidents are likely to occur and recommend urgent revision of the safety regulation

Sodium/proton exchanger 3 (NHE3) and sudden infant death syndrome (SIDS)

The sodium/proton exchanger protein 3 (NHE3) is located in chemosensitive areas of the medulla oblongata and plays an important role in the central control of respiration. Overexpression of NHE3 is correlated with lower respiration and might therefore contribute to the vulnerability of infants dying suddenly and unexpected (sudden infant death syndrome, SIDS). Our aim in this study was to verify already reported genetic variations in the NHE3 gene in an independent SIDS cohort from Switzerland. Two single nucleotide polymorphisms (SNPs) in the promoter region (G1131A and C1197T) and one variation in the coding sequence of exon 16 (C2405T) in the NHE3 gene were analyzed in 160 Caucasian SIDS infants and 192 Swiss adult controls by using a single base extension method (SNaPshot multiplex). No significant differences were detected in the allelic frequencies of the three NHE3 polymorphisms between SIDS cases and controls. We conclude that the three investigated NHE3 SNPs are unlikely to play a major role in the pathogenesis of SIDS in Caucasian infants. However, further genetic investigations in different ethnicities are required to determine whether variations in NHE3 are associated with an increased SIDS risk

The Cryosphere / Circumpolar patterns of potential mean annual ground temperature based on surface state obtained from microwave satellite data

Gap filling is required for temporally and spatially consistent records of land surface temperature from satellite data due to clouds or snow cover. Land surface state, frozen versus unfrozen conditions, can be, however, captured globally with satellite data obtained by microwave sensors. The number of frozen days per year has been previously proposed to be used for permafrost extent determination. This suggests an underlying relationship between number of frozen days and mean annual ground temperature (MAGT). We tested this hypothesis for the Northern Hemisphere north of 50N using coarse-spatial-resolution microwave satellite data (Metop Advanced SCATterometer ASCAT and Special Sensor Microwave Imager SSM/I; 12.5 and 25km nominal resolution; 20072012), which provide the necessary temporal sampling. The MAGT from GTN-P (Global TerrestrialNetworkfor Permafrost) borehole records at the coldest sensor depth was tested for validity in order to build a comprehensive in situ data set for calibration and validation and was eventually applied. Results are discussed with respect to snow water equivalent, soil properties, land cover and permafrost type. The obtained temperature maps were classified for permafrost extent and compared to alternative approaches.An R2 of 0.99 was found for correlation between and MAGT at zero annual amplitude provided in GTN-P metadata and MAGT at the coldest sensor depth. The latter could be obtained with an RMSE of 2.2C from ASCAT and 2.5C from SSM/I surface state records using a linear model. The average deviation within the validation period is less than 1C at locations without glaciers and coastlines within the resolution cell in the case of ASCAT. The exclusion of snow melt days (available for ASCAT) led to better results. This suggests that soil warming under wet snow cover needs to be accounted for in this context. Specifically Scandinavia and western Russia are affected. In addition, MAGT at the coldest sensor depth was overestimated in areas with a certain amount of organic material and in areas of cold permafrost. The derived permafrost extent differed between the used data sets and methods. Deviations are high in central Siberia, for example. We show that microwave-satellite-derived surface state records can provide an estimation of not only permafrost extent but also MAGT without the need for gap filling. This applies specifically to ASCAT. The deviations among the tested data sets, their spatial patterns as well as in relation to environmental conditions, revealed areas which need special attention for modelling of MAGT.(VLID)278661