Evidence map›Paper›PMID 39508284›Full record

ArticleJournal of forensic sciences2025

Mercy killing of a 72-year-old woman through heroin intoxication.

Johann Zwirner, Stefanie Iwersen-Bergmann, Klaus Püschel, Benjamin Ondruschka

Abstract readCase Reports
In one paragraph

Article in Journal of forensic sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Johann ZwirnerInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.ORCID https://orcid.org/0000-0002-3560-3915
Stefanie Iwersen-BergmannInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Klaus PüschelInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Benjamin OndruschkaInstitute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Active euthanasia is legally permissible in only eight jurisdictions worldwide and may only be administered by qualified personnel following specific selection criteria. Mercy killing refers to the deliberate termination of the life of an individual suffering from a terminal chronic medical condition. Detecting both illegally performed active euthanasia and instances of mercy killing presents challenges for forensic pathologists. The presented case describes a mercy killing involving a 72-year-old woman with multiple chronic conditions who was killed by her grandson via heroin intoxication after administration of the anxiolytic alprazolam. Key findings from the external postmortem examination included a single fresh injection site on the inside of the elbow and a superficial T-shaped cut on the flexor side of the left forearm. Toxicological analyses revealed elevated blood levels of heroin metabolites, including 6-monoacetylmorphine and absence of hydroxyalprazolam, indicating an only short survival time following heroin injection. A cocaine concentration in blood was comparatively low but rather high in hair samples. Elderly individuals with multiple chronic conditions are at increased risk of becoming homicide victims. Comprehensive forensic documentation of injection sites is essential to avoid overlooking deaths caused by injection and to differentiate them from medical measures during resuscitation attempts.

Indexed as

AlprazolamHeroinHomicideAgedAnti-Anxiety AgentsChronic DiseaseFemaleHairHumansMorphine DerivativesNarcotics6-O-monoacetylmorphineAlprazolamAnti-Anxiety AgentsHeroinMorphine DerivativesNarcoticsactive euthanasiaalprazolamexternal postmortemheroinhydroxyalprazolammercy killing

Identifiers

PMID39508284
PMCPMC11693526

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.