
The pathologist who examined Dr David Kelly has been widely reported as saying that his death was a "textbook" case of suicide. This depends very much on the textbook.
In a textbook of physical pathology, Dr Kelly's injuries might well provide an exemplar of a suicide by wrist-cutting. But from a psychiatric epidemiological perspective, a different picture presents itself.
Wrist-cutting is such an unusual form of suicide that it is not recorded separately in national statistics, but is lumped together with other uncommon suicide methods involving self-stabbing.
In men of Dr Kelly's age in the UK who kill themselves, less than 3 per cent do so by using any sort of sharp implement. A much smaller number will therefore have actually cut their wrists. So, the physical pathological findings might be typical, but typical of a rare event.
Of course, Dr Kelly's death may still indeed have been a suicide. But, compared with most suicides, his case is neither representative nor characteristic. It is so unusual that it surely justifies a full and open public inquiry.
Dr Philip Timms FRCPsych, Consultant Psychiatrist, South London & Maudsley NHS Foundation Trust