Abstract
To the Editor,
As forensic pathologists trained and working in human forensic medicine, we read with great interest the article by Maccagnan et al 3 on Wischnewsky spots in starved dogs and cats. We are aware that direct extrapolation from human to non-human pathology may be scientifically inappropriate, but precisely for this reason, however, we found the article particularly valuable. It shows how human and veterinary forensic pathologists may recognize common biological patterns, discuss shared interpretive problems, and mutually refine their diagnostic reasoning.
Maccagnan and colleagues suggest that Wischnewsky spots may support the diagnosis of starvation-related death, because they interpret the lesions as probably related to the combined effects of starvation-associated hypothermia and prolonged stress. This interpretation is biologically plausible and is consistent with human forensic experience, in which Wischnewsky spots have traditionally been associated with fatal hypothermia.2,6,9 The veterinary data presented by Maccagnan et al therefore expand the discussion beyond a single diagnostic category and invite consideration of a broader pathophysiological continuum involving energy depletion, thermoregulatory failure, stress response, superficial gastric mucosal injury, and hematin formation. Also, from the human forensic perspective, starvation is rarely diagnosed on the basis of a single lesion. It is usually a diagnosis of integration, requiring the careful correlation of circumstantial information; external examination; body weight and growth parameters, when applicable; gastrointestinal findings; generalized loss of adipose and muscle tissue; organ atrophy, histology; toxicology; and ancillary investigations.1,4 Fatal starvation in children, in particular, has repeatedly shown that the autopsy must be interpreted together with the scene investigation and the broader context of neglect or coercive deprivation. 7 The work by Maccagnan et al is valuable because it adds another potentially informative gastric finding to this integrated approach while also reminding us that no morphological sign should be isolated from its biological and circumstantial context. This point is especially important today. Starvation, once considered as an uncommon cause of death in industrialized countries, mainly encountered in neglect, mental illness, anorexia nervosa, or hunger strikes, has tragically re-emerged as a contemporary forensic and humanitarian concern. Recent medical, forensic, and legal literature has emphasized that deliberate deprivation of food, water, and medical care may constitute not only a cause of suffering and death but also a method of warfare, torture, or collective punishment. 5 In such contexts, the responsibility of pathology is not rhetorical but methodological: to document, classify, and interpret biological evidence with the greatest possible rigor. 8 In an era in which starvation has again become a subject of medical, forensic, and legal urgency, dialogue between human and veterinary forensic pathologists is more than intellectually interesting. It is a reminder that scientific rigor is the common ground of our disciplines. From that rigor derive both the credibility of forensic evidence and, ultimately, respect for law, dignity, and humanity.
Footnotes
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
