Simulated drowning in erotic play

A case of fatal suffocation during unusual autoerotic practice. The manner of death in each was accidental. A total of cases of such deaths has been reported in 57 articles. Often the first sign of the activity usually a surprise to family and friends is death itself. Cross-dressing was a feature in 4 cases. These articles were obtained through a systematic Medline database search.

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Autoerotic death refers to the accidental death of an individual engaged in solitary sexual activity due to a failure of one of the devices or materials that was being used to augment the behavior. The clandestine nature of this paraphilia may, however, make subsequent identification and diagnosis difficult unless the death scene features are typical. Laboratory methods for the diagnosis of drowning have their rationale in the shift of liquid and electrolytes across the pulmonary air-blood barrier, which may cause blood volume and electrolyte changes. The most commonly encountered autoerotic practice, specifically, autoerotic asphyxia, denotes death resulting from failure of a release mechanism of the apparatus designed to attain cerebral hypoxia for heightened arousal. The person with a paraphilia is not necessarily seen as someone with a problem and in need of treatment. The psychological autopsy is an important assessment tool used to identify aspects of a person's life that explain any lingering mystery that shrouds their death. Thorough investigations regarding life and environment of the victim and the circumstances of death may be effective in the determination of the manner of death in equivocal cases.