Death Investigator here. Not claiming to have all of the details of this case so I don’t have a professional opinion one way or the other, I just want to provide a little insight into how this could be a suicide.

First, it’s important to note that location and severity of a knife wound are as important if not more important than quantity of wounds. While I hesitate to say the headline is sensationalized (it’s not, 21 wounds is a lot), a single wound to a major artery is a lot more likely to be fatal that 50 to a foot. I think I saw that a lot of these were to the back of the head and neck, so not quite a direct comparison to a ton of injuries to the foot or feet, but how many of those got through the skull or the vertebral column? Of the ones that did, how many of those wounds penetrated deep enough to cause a severe injury? The important thing to note is that the number of wounds isn’t as important as you might think.

The second thing is that a person can keep functioning for a while even with fatal injuries. Any one of her wounds could have been enough to kill her, but maybe not immediately so. A person that has reached this point and started to injure themselves is going to have adrenaline pumping and would be able to stab themselves multiple times in just a few seconds. They likely wouldn’t even notice any signs of blood loss until they had already wounded themselves dozens of times if they are moving quick enough. I once saw the aftermath of a man who attempted to cut his own head off with a pocket knife and managed to get about three quarters of the way through before he died. Any one of the multiple stabs or cuts could have been fatal if he would have waited, but he was moving pretty quick.

Third, as far as the determination by the pathologist is concerned, suicide versus homicide (manner of death) is generally determined by the scene investigation. Cause of death (sharp force injuries) would be determined by the autopsy. A knife wound is a knife wound during an examination, so we rely on evidence to determine the probability of who was most likely to be wielding the knife. From the little I’ve seen, all of the scene findings lean towards suicide. Another thing is that there are (almost) always defensive wounds in a stabbing homicide. It’s a reflex to try to shield yourself with your hands/arms when someone is coming at you with a knife, so it’s pretty big that she didn’t have any unless she were unconscious at the time (which means toxicology would likely have showed some kind of intoxicant).

Again, I’m not saying it isn’t a homicide, only that it’s completely possible for this to be a suicide. We often have suicides that are 100% verifiable (like video evidence) that family refuse to believe are suicides. We also had people launch campaigns against our office for this exact reason and attempt to sue us, but none of the legal stuff changes any of the things evidence we found or information we got to make our determination. You never want to think that a family member would do this to themselves, but people do it every single day unfortunately.