臺灣博碩士論文加值系統

在台灣，高處墜落死因及死亡方式的判定一直是法醫相驗實務上的難題，即使是在解剖率百分之百的新加坡，高處墜落的死亡方式也只有30%至40%能依照工作經驗、專業知識等做合理猜測。因此本研究綜合彰化地方法院檢察署2004年1月至2005年12月兩年內高處墜落案例總共73件-意外52件，自殺21件，根據法醫驗斷報告、相驗初步調查報告以及現場鑑識報告，冀望找出影響高處墜落的可能因子，面對未來相驗時，能採用研究結果來對死亡方式做初步的判斷。影響高處墜落的可能因子利用羅吉氏迴歸分析統計上有顯著意義的是性別、工作狀況、發生地點、報案人、與掉落地點的關係、墜落高度、掉落點與建築物距離、過去病史、自殺紀錄、自殺傾向、遺書、藥物、存活時間分析等十三項，再使用因子分析找出發生地點、墜落高度（公尺）、自殺紀錄、有自殺傾向以及死亡方式等五因子和高處墜落意外和自殺明顯有關。有自殺紀錄和有自殺傾向及墜落高度高於15公尺的人，可合理推判死亡方式為自殺；而發生墜落地點為工作地點的人，可合理推判死亡方式為意外。

In Taiwan , it have become a hard challenging task for medicolegal expert in facing a victim of height fall to determination manner of death (suicide or accident). Similarly,even in Singapore, a country of 100% forensic autopsy rate, only 30 to 40% of such cases can be predicted by experts own work experience, expertise, etc. In fact, little attention has been paid to tackle this problem in a systematical approach. To determine factors that could contribute to the reason(s) for height fall, this research triesto sowe the problem by reviewing current literature and scrutinizing cases documented from Changhua District Court from January of 2004 to December of 2005: total 73 cases about height fall including accident 52,suicide 21 diagnosed a cording to coroner records、preliminary investigatory report and forensic scence report. The result of this research concludes following factors using logistic regression analysis play a significant role in the reason(s) for height fall and the manners of death, they are: gender, vocation, location, people who report a case to the police, occurring place, height of the fall, place of dropping and the distance to the building, medical history, history of attempting/uncommitted suicide, likelihood of committing suicide, the suicide-association letter or notes , ordinary drug history of the dead, and life expectancy. In addition, use factor analysis again and it is found that work condition, height of the fall, history of attempting/uncommitted suicide, tendency of committing suicide, and the manners of death have a significant relationship with height fall and suicide. Also, for those who used to try to committed suicide together with the height fall of over 15m we could infer the manner of death to be more in favor of suicide; and for cases that happen in job site to be casualty may be category in accident.

中文摘要…………………………………………………………………1
英文摘要…………………………………………………………………2
第一章 緒言..……………………………………………………………3
第一節 研究背景…………………………………………………..3
第二節 研究目的…………………………………………………..4
第二章 文獻探討..………………………………………………………6
第一節 高處墜落定義..……………………………………………6
第二節 高處墜落的年齡和性別在意外和自殺的分佈..…………7
第三節 高處墜落掉落高度和掉落距離在死亡方式上比.....…...10
第四節 高處墜落掉落發生地點和墜落地點在死亡方式上比較12
第五節 高處墜落死亡方式和傷勢分析比較..…………………..14
第六節 存活時間率..……………………………………………..19
第七節 高處墜落生物力學的影響..……………………………..20
第八節 高處墜落者自殺紀錄、遺書和毒化物的分佈…………21
第九節 勞工安全衛生設施規則..………………………………..22
第三章 材料和方法..…………………………………………………..28
第四章 統計方法..……………………………………………………..33
第五章 結果..…………………………………………………………..35
第六章 討論..…………………………………………………………..49
第一節 性別、年齡和婚姻狀況…………………………………..49
第二節 墜落高度和建築物距離..………………………………..53
第三節 高處墜落發生地點和墜落地點..………………………..55
第四節 高處墜落傷勢分析.….…………………………………..57
第五節 存活時間分析..…………………………………………..60
第七章 研究限制..……………………………………………………..63
第八章 參考文獻……..………………………………………………..64
第九章 附錄……..……………………………………………………..68
表格 1：高處墜落死亡方式在年齡、性別和婚姻狀況上的區別…..68
表格 2：從何處掉落在意外和自殺的區別……………………………69
表格 3：掉落起始點材質在意外和自殺的差異………………………70
表格 4：墜落處材質在意外和自殺的分佈……………………………71
表格 5：葯物、酒精、毒化物在意外和自殺的分佈…………………72
表格 6：掉落意外和自殺在傷勢上的比較……………………………73
表格 7：存活時間分析…………………………………………………74
表格 8：存活時間與墜落材質的比較…………………………………75
表格 9：年齡、存活時間、墜落高度、墜落點與建築物距離、賠償
金額、身高、胸寬、胸厚和死亡方式的比較……………..76
表格 10：性別和存活時間、墜落點與建築物距離、墜落高度分析…77
表格 11：年齡和存活時間、墜落點與建築物距離和墜落高度的關係……………………………………………………………..78
表格 12：年齡與建築物距離、墜落高度、存活時間、賠償時間相關分析…………………………………………………………..79
表格 13：墜落高度和傷勢分析……………………………………….80
表格 14：年齡層和傷勢分佈分析…………………………………….81
表格 15：多變向cox迴歸分析……………………………………….82
表格 16：各變數對死亡方式的Logistic迴歸分析…………………..83
表格 17：因子分析…………………………………………………….86
圖 1：有業無業在意外和自殺的差異…………………………………87
圖 2：工作經驗在意外和自殺的分佈...………………………….….88
圖 3：工作類型在意外和自殺的分佈..………………………………89
圖 4：意外和自殺在發生時段上的差異...…………………………..90圖 5：意外和自殺在發生地點的分佈情...………………………….91
圖 6：意外和自殺在死亡地點的分佈情形…………………………..92
圖 7：報案人在意外和自殺的分佈…………………………………..93
圖 8：目擊證人在意外和自殺的分佈………………………………..94
圖 9：與掉落地點的關係在意外和自殺的分佈…………..………....95
圖 10：意外和自殺保險種類的分佈…………………………..……..96
圖 11：意外和自殺賠償金有無的分佈…………………..…………..97
圖 12：意外和自殺在過去病史的分佈…………..…………………..98
圖 13：意外和自殺在自殺紀錄和自殺傾向分佈…………………….99
圖 14：意外和自殺在墜落紀錄的分佈……………………..………..100
圖 15：意外和自殺在遺書和爭吵的分佈……………………………101

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