Potential significance of swastika tattoos in a medico-legal setting.

Although the increasing popularity of tattoos has challenged the previous associations with criminality and psychiatric illness, particular subsets of tattooed individuals may still have an association with unnatural deaths in a forensic context. A retrospective review of the autopsy database at Forensic Science South Australia was undertaken over a 23-year period from 1997 to 2019 for cases with swastika tattoos. Twenty-six cases (23 males and 3 females) were identified, ranging in age from 19 to 67 years (Mage = 36 years). The cases comprised seven (27%) suicides, seven (27%) accidents (including five vehicle crashes), five (19%) drug-related deaths (toxicity/overdose), four (15.4%) natural deaths and three (11.5%) homicides. There were significantly more unnatural deaths in the group with swastika tattoos compared to tattooed controls (p < 0.01). Multiple swastikas, expletives and white supremacist sentiments were also present in a number of cases. However, in one Asian male, the presence of a sacred Buddhist tattoo suggested that the swastika tattoo instead had religious rather than antisocial/racist significance. This study shows that in the population of individuals undergoing forensic autopsies, subgroups may be identified by their tattoos who have a predisposition to violent and unnatural death. Evaluation of this risk has to be tempered by considering the cultural/religious background of a decedent, as the symbol may have completely different connotations for certain religious groups such as Jains, Hindus and Buddhists.