Planned complex suicide. An unusual suicide by hanging and gunshot.

We report a case of planned complex suicide (PCS) by a young man who had previously tried to commit suicide twice. He was found dead hanging by his neck, with a shot in his head. The investigation of the scene, the method employed, and previous attempts at suicide altogether pointed toward a suicidal etiology. The main difference between PCS and those cases defined in the medicolegal literature as combined suicides lies in the complex mechanism used by the victim as a protection against a failure in one of the mechanisms.