The convenient death of accused child sex trafficker Jeffrey Epstein while in federal custody has set off a firestorm of controversy and speculation. Was it homicide or suicide? Was he murdered by others acting on behalf of his wealthy and powerful friends who might be exposed  or incriminated in his upcoming trial? Was he killed by another inmate looking for street cred or acting out of a hatred for child abusers? Whether murder or suicide, how could the staff at the feds’ Metropolitan Correctional Center in Manhattan have failed to keep such a high profile defendant from harm?

According to media reports, weeks before he died, guards found Epstein sprawled on the floor of his cell with injuries to his neck. The precise nature of those injuries were not disclosed. One anonymous source said that Epstein had been attacked. Other sources said that his injuries may have been self-inflicted.

He was immediately taken to the hospital, treated and returned to custody in the MCC’s special housing unit for high-profile prisoners. Reportedly he was placed on a suicide watch, but the measures entailed by that procedure remain unclear. Also unclear is whether Epstein was taken off suicide watch just before he was found dead.

The New York Post has published an article citing an anonymous former inmate of the MCC’s special housing unit who offers the following insights:

There’s no way that man could have killed himself. I’ve done too much time in those units. It’s an impossibility. Between the floor and ceiling is like 8 or 9 feet. There’s no way for you to connect to anything. You have sheets, but they’re paper level, not strong enough. He was 200 pounds – it would never happen…The clothing they give you is a jump-in uniform…Could he have done it from the bed? No sir. There’s a steel frame, but you can’t move it. There’s no light fixture. There’s no bars. 

If this anonymous source is correct, the manner of Epstein’s death could not be suicide by hanging. So was it homicide?

Attorney General William Barr is reportedly “appalled” at Epsetin’s death and has ordered an investigation by the FBI and the Department of Justice’s Inspector General. These steps are important given the stakes involved and the general distrust of government. Did MCC staff look the other way while Epstein was taken out? Is our government complicit in murder?

Beyond Barr’s announcement, by far the most reassuring development thus far is today’s report that Epstein’s representatives have hired forensic pathologist Michael Baden, M.D., to observe Epstein’s autopsy by the New York Medical Examiner’s Office and to re-autopsy the body.  Dr. Baden is the former Chief Medical Examiner for the City of New York and past Director of the New York State Police Medico-Legal Investigations Unit.

Over the years, as both a prosecutor and in private law practice, I have been privileged to work cases with Dr. Baden. He is meticulous, clear-thinking, amiably brilliant and brings a wealth of experience gained by performing over 20,000 autopsies over 50 years. He is, in my humble estimation, the world’s leading forensic pathologist and a man of absolute integrity.

Years ago, as an Assistant District Attorney in Philadelphia, I was tasked with investigating the death of a young man which happened while he was in police custody. He had been arrested for driving under the influence and placed in a cell at one of the police districts. Following standard procedure, his belt and shoe laces were taken from him. But, later that evening, he was found dead from asphyxiation. He was on his knees with his tee shirt wrapped around his neck and tied to a cross bar of the cell which was three feet from the floor. In this position, with his body weight fully supported by the cell floor, he had leaned into the tee shirt noose and asphyxiated himself.

The decedent’s family believed that he had been killed by the police. Quite understandably they could not believe that their loved one had been able to hang himself in the manner described and did not trust either the Philadelphia Police, the District Attorney’s Office or the Philadelphia Medical Examiner’s Office to do an honest investigation. To alleviate their concerns and to get a fresh set of eyes on the matter, I asked Michael Baden to analyze the case.

I had previously worked a murder case with Dr. Baden in which he had performed brilliantly and hoped that he would be able sort out this unusual situation. Ultimately, Dr. Baden confirmed the finding of suicide. And, in the process and not for the last time, he taught me how an experienced forensic pathologist can determine not just the cause of death (in that case asphyxiation) but the manner of death (suicide).

Part of that determination involves developing a psychological profile of the decedent. What kind of person was he? Was he depressed? Had he previously exhibited self-destructive ideation or tendencies? Was he experiencing stress? And so on.

What I learned from Dr. Baden in that case has direct application to the mysterious death of Jeffrey Epstein. While we don’t yet have all of the facts, let’s take a look at what has been reported about Epstein’s state of mind.

According to media reports, Epstein was reportedly in good spirits just before he died. This could cut either way. It is not uncommon for persons contemplating suicide to become calm, contented  and seemingly happy once they have made a firm decision to end their anguish by killing themselves. Or it could well be that Epstein was in a hopeful, non-self-destructive state of mind as the decision denying him pre-trial release was being appealed. Certainly he was in serious legal jeopardy, but he had been in that kind of difficulty before and had enormous resources to fight the charges.

Was Epstein too narcicisstic and in love with himself to commit suicide? Certainly that needs to be investigated, but the answer to that question while helpful would hardly provide a definitive resolution as to the manner of death.

But there is a more promising and seemingly more concrete body of evidence which offers insight into Epstein’s psychological profile and possible motive.

According to the New York Post, court documents released the day before his death disclosed that Epstein “had an insatiable sexual appetite” and “required three orgasms a day”. If true, then how would Epstein go about indulging his sexual urges while in jail? One likely way would be autoerotic asphyxiation, a practice by which an individual intentionally restricts the flow of oxygen to the brain for the purposes of sexual arousal. The Diagnostic and Statistical Manual of the American Psychiatric Association  classifies this activity as a paraphilia or sexual perversion which is known to heighten masturbatory sensations.  As described by researchers, depriving the brain of oxygen induces a lucid, semi-hallucinogenic state of hypoxia which, combined with orgasm, has been found to be highly addictive and no less powerful than cocaine.

Moreover, forensic pathology texts are replete with examples of individuals who intentionally induced hypoxia for sexual gratification and ended up accidentally killing themselves.  The ground breaking Legal Medicine and Toxicology by Gonzales, Vance and Halpern, published in 1937, states that a person can hang himself “by merely bending his knees in a standing position with his feet still resting on the ground. A person can hang himself in a sitting posture or while reclining in the supine or prone position. Apparently consciousness is lost so rapidly that the individual cannot free himself, even when it seems ridiculously easy.”

Just as the manner of death can be homicide or suicide, it can also be unintentional or accidental. So consider the following.

It is entirely possible that Epstein, in seeking a powerful orgasm, wrapped his neck in his prison jumper, tied the noose  to his metal bed frame and used this to restrict the flow of oxygen to his brain while sitting on the floor of his cell. Quite possibly he had done this before as in the time he was taken to the hospital with injuries to his neck. Only this last time, as he was pleasuring himself in his hypoxic state,  he could have quickly lost consciousness and accidentally caused his own death.

Since we don’t have all of the facts, this analysis is most certainly speculative. But, in light of the ample evidence of Epstein’s reputedly voracious and deranged sexual obsessions, this accidental manner of death should be given serious consideration by the FBI and Inspector General as they investigate his death.

George Parry is a former federal and state prosecutor. He is a regular contributor to the Philadelphia Inquirer and The American Spectator. He may be reached by email at kignet1@gmail.com.