Letter correspondence regarding article “Studying asphyxiation in the lab: the role of experimental evidence in cause-of-death inquiry”

Abstract

Positional • Restraint • Asphyxia Dear Editors,We read with interest the article "Studying asphyxiation in the lab: the role of experimental evidence in cause-of-death inquiry" by Fischer and Jukola (Fischer & Jukola, 2026) recently published in the journal History and Philosophy of the Life Sciences.The authors unfortunately made a number of erroneous claims regarding the investigative studies conducted by our research group (as well as others) and we appreciate the opportunity to respond and provide a better understanding and history of the research on positional and restraint asphyxia.Fischer and Jukola attempt to argue that experimental evidence can identify "potential causes" but not "actual causes" of death (or exclude as such) in these cases citing the study by Reay in 1988 as the earliest experimental study suggesting asphyxia as a potential cause based on purported impacts on peripheral oxygenation saturation and heart rate of the prone maximal restraint position (PRMP) in test subjects (Reay et al., 1988).This study had a number of methodological issues including lack of randomization, inadequate measurement of oxygen levels, and statistical errors that led to questions regarding its validity.The authors then cite our study in 1996 in which we conducted specific respiratory measurements including pulmonary function testing as well as arterial blood oxygen and carbon dioxide (CO 2 ) measurements that did not find any impact on oxygenation and CO 2 levels-a sine qua non for asphyxiation risk (Chan et al.,

The authors' abstract, as published at the source. History & Philosophy of the Life Sciences, 2026 · DOI ↗