Femicide as the extreme expression of violence against women: medico-legal definition, forensic evidence and prevention perspectives from an Italian nationwide study

Objective: Femicide represents the most extreme expression of violence against women. This article aims to frame femicide through a shared medico-legal definition and to illustrate its distinctive forensic characteristics, highlighting their relevance for prevention, while also addressing the convergence between forensic evidence and the recent legal recognition of femicide in Italy. Methods: The paper integrates conceptual analysis with empirical evidence derived from a nationwide forensic case-series conducted in Italy, involving 27 university Institutes of Forensic Medicine. Femicide cases were identified according to a shared medico-legal definition grounded in the violation of the victim's right to self-determination. Circumstantial, relational, and lesional patterns were systematically analyzed and interpreted within an interdisciplinary framework. Results: Femicide emerged as a distinct form of female homicide, predominantly occurring in intimate or domestic contexts and characterized by recurrent forensic features, including overkillng, involvement of identity-related body areas such as the face and erogenous zones, and the use of multiple or combined methods of attack. These patterns were significantly less frequent in other female homicides and challenge narratives centered on psychopathology of the perpetrator. Discussion and conclusions: Findings support the recognition of femicide as a specific and identifiable phenomenon rooted in the denial of women's self-determination. The medico-legal approach provides objective elements that not only facilitate post hoc classification but also offer valuable insights for risk assessment and prevention. Knowledge, shared definitions, and awareness are essential tools to recognize violence early and to prevent its lethal escalation.