From “Hard Object” to “Bullet”: When a Medical Term Becomes the Basis for a Narrative

From “Hard Object” to “Bullet”: When a Medical Term Becomes the Basis for a Narrative

“Impact from a hard object.”

“High-velocity projectile.”

“Bleeding caused by impact from a hard object.”

“Bullet impact.”

“Firearm bullet.”

These words caught my attention after I had read dozens of forensic reports, opinions, death certificates and burial permits, and, in particular, accounts from the families of people killed during the protests. Similar phrases appeared again and again; but what mattered more than the words themselves was the narrative that was sometimes subsequently built on the basis of just a few words.

This article is not an accusation against forensic doctors. The question is: what exactly do these terms establish, what do they not establish, and how might the gap between the two create room for an official narrative to be constructed?

From observing the body to determining the ultimate cause of death

A forensic report does not begin with its final conclusion. The doctor first records what they observe: the body’s identifying details, its external condition, clothing, old marks, post-mortem changes, and then the location, shape and characteristics of the injuries.

An autopsy is carried out where necessary; internal organs, fractures, bleeding and the path of the injury are examined, and samples are sent for toxicology, histology or other tests.

In projectile injuries, too, the matter is not simply a question of observing a hole. The characteristics of the entry and exit wounds, the projectile’s path, damage to organs and other signs are examined; where necessary, a firearms and ammunition assessment is also added.

There is therefore a difference between “describing an injury” and reaching a “final conclusion about the ultimate cause of death”.

And it is at the very end of this process that a few words take on importance.

What does “hard object” prove?

Suppose the report says:

“Brain haemorrhage caused by impact from a hard object to the head.”

This statement may be entirely correct from a medical point of view. But what is a “hard object”?

A stone? A baton? A piece of metal? A wall? Tarmac? Or the head hitting the ground during a fall?

The phrase itself does not answer that question.

The same is true of “high-velocity projectile”. A projectile is not necessarily a bullet. Yet some forensic reports explicitly say “bullet”, “shotgun pellet” or “firearm bullet”.

These terms are therefore not interchangeable. The more precise the diagnosis, the narrower the range of possibilities—and consequently the scope for interpretation.

When a medical term enters the official narrative

In Nika Shakarami’s case, the cause of death on the burial permit was recorded as “multiple injuries caused by impact from a hard object”. A judicial official later said that her death was not caused by “beating or gunfire” and put forward a version involving a fall. Her family rejected that account. But the phrase “hard object” on its own proves neither a fall nor an assault.

In Sarina Esmailzadeh’s case, the burial permit referred to “shock caused by a blow”, fractures and bleeding, and “impact from a hard object (fall from a height)”; judicial authorities declared her death a suicide resulting from a fall—a version that was also the subject of serious disagreement.

In Aida Rostami’s case, the forensic authorities attributed her death to “brain injuries and fracture of the skull following impact from a hard object”. Her family initially heard the account of an “accident” from the police, while the judiciary’s media outlet later published a version involving suicide and a fall from a footbridge. A single medical phrase was accompanied in the public arena by different accounts.

Mahsa Amini’s case is different. Here, the Forensic Medicine Organisation did not use only a general phrase; it presented a medical sequence: a history of surgery and underlying disorders, loss of consciousness, disruption of heart rhythm and blood pressure, cerebral hypoxia and, ultimately, multiple organ failure. It explicitly stated that her death was not caused by blows to the head or vital organs. Her family and some doctors disagreed with this conclusion. This case shows that sometimes the forensic opinion itself—not merely an ambiguous term—becomes the central point of dispute over the account of a death.

These examples raise a shared question:

Which part has forensic medicine established, and which part has been added to the medical findings afterwards?

The advantage of ambiguity for a narrative

This is where the main point of this article becomes clear.

There is no need to alter a forensic report in order to construct a narrative. Sometimes it is enough to draw more from a medical phrase than it actually says.

“Hard object” may be consistent with a fall; but on its own, it does not prove that a fall occurred.

A “high-velocity projectile” may or may not be a bullet; but the mere absence of the word “bullet” does not, on its own, prove that no firearm was involved.

As a result, the more general the final wording, the more room remains for interpretation. In a disputed death, that empty space can be filled with an account of an accident, a fall, suicide, or a cause unrelated to the protests.

This is precisely where we must distinguish between a forensic report and the government’s use of that report.

Responsibility for the Final Line

Under the law, the Iranian Legal Medicine Organisation operates under the supervision of the Head of the Judiciary. Its legal duties are to provide expert opinions, conduct autopsies, and carry out medical and laboratory examinations at the request of judicial authorities. This institutional dependence makes the physician’s scientific independence and precision in choosing words all the more important.

This does not mean accusing forensic doctors. On the contrary, a doctor should not write anything that science cannot establish.

But if the findings allow for a more precise diagnosis, using a broader term may have consequences that extend far beyond the autopsy room.

Doctors, including forensic doctors, are bound not only by legal responsibilities but also by the principles of science and medical ethics. The Iranian Medical Council’s professional ethics guidelines also regard the Hippocratic Oath as a permanent commitment.

In cases that may be re-examined years later, a few words written today can become tomorrow’s evidence.

Forensic medicine is not there to identify the killer; but it must record the most precise finding that medical science allows.

Because if a gap remains between what the body has shown and what is written in the final line, others can fill that gap with their own account.

And perhaps this is the central question:

When these cases are reopened years from now, will the final line of the death certificate be defensible only in administrative terms, or also in terms of medical science and professional conscience?