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According to Naeve, forensic medicine also deals with medical topics concerning accidents associated with watercrafts. This field is not limited to the open sea but also refers to rivers and lakes. In the presented study, fatal boating accidents were investigated over a period of four decades. The majority of the victims died from hypothermia and drowning. The article points out the difficulty to prove hypothermia in cases with a short survival time. Medical expert opinions on deaths due to boating accidents must not ignore the results of the technical and nautical investigations--the more so as the hydrometeorological situation may be crucial for the outcome. Too little attention is still paid to circulatory shock occurring in connection with the pathophysiology of hypothermia and drowning, although it may have a decisive influence on the effectiveness of rescue measures. The final assessment of fatalities in users of watercrafts should always be left to experienced specialists.

Deaths on the water are common in the autopsy material of medicolegal institutes situated on the coast or big rivers and lakes (illustrated by the example of the Institute of Legal Medicine of Greifswald University). They mostly occur during recreational boating activities. Apart from hydro-meteorological influences, human error is the main cause of accidents. Often it is not sufficiently kept in mind whether the boat crew is fit for sailing and proper seamanship is ensured. Drowning (following initial hypothermia) is the most frequent cause of death. Medicolegal aspects are not decisive for ordering a forensic autopsy. As statistics are not compiled in a uniform way, a comparison of the data of different institutions engaged in investigating deaths at sea and during water sports activities is hardly possible, neither on a national nor an international basis--and the reconstruction of aquatic accidents is generally difficult. Fatal accidents can only be prevented by completely clarifying their causes.