Cyber-assisted Homicide at the Medical–domestic Interface: Digital Interference, Forensic Indicators, and Investigative Implications

Abstract Digital transformation has moved healthcare far beyond traditional hospital settings into homes through connected medical devices, remote patient monitoring systems, implantable technologies, and smart-home integrated care environments. While these innovations improve accessibility and continuity of care, they also introduce new vulnerabilities in which cyber interference may influence treatment delivery, monitoring accuracy, clinical decision-making, and ultimately patient survival. Current medicolegal death investigation systems remain largely focused on conventional pathology, toxicology, and physical scene interpretation, creating a potential gap in recognizing deaths that may involve digitally mediated harm. This narrative review synthesizes evidence from forensic medicine, digital forensics, healthcare cybersecurity, patient safety literature, and regulatory safety communications to explore the plausibility and forensic implications of cyber-assisted homicide at the medical–domestic interface. Although confirmed peer-reviewed forensic case reports directly attributing homicide to malicious cyber manipulation remain exceedingly rare, multiple converging lines of evidence demonstrate realistic pathways through which lethal outcomes could occur. Healthcare cyber incidents have shown that digital disruption can delay treatment, corrupt clinical data, disable monitoring systems, or alter device functionality. Regulatory agencies have also documented vulnerabilities in medical devices capable of unauthorized access or manipulation. In parallel, digital forensic research has established the recoverability of evidentiary artifacts from smart-home ecosystems, voice assistants, and implantable cardiac devices, which may assist postmortem reconstruction. Collectively, these findings support the need for a forensic framework that recognizes suspicious deaths involving connected care technologies as potentially digitally mediated. Incorporating cyber-forensic expertise, digital evidence preservation, and targeted investigative red flags into medicolegal practice may reduce misclassification and strengthen accountability and prevention efforts.