Legal history of prosecution and mortality stats
If a person is found to have died of auto-erotic asphyxiation, it may be ruled a suicide instead of an accident. It may also be considered a self-inflicted injury if a person manages to survive but is harmed. Therefore, a person should be aware that it will most likely invalidate their health insurance and life insurance.
I have to do better research in this area. I am currently aware that some people have had to face criminal prosecution or mandatory counseling because of their participation in consensual breath control. If you are caught in the act or are turned in as someone attempting suicide, most states can involuntarily commit you for a short time or force you into counseling. If you are involved in this play with a partner and something goes wrong, you could face charges involving manslaughter, murder, or criminal negligence. If your partner is injured or is angry at you, they may decide to sue you or take you to court for attempted murder, assault, domestic violence, or other charges. It is very important to be involved with someone that you trust with your life and reputation.
I have heard it suggested that people involved in partnered play write out some form of contract showing that they were involved in a consensual arrangement. It is a nice idea, but parties cannot make a legal contract about an illegal activity. There would also be a very strong chance that even if one could prove the legality of such a contract that it would be dismissed out of suspicion of coercion.
That said, it may be a very good thing to show a jury something that backs up your statement that you were involved in a consensual situation. Just do not have a false sense of safety with a “contract.”
It is estimated that 1 person per million people in a population will die of erotic asphyxiation. Law enforcement has at times stated that they believe it to be much more like 4 people per million people in population but I would hesitate to put that statistic forward. I have read a bit about how forensic scientists and law enforcement decide that a death is erotic asphyxiation and most of the time it does make sense. They base it on obvious bodily signs of lack of oxygen like burst capillaries in the eyes and on the face of the victim to be sure they died of asphyxiation. They tend to put it in the “erotic” or “auto-erotic” category if they find pornography, open clothing, BDSM gear in the person’s home, or some sign that perhaps the victim was attempting not to die from what they were doing (such as a noose that was padded). Some of these may be very good indicators, but I think it is very likely that they may include people who are murdered and then made to appear to have died of auto-erotic asphyxiation. They may also include suicides of people that were simply into BDSM. I also must admit that it is quite possible that those discovered by family or who die during breath control with a partner may have the scene “sanitized” before law enforcement or forensic experts see what has happened. I would think that they would figure out that asphyxiation is the cause but they may think it is something like positional asphyxia or sleep apnea if the scene is properly sanitized and the form of asphyxiation was subtle enough.
I wish I could offer what percentage of people that practice breath control play experience injury or death but there is simply no available data on even how many people practice this form of play. I can say that most of the people to die of erotic asphyxiation are people who are solo players. This is something that is exceptionally dangerous to do alone. Most of those who have died are using bags over their heads (held there by rubber bands or such), nooses around their necks, complicated machines that are difficult to turn off, or other such devices that do not allow for the possibility of the person passing out or becoming somewhat disoriented and surviving.