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(CNN) - Strangling someone is seen by medical experts and victim advocates as a predictor of more serious violence, including homicide. While almost all states in the United States consider drowning someone a serious crime, some jurisdictions still treat it as a misdemeanor.
Several bills recently proposed by lawmakers in Maryland, Washington and Ohio could change that.
In Maryland, a bipartisan group of legislators presented bills in the House of Representatives and the Senate last week that would make it intentionally suffocate or strangle someone to be punishable by up to 25 years in prison.
- Police accused of strangulation and aggression after violent arrest
In Washington, Mayor Muriel Bowser proposed a bill to the Council in December that would make strangulation that does not end in death a serious crime, with an increase in sanctions if the victim was seriously injured or if the author was subject to freedom conditional.
And in Ohio, state Senate lawmakers introduced a bill last year that would broaden the definition of domestic violence to include strangulation, making it a serious crime.
"We owe each victim and survivor of domestic violence to strengthen our laws to improve their safety and protection," Bowser said in a press release. "By enacting this legislation, the district will be better able to hold criminals accountable and provide a sense of security to those who most need these protections."
Strangling is a misdemeanor in some states
Strangling is typically prosecuted as a misdemeanor in those jurisdictions. Although it is one of the deadliest forms of domestic violence, some state policies have overlooked strangulation because it does not always produce visible signs of assault, according to the Training Institute on Strangulation Prevention.
Under current Maryland law, a person who strangles another person can be charged with a first-degree crime, defined as causing serious physical injury, but the charges can also be reduced to second-degree assault, a misdemeanor.
Washington law treats it as a misdemeanor of simple assault, unless the attack has caused serious injury or an object has been used to strangle the victim.
Current Ohio law treats strangulation as a misdemeanor of domestic violence.
Along with Maryland, Washington and Ohio, South Carolina is the only other jurisdiction that does not specifically treat strangulation as a felony.
- Suspected of killing his wife said he did after seeing her strangle a daughter
Strangulation is a risk factor for other violence
Symptoms of strangulation may include a sore throat, difficulty swallowing, bruising, fainting or loss of consciousness. But even in the most serious cases, victims may not have visible injuries.
A 2008 study published in the Journal of Emergency Medicine found that strangulation was a significant risk factor for future lethal violence. Investigators found that women who experienced nonfatal strangulation by an intimate partner were six times more likely to be victims of an attempted murder and seven times more likely to be killed.
A study published by the National Institute of Justice in 2003 found that women who had been strangled by their partners were 10 times more likely to be killed by them.