Understand that a medical examiner only testifies to medical probabilities, i.e., that such and such a wound is consistent with a self-inflected injury because of whatever facts support that opinion.
The human body has a certain range of motion. For example, you can't touch your elbow with the fingers of that hand. Using that knowledge about range of motion, a medical examiner can identify what injuries someone can inflect on themselves. Further, using their knowledge of range of motion, they can identify wounds that are inconsistent with the probable position of an attacker. For example, although it is possible, it's harder for an attacker to place a knife and cut the inside of the wrist (it's doable, but not easily).
However, people are creative. Tell someone it's impossible to stab yourself in the back, and someone will figure out how to do it. And if you're an attacker, especially with some level of knowledge, you can make sure the indications show the injury is self-inflected.
As a result, the medical examiner is limited to discussing probabilities. Some suicides are actually murders and some murders are actually suicide. Whoops. If you're a medical examiner, you just hope it doesn't happen to you.
Best of luck,
Jim Clark-Dawe