The rope looks like it is around his chin and not the neck. His hair looks a little funny too, maybe try using the clone tool to fill in the missing spot. Oh and a high res would be great...I will hold my vote for now...Best of Luck

something tells me that the lighting fixture would just fall out. He also looks like he could stand up still. How did he get up there anyway? Need to make it a little more convincing.

It absolutly doesn`t make real ! and to be honest i think it`s not a good idea to put this kind of pics even if the message can be usefull.....

Good advice....
why do you put people who were sleeping?
it will be more obvious if the person is in an upright position

While I do see what you are trying to do here, you have to remember that there might be someone who will see this picture who could have lost a family member in that way. Just an observation.

I have to agree with the above comments ... in addition perhaps it is a little bit of the "most obvious use of the source". A bit of a cop out, perhaps? ... IMO