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1. What Is Forensic Medicine?

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1. What Is Forensic Medicine? FOREWORD The main objectives of Practising in Forensic Medicine, a brief textbook, are to optimize the practical learning of foreign students and to compilate medico-legal practice of most countries according to these law. The textbook contains original illustrations which reflect the everyday activities at the Institute of Forensic Medicine, Faculty of Medicine of the P. J. afárik University at Koice, Slovakia. Autors. FRANTIEK LONGAUER, Assoc. Prof., MD, PhD, Head of the Institute of Forensic Medicine, Faculty of Medicine of the P. J. afárik University at Koice, Slovakia. NIKITA BOBROV, MD, PhD, Assistant Professor of the Institute of Forensic Medicine, Faculty of Medicine of the P. J. afárik University at Koice, Slovakia. PETER LÁBAJ, MD, medico-legal expert of the Institute of Forensic Medicine, Louis Pasteur University Hospital at Koice, Slovakia. PDF created with FinePrint pdfFactory trial version http://www.fineprint.com CONTENTS 1. WHAT IS FORENSIC MEDICINE?................................................................................................................ 3 2. MEDICO-LEGAL SYSTEMS. THE STRUCTURE OF A DEPARTMENT OF FORENSIC MEDICINE.. 5 3. MEDICAL ASPECTS OF DEATH.................................................................................................................. 8 4. CHANGES AFTER DEATH.......................................................................................................................... 11 5. IDENTIFICATION......................................................................................................................................... 16 6. EXTERNAL AND INTERNAL EXAMINATION OF THE DEAD BODY. EXHUMATION. .................. 20 7. BLOOD STAINS, GROUPS, DNA AND IDENTIFICATION..................................................................... 23 8. THE EXAMINATION OF WOUNDS........................................................................................................... 26 9. EFFECTS OF INJURY................................................................................................................................... 31 10. REGIONAL INJURIES.................................................................................................................................. 35 11. FIREARM AND EXPLOSIVE INJURIES .................................................................................................... 39 12. MURDER, SUICIDE OR ACCIDENT? ........................................................................................................ 46 13. TRANSPORTATION INJURIES................................................................................................................... 49 14. ASPHYXIA AND PRESSURE ON THE NECK AND CHEST ................................................................... 54 15. IMMERSION AND DROWNING................................................................................................................. 57 16. INJURY DUE TO HEAT, COLD AND ELECTRICITY.............................................................................. 59 17. SUDDEN AND UNEXPECTED DEATH FROM NATURAL CASES....................................................... 63 18. MEDICO-LEGAL ASPECTS OF PREGNANCY AND ABORTION.......................................................... 65 19. DEATH AND INJURY IN INFANCY .......................................................................................................... 68 20. SEXUAL OFFENCES.................................................................................................................................... 72 21. FORENSIC HISTOPATHOLOGY ................................................................................................................ 74 22. MEDICAL MALPRACTICE ......................................................................................................................... 76 23. GENERAL ASPECTS OF POISONING ....................................................................................................... 78 24. MEDICO-LEGAL ASPECTS OF ALCOHOL ABUSING............................................................................ 82 25. DRUGS OF DEPENDENCE AND ABUSE.................................................................................................. 87 26. THE DOCTOR AND THE LAW................................................................................................................... 90 REFERENCES ..................................................................................................................................................... 92 GLOSSARY ......................................................................................................................................................... 93 PDF created with FinePrint pdfFactory trial version http://www.fineprint.com 1. WHAT IS FORENSIC MEDICINE? þ Forensic medicine (synonym: legal medicine) is a fundamental and independent part of medicine dealing with the interaction of medical science and practice with the law. The practice of using the terms "forensic medicine" and "medical jurisprudence" ha s led to considerable confusion as to their correct meaning. These definitions are closely related but somewhat different: Ø Medical jurisprudence is that part of law which is concerned with the regulations governing the professional practice of the doctor of medicine. Ø Forensic (or legal) medicine is that part of medical science which is employed by the legal authorities for the solution of legal problems. Theoretically all branches of medicine may be included in this definition and any doctor who te stifies in court in his professional capacity can be considered a practitioner of forensic medicine. But the term is us u- ally restricted to that specialized branch of medical knowledge used by physicians officially employed by the local government of a community when they investigate suspicious and violent deaths, or non-fatal cases such as rapes, sexual offenses or abortions which may subsequently come before the courts. The word "forensic" means "situated on forum romanum". Historically this famous market-place of an- cient Roma played an important part in law and administrative activities that time. Forensic medicine provides a tight connection between medical science and the law. Medical science can assist the administration of justice in: Ø civil matters Ø criminal matters. Forensic medicine is dealing with living and dead people, in order to solve these problems: w examination and evaluation of injury (disease) w effects of injury (disease) w cause of death w identification of living and dead w paternity w pregnancy and abortion w medical malpractice etc. Branches of medicine which assist in medico-legal problems are: anatomy, histology, pathology, dentistry, physiology, biochemistry, pharmacology, traumatology, resuscitation, haematology, genetics, microbiology, obstetrics, paediatrics, psychiatry, sexuology etc. Forensic medicine borrows methods of investigation from various natural and other sciences: anthropo- logy, biomechanics, analytical chemistry, entomology, criminology etc. Forensic medicine has its own branches: traffic medicine, alcohology, forensic thanatology, forensic toxi- cology, forensic genetics, forensic anthropology etc. (see tab. 1). Forensic medicine participates in prevention of negative social phenomena: Ü criminal violence towards health and life Ü traffic and working accidents Ü chronic alcoholism Ü drug abuse Ü suicides etc. The main tasks of forensic medicine 1. Autopsies in cases of: Ø violent deaths Ø sudden and unexpected deaths Ø "mors in tabula" Ø deaths caused by medical malpractice Ø exhumation. PDF created with FinePrint pdfFactory trial version http://www.fineprint.com 2. Clinical seminars and case analyses (regularly with the Departments of Traumatology, Neurosurgery, Intensive Medicine, Emergency Medicine). 3. Medical reports and statements, expert opinions. 4. Forensic toxicology and drug analysis (living and dead persons). 5. Forensic serology, haematology and genetics (examination of blood and other biological materials and DNA profiling for identification). 6. Forensic alcohology (the measurement of alcohol in blood, urine and other biological fluids). 7. Forensic anthropology (identification of decomposed or skeletalized human remains by anthropological methods). 8. The presence at the scene of crime. 9. Participation in mass disasters. 10. Investigation of living persons (examination of wounding, injury and trauma, pregnancy and abortion, sexual offences, abuse of alcohol and drugs of dependence etc.) 11. Pregradual and postgradual education. 12. Scientific research. Traffic medicine Alcohology Forensic thanatology Anatomy Forensic toxicology Histology Forensic genetics Pathology Forensic anthropology Dentistry Physiology Anthropology Biochemistry branches Pharmacology Biomechanics Traumatology Analytical FORENSIC MEDICINE Resuscitation chemistry Haematology problems Genetics Entomology Microbiology Criminology Virology Examination and evaluation of injury Parasitology (disease) Obstetrics Effects of injury (disease) Paediatrics Cause of death Identification of living and dead Psychiatry Paternity Pregnancy and abortion Medical malpractice Tab. 1. Relations between forensic medicine and other sciences. 1. What is forensic medicine? 2. What problems concerning living and dead people solves forensic medicine? 3. What are the main tasks of forensic medicine? Practical task: Visit the library of the Institute of Forensic Medicine,
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