ANALYSIS AND COMMENTARY The History of Legal

Cyril H. Wecht, MD, JD

J Am Acad Psychiatry 33:245–51, 2005

Before discussing legal medicine and forensic sci- pensation to cutting off the surgeon’s hand. Fees also ence, it would be helpful to have a general definition were fixed. The Code discussed various diseases of a of terms. is a broader term than legal slave that would invalidate a contract. Also included medicine. The former actually encompasses the lat- were references to incest, adultery, and rape. ter. The term “forensic” is used as an adjective to In ancient Egypt, the acts of the medical man were identify a growing group of subspecialties in science circumscribed by law. Stab wounds were differenti- and medicine, all of which convey the fundamental ated in the 17th century B.C. The Egyptians had a concepts of methods, hopefully both scientifically thorough knowledge of poisons. There is evidence valid and legally admissible, for the presentation of that priests made determinations regarding the cause 1 evidence in courts of law. Legal medicine is consid- of and whether it was natural or not.6 ered to be the field of study and accumulation of The Chinese published information about poi- materials that deals with the application of medical sons, including arsenic and opium 3000 years B.C. 2 knowledge to the administration of justice. For the In ancient Persia, wounds were put into one of seven purposes of this article, forensic medicine should be classes, ranging from simple to mortal. In ancient 3 considered synonymous with legal medicine. Greece, there was a knowledge of poisons and Medicine and law have been related from the ear- against abortions. However, autopsies were not per- liest times. The bonds that first united them were formed, since a dead body was regarded as sacred.7 religion, superstition, and . The functions of In Rome 600 years B.C., a law was passed requir- the physician and the jurist were united in the priest, ing that a woman who died in confinement should be the intermediary between God and man. In early immediately “opened” to save the child. The inves- civilizations, primitive legal codes, religious doc- tigators of murder were selected from the citizenry. trines, and social precepts were often ill distin- When Julius Caesar was assassinated in 44 B.C. guished, and laws with a medical content were often 4 (March 15), the physician Antistius examined his found within their context. Ecclesiastical courts and body and concluded that only one of the 23 stab canon law were concerned with much that related wounds was mortal.8 not only to religious matters but also to medicine— The legal code in ancient Greece (about 460 B.C.) for example, impotence, divorce, sterility, preg- was very elaborate. In addition, it was a time of great nancy, abortion, period of gestation, and sexual de- advances in medicine. Though there is no clear evi- viations. The oldest of these written records, the dence that medical knowledge was officially made Code of Hammurabi, includes legislation pertaining use of in establishing proof in courts of law, it is to the practice of medicine, dating back to the year 5 known that Hippocrates and others discussed many 2200 B.C. It covered the topic of medical malprac- tice and set out for the first time the concept of civil genuine medicolegal questions. These questions in- and criminal liability for improper and negligent cluded the relative fatality of wounds in different medical care. Penalties ranged from monetary com- parts of the body, the average duration of pregnancy, the viability of children born before full term, and Dr. Wecht is Coroner of Allegheny County, Pittsburgh, PA, and is in other matters. Moving across the Mediterranean, private practice at Cyril H. Wecht and Associates, Pitts- there is in existence a papyrus, found in Egypt and burgh, PA. Address correspondence to: Cyril H. Wecht, MD, JD, Office of the Coroner, Allegheny County, 542 Fourth Avenue, Pitts- dated from pre-Christian times, in which a medical burgh, PA 15219. E-mail: [email protected] officer in Alexandria submitted a report on a suicide

Volume 33, Number 2, 2005 245 History of Legal Medicine about which there had been some suspicion of start on a forward march again until after the French murder.5 Revolution in the next century.9 The Justinian Code, which made its appearance in Meanwhile, in Italy, a physician named Fortunato Rome between 529 and 564 A.D., included within Fedele published in 1602 a fairly comprehensive vol- its provisions a precept that indicated that a medical ume on forensic medicine entitled, De Relationes expert would not be used to proper or greatest advan- Medicorum. Another Italian, Paola Zacchia, a papal tage if he were to be simply regarded as an ordinary physician, published the huge Questiones Medicina- witness, appearing for one side or the other. The Legales, which quickly overshadowed Fedele’s work. Code, with much wisdom, stated that the function of Zacchia’s book discussed in detail questions of age, such an expert was really to assist the judiciary by legitimacy, pregnancy, death during delivery, resem- impartial interpretation and opinion, based on his blance of children to their parents, dementia, poison- specialized knowledge.5 ing, impotence, feigned diseases, miracles, rape, mu- There was also the recognition of medicolegal tilation, and the matters concerning public health. problems in the Far East. In China, in approximately The work has deficiencies that can easily be explained 1236 A.D., a volume entitled the Hsi Yuan Lu (freely by the era in which it was written; for instance, the translated, Washing Away of Wrongs) was compiled knowledge of and was sketchy that outlined procedures to be followed in investigat- and erroneous. The book also contains sections on ing suspicious . The book urged the medical the different methods of torture then in existence, examiner to make a thorough and systematic exami- and it has a section that deals with miracles. Despite nation of every corpse, however unpleasant its con- these shortcomings, it was a worthwhile and influen- dition. The book discussed the difficulties caused by tial volume.10 decomposition and even advised the examiner about Legal medicine was not treated as being just a the- the problems associated with counterfeit wounds. oretical pursuit. It was eventually brought into the Sections were devoted to wounds caused by blows courtroom. For example, in 1667 Schwammer- from fists or from kicking and to deaths caused by damm, in Germany, claimed that the lungs of a new- strangulation or drowning. Means for distinguishing born baby would float in water if the baby had actu- between the bodies of drowned persons and those ally breathed. That is, if it was not stillborn and had thrown into the water after death were discussed, as lived and subsequently died, either by natural causes were the distinctions between ante- and postmortem or by homicide. In 1681, the German physician burning. The examiner was also cautioned that noth- Schreger used this test forensically, and secured the ing in the inquest should be regarded as being unim- acquittal of a girl who had been accused of murdering portant. Considering its era, this volume was amaz- her illegitimate child.6 5 ingly thorough. Legal medicine began to be promoted within for- mal educational circles. In 1650, Michiaelis, in Ger- European Legal Medicine many, delivered lectures on legal medicine. By 1720, In 1553 the Germanic Emperor, Charles V, pub- professorships concerning the subject were founded lished and proclaimed the Caroline Code, which by the state. Germany, in fact, established the first clearly stated in its pertinent sections that expert known medicolegal clinic in Vienna in about 1830 medical testimony must be obtained for the guidance and a second one in Berlin in 1833. France estab- of the judges in cases of murder, wounding, poison- lished its first clinic in 1840. France has also pro- ing, hanging, drowning, infanticide, and abortion vided, since 1803, that judges appoint medical ex- and in other circumstances involving injury to the perts who must be graduates in medicine and must person.8 have attended a course (in earlier days this require- France also had an early start among European ment was fulfilled by going to one or more lectures) nations in the cultivation of a medicolegal system. and have passed an examination in legal medicine. From 1570 to 1692, France enacted laws that, like France established its first professional Chair in Legal those of Germany, favored the development of legal Medicine in 1794. Great Britain, in 1803, estab- medicine as an academic discipline. However, by lished its first Chair of Forensic Medicine at the Uni- 1690, medicolegal offices became corrupt, and versity of Edinburgh. By 1876, there were chairs in progress in legal medicine actually regressed, not to all of its medical schools.9

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These academic recognitions should not lead one of murder, the corpse had to be examined, and a to believe that legal medicine had entered into a thor- report made as to what had been found, the location oughly enlightened era. Its development was always of the injuries, and the likely mechanism that had academically turbulent and against the intellectual caused them.11 current of the times. For example, during the period In Italy, in 1249, Hugo de Lucca took his oath as from 1620 to 1720, a serious topic of conversation in a medicolegal expert. Medical reports from this time both medical and medicolegal circles was whether a show that autopsies were performed to determine the woman could be impregnated by the devil or in a cause of death. Pope Innocent III, in 1209, provided dream.9 In fact, in one case French judges actually for appointment of doctors to the courts for the de- legitimized an infant in a case in which the husband termination of wounds. In Germany, in 1507, a had been separated for four years from the mother, comprehensive penal code was established that called on the grounds that the child owed its paternity to a for proof of cause in all violent deaths. It allowed the dream. Until 1726, it was taught that in the presence opening of bodies and represented progress toward of the murderer, his victim’s wounds would “open the practice of medicolegal autopsies and the devel- their congeal’d mouths and bleed afresh.” Courts opment of legal medicine as a separate professional would accept the testimony of medical experts as to discipline. It became a subject for special instruction this miraculous bleeding of the corpse. Unearthed in the 17th century and, by the start of the 18th bones of animals would serve to convict men of mur- century, designated chairs in legal medicine were cre- der. The highest medicolegal authorities advocated ated in German universities. Around this time, the belief in ghosts, witches, and possession by the devil. earliest applications of medical observations de- They united with the clergy until 1752 in denounc- signed solely to aid justice were made. The hydro- ing all disbelievers in these precepts as heretics and static test to see whether a child had been born alive atheists. The authorities also recommended perse- was used in cases of suspected infanticide.11 cuting, drowning, and burning thousands of the in- The first book on legal medicine written in En- sane, since they were, after all, “firebrands of hell” glish was authored by Samuel Farr in 1788 and was who were “moved and seduced by instigation of the entitled Elements of , a succinct devil.” The going was not smooth, indeed.7 and compendious description of findings in the hu- In the 5th century, when the Germanic and Slavic man body that were required for judgment by coro- peoples took over Western Europe, they instituted a ners and courts of law in cases of divorce, rape, and system of indemnity to replace the primitive system murder, among others. The first British teacher of of personal vendetta. The person responsible for the legal medicine was Andrew Duncan, a professor of injury would pay an amount to the injured party or, physiology, who gave a course of lectures on legal in the case of death, to his relative. Since the payment medicine and public health, beginning in 1789. His varied with the severity of the wound, it was impor- son, Andrew Duncan, Jr, became the first professor tant to classify the wounds in the code and to be able on this subject at the University of Edinburgh, where to call on experts to testify as to the damages. In the the first Chair in Legal Medicine in the English- Visigothic and Bavarian Codes, mention is made of speaking world was established. Alfred Taylor injury to pregnant women, to the child in utero, poi- (1806–1880), Professor of Medical Jurisprudence at soning of prisoners, and penalties of negligent doc- Guy’s Hospital Medical School, wrote Principles and tors if the patient died.11 Practice of Medical Jurisprudence. The British Associ- Charlemagne attempted to give some unity to the ation in Forensic Medicine was established in 1950, and later the British Academy of Forensic Sciences laws of the empire. There was recognition of the 4 necessity of adducing all relevant evidence in judicial was created in 1960. cases. There were articles discussing the direct inter- vention of physicians and instructions to judges to American Developments seek all relevant medical evidence, especially in cases In the United States, the first lecturer on legal involving questions of wounds, infanticide, suicide, medicine was Dr. J. S. Stringham, who gave his lec- rape, bestiality, and divorce on the grounds of impo- tures in New York beginning at around 1804.12 In tence. The assizes of Jerusalem, in 1100, provided for 1813, the first Chair of Medical Jurisprudence was the courts to order medical examinations. In the case established by the College of Physicians and Sur-

Volume 33, Number 2, 2005 247 History of Legal Medicine geons of New York City and was filled by this same temporary cases for the purpose of teaching physi- Dr. Stringham. In 1815, the College of Physicians cians what to expect from malpractice litigation. Dr. and Surgeons of the Western District of New York John Odronaux, also a physician and an attorney, appointed Dr. T. R. Beck as the Professor of the published Jurisprudence of Medicine in 1867 and Ju- Institutes of Medicine and Lecturer on Medical Ju- dicial Aspects of Insanity in 1878. In 1894, Randolph risprudence.13 In the same year, the Medical Depart- A. Witthaus and Tracy C. Becker published Medical ment of Harvard University appointed Dr. Walter Jurisprudence, Forensic Medicine and .18 Channing as the Professor of Midwifery.14 For medical students and physicians, medical ju- Dr. Benjamin Rush is credited with emphasizing risprudence assumed the position of central impor- the significance of the relationship between law and tance in U.S. schools of medicine throughout most medicine in the early 1800s. As the nation’s first of the 1800s. During the course of the 19th century, surgeon general and a signatory of the Declaration of the institutions, laws, and judicial decisions in Amer- Independence, Rush established American legal ica reflected the increasing influence of sound medi- medicine with his published lecture “On the Study of colegal principles, especially those pertaining to Medical Jurisprudence,” which he delivered to med- mental disease and criminal lunacy. ical students at the University of Pennsylvania in After the Civil War, however, things changed Philadelphia in 1811. The lecture dealt with homi- drastically. Legal medicine became temporarily dor- cide, mental disease, and capital punishment.15 mant. American Professor and Dean Stanford Emer- The works of Stringham and Rush inspired the son Chaille expressed his view of the deplorable con- teaching of medical jurisprudence in other American dition of medical jurisprudence in the United States. medical schools. Among the early teachers were Dr. Chaille demonstrated how the teaching of medical Charles Caldwell in Philadelphia and Dr. Walter jurisprudence had deteriorated by noting that in Channing at Harvard. In 1819, Dr. Cooper, a legal some medical colleges the course had been dropped officer of distinction and president of the College of altogether.9 In others, it had been attached to some South Carolina, published Tracts on Medical Juris- other subject, and in many colleges the teaching of prudence. This volume contained almost all available medical students was entrusted to an attorney with literature written in English on legal medicine.16 no formal training in the medical field.2 In 1815 Dr. T. Romeyn Beck was appointed lec- Even in the early 20th century, the teaching of turer on medical jurisprudence at Western Medical medical jurisprudence was relegated to a position as College in New York state. In 1823, Beck published an occasional subject taught outside the main- the Elements of Medical-Jurisprudence, which defined stream.19 However, by the middle of the 20th cen- the field of legal medicine for about half a century of tury, legal medicine underwent a renaissance, as evi- American medical practice. Beck’s two volumes in- denced by the establishment of the American College cluded impressive topics, such as rape, impotence of Legal Medicine (ACLM), the founding of the and sterility, pregnancy and delivery, infanticide and Law-Medicine Institute at Boston University, and abortion, legitimacy, presumption of survivorship, the rekindling of contemporary interest in a vast ar- identity, mental alienation, wounds, poisons, per- ray of legal medicine issues, , physician sons found dead, and feigned and disqualifying and patients rights, and business and professional diseases.17 aspects of medical practice. In 1838, Isaac Ray published A Treatise on Medical In 1867, the Medico-Legal Society was organized Jurisprudence of Insanity. In 1855, the year that Beck in New York. It was the first society in the world to be died, Francis Wharton, an attorney, and Dr. More- organized for the purpose of promoting the princi- ton Stille, a physician, collaborated to publish A ples that an attorney could not be fully equipped for Treatise on Medical Jurisprudence. In 1860, Dr. John the prosecution or the defense of an individual in- J. Elwell, a physician and an attorney, published a dicted for homicide without some knowledge of book entitled A Medico-Legal Treatise on Malpractice, anatomy and pathology and that no physician or Medical Evidence, and Insanity Comprising the Ele- surgeon could be a satisfactory with- ments of Medical Jurisprudence, which highlighted the out some knowledge of the law. Harvard University issue of malpractice in the medical jurisprudence lit- established a separate professorship in legal medicine erature. Elwell’s book presented excerpts from con- in 1877.2

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Organizations 1960s, some law and medicine courses began con- In 1955, recognizing the growing impact of legis- centrating on broader medicolegal questions faced in lation, regulations, and court decisions on patient the courtroom, including disability evaluation and care and the general effect of litigation and legal med- medical malpractice. These courses were properly considered either advanced tort or trial practice icine on modern society, a group of physicians and 10 surgeons, some of whom were educated in the law, courses. organized what would later become the aforemen- In the 1970s the concerns of at least some law and tioned American College of Legal Medicine medicine courses expanded to include public policy, (ACLM). The college was incorporated on Septem- including access to health care and the quality of that ber 23, 1960, by nine doctors of medicine, three of care. At the same time, advances in medical technol- whom were attorneys. Of the 36 physicians who were ogy created new legal areas to explore—from brain designated founding fellows, 10 had earned law death and organ donation to abortion and in vitro degrees. fertilization. These topics were increasingly incorpo- The ACLM is the oldest and most prestigious U.S. rated into law and medicine courses, which were organization devoted to problems at the interface of themselves becoming known by the broader term of 10 medicine and law. Its membership is made up of “health law.” professionals in medicine, osteopathy, and allied sci- Teachers of health law in law schools and med- ences, including dentistry, nursing, pharmacy, podi- ical schools, together with health law teachers in atry, psychology, and law. The ACLM has published schools of public health and schools of manage- a scholarly journal, the Journal of Legal Medicine, ment, began meeting on a regular basis in 1976, since 1973. In 1988, the ACLM also published the when the first national health law teachers’ meet- first edition of the textbook, Legal Medicine; the sixth ing took place at Boston University under the aus- edition was published in 2004.10 pices of the law school’s Center of Law and Health In 1972, a physician and two attorneys founded Sciences (the successor organization to the Law- the American Society of Law and Medicine (Ethics Medicine Institute). The purpose was to help de- was added in 1992; ASLME) as a successor organi- fine the expanding field and develop necessary zation to the Massachusetts Society of Examining teaching materials.20 In 1987, the American Asso- Physicians. Its founding president was cardiologist ciation of Law Schools sponsored its first teaching Dr. Elliot Sagall, who also co-taught the law and workshop on health law. Although this narrower medicine course at Boston College Law School with group only recently convened, its program and George J. Annas, an attorney. The organization proceedings offer useful insight into the current quickly became the largest medicolegal organization state of health law in law schools. As the organizers in the world dedicated to continuing education, as of the workshop saw it, law and medicine (fields well as the publisher of the two leading medicolegal primarily concerned with medical malpractice, fo- journals: the Journal of Law, Medicine, and Ethics and rensic medicine, and psychiatric commitment) the American Journal of Law and Medicine. The latter had become subdivisions of the new field of health is published as a law review at Boston University Law law. Health law itself has three additional subdivi- School. The ASLME also has sponsored interna- sions: economics of health care delivery, public tional meetings in locations around the world in an policy and health care regulation, and bioethics. effort to bring physicians, attorneys, ethicists, and These three subdivisions are actually three differ- others interested in health law together.20 ent approaches to the same subject matter—the health care industry. Health law is applied law, much the way medical ethics is applied ethics.21 Education In an effort to bridge the gap between law and From World War II until the late 1960s, the field medicine, some attorneys enroll in medical school or of legal medicine was defined by law school courses in dual-degree MD/JD programs. The number of that were almost exclusively concerned with forensic medical school courses extraneous to a legal practice psychiatry and pathology and were properly consid- specializing in medicine also discourages attorneys ered advanced courses in criminal law. In the late from pursuing a formal medical education.22

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In 1993, Harry Jonas, Sylvia Etzel, and Barbara then, this Board has certified approximately 250 Barzansky noted that students can earn combined MD/JDs in legal medicine. These examinations are doctor of medicine and doctor of jurisprudence given annually. Other specialty groups that may have (MD/JD) degrees in only 9 of 125 degree-granting some relevance to MD/JDs are the American College U.S. medical schools fully accredited by the Liaison of Physician Executives and the American College of Committee on Medical Education (LCME). Pres- Quality Assurance.10 ently, there are 15 such programs. In contrast, stu- The teaching of medicolegal problems in our dents can earn combined doctor of medicine and country’s medical schools has not, however, been as doctor of philosophy (MD/PhD) degrees in 113 of swift or as comprehensive as one would desire. Al- the 125 U. S. medical schools. Most individuals who though many respected authorities in the field have currently have MD/JD degrees, however, earned urged for a long time that the active teaching of fo- their doctorate degrees separately, with most of them rensic medicine should be a responsibility and duty earning the MD first.23 of our medical schools to their medical students, In 1985, Eugene Schneller and Terry Weiner pub- most medical schools have been slow in paying heed lished their findings regarding individuals who to this advice. In 1951, one respected authority in the earned MD/JD dual degrees and noted that cross- field, Dr. William E. B. Hall, stated before the Acad- professional education in law and medicine remains a emy of Forensic Sciences that America’s medical schools had been, for the most part, derelict in their relatively rare phenomenon in the United States. 26 They concluded that duty. Hall felt that medical students received only a cursory indoctrination in the rights and duties of . . .without the development of institutionalized career lines the physician, the rights of the patient, the various and the acceptance of cross-disciplinary approaches to problem aspects of malpractice, and the functions of the solving MD/JDs must negotiate their jobs and job descriptions courts. Hall stated: within an occupational structure that rewards disciplinary ef- forts. The marginal status of the interprofessional specialist per- We ask that our medical schools train our students, that they sists in the decade of the 1980’s [Ref. 24, p 337]. may at best recognize something of the medicolegal aspects of the various contacts in this practice, that they be better able to A combined MD/JD program is probably not the avoid misinterpretations of the facts and observations of a case, most effective way to teach medical concepts to law that they recognize when more capable advice and assistance are needed, so that the innocent may not needlessly be subjected to students, and it is doubtful that many students are prosecution, and the operations of justice will be furthered [Ref. willing to pursue such a long period of training. 26, p 555]. Moreover, there is more than enough to learn in We have come a long way in the past 25 years either field.24 toward meeting Hall’s criteria.27 The output of liter- These reasons probably explain the increasingly ature on medicolegal subjects has increased year by popular movement toward providing a health law year, and, in general, forensic medicine in America, concentration in many law schools and offering joint with regard to teaching and research, appears to be JD/MPH degree programs (such as those at Boston progressing. However, there is a still a long way to go University and Georgetown University) for students before we can be intellectually satisfied with the level interested in health law. Practicing attorneys need a of understanding, acceptance, and utilization of this working knowledge of the health care industry, but extremely important field of study. do not need to know most of the material taught in medical schools. A well-developed health law pro- References gram designed to fit into the law school curriculum 1. Moritz AR: The need of for academic sponsor- can prepare an attorney to handle medical matters ship. Arch Pathol 33:382–6, 1942 competently. Existing programs, such as health law 2. Curran WJ: Titles in the medicolegal field: a proposal for reform. concentrations at Boston University, Georgetown, Am J Law Med 1:1–11, 1975 3. Wecht CR: Relationships of the medical examiner. Marshall Law Case Western, St. Louis University, and Loyola of Rev 14:427, 1965 Chicago, are still few in number.25 4. Smith S: The development of forensic medicine and law-science In 1982, the American Board of Legal Medicine relations. J Public Law 3:305–6, 1988 5. Smith S: The history and development of legal medicine, in Legal was established to administer examinations to indi- Medicine. Edited by Gradwohi RBH. St. Louis: CV Mosby; viduals with both legal and medical degrees. Since 1954, pp 1–19

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6. Oliver JR: Legal medicine in Europe and America. ABAJ 18:405– 17. Beck T: Elements of Medical Jurisprudence (ed 5). London: 11, 1932 Longman, 1836 7. Camp FE (editor): Gradwohl’s Legal Medicine (ed 2). Baltimore: 18. Ray I: A Treatise on the Medical Jurisprudence of Insanity. Bos- Williams & Wilkins, 1968 ton: Little Brown Company, 1860 8. Spitz WU (editor): Medicolegal Investigation of Death (ed 3). 19. Curran WJ: Medicine and law at the Harvard Law School. Har- Springfield: Charles C Thomas, 1993 vard Law School Bull 17:9–10, 1966 9. Chaille SE: Origin and progress of medical jurisprudence. J Crim 20. Annas GJ: Health law at the turn of the century: from white dwarf Law Criminol 40:397–402, 1949 to red giant. Comm L Rev 2;551–69, 1989 10. Sanbar SS: Legal medicine: historical roots and current status, in 21. Havighurst C: Health care as a laboratory for the study of law and Legal Medicine (ed 6). Edited by Sander SS. St. Louis: CV Mosby, policy. J Legal Educ 38:499–504, 1988 2004, pp 3–11 22. Wecht CH, Koehler SA: Case studies in . J 11. Smith SS: The history and development of legal medicine, in Legal Med 24:587–97, 2003 Legal Medicine. Edited by Gradwohl RBH. St. Louis: CV Mosby, 23. Barzanski B, Jonas HS, Etzel SI: Educational Programs in U.S. 1954, pp 1–19 Medical Schools, 1999–2000. JAMA 270:1061–8, 1993 12. Stewart GH: Legal Medicine. Indianapolis, IN: Bobbs-Merrill Co., 1910, pp 1–6 24. Schneller ES, Weiner TS: The MD/JD revisited: a sociological 13. Burns CR: Legacies in Law and Medicine. Canton, OH: Science analysis of cross-educated professionals in the decade of the 1980s. History Publications, 1977 J Legal Med 6:337–59, 1985 14. Curran WJ: History and development, in Modern Legal Medi- 25. French AJ: The history and significance of the issuance of certifi- cine, Psychiatry, and Forensic Science. Edited by Curran WJ, cates in forensic pathology by the American Board of Pathology, McGarry AL, Petty CS. Philadelphia: FA Davis Co., 1980, pp in Legal Medicine Annual. Edited by Wecht CH. New York: 1–26 Appleton Century Crofts, 1969 15. Rush B: Introductory Lectures Upon the Institutes and Practices 26. Hall WEB: A proposal to introduce forensic science in the uni- of Medicine. Philadelphia: Bradford and Innskeep, 1811, p 363 versity curriculum. J Crim Law 42:550–9, 1951 16. Cooper T: Tracts on Medical Jurisprudence. Philadelphia: James 27. Miles SH, Lane LW, Bickel J, et al: Medical ethics education: Webster, 1819 coming of age. Acad Med 64:705–14, 1989

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