Medicine, Science and the Law最新文献

Complex Suicide (CS) is defined as an unusual form of suicide in which several harmful methods are used, simultaneously or in succession, whose purpose is to avoid the possible ineffectiveness of one of the methods used to produce a certain fatal outcome. The study of CS is of great interest and plays a fundamental role in characterizing the knowledge of these rare events. We have retrospectively evaluated all CS cases examined at the Institute of Forensic Medicine of Milan from 1993 to 2022 (n = 75) with the aim of characterizing the deceased who have resorted to it. We also compared the sample of 75 CS cases with a sample of paired 115 "simple" suicides (with a single method). Our analysis revealed that the CS cases were carried out by a "typical" subject identified as an adult male, between 41 and 50 years old, suffering from psychiatric disorders and, in particular, major depressive disorder. The most frequent harmful mode was plastic bag suffocation associated with self-poisoning. CS cases used less violent methods than simple suicide controls. The pathological-forensic approach has brought to light elements that can be useful both for forensic professionals (pathologists and psychiatrists) in correctly classifying these unusual and challenging events and for clinicians working on the front line. Some profiles have been outlined that can be used to identify potentially vulnerable individuals who could benefit from increased health surveillance to treat and prevent suicide.

One-punch deaths draw considerable legal and media attention due to the nature of catastrophic events and their impact on victims and families. Empirical research on the sentencing outcomes and offence categories faced by the perpetrators is non-existent. This Australian study examined judicial sentencing reviews to unpack perpetrator characteristics, offence patterns and sentencing outcomes for one-punch fatalities over a 30-year period. Two hundred and eighty-seven perpetrator convictions were reported by various parameters such as median sentencing length, injury mechanism and maximum sentencing categories. Secondary outcomes were details of concentrations of alcohol and illicit drug usage and usage of one-punch specific laws, hitherto unelucidated for one-punch assaults. Nearly all perpetrators were male with a median age of 26 years, with 61% charged in New South Wales and Victoria alone. The median sentence length of imprisonment was 3.8-11.5 years for a manslaughter conviction. Median sentence length when categorized by injury mechanism demonstrated variation in both life sentence and one-punch offence categories. About 40% of Australian perpetrators were convicted under one-punch laws in states where these were introduced. The study will increase knowledge and public awareness regarding the impact of one-punch violence and outcomes.

Nonthrombotic pulmonary embolism is defined as the partial or total occlusion of the pulmonary circulation by various nonthrombotic agents, such as biological, nonbiological and foreign body material. A case is reported of lethal embolism of fragments of a renal calculus: A 64-year-old woman collapsed and died following laser lithotripsy. At autopsy calculous debris was found in the calyces of the right kidney with widespread microscopic fragments of birefringent foreign material in keeping with renal calculus within the pulmonary arterioles. Death was due to pulmonary calculus embolism complicating lithotripsy of a right renal calculus. Review of other causes of nonthrombotic pulmonary embolism revealed fat, bone marrow, amniotic fluid, trophoblast, tumours, septic material, hydatid cysts, bone, soft tissue/organ parenchyma, gastrointestinal tract contents/bile, gas, and foreign material that was introduced iatrogenically and non-iatrogenically. All of these possibilities should be considered at autopsy in the appropriate setting, with pulmonary microscopy often being essential to establishing the diagnosis.

Missing persons are a major part of everyday policing. However, some missing person cases can be highly emotive and challenging such as missing women and girls. Women who go missing have a greater risk of coming to harm. This study focused on 38 long-term missing women and girls from the Irish Republic from 1971 to 2023 of which 12 cases are now classified as homicides, and the whereabouts of the bodies remain unknown. The majority of cases are in Leinster with 25. Eight missing persons are under 18 years, and 22 are between the ages of 18 and 45 years. Domestic violence was a feature in five cases, involvement in a fight prior to disappearance in seven cases, and inconsistencies in statements by intimate partners and close family members regarding the victim's mental health were noted in seven cases. In nine cases, the personal belongings of the victim remained in the home. In seven cases, there was suggestive evidence that the victim entered water. These factors were seen in both the missing and classified homicide cases. The suicide narrative is heavily implied in many of these cases. A woman's mental health and stage of life such as pregnancy, childbirth and menopause can be exploited and used as an advantage to a potential killer. It is therefore paramount that missing women who are considered to have taken their own lives should be thoroughly investigated, with a special focus on cases where evidence suggests drowning and jumping from a height.

In the recent past, human genetics and in vitro fertilization (IVF) have undergone various advances to combat with several congenital and developmental disorders. These advances are a boon for the families and patients who were restricted from having a child due to one or the other reasons. One such reason is the mitochondrial DNA (mtDNA) mutations, which are definitely transmitted from the mother to the child due to uniparental/maternal inheritance of mitochondria. Depending upon the range of the mutation (mutation loads) present, the mtDNA mutation leads to various devitalizing to fatal disorders, all of which are incurable. Scientists and researchers developed a technique known as mitochondrial donation technique or mitochondrial replacement therapy (MRT) to combat with the mtDNA mutations. The technique relies on the replacement of faulty mitochondria in the mother's egg with the normal wild-type from a donor female resulting in a "three-parent baby." On the other side, forensic scientists and anthropologists continuously explore the mtDNA in various medicolegal cases and in uncoupling the mystery of human origin and migration respectively. In this regard, we explored the genetic, forensic and ethical aspects of a "three-parent baby." The present communication also attempts to highlight the importance and limitations of the MRT technique/three-parent baby in a medicolegal context.

Advanced putrefaction causes extensive loss of soft tissue, rendering it difficult to use the diatom test as a reliable diagnostic tool for drowning investigations. A positive diatom test in carrion insect larvae may provide significant assistance in overcoming the challenge of decomposition. The studies determined the utility of diatom test in carrion larvae on severely decomposed bodies. A modified acid digestion method involving nitric acid, K₂Cr₂O₇ and HCl, was used to digest the blowfly larvae feeding on piglet carrion previously drowned in freshwater and sea water, respectively. Extracted diatom frustules were analysed and characterised using light microscopy coupled to a digital camera. Diatoms recovered from maggots on sea-drowned piglets were similar to diatoms from sea water (drowning medium). Centric diatoms recovered in maggots were higher (200 ± 60 diatoms/ mL) than pennate diatoms (80 ± 20 diatoms/mL). Isolated diatoms common to both maggots and water samples included Coscinodiscus sp. and Navicular spp. Albeit, there were no diatoms recovered from maggots on freshwater-drowned piglets. The findings of this study suggest that the diatom test is still a reliable diagnostic tool to determine if drowning was involved in the death of a fully decomposed body. This is the first study that isolated diatoms from maggots feeding on drowned bodies. It serves as the basis for further research into the utility of maggots for drowning investigations.