Medicine, Science and the Law最新文献

Dental age (DA) estimation plays a crucial role in forensic investigations, clinical diagnosis, and treatment planning. It is considered more reliable than skeletal methods due to the predictable nature of dental development. This study aimed to evaluate the accuracy of three DA estimation methods-Nolla method, Cameriere-European formula, and Blenkin-Evans method-in Turkish children aged 6-14 years. A total of 1014 panoramic radiographs were analyzed. DA was estimated using the three methods and compared with chronological age (CA). Accuracy was assessed based on mean absolute error (MAE), mean difference (DA-CA), and correlation coefficients. Statistical analyses were performed to determine significant differences among methods. The Cameriere-European formula demonstrated the lowest MAE (0.44 for boys, 0.48 for girls, and 0.46 for all samples), indicating the highest accuracy, followed by the Blenkin-Evans (0.54 for boys, 0.53 for girls, and 0.54 for all samples) and Nolla (0.57 for boys, 0.65 for girls, and 0.61 for all samples) methods. However, the Cameriere-European formula slightly underestimated CA, particularly in older children. The Blenkin-Evans method showed relatively stable accuracy but overestimated CA in both sexes. The Nolla method generally underestimated CA, except in boys, where it slightly overestimated age. All three methods exhibited strong correlations with CA (Spearman rho correlation coefficients ranging from 0.953 to 0.970, all p < .001). The Cameriere-European formula provided the most accurate DA estimation method, followed by the Blenkin-Evans and Nolla methods for Turkish children from the Northwestern Anatolia. However, the observed biases highlight the need for population-specific calibrations.

People living in prisons have higher mortality rates compared to the general population. We undertook a retrospective analysis of deaths recorded between 2010 and 2018 at the sole prison hospital in Greece (Korydallos Prison Special Health Centre for men) to assess the causes of death overall and by type of offence (drug-related or other), sociodemographic characteristics by cause of death, and mortality trends over time. Permission to access forensic reports and criminal files was obtained from the relevant authorities. Deaths were categorized as either non-natural (drug overdose, suicide, and homicide) or natural (cardiovascular disease, cancer, and others). Between 2010 and 2018, 236 deaths were reported; 80.9% were natural deaths, and 19.1% were non-natural deaths. The primary causes of death were circulatory disease (34.7%), cancer (17.8%), suicide (10.2%), respiratory disease (8.9%), and overdose (6.4%). Suicide and overdose accounted for 53.3% and 33.3% of non-natural deaths, respectively. The mean (SD) age at death was 52.4 (16.2) years, with individuals experiencing non-natural deaths being significantly younger than those experiencing natural deaths [39.1 (10.5) vs. 55.5 (15.7), p < 0.001]. Among individuals incarcerated for drug-related offences, 23.8% died from non-natural causes, with drug overdose accounting for 60% of non-natural deaths. A significant peak in mortality was observed in 2013. This study emphasizes the need to closely monitor mortality rates, including drug-related fatalities, to implement suicide prevention training as well as measures to prevent deaths by overdose, including comprehensive harm reduction strategies, overdose education, and naloxone training.

Independent mental health homicide inquiries in England are required to comment on predictability and preventability and attribute causation. National commissioning bodies do not provide definitions. This study examines how predictability and preventability were determined, and causality attributed, by independent mental health homicide inquiries published in England between 2010 and 2023. The conceptual underpinnings of predictability and preventability in other specialities of medicine, and in suicide and homicide assessments in psychiatry are examined. We found 189 independent reports relating to mental health homicides, of which 162 independent homicide inquiries were included in the final analysis. No inquiry described how it attributed causation or addressed cognitive biases. A total of 130 of the 162 inquiries (80%) commented on either predictability or preventability: of these, only eight (6%) included a clear definition of predictability and preventability. Homicides were deemed predictable if the inquiry panel felt that the perpetrator's words or actions should have alerted professionals to a risk of significant violence; and preventable if the clinical team had knowledge, legal means, and opportunity to stop the homicide from occurring. 105 inquiries (81%) provided a firm view on both predictability and preventability. Of these, four homicides (4%) were deemed to be both predictable and preventable, ten (9%) were preventable but not predictable, five (5%) were predictable but not preventable, and 86 (82%) were neither predictable nor preventable. The implications of these findings are discussed, with recommendations to national commissioning bodies.

The incidence of fatal staircase accidents in Japanese households has remained consistent for several decades, with staircase dimension regulations seeing minimal revisions since their inception. Studies concurrently investigating the influence of staircase factors and user factors on staircase accidents, particularly in terms of severity, are lacking. This study examined how these factors influence the severity of accidents by means of an Internet-based questionnaire survey. A private company was tasked with conducting the survey, and logistic regression analysis, encompassing both staircase and user factors, was performed on 165 individuals in the mild injury group and 129 in the severe injury group from a pool of 6945 responses. The odds ratio (OR) of the severe injury group to the mild injury group was assessed. For staircase factors, the OR of severe injury was 2.16 (95% confidence interval (CI): 1.23-3.79) for straight stairs, with increased OR observed with a higher number of steps and wider staircases. Regarding user factors, the OR was 3.80 (95% CI: 1.29-11.14) for individuals with visual disturbance, with the OR escalating with age. This study suggests that in Japan, among the legally defined factors for stairways, limiting the installation of straight stairways and setting limits on stairway width can reduce the impact on the severity of accidents. And, of course, it is crucial to promote the use of alternatives, especially among high-risk users.

This article explores the development and application of Italian case law since 2005 regarding the criminal responsibility of individuals with mental disorders, focusing on the landmark decision by the Joint Chambers of the Court of Cassation in the Raso case. This ruling transformed the interpretation of mental illness in the context of criminal responsibility. The article examines the impact of this shift, identifying diagnostic ambiguities and the challenges of applying the new standards, as well as the significant increase in insanity-related acquittals and the growing use of noncustodial preventive measures. The aim is to provide a critical overview of the legal and social consequences of these decisions, offering reforms and recommendations to improve the consistency and fairness of the Italian judicial system.

A number of the issues raised by Professor Kopelman in his Viewpoint are discussed and used to make recommendations that should enable psychiatrists better to assist the courts, uphold the expert witness's expectation of integrity, reduce the risk of judicial criticism and adverse publicity, provide clarity as to how to proceed when there is, or is perceived to be, a conflict between the duty as a doctor and the duty as an expert, particularly in cases involving safeguarding issues, and promote the medicolegal discourse necessary for the medical and legal professions to work together harmoniously in the interests of justice.

The possession and trafficking of drug substances is one of the major public health problems. When examining court records of drug offenses, it is often found that the dealer may claim to be a user in order to avoid punishment. Of course, it is essential to determine whether the crime is drug trafficking or personal possession.The role of the courts in determining the purpose of possession is quite complex, as it requires an understanding of the offender's intent. This situation shows us that two articles in Turkish law (TPC No. 5237, Articles 188 and 191) could not be drawn with clear lines. Although there are many factors that cause this unclarity, the most complex one is the amount of substance recovered, i.e., the threshold value. This threshold terminology is a situation of great importance, given the increase in the types of illegal substances in today's world. In this study, we examined the verdicts (805 files) on the four main classical illicit substances commonly found in Turkish courts between 2016 and 2023 to determine the conditions that play an important role in determining the intention to supply drugs based on judicial principles.

In Italy, the issue of medically assisted suicide is addressed by the sentence number 242 of the Constitutional Court (22^nd November 2019). Further indications of organisational nature are needed, which are under the responsibility of the Italian Parliament and each regional health administration. Recently, the sentence number 135 of the Constitutional Court (1^st July 2024) has provided further specifications regarding 'life-support treatment', which still remains controversial. Regional differences in Italy regarding medically assisted suicide are reported in this article, showing that, on the date of 11^th February 2025, Tuscany is the first and only Italian region to have passed a regional law on medically assisted suicide. One possible approach to discussion and management of this sensitive and controversial issue could be cooperative forms of regionalism while waiting for a national law. To date, after the first Italian case, which refers to Marche region and occurred on 16^th June 2022 (Federico Carboni, also known as 'Mario'), four more individuals in Italy have resorted to medically assisted suicide: 'Gloria' in Veneto, 'Anna' in Friuli-Venezia Giulia, a man in Emilia Romagna, and 'Vittoria' in Veneto. It is hoped that a national law will be approved soon, as strongly urged by the Constitutional Court; if not, efforts should be made to identify and implement shared and standardised procedures throughout the Italian territory, encouraging cooperative forms of regionalism. This would allow patients to know that the request is followed by unambiguous responses from the authorities, within a reasonable time.