Medicine, Science and the Law最新文献

As a part of a study of suicide in children aged 17 years and under in three centers-Hennepin County in the United States (US), Auckland in New Zealand (NZ), and South Australia in Australia (AUS) from 2008 to 2017 it was decided to characterize potential risk factors and to determine whether these differed by jurisdiction. Reviewed data included a history of psychiatric illness, symptoms prior to suicide, events preceding suicide, previous suicidal ideation or suicide attempts, and communication of suicidal intent. The most common events preceding suicide were arguments with family/friends and relationship issues; in addition depression with or without expressed suicidal ideation, self-harming behavior, sadness, distress, drug/substance abuse, and anorexia were documented. Suicidal intent was on occasion communicated via technological means. In 79.5% of cases in South Australia decedents had a previously diagnosed psychiatric illness, with 62% in Hennepin County. This compared to a much lower proportion of cases in Auckland (23.8%). Whether this reflects more limited access to psychiatric services or a reluctance to seek support and therapy in Auckland is unclear. It does, however, demonstrate that risk factors for child suicide are not uniform among communities and so extrapolation of data from one area to another may not be appropriate. Disturbingly parents/carers were not aware of the decedent's suicidal intent in 84-87.2% of cases.

The recent Julian Assange case raised a number of important issues regarding the role of expert witnesses in court. While written from a personal perspective, this paper will suggest that these issues need much fuller discussion than they have received to date. They will be discussed in the context of what actually happened in this case, the details of which were reported only sketchily (and sometimes inaccurately) in the press. First, there is the question of what is properly a medical or a legal responsibility. A second issue concerns whether re-litigation of already determined matters should be permitted in higher courts, when the expert does not have the opportunity to respond. A third matter involves the apparently differing professional views and ethos of the legal and other professions regarding matters of personal privacy for non-participants, particularly with respect to the safeguarding of children. Other issues include the language which may be used by some lawyers in criticising expert testimony, the protection of experts from potentially libellous reporting in the press, and the use and abuse of diagnostic classifications, such as the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual (DSM). These various matters have implications for larger concerns regarding the recruitment of suitable expert witnesses to the courts.

Many femicide cases are initially reported as missing persons to the police. Women who go missing have a greater risk of being a victim of homicide. This study explores the circumstances surrounding the disappearance and killing of women and girls in the Republic of Ireland from 1962 to 2023. A total of fifty-four cases were analysed, 52 cases were homicides. Most femicides occurred during 1990-1999 (n = 13; 24%) and 2000-2009 (n = 17; 32%). Twenty-five victims knew the offender and the leading cause of death was strangulation with 27 cases. Dumping/leaving the body on open ground with little or no concealment was the predominant method of disposal. The leading risk factors were the engagement of the victim in a fight or row before disappearance and domestic violence. The 'suicide narrative' should be treated with extreme caution in the disappearance of women.

Firearm wounds reppresent a significant cause of mortality worldwide. The differentiation between suicide, homicide, and accidental incidents can be complex, particularly in the absence of clear injuries linked to third-party involvement. Autopsy characteristics of wounds are pivotal in determining the manner of death. A review of the Institute of Legal Medicine of the University of Rome Tor Vergata's database identified 64 deaths due to rifled weapon discharge wounds, excluding accidental deaths. We recorded demographic, circumstantial, and autopsy data for homicides and suicides, with a focus on bullet intrasomatic wound paths analysis. Differences in frequencies of circumstantial data were observed, notably in the locations where victims' bodies were discovered. Autopsy findings revealed distinct anatomical wound distribution. Bullet wound paths across three anatomical planes indicated patterns associated with the manner of death. Leftward, upward, and backward pathways were unique to suicides, while frontward and rightward pathways strongly indicated homicide. Therefore, comprehensive data integration is essential for accurate forensic diagnosis, and projectile directionality alone should not be considered a definitive criterion to distinguish between suicide and homicide, as similar wound paths may arise in both contexts depending on the circumstances.

Purpose: Through a visual analysis of the literature on postmortem interval estimation research collected in the Web of Science database, this study aims to explore the development process, research hotspots, and technical approaches in this field, providing a reference for scholars and professionals in related fields. Methods: It retrieves English-language articles related to postmortem interval estimation published in the Web of Science Core Collection from its inception until December 31, 2023, that meet the inclusion criteria. The study calculates the annual number of publications and citations and analyzes the trends. Based on these annual publication volumes, a second search is conducted for the period during which the number of publications in this field exceeded 100 per year, specifically from January 1, 2014, to December 31, 2023. CiteSpace 6.2.R4 software is used to perform a visual analysis of the second set of retrieved documents. Results: The first search retrieved 1778 articles related to postmortem interval estimation research. The second search retrieved 1265 articles, with an average annual growth rate of 6.84%. Based on the publication trend line for this period, it is predicted that approximately 150 articles will be published in this field in 2024. Conclusion: In the future, the development of postmortem interval estimation will likely remain in a steady phase. Interdisciplinary interactions and constraints still exist. The future direction may focus on using multiomics approaches, combined with advancements in artificial intelligence, to establish comprehensive data models for more accurate postmortem interval estimation.

Sudden deaths may result from many conditions which are either not apparent at autopsy or might be missed and such cases can be tricky as there is no definite cause of death. One such entity is Intracranial colloid cysts, they are congenital neuroepithelial cysts which might be missed or might rupture at the time of dissection. They typically arise within the third ventricle of the brain and can pose a significant risk of sudden death if left undiagnosed or untreated. These are rare entity and on cut-section, these cysts contain mucoid and gelatinous material. In this paper, we have discussed in depth about five cases of colloid cysts, most of which were brought dead to the hospital and were discovered during autopsy without any prior history suggesting the same.

It is not always possible to determine the exact origin of death in cases of suspicious female deaths. Deaths resulting from falls present many challenges in forensic medicine. In order to overcome these difficulties, we screened the approaches to suspicious female deaths from international documents aimed at preventing violence against women worldwide, and we conclude that the Latin American Model Protocol (LAMP) is the most qualified one in addressing this issue. We have converted the LAMP into a checklist, compared it with the circumstances in the cases we present, and evaluated the potential benefits that LAMP could provide. The study examines three cases of women from Turkey who have died by falling from a height. In all cases, the women's partners were present with them at the time of incident. In all these three cases, partners were in a legally suspicious position and claimed that the incident was a suicide. The investigation and trial processes were different in all three cases, and various difficulties were encountered during the establishment of the truth. This study has demonstrated that, despite the actual occurrence of femicide, the use of the investigation steps proposed by LAMP and a comprehensive approach utilizing the scientific methods of forensic medicine, law, and other disciplines that can assist in analyzing the incident during the investigation process can help reveal the cases where defendants claim cases are suicide despite cases being a femicide.

Xylazine, a non-opioid veterinary anaesthetic tranquillizer that is not licensed for human use, has been linked to an increase in overdose fatalities worldwide. The study delves into the forensic aspects of xylazine usage, emphasizing on chemical, clinical and toxicological analyses of drug seizures, bodily fluids and tissues. It advocates for validated analytical methods for determining xylazine. This study provides supporting material to pave the path for the usage and development of relevant and verified alternative screening and confirmation methods for laboratories. Google Scholar, Scopus, Science Direct and PubMed were searched for relevant articles and case reports in relation to xylazine misuse and established analytical methods for forensic investigation until April 2023. A total of 79 articles were evaluated, and 40 publications met the inclusion criteria. The most prevalent xylazine exposures recorded were incidental and intentional misuse/abuse. Common symptoms upon presentation were hypotension, bradycardia, drowsiness and lethargy, although mortality was less prevalent. Solid-phase extraction and liquid-liquid extraction are two extensively used sample preparation techniques. These techniques are used to extract desired analytes from complex matrices. Several analytical techniques have been stated, including GC-MS, LC-MS/MS, HPLC-DAD and others. The analytical procedures used are determined by the matrices involved, the amount of xylazine present, interfering compounds, the degree of precision required and the laboratory infrastructure. In the present context, the LC-MS/MS methods are preferred as the gold standard. In the near future, many analytical techniques such as capillary electrophoresis, PSI-MS, immuno-analytical techniques and SERRS may show significant potential.

Ever since patients started to be admitted into mental institutions, absconding from such institutions has been a fact of life. Also, clear statutory authority to retake absconders has existed since county asylums, the forerunners of today's mental hospitals, started to be built following the County Asylums Act 1808. At present section 37 of the Mental Health Act 1983 concerns patients detained under a hospital order without restrictions on their discharge, etc. Section 3 of the Act, on the other hand, governs patients who are non-offenders but who are compulsorily detained in hospital for treatment. In the past, where a detained patient absconded from hospital and stayed at large beyond the period during which he could be retaken, he was deemed automatically discharged (i.e. 'discharged by operation of law'). Regarding sections 3 and 37 patients, such discharge was effectively abolished by the Mental Health (Patients in the Community) Act 1995. Not much attention has been given to this topic in the literature. This article adopts a solely legal perspective. It looks briefly at when the power to retake absconders from mental hospitals may be exercised and then examines the concept of discharge by operation of law and its abolition. It concludes that the abolition of discharge by operation of law in the case of patients detained under sections 3 and 37, Mental Health Act 1983 was, though long-overdue, sensible and must be applauded.