Medicine, Science and the Law最新文献

A new Medical Examiner system was introduced in England and Wales in 2019 to scrutinise all non-coronial deaths. The three key roles of independent Medical Examiner scrutiny are to establish accurate causes of death, determine whether coronial referral is required and identify any care concerns. This is the first published service evaluation exploring the views of doctors and next of kin with whom Medical Examiner Services interact. The aims were to understand whether the Medical Examiner Service was achieving its three main roles. Surveys were sent electronically to the qualified attending practitioners, and by post to the next of kin, of a consecutive series of deceased patients reviewed by an acute NHS hospital Medical Examiner Service in the East of England. Recruitment took place over a five month period in 2023. Results are based on 100 returned surveys from doctors (response rate 35%) and 179 completed by next of kin (response rate 65%). Findings suggest the Medical Examiner Service was successfully achieving its three key roles and well received by both doctors and next of kin. Service user feedback is clearly important as Medical Examiner Services continue to develop into the statutory phase during 2024, when they are anticipated to review approximately 400,000 deaths per annum in England and Wales. This study demonstrates such feedback is not only useful for service development, but also eminently possible.

Selfies are self-surveillance images or videos captured by individuals using digital cameras that, in the attempt to obtain content, may lead to selfie-related injuries or deaths. Criminal selfies refer to offenders who take selfies with their victim(s) during crimes. Globally, both phenomena are underestimated due to deficient official data and the social nature of these incidents. This pioneering media-based retrospective study on selfie-related trauma aims to offset the literature deficit on this topic in Egypt, as an Arabic-speaking country, and extend the global understanding beyond the Western context. We utilised the Egyptian newspaper articles published between January 2014 and May 2023. We identified 25 reports of selfie-related accidents that resulted in 29 casualties with an 82.8% fatality rate. Male victims outnumbered female victims and the mean age was 21.8 years, with most victims aged in their twenties. Regarding the causes of selfie-related deaths, drowning in the Nile ranked first (43.4%) followed by falling from a height (26%). Unless suicide was suspected (n = 1), the remaining cases were considered accidental. We also found four reported criminal selfies that were associated with intimate partner violence. Three of these offenders were male, of which two had a history of drug addiction. In contrast to selfie cases, only one offender belonged to the second decade age group. Overall, selfie-related deaths were infrequent, with an average of three incidents per year. In conclusion, audio-visual communication has altered the modus operandi of crimes, so the digital media analysis should supplement the criminological and medicolegal processes.

Femicide, the killing of women, girls, and infants, is a pervasive problem affecting all global societies. Policy and research are impeded by inaccurate and missing prevalence data, gaps in understanding of femicide, especially for hard-to-reach marginalized populations, and conflicting perceptions between jurisdictions. Leveraging on a combined socio-ecologic model and Public Health approach, the paper spans the methods of a computed tomography-based injury study, an in-depth media-analysis, a legislation evaluation study, and a data barriers' study. Injury patterns, media depiction, and end-user consultations will close the loop on residual problems such as implementation, data gaps, and cultural perceptions. By mixed methods research representing multiple regions, and stakeholders, this project will enhance knowledge on interpersonal, institutional, and societal factors of femicide, advancing the humanitarian forensic discipline. The research method will identify emerging trends and facilitate improvements in tertiary prevention of femicide, specific to resource settings.

A total of 126 cases of serial neonaticide (with at least 3 neonates killed) have been collected, 54 from medical reports and 72 from newspapers. Compared with single neonaticides, and especially when five or more infants have been killed, they have more often been perpetrated by women in conjugal or stable relationships and have more frequently involved other family members. In some cases, the explicit motive has been family limitation. It is clear from the preservation and care of the corpses, that some mothers have had an emotional attachment to their infants. Medical under-reporting and the apparent ease of concealment suggest that this criminal activity is more common than has been appreciated.

This article provides an analysis of the legal rights and protection accorded to fetuses under the Nepali law and the comparative common statues. It also analyses the abortion law in Nepal, which aims to balance the needs of women seeking abortion with limited protections for late-term fetuses. The article considers the case, "Lakshmi Dhikta v. the Government of Nepal," which held that access to abortion was a constitutionally formed right. However, barriers to this right still exist, especially among disadvantaged women. Globally, the debate continues between those who advocate for the rights of the fetus and those who put the autonomy of the women first. While some countries grant the fetus limited legal rights, others grant the fetus personhood rights. It is therefore pertinent to discuss the ethics of prenatal harm, sex-selective abortion, and the possible conflict between maternal and fetal interests. The multifaceted law should regulate maternal health, the interest of the fetus, and discrimination while ensuring feasible and affordable abortion.

Coronary vasospasm and coronary artery dissection are two recognized causes of Sudden Cardiac Death [SCD] in association with Myocardial Infarction in Non-Obstructive Coronary Artery [MINOCA]. This is a case of post procedure death in a 50-year-old female during cardiac angiography, who had a family history of coronary spasm with sudden cardiac death in her mother. She went into cardiac arrest during the procedure with iatrogenic acute coronary dissection which was treated with LMS/LCx vessel stenting. However, she died in 4 days post procedure. Postmortem cardiac examination demonstrated a transmural hemorrhagic infarction of the entire circumferential wall of the left ventricle with normal coronaries both macroscopically and microscopically. Acute coronary dissection was confirmed histologically in the left main stem.Coronary vasospasm is transient constriction of coronary arteries, which causes partial or complete obstruction of the vessels. The exact pathophysiological mechanism is poorly understood, but atheroma, drugs and a genetic predisposition are common associations. This case highlights the strong genetic link of coronary vasospasm in both mother and daughter and also the complication of iatrogenic coronary dissection which is a rare, but serious complication reported in about 0.1% of coronary angiography. This is the first postmortem report of procedure-related dissection in a patient with vasospasm indicating the cause is functional. Forensic practitioners need to be aware of coronary vasospasm and the complications of coronary angiography as a cause of acute myocardial infarction. Detailed autopsy yields valuable information in this rare condition.

In Sweden, from 1990 to 2013, most homicides occurred between family members, friends or acquaintances: the annual rate of incidents between unacquainted offenders and victims ranged between 8% and 13%. In the majority of these "stranger homicides," three common motives, as defined by the precipitating event, could be identified: homicides resulting from a spontaneous altercation; homicides committed in the context of a robbery or burglary; and homicides committed in the context of a gangland conflict. The remaining minority-with uncommon or indiscernible motives-could, nonetheless, be categorized according to their nonconventional distinguishing feature: homicides characterized by the offender's ostensibly mentally aberrant behavior; homicides committed in the context of a hate offense or politically motivated offense; homicides committed in the context of a sexual offense; and homicides committed in the context of a mass killing or series of homicides. In this registry-based study of 224 incidents, "conventional" stranger homicides, defined by their commonplace motive, were compared with "nonconventional" stranger homicides, defined by their lack of such motive. The former were more often committed with an accomplice, against a male victim, whereas the latter were more often committed in a public place, after contact initiated by the offender. In the latter, offenders were less often intoxicated at the time of the offense and more often adjudged to suffer from a severe mental disorder. The subcategory of nonconventional stranger homicides characterized by the offender's ostensibly mentally aberrant behavior corresponded largely to both the archetypal stranger-homicide construct and the popular notion "act of madness."