Medico-Legal Journal最新文献

Self-strangulation is an uncommon method of suicide. The body was found lying on the floor in front of the "multi-gym" inside the gym in the basement of the deceased's house. It was initially presented as a case of sudden death, but during autopsy, a ligature mark was noted over the deceased's neck and bilateral temporal regions along with findings supportive of ligature strangulation. A visit was made to the crime scene. A plausible reconstruction of events suggested that the deceased had used the metallic rope of the multi-gym for this purpose. The rope was connected to weights from one end, passed through a pulley and connected to a rod at the other end. Its width and pattern matched with the ligature mark. The deceased wound the rod end of the rope around his neck and entangled the rod to the rope over his head so that the weight attached to the other end tightened the rope around his neck and strangled him. As the rope unravelled, gravity caused the body to fall to the ground while the rope with the rod resumed its normal position due to the pull of the weight attached at the opposite end. This case is reported for its rarity and the unusual means used to commit suicide by self-strangulation.

Background: In addition to poor infrastructure, and human resource constraints, forensic medicine specialists in developing countries face many external challenges.

Objectives: We aimed to investigate the prevalence, type, and source of external challenges confronting them including sex, age, religion, deceased's place of residence and the number of accompanying relatives.

Materials and methods: This cross-sectional, observational study was conducted between August 2020 and July 2022 at the Mortuary of AIIMS, Bhubaneswar with the approval of the ethical committee.

Results: Of note, forensic medicine specialists faced external challenges in about one in five cases (20.5%). Most demands were to either minimise the autopsy procedure (n = 65) or to conduct the autopsy at inappropriate times (n = 58). The demands to minimise the autopsy procedure were significantly associated with the deceased's age (p = 0.046), religion (p = 0.010), socioeconomic class (p = 0.020) and manner of death (p = 0.019).

Conclusions: Our study found that forensic medicine specialists in India face significant external challenges. Avoiding unnecessary complete autopsies, implementing night autopsies, and embracing minimally invasive autopsies are recommended to mitigate these challenges.

Background: This work emerged from a need to better understand the "lived experience" of early marriage for girls and how it should impact on contemporary attitudes in the Muslim community and encourage it to support the international movement with the aim of a minimum common age of 18 years for marriage of young people.

Objective: To identify from contemporary published literature, including autobiographies and religious texts dealing specifically with early marriage, the effects of early marriage on individuals and to set this as a background to the extensive literature on its medical, psychological and social impact.Participants and setting: The setting is the published words of two women and a man who were involved in early marriages and a commentary on the topic by an Ibadi theologian.

Methods: The documents were identified through searching a range of databases using various search engines. Texts were then analysed for key terms describing the impact of early marriage and these were then grouped into themes.

Findings: The extracts raise questions linked to the issue of consent and the role of adult coercion, including physical force and threat of harm. In practice girls are given in marriage by their guardians against their wishes and international conventions on the rights and care of children, as well as that outlined in Qur'an 4 v6.

Conclusion: Modern Muslim states face a real challenge in implementing 18 as the minimum age for marriage, especially in how to manage opposition to appropriate new legislation from some traditionalist groups.

Introduction: Informed consent is a crucial element in neurosurgical practice; failures of the consenting process are a common cause of litigation in neurosurgery and judgments that have particular relevance to neurosurgical practice will be reviewed here. Guidance for consent based upon current case law is discussed.

Methods: The legal databases BAILII and WestLaw were searched using the search term "informed consent". The BAILII search yielded 86 abstracts, WestLaw yielded 33. There were 15 duplicates. Ten of the remaining 104 abstracts were commentaries, leaving 94 judgments. From those judgments a further 21 cases were added. A total of 115 judgments were reviewed by both authors.

Results: A total of 23 judgments dealing with issues of informed consent in neurosurgical and other surgical practice were selected. The cases and their implications for neurosurgical consent are discussed below.

Discussion: When proposing a surgical procedure to a competent adult, the treating surgeon must discuss the benefits, risks and alternatives to treatment with the patient. The surgeon can be guided by professional guidance from the GMC, or another professional body, and/or case law. Relevant issues include: (i) the risks and benefits of surgery; (ii) information that is accurate (or inaccurate, incorrect, missing or late information); (iii) established practice; (iv) the current state of knowledge; (v) reasonable alternative treatments; and (vi) surgery performed on a different day or by a different surgeon.

Background: Self-inflicting injury is a recognised psychiatric disorder. Such cases are regularly seen in the emergency department, with a false history of assault. Most of these are easily detected by a forensic medicine expert as they present as described in literature but are difficult to explain if altered by professionals for nefarious reasons.

Method: This was a prospective study carried out at a tertiary centre. The data was collected and analysed from the office records of medico-legal reports prepared at our institute between 25 February 2022 and 25 February 2023.

Results: 21 cases were recorded, that met with our criteria. Most involved males (90.5%). Minimum age was 27 years and maximum age 66 years with a mean of 48.6 years and a standard deviation of ±11 years. Most offenders were unemployed (38.1%). Most fractured bone was tibia (47.6%). Left-sided fractures were more common (61.9%). Injuries corresponded with the findings on clothes in three cases (14.3%).

Discussion: Fabricated wounds will reflect the intentions of the fabricator and may range from superficial wounds to grievous injury. Only a critical analysis of all medico-legal cases will identify them, and they will have similarities of presentation.

Conclusion: Such findings have rarely been reported in other parts of India. A diligently prepared medico-legal report and profiling of all cases can help establish patterns of such injuries.

Forensic science is a multidisciplinary field that involves the use of various scientific methods and techniques for the investigation of crimes. Forensic scientists are often required to testify in court as expert witnesses and explain the meaning of chemical, physical, and/or medical evidence to a judge and jury. This article took advantage of a citation database to identify the most highly cited forensic practitioners in four Nordic countries within the discipline of legal and forensic medicine. The starting point was 7 million scientists indexed in the SCOPUS database, each of whom had their name on at least five entries. Six different citation metrics were used to calculate a person's composite citation score. Those within the top 2% of their primary research discipline were considered highly cited.

Spine surgery is highly litigious; misplaced screws and intraoperative neuromonitoring frequently feature in lawsuits. Intraoperative neuromonitoring aims to prevent injury but its standards are debated, and literature suggests its benefits are mixed. We surveyed its use among neurosurgeons from the Congress of Neurological Surgeons with Pearson's chi-square test applied to analyse data within R. Among 188 respondents, 39.9% worked in private practice or academic institutions. Usage rates were 50.5% always, 27.7% never and 21.8% sometimes. Opinions on intraoperative neuromonitoring necessity varied, with 55% disagreeing and 32% agreeing. No differences were noted by practice type or location. Among intraoperative neuromonitoring users, 47% found it sensitive and specific, while 45% used it for medico-legal reasons. Of non-users, 26% preferred other technologies. Overall, the usage of intraoperative neuromonitoring is nuanced and opinions leaned more heavily toward its implementation not being a current standard of care in pedicle screw placement surgery.

Coronary artery anomalies are a heterogeneous group of congenital disorders affecting the coronary pattern with a characteristic (origin, number, number of hosts, course, etc.). They are rarely found in the population. We report the case of a 21-year-old male who died from sudden cardiac death caused by an isolated coronary ostial obstruction, secondary to a rare anomaly, the presence of a valve-like ridge consisting of a small fold in the Valsalva aortic sinus. The study provides a brief literature review on the pathophysiology, diagnosis, and clinical and medico-legal issues in coronary artery anomaly cases that may be helpful in forensic practice when dealing with sudden cardiac death in young people and highlights key points for further research and public health measures.