Medico-Legal Journal最新文献

A judicial on-site examination is essential for the correct analysis of a forensic case, particularly when there has been a fatal fire, as heat-related changes to bodies make identification by the forensic pathologist and other specialists difficult along with estimating the post-mortem interval and determining the precise cause and manner of death. We systematically reviewed all relevant articles dating from 2003 to 2022 in the PubMed database with a view to updating recommendations on how best to proceed. Our recommendations highlight the importance of a multidisciplinary team approach involving various forensic specialists.

People failing to give a specimen of breath at a police station are assumed to be deliberately obstructive and are charged with Failure to Provide under the Road Traffic Act 1988. However, spirometry records of 281,210 healthy individuals from UK BioBank showed that a significant minority cannot use existing evidential breath analysis machines. Women were three times more likely to be unable to use them than men (1.64% vs 0.54%) with the risk rising with age six-fold from those in their 40s (0.43%) to 2.7% in their 70s, with women more affected (0.65% to 3.8%). Short stature was a further risk factor: 2.6% of men and 3.8% of women below the 2^nd percentile of height could not use the current machines, with almost one in ten elderly, short women unable to do so, while smokers aged 50+ were twice as likely as non-smokers of the same age to be unable to provide breath specimens.

Objective: To review the nature and extent of bladder exstrophy-epispadias related malpractice litigation in the United States.

Methods: Two legal databases (Nexis Uni, WestLaw) were reviewed for state and federal cases using the terms "bladder exstrophy", "cloacal exstrophy", "epispadias", in combination with "medical malpractice", or "negligence", or "medical error", or "complication", or "malpractice", or "tort". Databases were queried from 1948 to 2022 and reviewed for medical and legal details.

Results: Our search yielded 16 unique legal cases with 6 fitting established criteria for analysis. Urology and paediatric urologists were named in 50% of cases as were community medical systems. Cause for lawsuit included negligence in surgical performance (50%), primary closure of exstrophy (33%), and post-operative care (50%). Settlement agreement was reached in one case (17%). Outcomes favoured the physician in 60% of trials. Lawsuits alleging negligent surgical performance and/or post-operative care exclusively named urologists with outcomes favouring the surgeon in 66% of cases. The settlement payment (n = 1) was $500,000 and monetary damages (n = 1) equated to $1.3 million.

Conclusions: Malpractice litigation related to BEEC treatment is rare. Trial outcomes favour the medical provider. Cases that resulted in financial liability successfully alleged avoidable negligence resulting in irreversible physical damage. The authors recommend families with BEEC seek board-certified paediatric urologists experienced in treating this complex and/or Bladder Exstrophy Centers of Excellence. Further, we recommend surgeons treating BEEC properly educate patients and families on the severity of this major birth defect including its lifelong implications and need for surgical revisions.

With medical litigation on the rise, physicians require a nuanced understanding of the legalities of consenting patients to reduce their liability while practising evidence-based medicine. This study aims to a) clarify the legal duties of gastroenterologists in the UK and USA when gaining informed consent and b) provide recommendations at the international and physician level to improve the consent process and reduce liability.A bibliometric analysis of the Web of Science database with the MeSH terms "gastroenterology" and "informed consent" yielded 383 articles, of which 228 were excluded due to not meeting the inclusion criteria. Of the top 50 articles, 48% were from American institutions and 16% were from the UK. Thematic analysis showed 72% of the articles discussed informed consent in relation to diagnostic procedures, 14% regarding treatment, and 14% regarding research participation.Both the USA and the UK have progressed from previously paternalistic Natanson case (1960) and Bolam test (1957), respectively, where physicians were held to the standard of a "reasonable and prudent medical doctor". The American Canterbury case (1972) and the British Montgomery case (2015) radically shifted the standard of disclosure during the consent process by requiring physicians to explain all information pertinent to a "reasonable patient".It is our recommendation that a two-pronged approach be taken; a) creation of international guidelines for consenting patients for invasive procedures in gastroenterology, and b) development of internationally standardised endoscopy consent forms containing all the details pertinent to a "reasonable patient".

Human sacrifice is a gruesome and controversial practice where one or more individuals are killed as part of a religious ceremony or as a gift to a deity. While the practice has been widely condemned globally, it still persists in some communities in some countries. Nepal, in particular, has a history of animal sacrifice with larger offerings taking place every five years. While animal sacrifice is legal, the ultimate punishment for engaging in human sacrifice is a legal sentence. This article examines the historical and cultural context of sacrifice in Nepal and explores some contemporary cases of human sacrifice reported in the media. The article also considers the impact of superstitious beliefs and the need for evidence-based attitudes to support human rights.

In the USA, intentional and accidental injuries are the most frequent causes of death in children. Many of these deaths could be avoided through preventive measures, and aetiological studies are needed to reduce fatalities. The leading causes of accidental death vary by age. We analysed all paediatric accidental deaths recorded by a busy urban Medical Examiner"s Office in Chicago, Illinois (USA). We searched the electronic database for accidental deaths in children aged under 10 between 1 August 2014 and 31 July 2019. 131 deaths were identified with a preponderance of males and African Americans. This is consistent with ratios of other deaths recorded for this age group (during the same period and area). The leading causes of death were asphyxia due to an unsafe sleeping environment (in subjects <1-year-old), and road traffic accidents/drowning (in subjects >1-year-old). Behaviours, risk factors and environments most likely to contribute to fatal injuries are discussed. Our study highlights the role of forensic pathologists and medico-legal death investigators who identify the causes and circumstances surrounding these deaths. The research results may help from an epidemiological perspective to implement age-specific preventive strategies.

Since its launch, ChatGPT, an artificial intelligence-powered language model tool, has generated significant attention in research writing. The use of ChatGPT in medical research can be a double-edged sword. ChatGPT can expedite the research writing process by assisting with hypothesis formulation, literature review, data analysis and manuscript writing. On the other hand, using ChatGPT raises concerns regarding the originality and authenticity of content, the precision and potential bias of the tool's output, and the potential legal issues associated with privacy, confidentiality and plagiarism. The article also calls for adherence to stringent citation guidelines and the development of regulations promoting the responsible application of AI. Despite the revolutionary capabilities of ChatGPT, the article highlights its inability to replicate human thought and the difficulties in maintaining the integrity and reliability of ChatGPT-enabled research, particularly in complex fields such as medicine and law. AI tools can be used as supplementary aids rather than primary sources of analysis in medical research writing.

Elder financial abuse is a growing problem, with significant consequences for society. It is unclear if differences exist in the clinical and legal approach to financial abuse across Canada, thus the purpose of this review. Five databases were searched during the primary literature search. Secondary literature search involved searching grey literature and handpicking references from selected articles. Only articles in English were included. From 10,260 articles initially screened, 30 were included in the review. No literature was identified describing differences in the clinical approach to financial abuse, and no single definition or legislation on financial abuse was identified. Mandatory reporting is required for individuals in a hospital or care facility by only five provinces. This review has identified several important knowledge gaps on the differences in the clinical management of financial abuse, and a lack of definition, legislation and overall mandatory reporting across Canada, which requires further research.

A 6-year-old girl was brought to the emergency department with a history of an accidental fall a few days earlier. She presented with a fever, cough and constipation. Sars-CoV-2 infection being suspected, she was transferred to a paediatric facility for Covid-positive patients. During the diagnostic process, the clinical picture suddenly deteriorated with the development of bradycardia, tachypnea and altered sensorium. Despite cardiopulmonary resuscitation attempts, the child died about 16 hours after admission to the emergency department. A judicial forensic autopsy was performed that concluded that her death was due to multiple acute pulmonary, cardiac and renal infarctions secondary to septic thromboembolism in the course of post-traumatic bacterial necrotizing pyomyositis of the right ileo-psoas muscle.