Medico-Legal Journal最新文献

Child sexual abuse (CSA) is a very serious issue. In India, The Protection of Children from Sexual Offences (POCSO) Act 2012 introduced stringent laws and severe punishments to deter such offences. Notwithstanding, child sexual abuse continues, with many cases going unreported due to societal stigma, fear and lack of awareness. Girls are the most common victims, but boys, whose cases are less frequently reported, may also be victims. Social taboos surrounding sexual abuse of boys contributes to its underreporting. This abuse typically comprises either penetrative or non-penetrative sex acts, primarily resulting in penile and anal injuries, in addition to other extragenital injuries. We report the case of a 7-year-old boy who was brought to the emergency department with active penile bleeding. Investigation revealed sexual abuse perpetrated by his father's co-worker. Examination revealed a penile frenular tear with haematoma, indicative of inflicted trauma. This case highlights the forensic significance of penile frenular tears in non-penetrative abuse in male children, distinguishing them from self-inflicted or accidental injuries. It underscores the medico-legal challenges, injury patterns, mechanisms and circumstances involved, emphasising the need for prompt evaluation, legal enforcement and awareness to protect children and ensure justice.

Forensic toxicologists routinely perform pharmacokinetic calculations for alcohol, such as retrograde extrapolation calculations that rely on assumptions about when alcohol absorption is complete. However, examination of current practice reveals a uniformity in applying standardised timing assumptions despite well-documented individual variation in alcohol pharmacokinetics. This paper highlights factors that can influence alcohol absorption and cause the absorption of alcohol to extend beyond the conventional 2-hour timeframe since the last drink. Various physiological conditions, including the presence of food, certain medications, medical conditions and other factors, can prolong alcohol absorption beyond 2 hours. Toxicologists performing pharmacokinetic calculations for alcohol should disclose that population averages regarding the absorption of alcohol may not apply to individual cases.

Suicides in women are frequently associated with psychiatric illnesses but may result from other life stressors such as relationship problems, domestic abuse and coercive and controlling behaviour, for example. It is no body suicides that are concerning when a woman is reported missing, presumed to have died by suicide, but no body is recovered. Many are later legally declared dead but many more remain missing. Four cases from the Republic of Ireland demonstrate the similarity in each case but also highlight uncomfortable questions surrounding the women's disappearance. Caution should be exercised as mental health history can be easily exploited, and scene staging should be seriously considered especially if the victim is presumed to have entered water. There are too many cases of women disappearing to presume that their bodies are lost at sea with suicide the most likely explanation.

Rabies is a zoonotic disease that affects many mammals, including humans, through bites from infected animals. We report a necropsy of rabies in a male patient from a rural background and the vital role of forensic histopathology in confirming the diagnosis of rabies. A man was admitted with fever, altered sensorium, aggressive behaviour and unconsciousness. Two years earlier he had been scratched on the foot by a stray dog but had received no anti-rabies treatment. He died within 96 hours of symptom onset. Histopathological testing of the brain during necropsy showed the presence of Negri bodies and confirmed the diagnosis of rabies. Although the incubation period of rabies can vary widely, this was not a classic case of rabies infection with a normal incubation period. In rural settings, where molecular testing is difficult, appropriate testing and analysis of samples with histopathology can clarify the diagnosis.

Genetic chimerism is crucial when assessing the effectiveness of medical treatments and surgical procedures. Factors that cause chimerism include genetic mutations, cell division processes, radiation exposure and cell fusion. Natural chimerism results from natural factors, while artificial chimerism results from medical procedures. It may produce deceptive DNA evidence, potentially causing erroneous accusations or exoneration of a guilty individual. This study aims to understand this phenomenon, measuring techniques and the standards followed in the interpretation of artificially induced chimerism following a systematic review of the literature related to chimerism and forensic evidencing techniques. This study comprehensively explores and consolidates existing studies on chimerism and its implications for sexual offences and investigates the influence of chimerism on forensic inquiries, particularly emphasising the treatments and procedures that may produce artificial chimerism. We reviewed multiple databases, encompassing peer-reviewed journals, grey literature and various online resources. DNA evidence plays a vital role in linking perpetrators to sexual assault cases but may produce misleading outcomes in instances involving a chimera. This concern is particularly significant where medical histories involve transplant or transfusion procedures. Though rare the potential impact on forensic investigation of sexual offences must be considered.

The digital revolution has transformed the way health records are kept and communicated. Electronic health records (EHR) have improved integration of patient data and increased their accessibility for both patients and healthcare providers. A drawback is the danger of a data breach and thus of patient confidentiality. This article provides an overview of patient data security in the digital era. It examines the different challenges and concerns related to data security and suggests potential solutions to protect patients' sensitive data. Additionally, we discuss the ethical and legal implications of data security in the healthcare sector and the probable impact on patient trust.

In 2022, the Health and Care Act created the Health Services Safety Investigation Body (HSSIB) with the intention of reducing risks to the safety of patients. Its investigators were given significant powers for entering properties, copying and taking away documents and equipment and calling people to interview. Obstruction by individuals, including refusal to address questions put to them at interview, is a criminal offence leading, on summary conviction, to a fine. However, the Act provided no safeguards in the form of an independent complaints process or a requirement that entries to properties and interviews must be video recorded.

We report an atypical case of suspension death involving chest compression. A 41-year-old male was found suspended from the veranda of his residence by means of multiple woollen shawls tied together to form an improvised rope. Autopsy revealed mechanical asphyxia as the cause of death with no evidence of foul play. The death was accidental, most likely due to the deceased's attempt to descend from the first floor by rope. This case highlights the need to carry out meticulous death scene investigations and autopsy examination to identify unusual suspension mechanisms, particularly in accidental deaths.

We report a fatal case of Ammi visnaga poisoning at Tangier's Forensic Medicine Department.An 18-year-old woman self-medicated with Ammi visnaga powder to treat her vitiligo. She experienced a wide range of symptoms and rapid clinical deterioration with a fatal outcome. The autopsy revealed lesions consistent with cutaneous vitiligo, necrosis of the liver, kidneys, lungs and pancreas. Toxicological and histological analysis confirmed chronic inflammation and acute systemic damage, highlighting Ammi visnaga's potential toxicity. Its bioactive components vary, with the toxic dose estimated at 1 g per kg. This case demonstrates that prolonged consumption of herbal remedies like Ammi visnaga can be dangerous and indeed fatal. Raising public awareness on the dangers of self-medication and need for medical supervision and education on the dosage and side effects of Ammi visnaga is essential. The marketing of these products by non-professionals should be restricted.

This study compares the costs of cerebral palsy healthcare in South Africa's private healthcare system with the lump sum compensation typically awarded in medico-legal claims. The analysis reveals that private healthcare costs for cerebral palsy, particularly within high-coverage benefit options, are significantly lower than the capitalised values awarded by South African courts. This suggests that the projections used in medico-legal claims may overestimate the true financial requirements for cerebral palsy care. The study advocates for evidence-based methodologies in medical expert witness assessments to ensure accurate and fair cost estimations, reducing discrepancies between private healthcare costs and medico-legal compensation.