Revista Espanola de Medicina Legal最新文献

This contribution will address the shown inconsistency with regard to the mental health field of the Spanish Ministry for Equality's Law 4/2023, which affects people with sexual diversity. In order to provide a context for it, an extensive, non-systematic search of related scientific articles was undertaken, mainly in the MEDLINE and InDICEs-CSIC bibliographic databases. It will consider, in particular: (a) gender discordance as a sexual health diagnosis; (b) sexology, minority, and Spanish law; and (c) counter-conditional health interventions. The aforementioned law modifies the registration of the sex of children between the ages of 12 and 14, contrary to the criteria of the General Council of the Judiciary Eliminate (CGPJ), and classifies as a very serious offence the application of conversion treatment to those concerned. This law contradicts current global nosologies, nosographies, and nosotaxies that certain mental disorders can seriously distort the will of some people.

Introduction

Obstetrics and gynecology is one of the specialties most involved in malpractice claims. However, there are few studies that provide scientific information on this topic. The aim was to analyze the characteristics of medical liability rulings in Spain in public health care in the speciality of obstetrics and gynecology.

Methods

Cross-sectional observational study that analyzed the rulings handed down in the contentious-administrative jurisdiction by the Superior Courts of Justice (2008–2020), in the speciality of obstetrics and gynecology. The variables were administrative, clinical, judicial and compensatory.

Results

We analyzed 1,015 rulings, of which 142 (13.99%) related to the speciality of obstetrics and gynecology. A total of 67.61% of the rulings were dismissed at first instance and 89.28% at second instance. The most frequent reasons for an upheld ruling were diagnostic and/or therapeutic malpractice (40.90%), lack of information (20.45%) and loss of opportunity (18.18%). The most frequently claimed damage was sequelae (66.14%). The median award was 53,758.50 euros (2,000-800,000).

Conclusions

The high frequency of claims in obstetrics and gynecology indicates that these are “high risk” specialties for litigation. The vast majority of judgments are dismissed, i.e. in favor of the administration. The analysis of these results helps to structure the role of lawsuits and to increase professionals' knowledge of the medico-legal aspect of health care.

Introduction

Calliphoridae flies allow estimating the post-mortem interval, as they are the first to arrive at a decomposing body. Its larvae feed on the carcass and then move away to pupate (post-feeding dispersal). Since the environment alters the physiology and behavior of insects, the dispersal of larvae and the final location of pupae could be related to the place where the carcass is deposited. The aim of this work was to study the dispersal of post-feeding larvae in relation to environmental variables in northern Patagonia.

Materials and methods

The distribution of pupae in response to different illumination, temperature and soil inclination conditions was evaluated. A circular box divided into quadrants was used for each treatment and a control. Post-feeding larvae were placed in the center of each box, allowing them to disperse until they pupate. Differences in the number of pupae collected in each quadrant were evaluated by X² tests.

Results

According to the control, the dispersion of post-feeding larvae occurs randomly (p = 0.098). Regarding temperature, the larvae eluded the heat source (p < 0.01). The inclination treatments showed that larvae avoided the raised surface (p < 0.01). Concerning illumination conditions, no trend was observed (p = 0.41).

Conclusions

Knowing the dispersal patterns of larvae, considering environmental variables, reduces search times and let infers the sectors with the highest probability of finding pupae. In this way, it is likely to estimate a more precise post-mortem interval in the framework of medico-legal investigations.

Introduction

Human bone remains from forensic contexts can present different degrees of complexity due to the action of postmortem processes that can alter the state of the corpse. In these cases, osteometric methods to determine sex are very useful. This work aims to adjust 8 discriminant functions previously developed by Mansegosa et al. 2018, to determine sex in long bones with applicability in modern populations of central-western Argentina.

Materials and methods

8 discriminant functions for long bones were adjusted by surveying 8 variables in the clavicle, humerus, ulna, radius, femur and tibia in 103 adult individuals (42 females and 61 males) belonging to the Osteoteca de Mendoza para la Investigación Científica y Forense (Mendoza, Argentina). A cross-validation test was carried out and then the formulas were applied to a sample of 12 individuals with known sex corresponding to real forensic cases worked on by the Anthropology Laboratory of the Cuerpo Médico y Criminalístico de Mendoza.

Results

Of the 8 discriminant functions, three reached acceptable values (> 80%) in both sexes, which correspond to the humerus, radius and clavicle. Cross-validation yielded overall percentages ranging from 72.3 to 87.5%. The sample from forensic contexts could be completely sexed with an efficiency of 91.7%. The generated model constitutes a first step in the generation of methodology to strengthen forensic anthropological research in Argentina.

Introduction

After the approval of Law 35/2015, the insurer is obliged to submit a motivated offer in cases of traffic accidents and the possibility of requesting an extrajudicial expert advice from the Institutes of Legal Medicine in case of disagreement with the previous one.

Objective

The objective of this paper is to describe the differences between the motivated offers of insurers and the forensic reports of the 409 extrajudicial expert advice requested to the Institute of Legal Medicine in Valladolid from 2021-2022 and to propose a methodology for comparing.

Material and methods

All extrajudicial expert advice data from 2021-2022 was obtained, analyzing the days of personal injury and sequelae and translating them into compensation variables.

Results

Forensic reports are more favorable for traffic injuries in about 81% of cases, granting on average an amount of almost € 1,400 more. This difference is mainly due to a greater consideration of sequelae, as well as a higher proportion of days of moderate particular damage in the forensic report. However, this difference is more or less accentuated, depending on the company that makes the motivated offer.

Conclusion

Translating the data from the forensic reports and motivated offers to compensation variables, allows us to make a comparison of the differences between both reports, observing that the forensic reports are more favorable than those issued by the insurers, at least in the province studied, and more studies are needed to have a more complete view.

Given the inclusion of the Complex Post-Traumatic Stress Disorder (C-PTSD) in the International Classification of Diseases 11th edition, this article analyses the C-PTSD as a possible new diagnosis in women victims of gender-based violence to explain a wide range of symptoms resulting from interpersonal, persistent, continuous, severe and uncontrollable traumas that may occur in this context. Thus, it describes the psychological impact and the psychopathological consequences it produces on the victims, which are most serious when the violence suffered has occurred repeatedly and over time. In addition, it delves into the differential diagnosis of C-PTSD with other psychopathologies. Finally, a protocol for forensic psychological assessment is proposed based on C-PTSD as a clinical disorder, which explains the serious psychological impact on the evaluation of women victims of gender-based violence, considering this disorder as an alternative diagnostic hypothesis in the forensic psychological assessment of the psychological injury.

Despite progress in the development and validation of analytical methods. In the meantime, the challenges in interpretive forensic toxicology remain persistent, since it is no easy to establish a causal link between the concentration of a compound in biological samples and its impact on a real case. A proper interpretation of results is required to ascertain their relevance and to ensure that the investigator or jurist can make the most of the utility of the trace within the framework of the investigation or within the courtroom.

Because of their complexity and frequent presence at toxicology laboratories, in this article we have focused our attention on the interpretation of results in drug-facilitated offences, in cases where hair samples are involved and in cases related with post mortem investigation. Following this review, the advances in analytical results interpretation in the selected cases, are being mainly conducted towards metabolic studies.

In cases of drug-facilitated crimes it allows to extend the detection window and identify low concentration consumption markers for fast-clearing compounds. Regarding hair metabolomics analysis, recent studies can assist us to determine the deterioration caused by cosmetic treatments or to elucidate the difference between consumption and extern contamination, which are a well-known factor affecting the interpretation of hair analysis. Concerning post mortem results, progress is intended to ensure better reference data, to the study of drug-to-drug interactions as well as to the application of metabolomics and to the acknowledgment of the genetic variances related with drugs metabolism, location, and mechanism of action.