Forensic Medicine Introduction

1. Forensic MedicineIntroduction Dr. Raid Jastania

3. Forensic Medicine • Definition: • Branch of “Medical” practice concerns with • Legal issues • In Life and Death • Usually performed by Pathologists

4. Aspects of Forensic Medicine • Life and Death • Medical Malpractice • Abuse • Ethics in medical practice • Legal issues

5. History of Forensic Medicine • Not before civilization with: • Development of Law • Medical knowledge • Egyptian law and medicine • Medical, surgical knowledge • Law, prisons, pyramids • Toxins: arsenic, mercury, copper • First medico-legal expert

6. The Greek legal code: • Hippocartes and scientific methods • Legal code • Poisons, abortions • Romans, Chinese • Scientific medicine • Anatomy, physiology • Use of microscope • specialization

7. Exercise 1:

8. You receive a phone call from a lady that her father has died of lung cancer and you are asked to write a report of the “Cause of Death”. • She tells you that her father was working in a factory of construction material and she suspect that his death is related to toxicity of these construction material. She suspects “Asbestos” exposure. • What would you do?

9. Who can write this report? • What are the consequences? • What are the “Standards of Practice” is such a situation? • ما هي أركان الجريمة؟

10. Forensic Medicine • Who performs what: • It depends on the legal system of the country • Terms: • Coroner • Medical Examiner • Court • Death certification • Police

11. The Law • Source of the Law • Medical Profession Rules • Legal vs Ethical responsibilities

12. The Legal System • The Criminal System • Offences against public interest • Individual is presumed innocent until found guilty • Penalties: fines, imprisonment, beating, amputation of parts, execution • Civil Courts: • Between individuals • Restoration of position before the event • Usually financial compensation

13. Doctors and the Law • Citizen • Professional witness • Expert witness • Attendance at court • Written reports • Giving evidence • Behavior in court

14. How do Pathologist Collect the Evidence

15. Autopsy • Definition: • Post mortem examination of body • External • Internal organ • Types: • Clinical “Hospital” Autopsy • Forensic Autopsy • Description of Autopsy Suite

23. Medical Reporting

24. Medical Reporting • Who is requesting the Report • Police, judge, lawyer, government department • Am I entitled to write such a report? • Confidentiality • Lack of knowledge • Consent of living patient • “assumed” consent • Criminal cases

25. Exercise 2:What do we need to write in Autopsy report?Make a List!

26. Structure of a Report • Patient data • Doctor Data • Time, date, place • People attending autopsy • Consent of autopsy • Next of ken • Extent of autopsy • Special requests

27. Structure of a Report • Physical Examination • External • Internal • Treatment given • X-rays • Blood tests, toxicology • Injuries • Openion

28. Tips for Reporting • Make it Simple • Relevant information • ?Abbreviations • Background of death • Scene visit of death • Confidential • No change or delete

29. Exercise 3:

30. In a street fight, a 25 year old man had stabbing wound in the central chest. Few minutes later, he collapsed and died. • What is the cause of death?

31. The cause of death was written as: • (Cardio-Respiratory arrest following stabbing wound on chest)

32. Exercise 4:

33. You see a 6 year old boy in the ER, who was brought by his mother because of laceration in the forehead. • According to the mother, the boy was running and fell done on the floor. • On examination you noticed at least 3 bruises on the anterior aspect of the legs. • You documented and reported “Child abuse” and called the authorized person to investigate in the case.