Forensic Medicine Introduction Dr. Raid Jastania

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

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

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

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

Exercise 1:

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?

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

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

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

The Legal System The Criminal System Civil Courts: 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

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

How do Pathologist Collect the Evidence

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

Medical Reporting

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

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

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

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

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

Exercise 3:

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?

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

Exercise 4:

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.