The use of specialized (medical) knowledge in the criminal process: the practice of the European Court of Human Rights.

OBJECTIVE: Aim: This article is aimed at raising awareness and stimulating scientific discussion on the necessity of involving qualified medical professionals in conducting criminal procedural actions that involve intervention in human somatic rights, in order to further improve the legal instruments ensuring compliance with the European Court of Human Rights (hereinafter referred to as the ECHR) standards in this field. PATIENTS AND METHODS: Materials and Methods: In preparing the article, the following issues were worked out: the provisions of international legal acts; legal positions of the ECHR related to the use of medical knowledge in the criminal process; scientific studies of various aspects of the use of medical knowledge in the criminal process. The methodological basis of the research is dialectical, comparative-legal, systemic-structural, analytical, synthetic, complex research methods. CONCLUSION: Conclusions: The use of medical knowledge in the criminal process generally takes two forms: (a) expert and (b) ancillary. The expert form, particularly forensic medical examination, must adhere to a set of criteria reflected in the practice of the ECHR. Personal searches involving penetration into human body cavities generally align with the requirements of the he European Convention on Human Rights (hereinafter referred to as the Convention), provided certain conditions are met, including medical considerations. The criterion for the admissibility of coercive collection of biological samples for examination is the existence of samples independent of the individual's will.

[Legal and forensic medical problems of postmortem donation]. / Pravovye i sudebno-meditsinskie problemy posmertnogo donorstva.

The article is devoted to legal and forensic medical problems of postmortem donation. The substantive provisions of postmortem donation, as well as normative legal documents regulating the processes of organs harvesting from deceased persons for subsequent transplantation and governing the work of transplantologists and forensic medical experts have been considered. The practical examples illustrating the essence and nature of the problem of postmortem forensic medical expertise of persons with absent organs has been given and the importance of the participation of a forensic medical expert involved in the decision-making process on possibility (or impossibility) of the corpse's organs and tissues explantation without prejudice to the further expert examination has been emphasized. The authors pay particular attention to the inadequacy of the legal framework, including the lack of a clear understanding of the legal status of the person holding the position of forensic medical expert, who provides an expert opinion on the organs' explantation.

[Features of methodology for the formation of standard operational procedure in the practice of bureau of forensic medical expertise]. / Osobennosti metodologii formirovaniya standartnykh operatsionnykh protsedur v prakticheskoi deyatel'nosti byuro sudebno-meditsinskoi ekspertizy.

OBJECTIVE: To analyze and summarize data on formation and implementation in practice of standard operational procedures for developing algorithm to improve the quality management system of bureau of forensic medical expertise. MATERIAL AND METHODS: Normative legal documents regulating principles of standardization in healthcare were studied. Literature was analyzed in PubMed, Google Scholar, eLIBRARY search engines in English and Russian languages on the issues of development and implementation of standard operational procedures in practice. RESULTS: Data on using standard operational procedures as a standardization element in medical practice have been analyzed and generalized. Specific proposals for developing system of standard operational procedures, based on general principles for the creation of such documents, in forensic medical expert institutions have been proposed. CONCLUSION: Suggested recommendations can be used in practice to develop new common standard operational procedures.

The contribution of legal medicine in clinical risk management.

BACKGROUND: In advanced health services, a main objective is to promote the culture of safety and clinical risk management. In this regard, the reporting of sentinel events fits within a perspective of error analysis, attempting to propose solutions aimed at preventing a new occurrence of the harmful event. The purpose of this study is to analyze the contribution of medico-legal litigation in the management of clinical risk and to propose an organizational model so as to coordinate the intervention of clinical risk management and medico-legal services. METHODS: Retrospective review of 206 cases of medico-legal litigation, settled against a Hospital of a North-eastern city in Italy from January 1, 2014 and December 31, 2015. RESULTS: Approximately 20% of cases, that are classifiable as "sentinel events", were not reported due to various factors. The reason that these events are under-reported is mainly due to the latency between the event itself and its manifestation as a serious damage to health as well as the discomfort in reporting the events of this kind, which is still widespread among healthcare workers. The systematic research of the available documentation for medico-legal purposes permits the acquisition of more information concerning the clinical event, thereby increasing the number and accuracy of the reports to the clinical risk unit. CONCLUSION: The analysis of medico-legal litigation is a valid tool to enhance the reporting of "sentinel events". One possible proposal is the implementation of an organizational model to establish a rapid procedure for the reporting of sentinel events during the evaluation of medico-legal litigations.

Improving medicolegal death investigative gaps of fatal elder abuse.

The purpose of this brief is to present several case vignettes that illustrate omissions in the investigation of elder deaths. These vignettes demonstrate the need for a standardized approach in the conduct of medicolegal investigations of fatal elder abuse. For each of the described oversights, a recommendation is offered to address the gap in investigation processes, which in turn could improve the determination of cause and manner of elder death. Inherent limitations of resources and practical realities of death investigation are discussed and recommendations are made for future research. Viewed broadly, deficiencies in elder death investigations can lead to the underreporting of elder abuse and the reduction of legal options for victims, which may reflect a systemic pattern of social injustice.

Current legal issues of conducting a forensic medical examination of newborns' corpses.

OBJECTIVE: Introduction: Forensic medical examination is a mandatory investigative action in determining the causes of death of newborns. It is especially significant and occupies a key place in proving the corpus deliciti. The aim is to study the current legal issues of a forensic medical examination of newborns' corpses. PATIENTS AND METHODS: Materials and methods: The study of legal and literary sources was carried out. The library-semantic and the content analysis methods were applied. CONCLUSION: Conclusions: Forensic medical examination should also include questions regarding the mother of the newborn: whether she was healthy at the time of delivery; if the medical staff caused any harm to her or her child; if she had the necessary help before and during the childbirth, etc. Examination should be appointed if one of the parents has the desire, which must be expressed in writing in the form of a motion.

[Operational management of the state forensic medical expert activity in Russia as a scientific problem: brief history analyzed and prospects for further studies]. / Upravlenie gosudarstvennoi sudebno-meditsinskoi deiatel'nost'iu v Rossii kak nauchnaia problema: kratkii istoricheskii analiz i perspektivy issledovaniia.

The authors consider and systematize the methods currently in use for the purpose of operational management of the state forensic medical expert activity (FMA) in Russia throughout the entire historical period since the establishment and development of the forensic medical expertise service in this country as well as the prospects for its further improvement. The importance of the problem arises from the fact that the legal status of the forensic medical expertise in the Russian Federation remains a matter of scientific discussions. On the one hand, some experts consider it necessary to set up on a broader basis forensic medical facilities of a new type as an alternative to the existing governmental bodies. On the other hand, such structures are being de facto established by the state law-enforcement agencies. The organizational restructuring keeps abreast with the better understanding of the its theoretical principles, forms of and approaches to the operational management of the state forensic medical expert activity. Under these conditions, the historical analysis of the current forensic medical activities at different stages of their development and their operational management as well as prospects for their further improvement appears to be both highly justified and useful.

[On the occasion of the 200th birthday anniversary of D.E. Min]. / K 200-letiiu so dnia rozhdeniia D.E. Mina.

This article is dedicated to the memory of the outstanding Russian forensic doctor and literary figure professor D.E. Min on the occasion of his 200th birthday anniversary. The assignment of D.E. Min to the position of the head of Department of the State Medical Practice at the Emperor's Moscow University coincided with the large-scale judiciary reform carried out in the country at that time which envisaged, among other innovations, the practice of questioning of an expert in the court room. The new developments in the practical expert activities required the revision of the former approaches to the education and training of forensic medical experts. D.E. Min was the first to introduce the practice of public defense of expert judgements by the students of the Department as an indispensable component of their routine learning activities. He founded the museum of forensic medicine and pioneered the method for teaching the intravital forensic examination. D.E. Min initiated and supervised original research on mechanical asphyxia, forensic-medical toxicology, and traumatology. D.E. Min and his co-workers were frequently engaged by the agencies in charge of preliminary investigation to participate in forensic medical expertise associated with the inquiries into the most lurid criminal cases of those times. The scientist made the essential contribution to the development of forensic medicine in this country and the modernization of the academic process at the Department of the State Medical Practice that greatly promoted satisfaction of the basic requirements of practical forensic medical activities.

Medical immobilization as impairment of bodily organ functions within the meaning of the Polish Penal Code - consultative problems and a proposal for a method of judicial and medical evaluation.

AIM OF THE STUDY: The aim of the paper is analysis of the impact of immobilization treatment of "less severe" motor organ injuries affecting soft tissues on the position of medical experts and court decisions in crimes against health. We also analysed the attitude of courts to expert opinions and present a proposal for a model of judicial and medical opinion in such cases. MATERIAL AND METHODS: In the study, we analysed judgments of the criminal divisions of common courts, in which the use of medical immobilization of a given part of the body or lack thereof could have an impact on the degree of health impairment determined by the medical expert. RESULTS: Some experts consider medical immobilization to be tantamount to an impairment of the function of a body organ, and the courts rarely reject such opinions. For some experts, the key is not the actual function of the immobilized part of the musculoskeletal system after 7 days from injury, but the immobilization treatment itself, and not the time it takes. In addition, experts determine the severity of injuries when immobilization is/is not used. CONCLUSIONS: The degree of health impairment, as defined in the Penal Code, should be determined by a medical check-up carried out 7 days after the injury, with an assessment of its "biological" effects, and not by the use of immobilization treatment and the time for which it is maintained.

[Autopsies at the boundary between pathology and forensic medicine : Suggestions for interdisciplinary cooperation]. / Obduktionen im Grenzbereich zwischen Pathologie und Rechtsmedizin : Vorschläge zur interdisziplinären Kooperation.

There are many differences between forensic medicine and pathology but also many similarities, as they share a common basis. In this article the characteristics of the forensic autopsy and it's legal foundations are presented. Furthermore, possibilities are discussed for a cooperation between forensic medicine and pathology to increase the rate of autopsies. This could contribute to the legal certainty, to the quality assurance and to the training of physicians.

[What Surgeons Need to Know About Forensic Medicine]. / Was muss der Chirurg von der Rechtsmedizin wissen?

Background: Forensic medicine finds more and more resonance due to requests and queries from clinicians and acts as a mediator between the individual medical disciplines, in particular with regard to legal issues, and as an interface between the fields of medicine, police and judiciary. The aim of this short narrative overview is to make surgeons aware of the forensic aspects of their work, which is usually focused on clinical and curative aspects. Crucial points: Traditionally, the basic work in forensic medicine comprises sudden and unexpected deaths, for which it is important to definitely clarify the mode of death based on the detected cause of death. In addition to violent and unnatural deaths, there are sudden natural deaths, which are natural, but also unsolved. Clinical forensic medicine basically concentrates on the examination of victims of violence, which may comprise various types of bodily harm including sexual crime, child maltreatment and traffic accidents. The investigational results (autopsy findings, injury patterns, results from the investigation of traces) need to be presented and interpreted in public procedures at court by forensic medicine specialists, who act as experts answering questions while retaining a neutral position. Conclusion: Specialists in forensic medicine should not only be consulted for issues related to the inspection of corpses and to issue a death certification. Much rather, they should also be consulted as specialised partners of surgeons and other clinicians, e.g. for the documentation of specific findings and the description of injury patterns in injured persons who are still alive.

[Medicolegal aspects of child abuse]. / Rechtsmedizinische Aspekte der Kindesmisshandlung.

CLINICAL ISSUE: The prevention and clinical diagnostics of maltreatment of children and adolescents represents a great challenge to all medical disciplines concerned; therefore, an interdisciplinary collaboration is indispensable. DIAGNOSTICS: Medicolegal experts require specific radiological examination methods for the differentiation between accidental and non-accidental injuries, depending on the corresponding point in question. In addition, a clear and structured radiological appraisal of the findings is necessary. On the other hand, radiologists require an appropriate succinctly phrased question from the medicolegal expert. PRACTICAL RECOMMENDATIONS: A close collaboration between radiologists and medicolegal experts is mandatory for a better recognition of cases of child abuse; therefore, the joint establishment of diagnostic standards and a comprehensive implementation is necessary.

Conforming STOP Violence Against Women Formula Grant Program Regulations to Statutory Change; Definitions and Confidentiality Requirements Applicable to All OVW Grant Programs. Final rule.

This rule amends the regulations for the STOP (ServicesTrainingOfficersProsecutors) Violence Against Women Formula Grant Program (STOP Program) and the general provisions governing Office on Violence Against Women (OVW) programs to comply with statutory changes and reduce repetition of statutory language. Also, this rule implements statutory requirements for nondisclosure of confidential or private information relating to all OVW grant programs.

[A critical review of applied criminology]. / Angewandte Kriminologie auf dem Prüfstand.

By reporting on a recent decision of the Regional Court (LG) of Marburg (Germany) calling attention to applied criminology, a concept still insufficiently considered in the administration of criminal justice, the paper argues that professional action in the execution of the sentence represents nothing else but applied criminology. Based on this assumption, the paper discusses practical diagnosis and correctional planning. Beyond that, the paper deals with the future of criminology. In the opinion of the author an important aspect for the future of criminology will be if it will be able to remain in touch with the world in which we live, as an independent empirical science. Applied criminology and its methodology constitute the link between science and practice.

On manual laterality (handedness) in humans and its forensic significance - a literature review.

Manual laterality (handedness) in humans has some significance for forensic practice where it is primarily employed in the form of handedness preference, based on a simplified three-stage classification (right-handed, left-handed and ambidextrous). In cases of homicide or suicide, the pattern of injuries, particularly cutting or stab injuries and gunshot wounds, may provide clues as to the perpetrator's handedness. In injuries inflicted by another person, the pattern of findings can in isolated cases allow to draw conclusions as to the handedness of the perpetrator. In self-inflicted injuries and suicide, the dominant hand is usually used either alone or as the lead hand. If it is found that fatal injuries were inflicted by the non-dominant hand, this gives rise to doubt that the manner of death is suicide. Evidence of handedness is of little value in distinguishing between suicide and homicide. Due to new developments in dentistry, imaging procedures and especially genetics, the utility of handedness in the identification of unknown persons or cadavers has significantly diminished. In living subjects, useful evidence of handedness can be obtained by observing the performance of specific gestures or activities. The subject should be asked to perform tasks involving one and two hands in a specific sequence. Standardised measurements of the morphology of the shoulders and upper extremities are able to make a statistical distinction between right and left. Since the accuracy of this process is, however, only,around 75 %, morphological determination of handedness should not be used in living subjects, but should be restricted to the identification of unknown cadavers or other post-mortem examinations.

,,Flora and fauna" in criminalistics - an analysis of the current use and relevance of non-human biological trace materials in criminal proceedings.

The analysis of biological, non-human trace specimens can contribute significantly to solving a criminal case. The present study searches the relevant German criminal, forensic, legal and biological literature, focusing on animal hairs, insects and plant fragments, and assesses the current opportunities of this special forensic branch and its acceptance and relevance for the evidence in court. It turns out that the analysis of these trace materials has an enormous range of potential applications which should not only be reflected in the forensic sciences, but also in the criminal trials. However, in the legal literature and legal annotations the topic of biological, non-human trace materials is addressed only sporadically. To derive the greatest practical benefit from the developments of forensic biology, the knowledge about the use of biological, non-human trace specimens should be promoted for the criminal proceedings. Investigators, judges, prosecutors and defense lawyers should be more thoroughly informed and become trained by forensic biologists.

The Clinical-Forensic Network of Styria as a pilot project: findings of the accompanying socio-scientific study.

The clinical-forensic documentation of domestic violence and sexual offences should preferably be done shortly after the incident both under standardized and professional conditions in order to secure items of evidence for any legal proceedings in the best possible way. For this purpose, Austria's first low-threshold clinical forensic care unit was founded in 2008 in Graz. The resulting model project "Clinical-Forensic Network of Styria" (,,Klinisch-forensisches Netzwerk Steiermark") was developed to offer Styria-wide low-threshold facilities for forensic examinations, legally admissible documentation and securing of evidence. The need to pursue and extend this interdisciplinary network is obvious; this project may have a role model effect on the establishment of clinical-forensic networks in other federal states of Austria. In this regard, a high potential and an integrative effect on inter- and transdisciplinary network building are attributed to forensic medicine.

The Origin and Development of Medical Jurisprudence in Xiangya.

The origin of medical jurisprudence in China can be traced back to as early as 1920s, and since then, the discipline has undergone a great development. This paper, based on the disciplinary development of medical jurisprudence at Xiangya School of Medicine, illustrates its evolution in three aspects covering the scientific and theoretic foundation, legal system and policy support. The current investigation reflected a glimpse of the modern forensic science in China, providing useful historical reference for the development of Chinese forensic science.

[About the role of subjective factors in forensic expertise]. / O roli sub''ektivnykh faktorov v sudebnoi ekspertize.

The article examines the influence of subjective factors on the activities of a forensic expert. It is noted that to improve the objectivity and reliability of the findings of forensic experts is necessary to strictly observe the presumption of innocence, to develop guidelines for certain types of expertise, production of which is not carried out in the state forensic institutions, as well as carry out some other organizational and methodical activities.

[The new federal law in the light of forensic medical and legal proceedings].

The objective of the present study was the article by article analysis of the Code of administrative legal proceedings of the Russian Federation with special reference to the judicial-expert procedures with a view to enhancing the awareness of the readers with the new directions of activities of forensic medical experts in the law-courts. It is emphasized that a number of provisions of the Code have not been properly elaborated, nor have they been adequately coordinated with the standard regulatory acts concerning the analogous or related issues. It is concluded that the provisions of the Code pertaining to the activities of the forensic medical experts remain to be widely discussed in the public domain to provide a basis for the development of recommendations for the legislative correction of the selected articles of the Code.