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1.
Forensic Sci Med Pathol ; 17(2): 216-222, 2021 06.
Article in English | MEDLINE | ID: mdl-33151523

ABSTRACT

The rapidly evolving context of the COVID-19 pandemic has necessitated profound modifications to the provision of health care services on a global scale. The concomitant requirements of lockdowns and social isolation has had marked ramifications for vulnerable individuals at risk of violence. This ripple effect of the pandemic has been observed globally. It is crucial that clinical forensic medical units continue to provide quality and timely essential services to those affected by interpersonal violence. As such, processes in this field must be modified as COVID-19 cases present and knowledge about the disease changes. The experiences of conducting sexual assault forensic examinations of suspected and confirmed COVID-19 positive (S/COVID-19) patients in a hospital hot zone are presented, and additional forensic issues specific to the emerging COVID-19 context are discussed.


Subject(s)
Crime Victims , Forensic Medicine/organization & administration , Infection Control , Physical Examination , Sex Offenses , Australia , COVID-19/prevention & control , COVID-19/transmission , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics , Personal Protective Equipment
2.
J Forensic Nurs ; 16(4): 207-214, 2020.
Article in English | MEDLINE | ID: mdl-33149100

ABSTRACT

Forensic nurses currently serve in medicolegal death investigation settings nationwide, yet registered nurses seldom recognize death investigation as a career option. The purpose of this article is to describe medicolegal death investigation in the United States and the roles nurses can achieve, depending upon state and agency job requirements. Duties and qualifications for job positions, whether filled by election, appointment, or staff hiring, are described to provide examples of nurses' roles within the medicolegal death investigation setting and to present career options. Forensic nurses have the educational preparation, medical skills, and forensic knowledge to serve within death investigation systems as a chief officer (e.g., coroner), deputy officer, or staff investigator.


Subject(s)
Coroners and Medical Examiners/organization & administration , Forensic Medicine/organization & administration , Nurse's Role , Death Certificates , Humans , United States
3.
J Forensic Leg Med ; 76: 102036, 2020 Nov.
Article in English | MEDLINE | ID: mdl-33208233

ABSTRACT

The COVID-19 pandemic has forced forensic practitioners to consider how we perform our normal duties, especially when those duties involve humans. The potential for contracting the virus from working in close contact with living sufferers is high, and we have yet to fully determine the risk of infection from the deceased. In an attempt to support the community, the Journal of Forensic & Legal Medicine has drawn together three articles which underline the importance of continued forensic medical practice during the pandemic and highlight some factors to consider in a Roadmap towards safe practice. Our Roadmap has intentionally taken an international perspective and supports other work we have published in the Journal on our collective response to the COVID-19 crisis.


Subject(s)
Betacoronavirus , Coronavirus Infections/pathology , Infection Control/organization & administration , Mortuary Practice/organization & administration , Personal Protective Equipment/statistics & numerical data , Pneumonia, Viral/pathology , COVID-19 , Containment of Biohazards/methods , Coronavirus Infections/prevention & control , Forensic Medicine/organization & administration , Humans , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , SARS-CoV-2
4.
Forensic Sci Int ; 313: 110339, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32480289

ABSTRACT

The Gorkha Earthquake hit the region on 25th of April 2015, at 12:58, with the epicentre approximately 80 km N-NW of Kathmandu, recording 7.8 Mw on the Richter Scale. The disaster left almost 9000 individuals dead. The search and recovery as well as the subsequent Disaster Victim Identification (DVI) operations left much to be desired. The entire DVI operations consisted of examination of 365 bodies and collection of 15 blood/hair samples and 60 bone/tooth samples. This resulted in the scientific identification of eight individuals and visual recognition of 357. The scientific basis of identification of more than 8000 individuals, remains a question. The Disaster Response was hampered by miscommunication, incoordination and mismanagement on the part of all stakeholders and could have led to misidentification as well as missed identification. This demonstrates the importance of systematic management of dead bodies in mass casualty events to ensure dignity and respect of the deceased as well as family members. The helplessness felt by technical experts was compounded by the general lack of political will and the pressure on the law enforcement for quick disposal, irrespective of the available standards and protocols. Therefore, DVI operations can only be assumed to be a disaster in the making, when faced with lack of political will, lack of strict adherence to international standards as well as lack of determination from all stakeholders. Such a response from authorities is usually driven by panic following mass fatalities especially in disasters of great magnitude, like this one. The article discusses the challenges faced by the technical experts in the field and describes the advancements as well as recommendations for further improving the DVI operations in a resource-stricken country.


Subject(s)
Disaster Victims , Earthquakes , Forensic Medicine/organization & administration , Mass Casualty Incidents , Disasters , Humans , Nepal , Rescue Work
5.
Rev. esp. med. legal ; 46(2): 71-74, abr.-jun. 2020. tab, graf
Article in Spanish | IBECS | ID: ibc-193993

ABSTRACT

INTRODUCCIÓN: La implantación de un Servicio de medicina legal hospitalaria, como asesor y consultor en aspectos médico-legales, éticos y deontológicos de la práctica asistencial, se ha consolidado en el Hospital Clínico de San Carlos de Madrid. Una cartera de servicios sencilla basada en la prevención de riesgos legales, ha permitido que los profesionales, la administración sanitaria y los propios pacientes confíen en él. RESULTADOS: En el período 2007-2017 se gestionaron 1.213 expedientes, aumentando de forma progresiva y destacando los años 2009 y 2017 con un 13,8 y 12,3% de la actividad total, respectivamente. Las unidades que más consultaron fueron el equipo directivo 158 (13%), el Instituto de la Mujer 144 (11,9%) y el Servicio de Atención al Paciente 116 (9,6%). DISCUSIÓN Y CONCLUSIONES: El servicio participa en múltiples comisiones y grupos de trabajo elaborando guías, documentos y protocolos, abordando conflictos, dudas normativas, deficiencias formativas, recomendando cursos de acción, e intermediando con pacientes y familiares para disminuir la incertidumbre del profesional


INTRODUCTION: A hospital legal medicine department, to advice and consult on the legal, ethical and deontological aspects of healthcare practice, has been implemented in our centre, Hospital Clínico San Carlos (Madrid Spain). A simple service portfolio based on the prevention of legal risks, has allowed professionals, health service and patients to place their trust in it. RESULTS: The number of cases over the period 2007-2017 reflects major activity, and 2009 and 2017 are highlighted with 13.8% and 12.3% of the total activity respectively. The units that consulted the most were the management team 158 (13%), the Institute for Women's Affairs 144 (11.9%) and the Patient Care Service 116 (9.6%). DISCUSSION AND CONCLUSIONS: The department participates in multiple committees and working groups preparing guidelines, documents and protocols, addressing conflicts, regulatory doubts, training deficiencies, recommending courses of action, and mediating with patients and family members to reduce professional uncertainty


Subject(s)
Humans , Forensic Medicine/organization & administration , Delivery of Health Care/legislation & jurisprudence , Forensic Sciences/education , Hospital Units/organization & administration , Judicial Role , Directive Counseling
7.
Med Sci Law ; 60(3): 216-222, 2020 Jul.
Article in English | MEDLINE | ID: mdl-32299294

ABSTRACT

The autopsy rate in Japan is lower than that in other countries, and most death investigations have historically been conducted by police officers through external inspection. Although medicolegal autopsy was not performed during the samurai administration, the European death investigation system was adopted in the second half of the 19th century and judicial autopsy began in universities' forensic medicine departments. After World War II, the medical examiner system was introduced under US influence, but it was only adopted in certain areas. Further reforms were introduced in the 21st century-in 2012, two laws relating to death investigation were enacted: The Act on Promotion of Death Investigation (Promotion Act), which provided foundational principles and included measures for investigating the causes of death and identification of bodies, and the Act on the Investigation of Cause of Death and on Identification of Bodies Handled by the Police, which recommended a procedure for death investigation, including a new autopsy system.The Death Investigation Promotion Program was to meant to be decided by the government in 2014. However, the relevant Act expired after it ran out of time. Later, in 2019, the Basic Act for Promotion of Death Investigation, the successor to the Promotion Act, was passed. This Act is significant because it sets the basic foundational principle and imposes plans created by the government. However, it remains unclear how these measures can be implemented, so further discussion and financial investment are now required.


Subject(s)
Autopsy/standards , Forensic Medicine/legislation & jurisprudence , Forensic Medicine/organization & administration , Autopsy/history , Forensic Medicine/history , History, 18th Century , History, 19th Century , History, 20th Century , Humans , Japan
10.
Sud Med Ekspert ; 62(5): 64-67, 2019.
Article in Russian | MEDLINE | ID: mdl-31626198

ABSTRACT

A complex algorithm is proposed for the forensic medical service response in emergency situations marked by a large number of deaths from fire. Its use will promote increased efficiency in the work of forensic medical units while limiting the consequences to human victims in emergency situations.


Subject(s)
Fires , Forensic Medicine/organization & administration , Mass Casualty Incidents , Humans
11.
Hawaii J Med Public Health ; 78(6 Suppl 1): 55-60, 2019 06.
Article in English | MEDLINE | ID: mdl-31285971

ABSTRACT

The Medical-Legal Partnership for Children in Hawai'i (MLPC) has worked to address the social determinants of health for low-income patient-families since 2009. Focused on identifying health-harming legal needs, doctors and lawyers work together to assist families with family law, housing, public benefits, education, employment, civil rights, and other concerns. Providing free, direct legal service in the medical setting allows the medical-legal partnership (MLP) team to identify community-wide concerns such as language access violations, racial discrimination, and unfair policies. These individual concerns then inform systemic advocacy and community engagement efforts. The MLPC Hawai'i team has grown through its experiences working with public housing residents, Micronesian migrant communities, and low-income families, ultimately evolving the national MLP framework to become a patient-centered "medical-legal home." This evolution is possible through the utilization of "rebellious lawyering" concepts of working with, not just on behalf of, community clients. This article will introduce the concept of a medical-legal partnership, provide examples of lessons learned from working alongside vulnerable and resilient communities, and explore the idea of the patient-centered medical-legal home as an innovative program to improve the social determinants of health and reduce health disparities.


Subject(s)
Forensic Medicine/organization & administration , Patient-Centered Care/organization & administration , Forensic Medicine/trends , Hawaii , Humans , Patient-Centered Care/methods , Patient-Centered Care/trends , Social Determinants of Health , Vulnerable Populations/statistics & numerical data
12.
Int J Legal Med ; 133(4): 1083-1088, 2019 Jul.
Article in English | MEDLINE | ID: mdl-29943089

ABSTRACT

Self-inflicted fractures simulating traffic accident represent a new social fraud opportunity for criminality. Recognising scams through an increase of awareness of existence of self-inflicted arm fractures for insurance fraud could help community health workers to report these injuries to the competent authorities. In this article, authors have recognised an unusual but consistent pattern of upper and lower limb fractures whose incidence does not coincide in numerical terms with what is reported in literature. The aim of the present study is to describe fracture patterns observed over the past 2 years. Further, authors describe clinical presentations of these fractures and attempt to define a possible mechanism of these types of injuries.


Subject(s)
Accidents, Traffic/legislation & jurisprudence , Fractures, Bone/diagnosis , Fraud/legislation & jurisprudence , Insurance, Accident/legislation & jurisprudence , Self-Injurious Behavior/diagnosis , Forensic Medicine/organization & administration , Humans
15.
J Elder Abuse Negl ; 31(1): 56-65, 2019.
Article in English | MEDLINE | ID: mdl-30375941

ABSTRACT

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.


Subject(s)
Elder Abuse/diagnosis , Elder Abuse/legislation & jurisprudence , Forensic Medicine/legislation & jurisprudence , Forensic Medicine/organization & administration , Aged , Autopsy , Coroners and Medical Examiners/legislation & jurisprudence , Death Certificates , Emergency Medical Services , Humans , Physical Examination , Police
16.
Forensic Sci Med Pathol ; 14(4): 460-468, 2018 12.
Article in English | MEDLINE | ID: mdl-30276619

ABSTRACT

The scope, roles, and tasks of forensic medicine and forensic medical experts currently vary widely between countries and legal systems, which has resulted in barriers to organization, standard setting, and quality assurance for practice in forensic medicine, including for reporting. The legal fact finder is thus confronted with variability in the quality, structure, and content of forensic medical reports. We sought to define and categorize the scope, methods, and practices that fall under the description of forensic medicine, the various issues encountered in current forensic medical practice, and the potential role of evidence-based practice in forensic medicine. We searched electronic databases and reviewed relevant articles, as well as conducting personal correspondences with forensic medical practitioners around the world, to obtain a description of current forensic medical practice. The terms forensic medicine, legal medicine, medical jurisprudence, medico-legal services, forensic pathology, and clinical forensic medicine are used with mixed interpretations in different countries. The systems and services rendered are not uniform either. The methods used by forensic medical practitioners are not always evidence-based, or based on standardized methods, and vary greatly between experts and centers. There are also no universally accepted guidelines to prepare a standard and admissible report. The lack of a uniform system in forensic medicine creates difficulties in assessing the development and performance of forensic medicine as a distinct discipline. To prepare evidence-based forensic medical reports, generally accepted guidelines are necessary.


Subject(s)
Forensic Medicine/organization & administration , Humans , Terminology as Topic
17.
Sud Med Ekspert ; 61(5): 4-13, 2018.
Article in Russian | MEDLINE | ID: mdl-30307430

ABSTRACT

The Saint-Petersburg Bureau of Forensic Medical Expertise has created the universal system of the internal quality control oriented toward the more rational exploitation of the available resources, material and technical facilities, and systemic management of the quality of forensic medical activities. The system serves as a basis for the timely identification of undesirable problematic situations, efficiently predict and/or prevent them and the resulting deterioration of the quality of expert work leading to the inadequate provision of finance and resources. Moreover, the system makes it possible to optimize and correct the operational management of the Bureau activities and develop programs for successful carrying them out in the future. The results of the evaluation of all forms of control are used to work out the modern technologies for the management of forensic medical expertise activities together with the final concluding reports and analytical reviews of the positive experience and of the typical imperfections in forensic medical expertise operations are distributed among the structural departments of the Bureau. These materials are used as a basis for the development of the measures and recommendations for the improvement of forensic medical expert activities of the Bureau, compilation of analytical reviews, specification of the criteria for the effectiveness of the forensic medical expertise, improvement of the procedures for the specialist screening studies (in conformity with the internal standards adopted by the Bureau), the subject matter and the schedule of advanced expert training, contents and procedures of instructions, the systems of delegation of authorities and empowerment with responsibilities, provision of economic incentives for the staff members, etc.


Subject(s)
Forensic Medicine/organization & administration , Health Facilities , Humans , Quality Control , Russia
18.
Sud Med Ekspert ; 61(5): 3, 2018.
Article in Russian | MEDLINE | ID: mdl-30307429

ABSTRACT

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.


Subject(s)
Expert Testimony , Forensic Medicine/organization & administration , Forensic Medicine/history , Forensic Medicine/legislation & jurisprudence , History, 21st Century , Law Enforcement , Russia
19.
Sud Med Ekspert ; 61(5): 18-20, 2018.
Article in Russian | MEDLINE | ID: mdl-30307432

ABSTRACT

The article describes the system of quality control at all stages of forensic chemical investigations (including pre-analytical, analytical, and post-analytical ones) carried out by the Saint-Petersburg Bureau of Forensic Medical Expertise It is shown that standardization and control taken together make up a solid foundation for obtaining the reliable and reproducible results of forensic chemical investigations. Responsibility for the quality control at all stages of forensic chemical investigations lies on the heads of the respective departments. Special staff members are appointed to supervise performing each concrete form of control and keeping the relevant documentation.


Subject(s)
Forensic Medicine/organization & administration , Forensic Medicine/standards , Documentation/standards , Humans , Quality Control , Russia
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