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:
– 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
• 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
– 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.