Post on 30-Dec-2015
description
Forensic MedicineIntroduction
Dr. Raid Jastania
Books
• Simpson’s Forensic Medicine, 12th Edition
• Color Atlas of Forensic Pathology by Jay Dix
• Jastania@hotmail.com• http://uqu.edu.sa/staff/ar/4180114
This Course
• Elective
• Appreciation Orientation of Forensic Medicine
• Contents, Syllabus
• Objectives of the the course
• Exam
Well,What is this Course about?
Problem 1
• You are on call in the medical ward. At 3 am the nurse calls you and asks you to come to see a patient. You come to the room and find the patient “Dead”
• What do you do?
Problem 2• You are doing ICU rotation. You see this 24 year
old man who had RTA and is on mechanical ventilation for 2 years.
• The family approach you and ask you: Is the patient “Brain Dead”? Is there a chance of recovery? Can you disconnect the mechanical ventilation?
• Another family member starts telling a story about someone who has been in “coma” for 2 years and then has full recovery!!!
Problem 3
• During your rotation in the Geriatric ward, one of you patient dies. The patient’s daughter comes to you and asks you:– (My father was working in a factory of
construction and isolation material, and I suspects that he has been exposed to a “carcinogenic material, Asbestos”. Is this death related to this?
• What would you do?
Problem 4
• In a fire, a man is found “Dead”!
• The Police is questioning:– Is this Accident?– Or is it murder?
• What do you think?
Problem 5
• During your ER rotation, you see this 5 year old boy with multiple injuries and bruises on the both legs, back and forehead….
• You have suspicion of “Child Abuse”!!
• What would you do?
Problem 6
• A 23 year old boy has epilepsy and does not hold a driving license. However, he is found dead following a car accident. He is the driver!!
• You are asked to fill in the “Death Certificate”
• What is the cause of death? Is this accident? Or is it natural death?
Problem 7
• A friend of yours calls you and ask for “sick leave” for 5 days. He knows that you work in the hospital and you can easily do him a favor!!
• What would you do?
Problem 8
• The police is investigating a case of Medical malpractice. They see your name in the patient’s file. They ask you to write a report about the patient. This report will be considered as “Evidence” in their investigation!
• What would you do?
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
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:
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