Forensic Medicine Introduction

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Forensic MedicineIntroduction

• Dr. Raid Jastania

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Books

• Simpsons Forensic Medicine, 12th Edition
• Color Atlas of Forensic Pathology by Jay Dix
• Jastania_at_hotmail.com
• http//uqu.edu.sa/staff/ar/4180114

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This Course

• Elective
• Appreciation Orientation of Forensic Medicine
• Contents, Syllabus
• Objectives of the the course
• Exam

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Well,What is this Course about?
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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?

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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!!!

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Problem 3

• During your rotation in the Geriatric ward, one
  of you patient dies. The patients 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?

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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?

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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?

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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?

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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?

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Problem 8

• The police is investigating a case of Medical
  malpractice. They see your name in the patients
  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?

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Forensic Medicine

• Definition
• Branch of Medical practice concerns with
• Legal issues
• In Life and Death
• Usually performed by Pathologists

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Aspects of Forensic Medicine

• Life and Death
• Medical Malpractice
• Abuse
• Ethics in medical practice
• Legal issues

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Forensic Medicine

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

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The Law

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

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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

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Doctors and the Law

• Citizen
• Professional witness
• Expert witness
• Attendance at court
• Written reports
• Giving evidence
• Behavior in court

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How do Pathologist Collect the Evidence
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Autopsy

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

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Medical Reporting
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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

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ExerciseWhat do we need to write in Autopsy
report?Make a List!
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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

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Structure of a Report

• Physical Examination
• External
• Internal
• Treatment given
• X-rays
• Blood tests, toxicology
• Injuries
• Openion

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Tips for Reporting

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