Forensic Odontology Quiz

Medico-legal Investigation

• Forensic medicine applies medical knowledge to legal issues, assisting courts in legal proceedings.
• It's used in civil and healthcare-related legal issues.
• Medical jurisprudence combines law and medicine.
• Forensic medicine includes clinical (living) and pathological (deceased) aspects.
• Forensic odontology uses dental science to investigate causes of death.
• Forensic science applies various scientific methods (fingerprints, toxicology, DNA, ballistics, etc.) to legal proceedings.
• Death investigation principles include determining circumstances, location, and body examination.
• Investigation aims for correct certifications, accurate statistics, and criminal/civil justice support.

Investigation of Death Principles

• Circumstances leading to death are key.
• The scene of the death is a significant area to investigate.
• Examination of the body is crucial to determine the cause of death.
• A death certificate is connected to all the above.

Aims of Death Investigation

• Accurate death certification.
• Proper documentation of bodily harm.
• Accurate and complete record keeping and statistical analysis.
• Criminal justice support in determining the cause of death.
• Civil justice involvement is necessary where disputes, estates or insurance is concerned.
• Public safety measures (eg, car safety regulations)
• Educating public about preventable deaths and general safety measures .
• Providing information to next of kin concerning the cause and circumstances of death.

Medico-legal Systems for Investigating Death

• Natural deaths where a doctor signs a death certificate allow for cremation or burial.
• If death is unnatural use investigation systems to identify cause and perpetrators.
• Legal officers (coroners, medical examiners, magistrates) investigate unusual, suspicious, or unexplained deaths.

Medico-Legal Systems in Malta

• Magistrates are appointed by the President (from nominated candidates) after 7 years of practice as a lawyer.
• They preside over inferior courts.
• Magisterial inquiries (inquiries on matters of general concern) are launched by police or private citizens, to investigate whether a criminal offence has occurred.
• In these inquiries, magistrates gather evidence to determine whether an offence has been committed.
• Magistrates also hold in-quests into suspicious deaths.
• They may conduct hearings on site or instruct police officers.
• They can appoint experts to help with investigations.
• Courts of Justice (Superior Courts) include: the Constitutional Court, Court of Appeal, Court of Criminal Appeal, Civil Court & Criminal Court.

Court Experts

• Clinical forensic physicians or pathologists examine the scene, and advise the Court.
• Scene-of-crime officers (SOCOs) also collect evidence at the scene with specific training.
• A photographer, architect and other experts are also crucial (ballistics, toxicologists, DNA experts, etc.).
• Court experts conduct independent investigations funded by the judicial system.

Deaths Reported to the Magistrate

• Article 551(1) Criminal Code requires reporting of violent or suspicious deaths to magistrates.
• Article 551(2) states inquests are necessary for persons imprisoned/detained in place of confinement.
• Inquests must be held when someone dies while in police custody or within a specific hospital.
• Guidelines are provided for uncertified cases, those due to violent incidents, unclear causes, cases in custody, or deaths related to accidents (vehicle, aircraft, etc.).
• Deaths in fires and explosions, unattended child deaths, unexplained child deaths, and possible suicides are also included.

Manner of Death

• There are 5 listed categories for the manner of death: natural, unnatural (accident/suicide/homicide), unknown, undetermined.
• Causes and mechanism of death are also distinct terms, the manner is the legal categorization (eg. natural, accident), cause is the medical condition (eg. stroke, cancer) and mechanism is the physiological derangement resulting in death (eg. cardiac arrest, respiratory arrest).

Case Studies for Identification

• Key info on the case - for example a burnt body.
• Information (position of the body on scene, personal effects from the scene, etc.) needed to identify a victim.
• External examination (height, weight, build, age, race, hair, eyes) needs for identification.

Identification Further Points

• Identifications can be from keys, papers, ID, clothing, jewellery etc..
• Features for an external exam are height, weight, build, loss of water/shrinkage,body length changes after death, degree of decomposition, appearance etc.
• Age examination uses fontanelles (babies), ossification centres & epiphyses (children), and teeth and bone (adults).

Bone Identification (Case 2)

• Bone characteristics include height, weight, build and age. (carbon 14 dating, amino acid analysis)
• Sex identification based on the skull (larger/smaller skull, square/round orbits, mastoid process) and the pelvis (infrapubic angle).

Dental Evidence (Case 2)

• Sexual determination can be from teeth (eg. males have wider/longer mandibles and differences in maxilla).
• Racial determination is more ambiguous.
• Age indicators can be with biochemical tests for acid in dentine.
• Various special methods exist for determination of age (eg, morphological dental and skeletal).

Medico-Legal Implications of Wounding and Head Injuries

• Article 216(1) - Grievous bodily harm (GBH) for any harm leading to potential loss of life, permanent disfigurement, or permanent disability.
• Article 218 - GBH related to inflicting permanent debility of health or impairment of any organ.

Deaths Reported to the Magistrate (continued)

• There are specific criteria for reporting deaths to a magistrate; various types of deaths are categorized (eg. uncertified deaths, due to violence or suspicion, death in legal custody, accidents involving vehicles).

Deaths in Infancy

• Foetal death occurs before expulsion from the mother.
• Perinatal covers deaths from 22 weeks of gestation up to 7 days after birth.
• Neonatal covers deaths from birth to 28 days.
• Infant deaths occur under 1 year of age.
• Signs of life are breathing, heartbeat, movement and crying.
• Stillbirth is the death of a foetus after 22 weeks of gestation which was born but not shown to be living.
• Causes of infant deaths include, prematurity, birth asphyxia, trauma, infections, congenital abnormalities, SIDS.

Death in Water

• Presence of a body in water does not always mean drowning.
• Drowning encompasses immersion (can exist in various liquids) where airway is obstructed and exchange of gas cannot occur.
• Cases of drowning could include natural, unnatural (eg., accident/suicide/homicide), or trauma related deaths.
• Several phases can be associated with drowning, including cold shock response, cold incapacitation, and hypothermia.
• Signs of drowning may include external signs (froth in airways), internal signs (fluid in the lungs), or pathological signs.

Road Traffic Accidents

• Autopsy findings used in RTA include examination of the external and internal injuries.
• Factors determining cause include injuries consistent with accident type and mechanism. Data collected includes reports from doctors and other officials, as well as scene photographs.
• The analysis identifies the cause, mechanisms of injury and type of vehicle.

Alcohol Metabolism and Legislation

• Alcohol is absorbed and distributed in the body and is broken down in the liver.
• BAC rates vary by person and activity (eating, drinking carbonated drinks, etc).
• Laws detail the permissible BAC limits.

Cybercrime and Digital Evidence

• Cybercrime encompasses various digital crimes (eg, hacking, malware, data breaches, fraud etc), typically involving a person or organisation using a computer, network or the internet against another for illicit means.
• Digital evidence refers to any data or information stored or transmitted on digital devices which may be used to determine or demonstrate something in court or other related legal processes. Collecting and preserving evidence requires measures like preventing alteration, establishing boundaries/barriers for the area, and establishing access controls for the scene of an incident.

Forensic Imaging

• Forensic image creation is a bit-level duplicate to preserve the original data so that alterations or changes are not made to the evidence.
• Best methodology includes careful documentation with labelling, use of anti-static bags and securing the items appropriately.
• Validity depends on the integrity/authenticity/relevance of the evidence.

Medical and Kindred Professions Ordinance

• This involves healthcare professionals' duties, registration requirements for various professionals (doctors, dentists, pharmacists, nurses), and regulations regarding the prescription and sale of medications, poisons and psychotropic drugs
• Licencing processes for various medical professions are detailed.
• Standards of conduct and ethical procedures are laid out and penalties for breaches are specified in detail.

Guardianship Act (Malta)

• Procedures and process for assigning a curator to individuals with mental incapacities, that lack capacity.
• Legislation on incapacitation, guardians and the role of the psychiatrist in evaluating a person's ability to make decisions.