Forensic Medicine PDF

INTRODUCTION DR. SABIR MEKKI FORENSIC MEDICINE HASSAN Objectives :By the end of this interactive session the learner should be able to defne forensic medicine. 1 To classify forensic medicine. 2 To defne autopsy. 3 Enumerate and discuss diferent types of autopsy. 4 To identify the objecti...

INTRODUCTION DR. SABIR MEKKI FORENSIC MEDICINE HASSAN Objectives :By the end of this interactive session the learner should be able to defne forensic medicine. 1 To classify forensic medicine. 2 To defne autopsy. 3 Enumerate and discuss diferent types of autopsy. 4 To identify the objectives of autopsy. 5 DEFINITION FORENSIC: Comes from the Latin word (FORENSIS) which literally comes from marketplace or forum It is defned as that branch of medicine which applies the knowledge and principles of medicine for the purposes of law. CLASSIFICATION CLINCAL FORENSIC MEDICINE: Practicing forensic medicine in living subjects e. g : 1. trauma. 2.suspected poison. 3.identifcation in living by age , sex , person and race. 4.suspected rape. 5.suspected criminal abortion. 6.suspected illegal pregnancy. 7.disputed paternity. P0ST-MORTEM FORENSIC MEDICINE: 1.external examination of a dead body. 2.autopsy. 3.exhumation. 4.identifcation of remains. Types of remains(dead bodies):- Fresh, putrifed,mummifed,saponifed,macerated, fragmented,skeletonized,dismantled,burnt, mangled. ?WHY STUDY FORENSIC MEDICINE 1.To defend ourselves against the ever increasing legal allegations. 2.To look after the medico-legal rights and interests of our patients SUBJECTS CLOSELY RELATED TO FORENIC MEDICINE 1.FORENSIC SCIENCES: This is the legitimate sister of forensic medicine. Includes: toxicology, serology, cytogenetic …etc.:- 1.the frst to go the scene of accident to collect the evidence. 2.after autopsy, they examine and analyze the samples taken from the body. 2.FORENSIC PATHOLOGY: Practiced by pathologists , usually, in natural death to know the cause of death to feedback the clinicians. Also they examine the tissue samples after autopsy. 3.FORENSIC STOMATOLOGY(ODONTOLOGY): Concerned with identifcation using teeth , bite marks , mandible etc….. 4.Forensic psychiatry:- Concerned with legal aspects of mental disorders. 5.Forensic anthropology:- The study of bodily shape and skeletal formation in legal sense and also for identifcation purposes. 6. Forensic entomology:- Use of insects for medico-legal purposes. MEDICAL JURISPRUDENCE: Concerned with the legal aspects of the medical profession such as laws and ethics that regulate the practice of medicine; where forensic medicine is mainly concerned with the medical aspects of law. AUTOPSY:-(NECROPSY , POST- MORTEM, THANATOPSY) Literally means look it for” oneself” This is external and internal examination of a dead body in a certain manner for many purposes. TYPES: 1.FORENSIC AUTOPSY: This is external and internal examination of a dead body for medico-legal purposes to obtain medico- legal fndings. It includes documents. 2.PATHOLOGICAL AUTOPSY: This is done by a pathologist and the main purpose here is the cause of death where it is uncertain.It is done in natural death. 3.RADIOLOGICAL AUTOPSY : This is a newly emerging type of autopsy e.g CT scan to see the water level in paranasal sinuses in case of drowning. 4.MOLECULAR AUTOPSY : This 5.VERBAL AUTOPSY : This is done by the treating doctors in cases of natural death in a hospital setting depending on the history , clinical examination and 6.Needle or sample autopsy:- Done in epidemics, examples:- 1.taking samples from internal body parts using a needle. 2.taking rectal swab in cases of cholera. 3.taking skin snip in cases of Ebola. 7.Second autopsy:- 1.To fnd out the cause of death when could not be found by the doctor who did the frst autopsy. 2. When the relatives are not satisfed. 8.Negative autopsy:- When the gross and microscopic fndings fail to reveal any apparent cause of death. Rate 5-8% even in well equipped centers worldwide. Possible reasons:- 1.Inadequate history. 2.Lack of proper external examination. 3.Improper internal examination. 4.Insufcient histological examination. 5.Inadequate pathologist training. 6.Cause of death needs cytogenetic studies.  9.Obscure autopsy:- No defnite cause of death or the cause of death is obscure. Causes are:- 1.Concealed trauma such as brain concussion. 2.Cardiac causes such blunt force injury , cardiac arrest ,cardiac arrthmias. 3.Refex vagal inhibition. AN AUTOPSY REPORT: There is no one agreed method to write an autopsy report, but generally:  it may be written in a simple(lay) language or a scientifc professional language with a glossary.  it should be legible( readable).  it should include the date and 1. includes the addressed authority , the date and time of autopsy, the identifying information of the deceased and the general description of the body from outside. 2.the opening of three cavities or any other necessary part and commenting on the normal and abnormal.  :-The objectives of autopsy To make a positive identifcation of the body and to assess the size, physique and nourishment. To determine the cause of death or, in the newborn, whether live occurred. To determine the mode of dying and time of death, where necessary and possible. To demonstrate all external and internal abnormities, malformations and diseases. To detect, describe and measure any external and internal injuries. To obtain samples for analysis, microbiological and histological examination, and any other necessary investigation. To retain relevant organs and tissues as evidence. To obtain photographs and videos for evidential and teaching use. To provide a full written report of the autopsy fndings. To ofer an expert interpretation of those fndings. To restore the body to the best possible cosmetic condition before release to the relatives. THANK YOU VERY MUCH