Accidental childhood deaths. The Metropolitan Dade County experience, 1978-1982

Accidental deaths in childhood were studied between 1978 and 1982 in Metropolitan Dade County. Cases were collected from both traffic and nontraffic accidental fatalities in which the victim was less than 12 years of age. Cases were then subdivided into traffic and nontraffic groups. Each group was then analyzed as to age, race, sex, cause of death, and scene circumstances. A total of 294 cases was studied.     

Postmortem dismemberment/mutilation--medicolegal and criminalistic evaluation of the autopsies performed by the Institute of Legal Medicine at the Hanover Medical School

Among all the autopsies performed by the Institute of Legal Medicine at the Hanover Medical School between 1978 and 1998. 16 cases of postmortem dismemberment/mutilation were evaluable under criminalistic and medicolegal aspects. In the present study, particular attention was paid to the psychosocial circumstances of the perpetrator's and victim's lives and also to the classification of the different types of postmortem dismemberment/mutilation illustrated by case reports. Apart from an unfavourable personal life situation at the time of the offence, essential predisposing factors were: poor integration in society and family, occupational problems, drug abuse and mental diseases. As the interactions between these factors differ in every single case and may be combined with other factors, the analysis of such homicides should always be based on the assessment of the individual case.     

医疗纠纷的性质及救济方式

本文从医疗纠纷的法律性质入手,对其归责原则、责任构成、证明责任、责任范围等进行比较分析,并提出获取救济的方式问题。     

法律文化与法律移植:中西古今之间

自传统社会,就出现了法律的跨文化和跨国家的传播和流动.在比较法学领域,研究者通常把这种法律的传播和流动称作法律移植.法律移植不仅涉及政治、经济、宗教和社会等外部因素,而且涉及法律文化.本文拟探讨法律文化与法律移植的一般含义,重新思考中西古今法律文化的异同及其与法律移植的关系.     

Blood alcohol concentrations of sudden unexpected deaths and non natural deaths.

This study reports on the relationships between the blood alcohol concentration (BAC) and the cause of death - which is of course common knowledge for forensic scientists! Our special aim was to gain unselected data for generalizing conclusions. The blood of 2465 consecutive cases (86% of all 2852 sudden unexpected and unnatural fatalities investigated at the Institute for Legal Medicine in Hamburg during the year 1989) was analysed. The BAC was evaluated according to sex, age, cause of death and place of death. In natural causes of death there were 80% cases under 0.05% BAC. Endocrine and digestive system diseases in particular were associated with positive BAC values. In unnatural death cases the BAC under 0.05% was found in 64% of the suicides, 62% of the accidents, 54% of the homicides and 51% of the drug intoxications. The drowning cases showed higher BAC's than traffic accidents. In suicides middle aged males had high BAC's.     

试论医疗纠纷司法鉴定的法律依据、特征及质量控制

医疗纠纷的矛盾一直比较突出,由于医疗纠纷的处理依赖于鉴定结论,因此医疗纠纷的鉴定一直成为社会各界关注的热点问题.本文认为医疗事故技术鉴定不该成为医疗纠纷处理的唯一途径,司法鉴定在医疗纠纷案件的处理中有其"作为"的空间一是它属于法医研究的内容和任务;二是有其法律依据.笔者分析了医疗纠纷司法鉴定的特征,进而提出医疗纠纷司法鉴定质量控制的思路,即建立法医与临床专家共同鉴定的模式;实行诊疗活动和鉴定材料的听证程序;强化医疗纠纷司法鉴定文书的说理性;坚持司法鉴定专家出庭接受质证制度.以切实维护医患双方合法权益和实现社会的公平和正义.     

Evaluation of certifier practices regarding alcohol-related deaths: Fulton County Medical Examiner's Center, Atlanta, Georgia, 2004

CONTEXT: Alcohol can contribute to various manners of death by acute intoxication that places a person at risk for fatal injury, acute fatal alcohol poisoning, or the various fatal complications of chronic abuse with or without superimposed acute intoxication. The reporting of alcohol use on the death certificate may vary with office policy or procedure, certifier judgment, and the timing of information received during investigation. OBJECTIVE: To determine the number of deaths including mention of alcohol use in the investigative case file, the number of death certificates on which alcohol use is reported, the number of discrepancies between the 2, and the possible reasons for observed discrepancies. DESIGN, SETTING, AND PARTICIPANTS: Retrospective case review of all deaths where alcohol use was mentioned in the investigative case file and/or on the death certificate for deaths investigated by the Fulton County Medical Examiner in Atlanta, Georgia, during a 1-year period between January 1, 2004, and December 31, 2004. MAIN OUTCOME MEASURES: Percentage of deaths with alcohol use reported on the death certificate, tabulation of where and how alcohol use is reported on the death certificate, and tabulation of the differences between the investigative case file and death certificate regarding alcohol's possible role in causing death. RESULTS: Among the 1324 deaths certified by the office, 105 (8%) had alcohol use reported on the death certificate. The majority (67%) of these cases were natural deaths. Sixty-nine (5%) deaths had mention of alcohol use in the investigative case notes but did not include it on the death certificate. Twenty-five (2%) deaths had mention of alcohol on the death certificate but did not have mention of it in the investigative case file based on our search criteria. However, subsequent review of additional case follow-up information disclosed a history of alcohol use or acute intoxication in each case. CONCLUSIONS: The data show that more natural deaths are considered to be directly caused by alcohol than other manners of death. For the unnatural manners of death (excluding acute alcohol poisoning), alcohol use is often viewed by medical examiners as an incidental, associated finding or risk factor surrounding the circumstances of death rather than being an actual cause of death. In such cases, alcohol use is often omitted from the death certificate. For deaths directly caused by alcohol, the proportion of cases involving possible underreporting or overreporting of alcohol involvement was relatively small and usually involved the omission of chronic alcohol use from the death certificate. Researchers need to be aware of potential limitations of death certificate data for studying alcohol-related deaths.     

Concurrent detection of heroin, fentanyl, and xylazine in seven drug-related deaths reported from the Philadelphia Medical Examiner's Office

Recreational drugs, such as cocaine and heroin, are often adulterated with other pharmacological agents to either enhance or diminish the drug effects. Between April 21, 2006 and August 8, 2006, the Philadelphia Medical Examiner's Office detected xylazine (a veterinary sedative) and fentanyl (a synthetic opioid) in specimens taken from seven cases. Initial immunoassay screening was performed on urine and blood for fentanyl, opiate, cocaine, phencyclidine (PCP), and benzodiazepines. All tests reported positive were confirmed by gas chromatography-mass spectrometry. All seven xylazine positive cases tested positive for fentanyl and six cases tested positive for 6-acetylmorphine (a metabolite and definitive marker for heroin). The seventh case was positive for morphine and had a history of heroin abuse. Xylazine was present in urine in all seven cases and blood levels were detected in three cases. The blood concentrations ranged from trace to 130 ng/mL. Fentanyl was present in the blood and urine in each case and blood concentrations ranged from 4.7 to 47 ng/mL. Adulteration of illicit drugs has become an epidemic health concern for drug users. Healthcare professionals need to be aware of this issue, so the patients can be treated in an effective, timely manner.     

Accidental sharp force fatalities--beware of architectural glass, not knives.

In a retrospective evaluation of 799 consecutive autopsies of victims of sharp force performed between 1967 and 1996 in Münster and Berlin, only 18 cases (2.3%) were classified as accidents. A typical pattern was present in 15 cases: inebriated adults (1.4-3.6g/l BAC) fell into an architectural glass surface in the form of a door or window (12 cases), an aquarium, a mirrored wardrobe or a telephone cell. Another man fell into a large drinking glass. Many victims in this group showed multiple scratches, abrasions and superficial incisions as well as one or more deep tear/cut/puncture injury. The wound margins can be clean-cut or irregular and abraded. Death was mostly caused by exsanguination except for one case of air embolism and one case of cerebral injury. The fatal injuries were produced by large and dagger-like slivers of glass, by sharp-edged fragments of glass remaining inside the frame or by a portion of glass which fell down and acted in a way similar to a guillotine. Ordinary types of flat glass were involved in all cases and it is not until the impact that sharp fragments or cutting edges are produced. So the motion of the person commonly provides the force necessary for a fatal injury. This was also true for the remaining two cases not involving architectural glass. A farmer suffered cerebral injury from a fall into the long prong of a pitch fork, and the wounding agent was a knife in only one case. A man who stated that he had fallen into the knife in his hand died from pneumonia after inadequate therapy following a single stab injury to the periphery of the left lung and liver. Accidents where the victim is killed by his own knife therefore appear to be extremely rare.     

论学区划分的法律属性及其法律规制

学区划分是县级教育行政部门依职权作出的规范义务教育招生入学秩序,影响适龄儿童少年享有义务教育资源机会平等权,能够对特定适龄儿童少年产生外部法律效力的具体行政行为。当前,学区划分存在划分标准不清晰,信息公开程度低、公众参与不足等问题。为规范教育行政部门在学区划分中的自由裁量权,有必要从标准和程序两个维度对其进行法律规制,以此实现学区划分法治化,进而推动义务教育治理现代化。     

医疗纠纷的法律误区与建立医疗纠纷仲裁制度的探讨

医疗纠纷是当今社会的热点问题之一,由于我国医疗纠纷在法律属性的界定上存在误区,致使医疗纠纷解决机制严重滞后,医患关系日趋紧张,卫生立法及配套改革显得刻不容缓。本文在分析医疗纠纷产生的原因及医患关系的法律属性的基础上,对建立我国医疗纠纷仲裁制度进行了探讨。     

孔子学院发展中的法律困境与建构

孔子学院法律制度建设落后,存在着主体资格定性不明、基本法律依据缺失等法律障碍,究其原因是由于我国不同于西方的法律文化传统和制度理念.为保障孔子学院的健康发展,我们应该制定《孔子学院法》,明确孔子学院在汉语言推广中的战略地位,完善孔子学院主体制度,并建立孔子学院危机应对法律机制.     

法学院教育的地方化与国家化

正规的法学院教育在培养德才兼备的法律家,实现法律家之治的进程中意义重大,因此颇受各国重视。但是,我国由于多层次办学等诸多原因,造成法学院教育的地方化:学生招收、培养、就业地方化及法学教授的地方化,从而不利于法学综合素质和学术精神的培养,甚至会影响司法公正和依法治国的实现。应当统一法律教育,实行法学院教育的国家化,将法学院教育的管理权收归国家,并采取所有的法学院在全国招生、全国就业和某些特殊限制的相关制度。