传染病病人或疑似传染病病人尸体解剖查验规定

第一条为了及时查明传染病病因,提高传染病诊疗水平,有效控制传染病流行,防止疫情扩散,根据《中华人民共和国传染病防治法》第四十六条(以下简称《传染病防治法)》,制定本规定。第二条本规定适用于病因不明的传染病病人或者疑似传染病病人尸体的解剖查验工作。第三条传染病病人或者疑似传染病病人尸体解剖查验工作应当在卫生行政部门指定的具有传染病病人尸体解剖查验资质的机构(以下简称查验机构)内进行。设区的市级以上卫生行政部门应当根据本辖区传染病防治工作实际需要,指定具有独立病理解剖能力的医疗机构或者具有病理教研室或者法医教…     

新冠疾病疫情期间死因不明尸体解剖处置流程和规范

公安法医在疫情期间随时会接触到未知名或疫情史不明确的尸体,尤其是死因不明的尸体需要进行尸体解剖,不可避免地要全程面对新冠病毒感染的高风险,笔者依据《中华人民共和国传染病防治法》等相关法律法规、新型冠状病毒及肺炎的特点、疫情防控工作指引和公安部《关于规范新型冠状病毒肺炎疫情防控期间现场勘查处置工作的指导意见》,结合本地公安法医鉴定工作实际,通过死因不明的尸体解剖工作流程上,对前期准备、人员防护、解剖操作、后期消毒及物资配备等方面进行探索,提出在新冠疾病疫情期间公安法医尸体解剖处置及防护建议,供一线法医和司法鉴定人员参考。     

虚拟解剖在新型冠状病毒肺炎法医病理学研究中的应用展望

传染病死者的尸体解剖对于公共卫生事件的管理具有重要意义。由于多种原因限制,新型冠状病毒肺炎(corona virus disease 2019,COVID-19)疫情发生以来,对2019新型冠状病毒感染死者进行法医学尸体解剖的数量较少,使法医学在传染病防治中的作用未能及时发挥。虚拟解剖(virtual autopsy,virtopsy)对传染病死者尸体的检验具有独特的优势,积累虚拟解剖影像学资料对COVID-19的病理机制研究及临床诊治具有重要意义。本文介绍了COVID-19的病理学和影像学改变的对应关系以及虚拟解剖在传染病尸体检验中的应用,旨在为法医工作者在COVID-19疫情中开展虚拟解剖检验提供参考。     

美国《法医学尸体解剖执行标准》介绍

由美国法医协会（National Association of Medical Examiners,NAME）标准委员会起草的《法医学尸体解剖执行标准》（Forensic Autopsy Performance Standards）于2005年颁布,该标准的主要目的是规定法医学尸体解剖应该完成的基本内容,包括：法医死亡调查的职责及其案件类型、需要法医尸检的案件类型及参加法医尸检的人员、个体识别、尸表检验的一般检查和特殊检查（各类损伤,性侵犯）、尸体解剖、     

新型冠状病毒肺炎流行期的现场生物物证取证初探

公安机关法医具有勘查非正常死亡案件现场、提取生物物证检材等职责,在各类现场环境中,不可避免地存在诸多潜在危险因素,威胁一线勘查人员的身体健康和生命安全。其中,传染性生物物证检材对于法医物证检验人员而言一直是个颇为棘手的问题。自2020年1月以来,2019新型冠状病毒(以下简称“新冠病毒”)蔓延成为一个全球性公共卫生安全问题。在此背景下,法医物证检验人员处理涉及新型冠状病毒肺炎患者(尸体)或疑似新冠病毒感染者(尸体)的案件时,既增加了现场生物物证检材(以下简称“生物物证”)采集和处理的难度,也增加了检验人员的人身安全危险系数。故本文从生物物证的采集、运输、DNA提取纯化、保存和废物管理5个方面,对处理涉及新型冠状病毒肺炎患者(尸体)或疑似新冠病毒感染者(尸体)案件的生物物证取证流程进行探讨。     

我国法医学尸体解剖室建设发展现状及对策初探

法医学尸体解剖在司法尤其是刑事案件中发挥着非常重要的作用。目前,我国的法医学尸体解剖环境相对较差,在制定各种规范和加强法医个人防护措施的情况下,加快尸体解剖室标准化建设显得尤为重要[1]。1法医学尸体解剖室建设发展现状1.1灾难性事件/案件中的法医工作环境及条件据调研,迄今为止,我国除省会城市和大城市外,绝大多数基层法医在极其简陋的工作环境中进行命案尸体及其他非正常死亡尸体的解剖和检验。     

一种法医解剖缝合辅助器的介绍

正尸体解剖是法医学检验的重要环节,对正确判断死亡原因、死亡方式、死亡时间、致伤物具有非常重要的意义。同时在解剖过程中对法医的保护也非常重要,应尽量避免解剖器械的误伤、传染性疾病的感染。为增强自我防护、克服解剖工作中的困扰,本研究改造出一种实用小工具——法医解剖缝合辅助器,其构造简单、方便实用,值得推广。1传统的尸体解剖、缝合技术在尸体解剖、缝合过程中,应特别注意:(1)用传统方法打开腹腔、盆腔的过程[1]为:使用     

充分发挥法医在审判工作中的作用

根据法院组织法关于“地方各级人民法院设法医。”的规定,青海省高级人民法院从一九八○年七月起配备了法医。在三年半的时间里,他们根据审判工作的需要,克服各种困难,逐步开展了尸体解剖、活体检查、损伤程度评定、法医书证审查、物证复核、法医知识咨询和法医案例讨论等工作,并给审判人员讲解法医课和聘请外地法医学教授     

西北政法大学司法鉴定中心简介

西北政法大学司法鉴定中心成立于1993年，是经司法部批准设立并首批核准公告的八家面向社会服务司法鉴定机构之一。中心设有文书检验室、痕迹检验室、声像资料检验室、DNA检验室和法医临床检验室等专业实验室，     

法医学高危尸检的风险识别与防护

高危尸检(High Risk Autopsy)是指对患有或者可能患有严重传染性疾病的尸体进行解剖检验,该传染性疾病可能传染给尸体解剖检验的法医及其他高危人群,从而导致严重疾病或引起死亡。本文对高危尸检中的感染风险、风险识别方面进行论述,在个人防护、解剖室防护、虚拟影像方面提出安全预防措施。     

新冠肺炎等传染病与法医学鉴定评述

新冠肺炎致死或引发的其他法律纠纷可能涉及法医学病理解剖或者法医临床学鉴定。在日常法医学解剖中时有遇到因传染性疾病死亡患者的尸体,法医鉴定机构及鉴定人应当有风险识别意识,充分认识到在解剖、检查这类尸体时的被传染风险。法医鉴定人需要采取充分有效的防护措施。由于新冠肺炎属于新型传染性疾病,相关研究成果、信息资料更新快,鉴定中的信息参考要慎重选择。同时本文对因传染性疾病死亡患者的尸体解剖中常见的职业伦理、知情同意、保险理赔和环境保护等问题进行讨论。     

新冠肺炎疫情期间公安法医应当加强尸体甄别和个体防护

因鉴定体制特点,公安法医除参与尸体有关的现场勘查工作外,还需进行尸体检验工作。在此过程中,可能面对很多风险,受伤和中毒等事件时有发生。然而,国内公安法医对新冠肺炎等传染病流行期间死亡的尸体如何甄别进行尸体检验鉴定,对现场勘查及尸体检验工作的防护只有少量规定,且内容不够详尽。本文对法医在现场勘查中遇到的尸体及尸体检验中实验室建设、职业现状、风险评估及防范措施等进行了论述。最后,建议出台相关的制度规定等具体约束规范措施,以保障公安法医现场勘查及尸体检验工作的顺利进行,以解除基层鉴定机构和鉴定人的后顾之忧。     

Discrimination between functions of an expert bureau and a burial firm (topic for discussion)

The authors suggest measures aimed at discrimination of the functions performed by forensic medical experts and the services rendered by burial firms. The responsibilities of pathology departments of hospitals and bureaus of forensic medical expert evaluations, which should be reflected in official documents, should be confined to manipulations needed to solve the professional problems and removal of sections. Cases when utilization of certain chemicals or manipulations aimed at restoration of the body are prohibited should be listed in detail. The order of transfer of the body from pathology department or forensic medical bureau to the burial firm and to relatives should be regulated with consideration for the results of autopsy. The moment of the end of autopsy studies is to be determined.     

The effects of the (fentanyl-fueled) drug overdose epidemic on medicolegal death investigation in the United States

The evolving opioid epidemic in the United States, fueled by illicit fentanyl, has greatly increased deaths from illicit drug use. These nonnatural deaths require formal death investigation. The National Association of Medical Examiners states in its Forensic Autopsy Performance Standards that autopsy remains a necessary component for proper investigation of suspected acute overdose deaths. If a death investigation office lacks adequate resources to investigate all deaths under its jurisdiction while meeting expected standards, then that office may be forced to consider altering its protocols for investigation by changing the types of deaths investigated or the extent of its investigations. Drug death investigations take longer to complete because novel illicit drugs and mixtures of drugs complicate toxicological analyses, prolonging a family's wait for completion of a death certificate and autopsy report. Public health agencies must also wait for results, but some agencies have developed mechanisms for rapid notification of preliminary results to allow timely deployment of public health resources. The increased deaths have strained the resources of medicolegal death investigation systems throughout the United States. Given the significant workforce shortage of forensic pathologists, newly trained forensic pathologists are too few to meet the demand. Nevertheless, forensic pathologists (and all pathologists) must make time to present their work and themselves to medical students and pathology trainees to encourage an understanding of the importance of quality medicolegal death investigation and autopsy pathology and to provide a model that can encourage interest in a career in forensic pathology.     

Death caused by a signal rocket--not an isolated case*

Fatalities related to sporting events are predominantly caused by blunt force injuries especially due to the emotional involvement of crowd, but occasionally other types of trauma are reported as well. A case of very rare trauma caused by shooting with a hand-held parachute signal rocket during a football match is presented. A 17-year-old football fan sustained fatal injuries, a combination of mechanical trauma caused by rocket penetration, as well as extensive thermal burning of the thoracic viscera. Analysis of the event was based on autopsy findings and evidence produced by medicolegal and ballistic experts. Improper use of a hand-held signal rocket, designed for marine distress signals, may cause serious injuries either mechanically, due to explosion, or as a result of thermal discharge. In the reported case, pattern of injuries is discussed, and medical finding corroborated to other available evidence. The presented case is a reminder that the forensic pathologist should be informed accordingly on the type and features of weapon suspected to produce injury, to be able to understand traumatic changes, and look for potential presence of foreign bodies at postmortem examination.     

Autopsy Identification of Viable Mycobacterium Tuberculosis in the Lungs of a Markedly Decomposed Body

Various infectious diseases, including COVID-19, MERS, and tuberculosis, are global public health issues. Tuberculosis, which is caused by Mycobacterium tuberculosis (MTB), is highly contagious and can be transmitted through inhalation of the bacteria. However, it has been assumed that the infectiousness of bacteria and viruses in dead bodies weakens as the time from death increases. In particular, there is little awareness of infection control measures concerning decomposed bodies or even the need for such measures. The deceased, in whom we discovered MTB 3 months following her death, was a woman in her 80s who died at home. We performed judicial autopsy, because police suspected homicide when her husband hanged himself. Obtained organs were used for microscopic examination by hematoxylin–eosin staining and Ziehl–Neelsen staining. In addition, real-time PCR and mycobacterial culture testing using Ogawa's medium were performed for the detection of MTB. We found that the MTB in the decomposed body remained viable and potentially infectious. To identify the bacterial strain further, we performed DNA-DNA hybridization and identified the strain as MTB complex. Potentially infectious live MTB survived in the dead body far longer than had been previously reported. Pathologists should consider microbial culture tests for all autopsied cases in which the decedent's medical history or macro-examination suggests possible infection, even when a long duration of time has passed since death. Pathologists and specialists who perform autopsies should recognize that all dead bodies are potentially infectious, including those in which long periods have elapsed since death.     

The diagnosis of pulmonary tuberculosis in the forensic medical study of cadavers]

Presents analysis of cases when pulmonary tuberculosis was diagnosed during autopsy by forensic medical experts. Before death the patients were not registered at tuberculosis control centres and were administered no treatment for tuberculosis.     

Independent forensic autopsies in an armed conflict: investigation of the victims from Racak, Kosovo

In January 1999, a team of Finnish forensic experts under the mandate of the European Union (EU forensic expert team, EU-FET) performed forensic investigations in a sovereign state, in Kosovo, the Federal Republic of Yugoslavia (FRY). The team served as a neutral participant in the forensic investigation of victims of an incident at Racak, which was receiving considerable international attention. The Finnish team performed forensic autopsies, monitored forensic autopsies performed by local experts and verified findings of earlier executed autopsies. The victims had sustained varying numbers of gunshot wounds, which were established to be the cause of death. The manner of death remained undetermined by the EU-FET, because the scene investigation and the chain of custody for the bodies from the site of the incident to the autopsy were impossible to verify by the team. The events at Racak were the first of those leading to charges by the International Criminal Tribunal for the former Yugoslavia (ICTY) against the highest authorities in power in the FRY for crimes against humanity and violations of the laws or customs of war.     

The topical problems pertaining to the performance of forensic medical expertise of the subjects suspected or accused of committing a crime and remaining in custody

The authors consider topical problems pertaining to the performance of forensic medical expertise of the subjects suspected or accused of committing a crime and remaining in custody. The discussion is focused on the organization of expertise and medical examination of such persons with the participation of personnel representing different clinical disciplines. The special emphasis is laid on the absence in the normative-legal basis of the well-specified criteria for the severity of disease, the degree of vital activity limitation, and duration of the treatment in specialized hospitals. The lack of such criteria hampers not only medical certification of the subjects suspected or accused of committing a crime and remaining in custody but also objective forensic medical estimation of their health status. Recommendations for addressing this problem and its resolution are proposed.