Specimens for teaching forensic pathology, odontology, and anthropology. II. Teeth and bone

A set of specimens has been collected, preserved, and organized specifically for the teaching of forensic pathology, odontology, and anthropology. Plastination of soft tissue, whole organs, bones, and teeth has proven valuable in preserving delicate, friable, and calcined specimens. The dry, odorless, biologically inert specimens are durable and resistant to damage caused by handling. Subtle features of soft tissue pathology are well preserved. Patterned injuries change due to shrinkage, but remain easily recognizable. Plastinated whole jaws are still readily identifiable from antemortem records. Radiograph density is essentially unchanged. Putrid and charred specimens become quite manageable.     

Forensic pathology and related sciences. A model for teaching medical students

Recently, awareness of the importance of forensic pathology and related sciences in the United States has grown. At our medical center, we developed a concise and systematic program on this subject and offered it as an elective in pathology to level II medical students. The course was very successful and rated highly by the medical students.     

Supplemental applications proposing labeling changes for approved drugs, biologics, and medical devices. Final rule

The Food and Drug Administration (FDA) is amending its regulations regarding changes to an approved new drug application (NDA), biologics license application (BLA), or medical device premarket approval application (PMA). This final rule provides that a supplemental application submitted under certain FDA regulations is appropriate to amend the labeling for an approved product to reflect newly acquired information and to add or strengthen a contraindication, warning, precaution, or adverse reaction if there is sufficient evidence of a causal association with the drug, biologic, or device, as defined in other FDA regulations and guidance documents.     

Criminals' explanations of their criminal behavior, Part II: A possible role for psychopathy.

The author reviewed the literature concerning the effect of criminals' current psychopathology on their explanations about their crimes. He then studied 100 incarcerated men, examining the associations between their explanations and various historically documented aspects of psychopathy. Previously and independently documented patterns of pathological lying, lack of remorse or guilt, callousness or lack of empathy, and failure to accept responsibility for their own behavior were significantly associated with the offenders not admitting responsibility for their crimes. Further, independently described histories of pathological lying were associated with criminals' blaming their convictions on a faculty criminal-justice system, while histories of failure to accept responsibility for their behavior were associated with blaming someone else for their index crimes.     

Fatal head trauma of an infant. Part II: Biomechanical reconstruction

An 18-month-old child was hit on the head by a falling wooden sculpture (c 60 kg) and sustained a fatal craniocerebral trauma. The kinetics of the trauma could be accurately reconstructed. The child's skull was then modelled using the finite-element-method. The material parameters known from the literature were assigned to the elements. The dynamic reconstruction performed on the basis of the kinetics calculated before was able to reproduce the destruction of the skull and the brain by simulating the impact-related topographical distribution of the intracranial pressure and the von Mises stress field.     

Medical and legal aspects of genital mutilation and circumcision. Part II: Male circumcision

In the last few years, male circumcision has become the subject of controversial discussion. On the one hand, medical and hygienic arguments, ideology, freedom of religion, cultural identity and social adequacy are claimed by those supporting male circumcision. On the other hand, the justification of this practice also has to be critically scrutinized just as the question whether the parents have the right to consent to the operation. Today, opinions range from those who claim that religion and culture alone justify the practice to those who consider circumcision of minors unable to give their consent as bodily injury subject to punishment. In contrast to female genital mutilation, most positions do not postulate that circumcision violates morality. If the person concerned is able to give his consent, freedom of religion may also justify circumcision after weighing its pros and cons as well as its risks and potential side effects.     

Drugs in oral fluid: Part II. Investigation of drugs in drivers

As part of the European project, Impaired Motorists, Methods of Roadside Testing and Assessment for Licensing, otherwise known as IMMORTAL (Deliverable R4.2), the University of Glasgow was required to analyse 1396 oral fluid samples, collected from drivers, for a wide range of drugs. A previously described method to include 49 drugs and metabolites was used. To include cannabis in the study a separate extraction method was required because of interferences caused by the collection device. The study group included drivers who were stopped at random and participation was entirely voluntary. The results showed that out of the 1396 samples tested, 16.8% were positive for at least one drug. In the majority of positive cases (85%), monodrug use was found and the most commonly detected drug was 3,4-methylenedioxymethamphetamine. This study showed that a significant number of the driving population are positive for at least one drug.     

Moral theories of torts: Their scope and limits: Part II

One approach to legal theory is to provide some sort of rational reconstruction of all or of a large body of the common law. For philosophers of law this has usually meant trying to rationalize a body of law under one or another principle of justice. This paper explores the efforts of the leading tort theorists to provide a moral basis - in the sense of rational reconstruction based on alleged moral principles - for the law of torts. The paper is divided into two parts. In the first part I consider and reject the view that tort law is best understood as falling either within the ambit of the principle of retributive justice, a comprehensive theory of moral responsibility, or an ideal of fairness inherent in the idea that one should impose on others only those risks others impose on one. The second part of the paper distinguishes among various conceptions of corrective or compensatory justice and considers arguments — including previous ones by the author himself — to the effect that tort law is best understood as rooted in principles of corrective justice. This paper argues that although the principles of justice may render defensible many (but by no means all) of the claims to repair and to liability recognized in torts, it cannot explain why we have adopted a tort system as the approach to vindicating those claims. Some other principle — probably not one of justice — is needed to explain why it is that the victim's claim to repair is satisfied by having his losses shifted to his injurer — rather than through some other means of doing so. The paper concludes that the law of torts cannot be understood — in the sense of being given a rational reconstruction — under any one principle of morality.     

The state of electroconvulsive therapy in Texas. Part 2: contact with physicians, hospitals, medical liability insurance companies, and manufacturers of stimulus generating equipment

Since mid-1993, all ECT treatments performed in the state of Texas (except for United States government hospitals) must be reported every quarter to the Texas Department of Mental Health and Mental Retardation (TXMHMR) on a data collection form provided by the Department. Part 1 of this paper reviewed that data. This paper reviews the responses to questionnaires and contacts made with physicians, hospitals, medical liability insurance companies, and manufacturers of stimulus generating devices regarding their experience with ECT in Texas. Questionnaires were sent to physicians and hospitals that had not performed ECT during the final two quarters of the review period. Medical liability insurance companies and the manufacturers of the stimulus generating equipment used in ECT were contacted regarding their experience with liability claims. The results indicate that medical liability in regards to the performance of ECT is extremely low. Physicians and hospitals that stopped performing ECT did so for reasons other than medical liability.     

Travel, time zones, and sudden cardiac death. Emporiatric pathology

In an 11-year retrospective study of coroner's autopsies on the Hawaiian island of Kauai, it was found that an unusual and apparently unique subset of travelers died suddenly. Death was caused by coronary arteriosclerosis, was characterized by acute coronary changes, and occurred in a group younger than the usual age for sudden cardiac death. Visitors with two-vessel disease had an incidence of sudden death nearly four times that of Kauaians (p less than 0.02), with a ninefold increase of coronary thrombosis (p less than 0.001), a sixfold prevalence of old myocardial infarcts (p less than 0.001), and three times the prevalence of cardiomegaly (p less than 0.001). The circadian pattern of these deaths was different from that previously described in acute myocardial infarction or sudden death, with the number of incidents rising steadily through the day in contrast to the morning peak described in previously published series. The syndrome was expressed in decedents with two-vessel coronary disease either with acute coronary artery lesions--thrombosis, hemorrhage in a plaque, or ruptured coronary artery--or no lesions, presumably spasm. Underlying chronic processes included enlarged heart or old myocardial infarct, which both occurred with a significantly greater incidence in travelers than in local residents, and in a totally different pattern from that occurring in subjects with three-vessel disease. It is postulated that the syndrome is caused by stress related to travel and time zone changes.