Police custody: deaths and medical attention

Information was obtained from all the county constabularies regarding deaths and medical attention given to those in police custody. It was presumed that this information covered all deaths in custody in Denmark during the period 1981 through 1985. There is no apparent increase in the absolute number of deaths during detention during the period 1969 through 1985. The number of deaths occurring in custody in relation to the annual number of persons incarcerated has fallen during the period 1955 through 1985. Simultaneously, a marked rise has occurred in the number of persons held in police custody. During the period 1981 through 1985, 7.9 persons were incarcerated per 1000 population per year. One homicide and nineteen other deaths occurred. The most frequent cause of death was asphyxiation as a result of aspiration of gastric contents during alcohol intoxication, drug poisoning, and intracranial hemorrhage. A physician had been consulted but had not diagnosed the seriousness of the condition in 42% of the deaths. All the deceased were men, and all suffered from the effects of social, psychiatric, and physical diseases. The lethality evaluated from hospitalized clients with the same type of life-threatening conditions was found to be 25%. A discussion is presented of the costs which will be incurred if a large group of those kept in police custody were admitted to hospital. Similarly, changes in the present arrangements are suggested that could ensure a greater certainty of avoiding deaths in detention.     

The perils of investigating and certifying deaths in police custody.

Procedures leading to the proper investigation and certification of deaths occurring in police custody are discussed. The importance of training and experience, of interchange of information between investigator and forensic pathologist, and of common sense in the pursuit of fairness toward this end is emphasized.     

Mental health at the intersections: The impact of complex needs on police contact and custody for Indigenous Australian men

Indigenous Australians experience significant social risk, vulnerability and disadvantage. Nowhere is this more starkly demonstrated than in the levels of contact that Indigenous Australians have with the criminal justice system, particularly the police. Utilizing a linked dataset of extant criminal justice, human and health service administrative data in New South Wales (NSW) Australia, this paper explores patterns of police contact and custody for a cohort of Indigenous males with complex needs. Four significant factors are identified that alone or in combination appear to impact on the frequency with which these men experience police contact and custody, including young age at first police contact, experiencing out of home care as a child, alcohol misuse, and limited locational mobility. Whilst it might be expected that the presence of mental ill-health and/or cognitive disability would be a key predictor of the frequency and intensity of police contact and custody, the findings suggest rather that the presence of multiple disadvantages beginning in the early years and compounding throughout individuals' lives, in which mental illness may or may not be a factor, is more significant than the presence of any one diagnosis in precipitating police contact and custody for this group.     

Deaths at the workplace. Accidents or homicides?

The medical examiner is responsible for certifying and determining the cause of death of any person dying from criminal violence, accident, suicide, when unattended by a physician, in police custody, or in any suspicious or unusual manner. A less well-recognized, but no less important, responsibility of the medical examiner is the investigation of deaths of individuals who die at the workplace. The manner of death of most job-related fatalities has been traditionally classified as accidental. In recent times, prosecutors have scrutinized these cases more carefully. The results of some investigations have prompted them to bring criminal charges against employers for blatant negligence that contributed directly to injuries and deaths of employees. This paper is devoted to a review of the controversy surrounding the issue of industrial homicide, illustrative cases, and the role of the medical examiner in the investigation of deaths at the workplace.     

Sudden death after release from police detention]

3 fatalities shortly after discharge from police custody are reported. Case 1: A 55-year old alcoholic was discharged from police custody after taking a blood sample under violent conditions and found dead in his flat 2 days later. Cause of death: arrhythmia due to acute coronary insufficiency or alcoholic cardiomyopathy. Case 2: A 27-year-old alcoholic was met highly intoxicated twice in the course of one day, was put in the family's care and was found dead the next morning. Cause of death: alcohol/drug intoxication with agonal aspiration. Case 3: A 32-year-old man known to be prone to seizures and to become aggressive under the influence of alcohol was left by the police in medical care confined to a litter in a "hog-tied" fashion with the help of 3 belts. Cause of death: cerebral hypoxia after respiratory and cardiac arrest of unknown reason. A causal relationship with positional restraint is discussed. The cases reported underline the duty of the police to examine prior to discharge from custody with the appropriate lot of care whether the person held in custody has recovered from the helpless state due to disease, injury or intoxication or if medical treatment is required.     

两大法系狭义羁押启动制度探究及对我国的借鉴

狭义羁押是指逮捕（抓捕）犯罪嫌疑人后经由法庭或法官审查批准后决定的羁押,我国的狭义羁押指的是侦查机关决定拘留犯罪嫌疑人和检察机关决定逮捕犯罪嫌疑人后的羁押。羁押的启动应当是在充分遵循羁押基本原则的前提下,严格依照法律规定的羁押启动条件,并经过必要的司法审查的刑事诉讼程序。各国在捕押分离的前提下对羁押的条件和司法审查都有着严格的规定,对于完善我国的羁押制度,保障人权有着非常重要的借鉴意义。     

Deaths in custody in Shelby County, Tennessee, January 1970-July 1985

The purpose of this study is to review retrospectively the deaths that have occurred in the Shelby County detention center from 1970 to 1985. The Shelby County data are compared and contrasted with other studies to discern significant and preventable causes of death in custody. This study confirmed natural causes as most prevalent; however, suicide accounted for greater than 20% of all deaths (15-50-fold greater than the general population). Suicide occurred by hanging in greater than 90% of cases. This is a preventable cause of death while in custody, and means of prevention are addressed.     

Police services detention centres: a proposed solution for action

Police services face daily challenges dealing with the health issues displayed by individuals in their custody. They often find themselves isolated from the services that can help the most. This paper scopes relevant literature on these challenges and some of the interprofessional interventions which have emerged to address them, such as the diversionary practices of crisis intervention teams, street triage, nurses in custody suites, and court liaison and diversion. Remote presence technology is proposed to be an innovative solution that can help to provide more efficient and effective pathways for care in Police Detention Centres. Remote presence technology has the ability to significantly affect the way interprofessional collaboration can take place for those in police custody.     

Assessing police treatment in Ecuador: the view of satisfied and disaffected female serious offenders

This empirical study examines procedural justice perceptions among 51 female serious offenders in Ecuador, with the aim of identifying differences between those women who were satisfied with law enforcement and those who were not. The results demonstrate that when women were treated with courtesy and respect, and their rights were acknowledged, they felt satisfied with the police, in a way that they did not give importance to the irregularities they observed while arrested and in custody. On the other hand, the majority of women participants were dissatisfied with the police. Their dissatisfaction with, and lack of trust in, the authorities affected their desire to cooperate with police activities. The study also demonstrates that, although the Ecuadorian police force has made considerable efforts in promoting citizens’ trust during the last 7 years, corruption and illegal police conduct when dealing with offenders are far from uncommon.     

"Who is first on the scene?"

Forensic specialists are well standardised throughout the world and their opinions are respected by the courts. Doctors involved in the immediate clinical forensic assessment of persons in police custody are not, however, so well standardised. Some countries employ trained police surgeons or police medical officers, other countries rely on hospital interns, others simply accept the first doctor available. Can courts rely on their testimony? Can specialists depend on their skills? A call is made for such generalists to meet on an international basis to establish standards.     

Characteristics associated with the prevalence and severity of force used by the police

Using a diversity of samples, sources of data, measures of force, analytical methods, and theoretical frameworks, prior research reported that the prevalence of police use of force ranges from 0.8% to 58.1% of police-suspect encounters. In addition, few characteristics of officers, suspects, police departments, or neighborhoods are associated consistently with the amount of force used by the police. Using self-report data by police from 7,512 adult custody arrests in six jurisdictions, this study found that the associations between encounter-level characteristics and police use of force are dependent on the incorporation of suspects' resistance and on the measure of force used.     

Hydrofluoric acid poisoning

A case of suicidal ingestion of hydrofluoric acid is presented. Death of the victim while in police custody was one of the more unique aspects of the case. This is the sixth case of poisoning of this type reported in Dade County. Clinical, pathological, and toxicological aspects of fluoride poisoning are discussed.     

63例监管场所非暴力性死亡的法医学分析

目的通过收集监管场所非暴力性死亡的案例,分析其法医学特点和相关影响因素。方法收集某鉴定中心2000—2015年间所受理的监管场所在押人员非暴力性死亡案例63例,对其致死性疾病的类型、发病季节、既往病史、临床表现、处理措施及病程进行回顾性分析。结果监管场所因病死亡者以男性居多,高发于中青年人群;主要致死性疾病以心源性死亡居于首位(50.8%),慢性炎性疾病包括胃肠道穿孔、肺结核病、肺炎、肝炎和胰腺炎等数量也较多。夏季是发病高峰,猝然发作的症状为睡眠中急骤发病、突然晕倒,慢性起病的以呕吐、腹痛、乏力、胸闷、气短、发热、纳差等最为常见。结论监管场所的管理制度、监管场所条件、医疗水平和相关知识等仍有改善空间,进行鉴定时需注意健康资料收集、尸体解剖、组织学检查和毒物检验等。     

Health characteristics of older police custody detainees in London,UK

The number of older adults involved in the criminal justice system is rising. Little is known about the state of health in older people who are arrested. This study compared characteristics and health care needs of older police custody detainees with their younger counterparts. The health characteristics of 57 police detainees aged over 50 were compared with 543 younger detainees. Older detainees had significantly higher rates of physical illness and risk of alcohol withdrawal. Although there were equivalent rates of mental disorder and drug taking compared with younger detainees, a higher proportion had presentations consistent with cognitive impairment due to possible dementing processes. Over 80% of older detainees were recommended to have a health assessment in police stations based on their presentation. Police detainees over 50 should be considered to have a health assessment as routine procedure. Further investigation should also be conducted into cognitive impairment in this group.     

‘Vulnerable by law (but not by nature)’: examining perceptions of youth and childhood ‘vulnerability’ in the context of police custody

This paper, drawing upon qualitative data produced through interviews with custody officers (COs) at two custody suites in England, examines how the vulnerability of children and young people is conceptualised generally, within the criminal process, and then, more specifically, in police custody. It uses the appropriate adult (AA) safeguard under Code C to the Police and Criminal Evidence Act 1984 as the point of reference and explores, firstly, how childhood is conceptualised and, secondly, how childhood vulnerability is understood by COs. The responses of COs are perhaps indicative of a wider issue within the criminal process – the construction of youth and childhood and, accordingly, the criminal law response to children and young people. Within this paper, whilst it is accepted that childhood and vulnerability are non-static concepts, it is nevertheless contended that children and young people are vulnerable, particularly when facing the criminal process.     

The masking of racial and ethnic disparity in police use of physical force: The effects of gender and custody status

The purpose of the present study was to examine racial and ethnic disparity in police use of physical force. Data from the Phoenix, Arizona Use-of-Force Project was used to assess disparity between White, Black, and Hispanic citizens. Racial and ethnic disparity in police use of physical force was found only for male citizens not in custody. The findings suggest that assessments of racial and ethnic disparity need to be situationally orientated in the theoretical meaning that race and ethnicity play in modern American society. Simple overall tests of disparity may not be adequate to understand and address the complex effects of race and ethnicity in the criminal justice system; thus, these disparities may lead to situations that further exacerbate already strained minority-majority relations in America.     

The efficacy of the appropriate adult safeguard during police interviewing

Purpose. The main aim of the study was to examine the efficacy of the appropriate adult (AA) safeguard for vulnerable adult and juvenile suspects undergoing police interviews. Method. We examined the records of suspects held in custody by the London Metropolitan Police at 74 charging stations during February 1997 (Medford, Gudjonsson, & Pearse, 2000). Adult suspects whose custody record indicated psychological vulnerability were included in the study, as well as juvenile suspects. Audiotaped interviews of suspects were analysed using a special coding frame. The contribution (or lack of contribution) made by the AA, the extent to which they fulfilled their role, and the effect of their presence on other persons and interview outcome were examined and analysed. Results. Of the 501 interviews available for analysis, 365 (73%) were with adult suspects and 136 (27%) with juveniles. An AA was present during 212 (58%) adult interviews and 135 (99%) juvenile interviews. The AAs of juveniles, who were mainly family members and friends, contributed more in interview, both appropriately and inappropriately, than did social workers and volunteers, although overall there was little direct intervention bythe AA. Conclusions. Although AAs contribute little to the police interview in terms of verbal interactions, their mere presence during the police interview has three important effects. First, in the case of adults, but notjuveniles, it increases the likelihood that a legal representative will be present. Second, it appears to be associated with less interrogative pressure in interview. Third, in the presence of an AA, the legal representative takes on a more active role.     

Referrals to a mental health criminal justice Liaison and diversion team in the North East of England

There is growing interest in the health correlates of people detained in police custody, and a number of innovations have been introduced to try to meet the complex needs of detainees. The implementation of Criminal Justice Liaison and Diversion (CJL&D) Services commissioned by the Department of Health in England is a substantial part of this investment. In this paper, we describe data from 858 detainees who were referred to the CJL&D service of a busy metropolitan police station in the North East of England. The detainees referred to the service had complex mental health needs, substance misuse and a range of vulnerabilities requiring specific intervention. The effective operation of these teams and how they interface with health and criminal justice systems also depend upon a number of systematic issues that emanate both from within the teams, and from external policy drivers.