Textbooks on legal medicine in the German-speaking countries

In this survey, the textbooks on legal medicine which were published in the German-speaking countries from the 17th century up to now are briefly reviewed. The textbooks with the most impact on the further development of legal medicines were those published by Johann Ludwig Casper in Berlin and Eduard Ritter von Hofmann in Vienna in the 19th century. The main textbooks of the 20th century are addressed as well, also the different development in both German countries.     

Student tragedy. Forensic-psychiatric and legal medicine aspects of an unusual crime

The unusual circumstances of the violent killing of an 18-year-old girl by her 18.8-years-old schoolfriend led us to undertake a forensic-psychiatric analysis of the offence action as well as a presentation of legal-medical points of view. The crime, which can be classified as a collective lover crime for which there is no parallel in the literature, was only solved 9 months later when one of the two delinquents confessed a further offence. The killing was planned and prepared, the victim being buried hurriedly in a previously made hole in a wood after she had been strangled.     

Bullet embolism with radiologic documentation. A case report

A case of bullet embolism is reported wherein a handgun missile, fired during a "shoot-out," perforated (among other structures) the anterior and posterior walls of the thoracic aorta, rebounded into the aortic lumen, and was transported to the left femoral artery where it came to rest. Roentgenographic study was instrumental in promptly locating the errant bullet whose recovery established the identity of the responsible firearm. The implications of bullet embolism of the arterial, venous, and paradoxical types for the forensic pathologist and the clinician are discussed briefly.     

The significance of the legal term "corpse" in forensic medicine

The definition of the term "corpse" is relevant for medicine in general and most particularly so for forensic medicine, as it has direct consequences on practical work: legally, postmortems and autopsies may only be performed on corpses. With this in mind, the legal term "corpse" was examined on the basis of German State Law regulations and provisions. Approximately half the burial acts include a definition of "corpse", but even here there are certain variations. The definitions for "corpse" can be divided into four categories: 1) according to the lack of vital signs or sure signs of death 2) according to the degree of decomposition and/or cohesion of body parts 3) on the basis of severed body parts, and 4) terminological differentiation of stillbirths and neonatal fatalities from miscarriages. Laws vary greatly in their definition of the term "corpse". Therefore, the decision whether or not human remains or parts thereof qualify as a "corpse" should be left to medical discretion.     

Expression of adhesion molecules in skin wounds: diagnostic value in legal medicine

The adhesion molecules identified in recent years can help improve the diagnosis of the wound age, especially of injuries with a short survival time. This is also indicative of the vitality of the wounds. The material investigated in the study originated from 465 skin wounds. The samples were taken from human autopsy material, during the surgical treatment of wounds (excision) of patients and from experimental incised wounds of mice. To judge the age of skin wounds the endothelial adhesion molecules were detected in paraffin sections after autoclaving and using the ABC technique. Human skin wounds: strong positive staining was observed of ICAM-1 1.5 h at the earliest and 3.5 days at the latest, for the P-selectin 3 min at the earliest and 7 h at the latest, for the E-selectin 1 h at the earliest and 17 days at the latest and for VCAM-1 3 h at the earliest and 3.5 days at the latest after the time of injury. The L-selectin was expressed constitutively. Mice skin wounds: strong positive immunohistochemical reactions were found as a rule earlier than in human skin wounds. The detection of an increased expression of ICAM-1, VCAM-1 and P- and E-selectins can improve the wound age assessment in injuries with short survival times.     

Optical 3D surface digitizing in forensic medicine: 3D documentation of skin and bone injuries

Photography process reduces a three-dimensional (3D) wound to a two-dimensional level. If there is a need for a high-resolution 3D dataset of an object, it needs to be three-dimensionally scanned. No-contact optical 3D digitizing surface scanners can be used as a powerful tool for wound and injury-causing instrument analysis in trauma cases. The 3D skin wound and a bone injury documentation using the optical scanner Advanced TOpometric Sensor (ATOS II, GOM International, Switzerland) will be demonstrated using two illustrative cases. Using this 3D optical digitizing method the wounds (the virtual 3D computer model of the skin and the bone injuries) and the virtual 3D model of the injury-causing tool are graphically documented in 3D in real-life size and shape and can be rotated in the CAD program on the computer screen. In addition, the virtual 3D models of the bone injuries and tool can now be compared in a 3D CAD program against one another in virtual space, to see if there are matching areas. Further steps in forensic medicine will be a full 3D surface documentation of the human body and all the forensic relevant injuries using optical 3D scanners.     

Death in homes for the aged/nursing homes from the legal medicine viewpoint

Following the death of 16 inhabitants of a nursing home within a period of 2 weeks, the prosecution ordered legal autopsies in all of the cases, which had not yet been buried or cremated, suspecting a neglect of nursing or active euthanasia respectively. Two out of a total of ten cases revealed drug overdoses which could have explained death. However, due to concurring causes of death, the evidence could not be furnished with adequate security. In the present case, the examinations helped--already in a preliminary stage of the investigations--to prevent the authorities from more expensive proceedings as well as the respective nursing home from being unjustly suspected of having committed a criminal offense.     

Ultraviolet radiation and its role in wound pattern documentation.

The history of ultraviolet illumination in photography is discussed. Particular attention is devoted to the forensic aspects of ultraviolet photography as it relates to patterned injury on human skin. The authors discuss the theory underlying ultraviolet illumination of wounds on skin as well as the equipment required for this type of imaging.     

A normality bias in legal decision making

It is important to understand how legal fact finders determine causation and assign blame. However, this process is poorly understood. Among the psychological factors that affect decision makers are an omission bias (a tendency to blame actions more than inactions [omissions] for bad results), and a normality bias (a tendency to react more strongly to bad outcomes that spring from abnormal rather than normal circumstances). The omission and normality biases often reinforce one another when inaction preserves the normal state and when action creates an abnormal state. But what happens when these biases push in opposite directions as they would when inaction promotes an abnormal state or when action promotes a normal state? Which bias exerts the stronger influence on the judgments and behaviors of legal decision makers? The authors address this issue in two controlled experiments. One experiment involves medical malpractice and the other involves stockbroker negligence. They find that jurors pay much more attention to the normality of conditions than to whether those conditions arose through acts or omissions. Defendants who followed a nontraditional medical treatment regime or who chose a nontraditional stock portfolio received more blame and more punishment for bad outcomes than did defendants who obtained equally poor results after recommending a traditional medical regime or a traditional stock portfolio. Whether these recommendations entailed an action or an omission was essentially irrelevant. The Article concludes with a discussion of the implications of a robust normality bias for American jurisprudence.     

Memory for murder. A psychological perspective on dissociative amnesia in legal contexts

There is currently a complex and inconsistent state in the law relating to dissociation and dissociative amnesia (McSherry, 1998). Although dissociative amnesia in defendants is relevant to both competency to stand trial and criminal responsibility in principle, courts have typically assumed a skeptical stance toward such claims in practice. However, there is considerable evidence from both nonoffender and offender populations to support the validity of dissociative amnesia in defendants. Further, there is information available to aid in the evaluation of amnesia, such as the quality of the report itself and characteristics of the person reporting the amnesia (e.g., psychopathy). When consideration is given to the legal response to reports of dissociative amnesia by complainants, the situation becomes even more complex. While some courts have rejected recovered memory evidence, others have convicted defendants of historical offenses based on such evidence. In some cases, judges have argued that jurors should be left to decide on the validity of recovered memories based on their common sense and experience. The uncritical acceptance of the validity of repressed memories in complainants by many courts stands in stark contrast to the response to claims of amnesia from defendants. It seems apparent that the courts need better guidelines around the issue of dissociative amnesia in both populations. We think that the increasing scientific understanding of memory in the past decade (see Schacter, 1999) can meaningfully contribute to the development of such guidelines. Responsible, nonpartisan expert testimony from mental health professionals would be one step in the direction of rectifying the current state of law in regards to dissociation.     

完善我国药品不良反应救济机制的法律思考

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