Peculiar approaches to the estimation of the severity of harm to health in children with non-fatal injuries

The medico-legal estimation of non-fatal injuries in the children and adolescents is presented. The data obtained have been used to develop and substantiate the algorithm of forensic medical expertise of such injuries. Scientifically sound criteria have been proposed to be used for the purpose of expert estimation of the severity of harm to health associated with non-fatal injuries taking into consideration their clinical manifestations. The procedures of forensic medical expertise for the estimation of the harm to health have been analysed with special reference to non-fatal injuries in children and adolescents. Main attention was given to the accompanying strategic, organizational, and methodological errors. The approaches to their prevention and correction are described.     

Evaluation of the severity of harm to health by gastrointestinal injury caused by blunt trauma

A total of 226 forensic medical conclusions in traumas of the gastrointestinal tract with blunt objects, 111 of these with lethal outcomes, are analyzed. The types of injuries, clinical course, medical care, complications, flaws in medical care and their consequences, and pathomorphology of the injury were analyzed. Criteria of harm inflicted to health are determined and a table of qualifying signs is suggested for cases with blunt injuries of the gastrointestinal system, with consideration for the type of injury.     

The application of the medical criteria for the harm to health: expert and law-enforcement practice

This paper is devoted to the practical application of the medical criteria (MC) for the harm to health (HH) put into force on September 16, 2008. The authors undertook the analysis of procedures of forensic medical expertises for the estimation of the harm to health during the periods before and after putting MC into action (between 2007 and 2010). The results of this analysis were compared with the number of documented criminal actions that caused harm to health and the number of subjects convicted of such crimes. It is shown that the frequency of crimes leading to the serious harm to health has increased (by 22%) in parallel to the roughly similar decrease in the frequency of crimes responsible for the moderate harm. These trends are unrelated to the changes in the number of subjects convicted of such crimes. The frequency of intentional infliction of the serious harm to health decreased by 12% and the number of subjects convicted of the crimes that caused serious (Criminal Code of the Russian Federation, parts 1-3, article 111) and moderate (Criminal Code, article 112) harm to health decreased in 2010 by 5% compared with 2007. The rise in the frequency of the crimes responsible for the serious harm to health (Medical Criteria, pp. 6.11.1-6.11.11) revealed during forensic medical expertises is unrelated to the number of documented crimes and subjects convicted of them under parts 1,2, article 264 of the Criminal Code. The number of documented crimes and subjects convicted of them after the new medical criteria had been put into force (2009 and 2010) decreased by 23% and 15% respectively. It is concluded that putting into effect the new regulations and medical criteria did not result in a substantial change in the relative frequency of the serious and moderate harm to health. Nor did the law enforcement practice gives evidence of any change in the relationship between cases of moderate and serious harm to health and in the number of grave crimes causing the harm to health. The new medical criteria allowed to put in order and present in a structured fashion the data on the harm to health depending on the degree of its severity.     

Evaluation of severity of harm to health caused by trauma aggravating a preceding disease

A severity of damage made to the health condition by an injury aggravating a preceding pathology is under discussion. It was demonstrated that such criteria as the time period of temporary disablement as well as the permanent disablement ensure, with respect for clinical data, an objective assessment of a severity done to the health in the discussed cases.     

Forensic medical evaluation of harm severity inflicted to one's health by slight craniocerebral injuries in the remote period

A pressing problem is discussed: forensic medical evaluation of harm inflicted to health by slight craniocerebral injuries. Analysis of 2150 expert forensic medical and medico-social conclusions revealed serious organization and methodological errors in evaluation of harm inflicted to health by slight craniocerebral injuries. Approaches to improving the quality of such forensic medical expert evaluations are outlined.     

Penal harm medicine: state tort remedies for delaying and denying health care to prisoners

In prison and jail subcultures, custodial personnel are committed to the penal harm movement, which seeks to inflict pain on prisoners. Conversely, correctional medical personnel are sworn to the Hippocratic Oath and are committed to alleviating prisoners' suffering. The Hippocratic Oath is violated when correctional medical workers adopt penal harm mandates and inflict pain on prisoners. By analyzing lawsuits filed by prisoners under state tort law, this article shows how the penal harm movement co-opts some correctional medical employees into abandoning their treatment and healing mission, thus causing denial or delay of medical treatment to prisoners. This revised version was published online in July 2006 with corrections to the Cover Date.     

Forensic medical evaluation of the severity of harm to the health in the cases of a fracture of the zygomaticoorbital complex complicated by ophthalmological disorders

Expert reports of the cases of a fracture of the zygomaticoorbital complex are presented along with their comprehensive assessment based on the available investigative, clinical, and anamnestic data. The analysis included 71 patients, materials of forensic medical examination and other medical documentation, civil, criminal, and administrative proceedings. It was shown that forensic medical evaluation of the severity of harm to the health in the cases of a fracture of the zygomaticoorbital complex including those complicated by ophthalmological disorders is possible both in terms of the total duration of health impairment and in terms of the persistent loss of ability to work (on a percentage base). It is concluded that the degree of harm to the health in the cases of a fracture of the zygomaticoorbital complex complicated by ophthalmological disorders can be categorized as mild, moderate, and severe depending on the total duration of health impairment and percentage loss of ability to work. In case of irreparable facial disfigurement, the moderate harm to the health can be re-evaluated by the court as a severe one.     

Duty to warn of genetic harm in breach of patient confidentiality

Harm caused by the failure of health professionals to warn an at-risk genetic relative of her or his risk is genetic harm. Genetic harm should be approached using the usual principles of negligence. When these principles are applied, it is shown that (a) genetic harm is foreseeable; (b) the salient features of vulnerability, the health professional's knowledge of the risk to the genetic relative and the determinancy of the affected class and individual result in a duty of care being owed to the genetic relative; (c) the standard of care required to fulfil the duty to warn should be the expectations of a reasonable person in the position of the relative; and (d) causation is satisfied as the harm is caused by the failure of intervention of the health professional. Legislation enacted subsequent to the Report of the Commonwealth of Australia, Panel of Eminent Persons (Chair D Ipp), Review of the Law of Negligence Report (2002) and relevant to a duty to warn of genetic harm is considered. The modes of regulation and penalties for breach of any future duty to warn of genetic harm are considered.     

Social harm future(s): exploring the potential of the social harm approach

The notion of social harm has sporadically interested critical criminologists as an alternative to the concept of crime. In particular, it has been viewed as a means to widen the rather narrow approach to harm that criminology offers. More recently, the publication of Beyond Criminology: Taking Harm Seriously has renewed interest in the notion of social harm. The book asserted a number of very valid reasons for a social harm approach that provoked a number of interesting critical responses. The article seeks to respond to five recurring questions: Should the social harm perspective move beyond criminology? If so, where should the perspective locate itself? From this position, how will the perspective continue to engage within ‘law and order’ debates and address the concerns of those affected by crime? If the notion of crime is problematic, how will the perspective form an alternative definition of harm? Moreover, without a notion of crime and the accompanying concept of criminal intent, how would the perspective allocate responsibility for harm? The article is not offering definitive answers to these questions, but possible directions for the perspective’s future development.     

Risk of harm: inmates who harm themselves while in prison psychiatric treatment

In this study, 242 randomly selected male offenders who were receiving psychiatric treatment in prison were administered psychological and neuropsychological evaluations and were followed during their treatment in a prison psychiatric hospital. Offenders who harmed themselves in treatment were compared to those who did not harm themselves. Eighteen percent of offenders harmed themselves, the severity of which required medical intervention. Young age, drug abuse, absence of Axis I mental disorder but presence of Axis II borderline personality disorder identified offenders who harmed themselves. Psychopathy checklist-revised (PCL-R) total rating > or = 30 and PCL-R Factor 2 (antisocial lifestyle) rating also identified offenders who harmed themselves. Additionally, offenders who harmed themselves also were 8.36 times more likely than their cohorts to harm treatment staff. Theoretical understanding of offenders who harm themselves, the importance of considering the environmental context in identifying risk factors for self-harm, and implications for treatment are suggested.     

On judgment proofness in the case of bilateral harm

This paper defies the widely held belief concerning the unambiguous superiority of negligence in settings of judgment proofness. We analyze a set-up with bilateral harm, bilateral care, and potential judgment proofness by one party to the accident. We establish that strict liability with a defense of contributory negligence can perform better than simple negligence and negligence with a defense of contributory negligence. It is shown that the former liability rule can better establish a discontinuity in individual costs conducive to inducing efficient care than the other rules.

Spontaneous fractures in the differential diagnosis of fractures in children

A four-year-old male with cerebral palsy and spasticity, as a result of a non-accidental head injury sustained when he was two years old, died of pneumonia. Postmortem full body X-rays revealed fractures of varying ages of the left humerus and both femora, tibiae, and fibulae. This led to a thorough investigation of the case by the Office of the Chief Medical Examiner. Child abuse, accidents, metabolic bone disorders, other primary or secondary diseases of the bones, and pathological fractures were ruled out. The final diagnosis was spontaneous fractures secondary to osteopenia. The term spontaneous fractures is used to define fractures that occur without any known external cause, especially in cerebral palsy patients with spasticity.     

Refusal of the biological proof practice and the harm of the law to effective judicial guardianship in constitutional jurisprudence]

The Spanish Constitution protects the free investigation of the paternity on its 39.2 the article, in which is granted that possibility. This right is not absolute, it has limits, but those limits will have to be interpreted in a restrictive way due to the principles based on it, such as the legal equality of children, and the integral protection of them. In view of this, the sentences are a very valuable element to delimit the aplication of this right, and establish its limitations.