Reenactment of circumstances in deaths related to restraint

Reenactment of the circumstances in deaths associated with restraint, utilizing participants and witnesses while memories are fresh, may help death investigators more accurately determine the cause of death. Two recent deaths in Ventura County that occurred during restraint are discussed. Within a day of the autopsies the restrainers agreed to participate in reenactments of the restraint process, utilizing live volunteers as subjects. They allowed videotaping. Deaths associated with restraint often have nonspecific autopsy findings. Timely reenactment of the circumstances of deaths associated with restraint can help death investigators more accurately determine the probable cause of death in these difficult cases.     

Increased Lung Weights in Drug‐related Fatalities

This study is of autopsy data for potential validation as to whether increased weights of the lungs support toxic effects of drugs as the cause of death. This retrospective study compared data from 133 deaths resulting from the toxic effects of drugs with previously reported normal lung weights (Toxicol Mech Methods, 22, 2012, 159; Am J Forensic Med Pathol 33, 2012, 368). The lung weights and their standard errors were used in a two‐sample independent t‐test comparing the average drug‐related death weight to the average control weights. To account for multiple comparisons, a Bonferroni‐adjusted alpha level of 0.0125 was used. We are 98.75% confident that the mean right lung weight for female drug‐related deaths is between 227 and 377 g greater than the mean right lung weight for female non‐drug‐related deaths. We are 98.75% confident that the mean right lung weight for male drug‐related deaths is between 245 and 378 g greater than the mean right lung weight for male non‐drug‐related deaths.     

Redressing wounds: finding a legal framework to remedy racial disparities in medical care

In recent years, numerous medical studies and reports have documented startling disparities between the health status of African Americans and White Americans. The literature is replete with evidence that one of the main causes of these racial disparities is the different treatment of patients of different racial groups. This Comment addresses the possibility that implicit cognitive bias, in the form of implicit attitudes and stereotypes, significantly contributes to these racial disparities in medical treatment. Finding existing legal frameworks inadequate to address current disparities in health care, this Comment recommends avenues for the reworking of Title VI of the Civil Rights Act of 1964. Specifically, it suggests that disparate-treatment provisions that encompass claims arising from unintentional discrimination should be incorporated into Title VI, and it offers the employment law frameworks of Title VII and the Age Discrimination in Employment Act as models for such reform.     

Fatalities due to intoxicated arrestees jumping out of moving police vehicles

Fatalities resulting from emergency vehicle crashes are relatively rare. Mortality, particularly in the case of unbelted occupants, is relatively high. Data on drunken (handcuffed) arrestees jumping out of a moving police vehicle or the circumstances of such events have not been published. Two cases of such fatalities are described in this paper. Since these cases should be considered as "death in custody," may give rise to significant covering and speculation in the media, and may raise liability questions, they require an in-depth medicolegal investigation, including investigation of the crime scene, complete medicolegal autopsy/toxicology, and reconstruction of the event in the presence of an experienced forensic pathologist. From the 2 cases described in this paper, it appears that mechanical malfunctioning of the locking device of the door of the police vehicle and lack of controlling the actual lock-tied closing of the vehicle door (instead just assuming that it happened) may precipitate such cases. Auditory control by the police officers of the arrestee tampering with or manipulating the car door may be hampered by the background noise of the police vehicle, the on-board radio, and the use of a siren. Regular visual control and adequate control of the actual locking of the vehicle door are of paramount importance to prevent such mishaps. Reconstruction of the event in the presence of the forensic experts is mandatory to test the different hypotheses of the fatal event.     

涉及死亡医疗纠纷的发生:27年医疗纠纷法医尸检回顾性研究之一

为了探讨医疗纠纷法医尸检的特点,回顾性研究了1972～1998年27年间318例医疗纠纷尸检资料.在这第一篇报告中,介绍与死亡有关医疗纠纷发生上的一些特点:医疗纠纷尸检的案例数从1972～1983年的23例上升到1984～1998年的295例;死者中男女性别无显著差别;年龄分布有两个高峰,10岁以下有104例(32.71%),20～40岁组161例(50.63%);发生在市(县)级中等大小医院的纠纷最多见,有195例,占61.32%,近年私人诊所的医疗纠纷明显增多;医疗纠纷尸检最常涉及外科(71例,22.33%)和产科(58例,18.24%);也简略讨论了206例非医疗过失纠纷和99例医疗过失纠纷发生的原因.     

Pediatric homicides related to burn injury: a retrospective review at the medical university of South Carolina

Many burn injuries are mistakenly referred to as "accidents" because they occur suddenly and seem unpredictable and uncontrollable; however, injuries often occur in predictable patterns. We reviewed all pediatric forensic cases referred to the Medical University of South Carolina Forensic Pathology Section over a 28-year period from January 1975 to December 2002. There were 124 cases with 121 fire-related fatalities and three scald fatalities. Ninety of the burn victims were in the 0-5-year age group. The manner of deaths showed 108 accidents and 12 homicides (four undetermined). Eleven of 12 burn-related homicides occurred at the home with all of the victims in the 1-8-year age group. The perpetrator of the home fire homicides was the mother in five cases and the sister in one case (two undetermined). Homicide involved a vehicle fire in one case in which the father caused an explosion with an accelerant. The three scald death perpetrators were the father, mother's boyfriend, and an aunt.This retrospective study and review of the literature may reveal patterns useful for evaluation of manner of death. By recognizing scene characteristics, potential perpetrators, and children at risk, we can better classify pediatric burn-related fatalities.     

应用Young-Burgess分型推断交通事故受伤人员骨盆损伤机制

目的根据骨盆骨折X线片Young-Burgess分型推断道路交通事故致死者（roadtrafficfatalities,RTFs）骨盆损伤机制,并探讨其法医学应用价值。方法回顾性分析128例车外成人RTFs尸体骨盆X线片的Young-Burgess分型,根据分型推断骨盆损伤机制,对照真实案情进行统计分析。结果可区分APC、LC亚型的推断骨盆损伤机制正确率（94.1%、92.9%）明显高于不区分亚型的（63.6%、70.7%）（P〈0.05）;区分LC亚型还能进一步推断后侧方、前侧方或是持续、较大的前侧方外力。结论综合各种影像手段区分Young-Burgess亚型可较好地推断骨盆损伤机制,为道路交通事故现场重建提供可靠依据。     

海洛因依赖及其相关法医学问题

近年来,随着吸毒人数的增加以及非法成瘾物质的种类日趋繁多,成瘾性药物的使用越来越成为世界上普遍存在的严重社会问题,而阿片的半合成品--海洛因更因为其高纯度及相对较低的价格被广泛使用.     

Roe v. Wade is constitutionally unprincipled and logically incoherent: a brief in support of judicial restraint

This "amicus curiae" brief was submitted by the Center for Judicial Studies and 56 members of Congress. They were concerned that "Roe" expands powers that belong to Congress and the states into the realm of federal government. Part I of the brief dealt with Missouri's claim that the laws that were at issue in "Webster" were permitted under "Roe" and shouldn't have been made invalid by lower courts. Most of the brief was in Part II. The thrust of it was that "Roe" was not based on any principle and is incoherent internally; "Roe" said that a privacy right existed under the US constitution. However, "Roe" didn't define this right of personal privacy. "Roe" cited a "line of decisions" to prove this point. However, none of the cases that "Roe" cited pretended to be based on the "right to privacy." They dealt with other issues. "Botsford" was said to be the beginning of the constitutional privacy right. It dealt with a "common law rule of evidence," not a right that was in the constitution. Therefore, it did not define the privacy right. "The process by which "Roe" moved from privacy to abortion was unfounded by judicial fiat." "Roe" said that it was protected by "the compelling interest standard," but did not give a reason why this was so. In "Roe," the woman';s interest in getting an abortion was analyzed in medical terms. But when talking about the State's interest in protecting potential human life, medical considerations were not controlling. Part III of the brief asked that "Roe" be overturned because it said that "a privacy right to abortion" was "devoid of any linkage to the text or history of the constitution." "Roe" should be abandoned because its "inadequacies" are "basic".     

Recidivism is related to psychopathy (PCL-R) in a group of men convicted of homicide

It is well known that psychopaths are a group with high risk for criminality. Despite that, researchers and clinicians have not yet agreed on a general cause of psychopathy. However Raine [Raine, A. (2002). Biosocial studies of antisocial and violent behavior in children and adults: A review. Journal of Abnormal Child Psychology, 30, 311-326.] advocated a biosocial model of violent behaviour where the greatest risk for criminal behaviour occurred when both heredity and environmental risk factors (e.g., social class, childhood history) were present. In this follow-up study, 35 men convicted of homicide were assessed retrospectively for psychopathy according to the Psychopathy Checklist-Revised (PCL-R). Information on personal history, as well as from legal documents and records of offences committed by the subjects was also obtained. Fourteen of the 35 men were classified as psychopaths. Two men, both rated as psychopaths, had criminal parents. Twenty-seven of the men had a social relationship with their victim, and eleven out of these were rated as psychopaths. There was no difference in PCL-R scores between those who had a social relationship with their victim and those who did not. The psychopaths relapsed more frequently than the nonpsychopaths into criminality after their prison term. This result confirms previous research indicating that psychopathy is a risk factor for recidivism. It is, therefore, very important that psychopaths get the best possible treatment, aftercare, and supervision.     

医疗事故鉴定相关问题分析

"医疗过失鉴定"概念应当取代"医疗事故鉴定结论"概念。医疗纠纷诉讼中的医疗鉴定机构应当统一为医学会。分析论证我国的医疗鉴定结论证明能力与证明力,结合我国实际提出了相关的立法完善建议。     

A Case Example of Asphyxia Due to Occupational Exposure to Airborne Chemicals and Review of Workplace Fatalities

Although worker injury and fatalities have decreased since adoption of the Occupational Safety and Health Act in 1970, it remains an important safety issue. This article describes a 27‐year‐old white male who died from occupational exposure to airborne chemicals. Several trends in the last several decades, both in the types of injuries and the occupations associated with fatalities, are noted. Additionally, individual risk factors such as age, gender, chronic disease, smoking, and alcohol and drug use are implicated in worker health and safety. The role of the forensic pathologist in the investigation of workplace deaths is highlighted, in addition to the future of occupational safety and current improvements brought about by such incidents.     

医疗事故鉴定相关问题分析

“医疗过失鉴定”概念应当取代“医疗事故鉴定结论”概念。医疗纠纷诉讼中的医疗鉴定机构应当统一为医学会。分析论证我国的医疗鉴定结论证明能力与证明力，结合我国实际提出了相关的立法完善建议。     

英美法对医疗过失的判定原则及对我国的启示

过失是医疗损害责任认定中最为重要的条件,如何确定过失是医疗纠纷和诉讼中最为关键的问题.我国在该问题上的研究及实践均存有欠缺之处,而英美国家在过失判定原则中,其注意义务标准的设定和认定具有一定的合理之处,对我国医疗过失理论研究和司法实践均有借鉴作用.     

论英美法中医务人员行为的注意义务

过失是构成侵权行为的一个重要条件 ,在英美法中 ,判断过失有无的标准就是注意义务。本文在概括介绍注意义务的前提下 ,着重介绍了英美法中行医人对其病人应承担的注意义务标准 ,以期对我国医疗事故案件处理有所借鉴。     

论英美法中医务人员行为的注意义务

过失是构成侵权行为的一个重要条件,在英美法中,判断过失有无的标准就是注意义务.本文在概括介绍注意义务的前提下,着重介绍了英美法中行医人对其病人应承担的注意义务标准,以期对我国医疗事故案件处理有所借鉴.