Petechiae of the baby's skin as differentiation symptom of infanticide versus SIDS

The successive killing of three siblings by their biological mother at two-year intervals is described. The children were 367 days, 75 days and 3 years old. Although sudden infant death syndrome (SIDS) or interstitial pneumonia could not be ruled out as the cause of death in the two younger children, who were killed first, the third child exhibited discrete signs of violence in the mouth and throat area which were interpreted as proof of infanticide. All three children had petechiae of the skin of the face and throat, the upper thorax, the shoulders and the mucous membranes of the mouth. None of the children exhibited signs of a disease-related hemorrhagic tendency. After the mother was convicted of murdering the three-year-old boy by smothering in combination with compression of the thorax, she confessed to having killed the other two children in a similar manner. In the absence of hemostatic disease, the presence of petechiae of the skin extending over the entire drainage area of the Vena cava superior can be regarded as evidence of an increase in pressure in the thoracic cavity secondary to obstruction of the airways with simultaneous chest compression.     

Spectroscopic determination of skin viability. A predictor of postmortem interval

We have demonstrated that skin viability decreases at a measurable rate following death in an animal model. The decreased skin viability was measured by fluorescein diacetate and ethidium bromide using fluorescence emission spectroscopy. There is significant decrease of the fluorescence intensity of the fluorescein diacetate assay between the 1-4 h, the 6-24 h, and the >40 h time points postmortem. For times between 6-24 h and >40 h postmortem the ethidium bromide assay showed consistent and significant increases in signal. The fluorescence measurements in this study showed that under the experimental conditions the time of death could be determined for <4, 6-24, and >40 hapotmotrem. The application of these assays in the field will require further study of the environmental factors.     

Autonomy, justice, and disability

In this Article, Professor Carlos A. Ball explores the philosophical foundations for the types of rights and benefits that our society currently provides to individuals with disabilities. The concept of autonomy places on society a moral obligation to assist individuals with disabilities when their basic human functional capabilities are impaired. The exercise of this obligation entails assisting individuals with crossing a minimum threshold of functional capabilities below which it is not possible to lead autonomous lives. In making this argument, Professor Ball responds to libertarian critics who contend that notions of freedom or liberty proscribe an activist role for government in this arena. He explains how even a libertarian state redistributes wealth in order to provide for some incapacities. Professor Ball also disputes the idea that the meeting of the needs of the disabled is enough to provide moral justification for the rights and benefits provided to individuals with disabilities. The problem with the concept of needs, Professor Ball argues, is that it fails to account sufficiently for the human good of personal autonomy.     

Oregon's guidelines for physician-assisted suicide: a legal and ethical analysis

Oregon's Death with Dignity Act was first passed by a ballot initiative in 1994, but numerous judicial challenges delayed implementation of the Act. In November of 1997, following the United States Supreme Court decisions in Vacco v. Quill and Washington v. Glucksberg, which left the states' power to regulate physician-assisted suicide undisturbed, the Oregon voters upheld their law. Oregon remains the only state in the nation to authorize physician-assisted suicide. The Task Force to Improve the Care of Terminally Ill Oregonians published a Guidebook for health care providers on the Oregon Act, and the New England Journal of Medicine recently issued a special report on the first year's experience under the Act. This paper analyzes the legal context of the Oregon Death with Dignity Act, discusses the efficacy of the tenets in the Guidebook, and explores ethical issues underlying the guidelines, particularly those pertaining to the meaning of a patient's request for assisted suicide and processes supporting informed consent.     

Forensic medical significance of anti-P1 immunoreagents with incomplete antibodies in blood analysis

Anti-P1 immunoreagents with incomplete antibodies are intended for detection of antigen of different degree of manifestation in blood traces during expert evaluation of material evidences by the adsorption-elution test. These reagents can be used for detecting weakly manifest P1 antigen in liquid blood in forensic medical studies.     

Forensic medical evaluation of professional working capacity in victims, who needs additional care

The philosophy of evaluating the need of a victim in extra care is discussed. The method for evaluating the need in transport vehicles for the victim is described in detail. Legislative documents which help solve such problems are cited, including those used by committees of forensic medical evaluations.