Repeat autopsies on corpses from abroad. A futile effort?

A large number of corpses transferred to Athens and the Piraeus Morgue from abroad have been examined in second autopsies. Lack of information, mistakes in data, useless effort, and disappointment on the part of the forensic pathologists because of the lack of new information revealed are characteristic of these cases. With some exceptions, the second autopsy provided no news for the anxious relatives, who, for the most part, had been prompted by their attorneys or other "well-meaning friends" to demand a second autopsy on the corpses of their loved one (who generally died on board ship abroad). Nevertheless, in 10 of 59 cases, the cause of death was completely different from the determined in the autopsy performed abroad or assumed from the information available. This fact ensures that any corpse from abroad undergoes a careful and thorough examination on its arrival in Greece.     

Euthanasia: a challenge for the forensic toxicologist

People die daily in the hospital. Mostly, they die because their illnesses were no longer treatable (natural death). Unfortunately, some people die an unnatural death, in particular, as the result of euthanasia. In contrast to the situation in most countries, in the Netherlands euthanasia is accepted by the courts under strict conditions. It can be very difficult for the legal authorities to establish whether a person has died from natural causes or from suicide, euthanasia, or murder. In addition to the pathologist and the lawyer, the toxicologist also has a number of problems in showing whether euthanasia has been carried out. These can consist of the following analytical problems: (a) interactions--the patients involved have frequently been receiving a large number of toxic and nontoxic drugs simultaneously; (b) identification--not all drugs administered are included in general screening procedures; (c) metabolites--a large number of metabolites may have accumulated toward the end of a long therapeutic regimen; and (d) determination--determination of quaternary muscle relaxants and their various metabolites, as well as other drugs, can be problematic. There are also toxicokinetic problems; because of poor kidney and liver function, low serum albumen, general malaise, and interactions between these factors and other drugs, the kinetics of a given drug can differ from normal. This makes it all the more difficult to determine whether the patient died from an accumulation of medication or from a so-called "euthanetic" drug mixture.(ABSTRACT TRUNCATED AT 250 WORDS)     

How medicine mistreats the elderly

Hamstrung by biases and limited facts, doctors routinely deliver shoddy care to old people. This guide shows how to reject that medical mindset and stay healthy longer.