唯物史观的历史前提与逻辑前提

马克思恩格斯在《德意志意识形态》中提出了唯物史观的两个前提(出发点)，即历史前提与逻辑前提。历史前提是从事实践活动的人，逻辑前提是人的实践活动。历史前提是逻辑前提的前提和基础，逻辑前提是历史前提的提炼和升华．二是辩证的、具体的统一，决不存在非此即彼的关系。提出并阐述唯物史观的历史前提与逻辑前提的辩证统一是唯物史观超越一切旧历史观的关键。     

Observations of high velocity bloodspatter on adjacent objects

In a recent homicide investigation, high velocity backspatter was observed on the sleeve cuff of the accused. These minute droplets were discovered only after microscopic examination and were limited in number. A study was initiated to determine if these were truly backspatter droplets or transferred blood produced from light contact with a bloody item. It was observed that the backspattered blood was primarily limited to contact or near contact shots. An exception was a shot into an already bloody surface. It was found that backspattered blood would deposit on the shooter's shirt sleeve irrespective of the weave pattern. Transferred blood was observed only on the fiber tops. This information was found to be useful in reconstruction of events in suicides as well as possible homicides.     

Ethics and the Physician-Patient Relationship

Book Reviews in This Article:
Getting Rid of Patients: Contradictions in the Socialization of Physicians . By Terry Mizrahi
Physicians and Social Change . By John Colombotos and Corinne Kirchner
Changing Values in Medicine . Edited by Eric J. Cassell and Mark Siegler
Professional Ethics and Primary Care Medicine: Beyond Dilemmas and Decorum . By Harmon L. Smith and Larry R. Churchill
Physician—Patient Decision-Making: A Study in Medical Ethics . By Douglas N. Walton
With Dignity: The Search for Medicare and Medicaid . By Sheri I. David
The Dismissal of Students with Mental Disorders. Legal Issues, Policy Considerations, and Alternative Responses .
Courtroom Toxicology . By Marshall Houts, Randall C. Baselt, and Robert H. Cravey     

Mentally disordered offenders in Sweden.

This article reviews the laws in Sweden concerning mentally disordered offenders. It also contains some figures on the relationship between mentally disordered offenders and other offenders sentenced to prison. The rules in Sweden are very different from other countries in that the responsibility concept has been abolished and thus there is no acquittal on a psychiatric basis.     

公务员法对公务员提供公共服务的新要求

建设服务型政府是人民政府应有的基本品格和追求的价值目标之一。公务员法从“全心全意为人民服务”和“提高工作效率”两个方面对公务员实现此目标提出了新的要求。     

Surveillance of human immunodeficiency virus (HIV) antibodies in medicolegal autopsies in Finland--monitoring early changes in HIV-seropositivity among risk groups and average population.

In order to cooperate with voluntary screening programs aimed at the surveillance of the HIV epidemic in Finland, we have studied medicolegal autopsies for HIV antibodies since 1986 using an enzyme immunoassay on postmortem sera. The investigation covered 47.4% and 39.2%, respectively, of all deaths under the age of 65 years in the metropolitan areas of Helsinki and Turku--two cities on the densely populated southern coast of Finland from which most HIV infections have thus far been detected. Nine HIV-positive cases (0.12%) were detected among the 7305 medicolegal autopsies tested in 1986 to 1990. This figure is higher than the prevalence of 0.01 to 0.03% in voluntary screening programs for the general population would suggest. Seven of our cases had previously tested positive, and two were previously unknown cases, indicating that people at high risk are clustered in the medicolegal autopsy series. Of the six cases in an early stage of infection, three committed suicide suggesting the importance of HIV-screening in suicide cases in tracing symptomless HIV carriers. Five of the cases were detected in 1990, a year when the number of new HIV infections had more than doubled compared to the previous two years. This suggests that testing of medicolegal autopsies as surrogate tests for the population gives useful information even in low-prevalence areas like Finland. Such testing has none of the ethical problems of many other back-up surveys, and may be particularly sensitive to early changes in epidemiology.     

Dissecting intramural haematoma of the coronary artery with intimal tears.

A dissecting intramural haematoma of the coronary artery is an infrequent cause of sudden and unexpected death. Most cases are women and in a significant number of these women, the haematoma occurred at term to 80 days postpartum. Because the intimal rupture and communication with the lumen were not found in most of the cases, the site of rupture has been considered to be a vasa vasorum. The authors report on a case of one woman who was at a later postpartum period (106 days). The microscopic finding of the dissected coronary artery revealed two intimal tears in a section. The case showed that the dissecting intramural haematoma of the coronary artery is caused not only by the rupture of the vasa vasorum but also by the rupture of the intima.     

Identification based on medical findings

1. The indications such as the place of finding, the identification of clothes or other personal items, represent only the first step towards the identification of a corpse. 2. An identification based on medical data, other than dental, is often possible, more often than it is believed. 3. The forensic pathologist plays a double role in the case of such an identification: a) in the phase of the inquiry, he must contact the investigators and the families to explain his wishes and the different possibilities of identification. b) he must use the gathered information in the appropriate way. 4. It would be desirable to compose some statistical tables of the various medical elements useful for the identification (mutilations, surgical operations, etc...). We present six cases of identification in our practice.