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Forensic medicine (forensic pathology)
1. FORENSIC PATHOLOGY(THE CONCEPT) Dr. Ab. Halim Hj. Mansar MD, DFM (Glasgow), MSC (Glasgow), FFLM(London) FORENSIC SCIENCE FSKB(UKM)
2. MEANING OF FORENSIC PATHOLOGY Forensic = Forum = Court (of law) Pathology = The study of the essential nature of disease (includes trauma).
3. DEFINITION OF FORENSIC PATHOLOGY Application of the knowledge of pathology/medicine to aid in the administration of justice (in relation to the courts of law). N/B: Medical aspect of law. Legal organization seeking help from expert/s in medical profession.
4. MEDICAL JURISPRUDENCE Legal aspects of the practice of medicine. Medical organization seeking help from expert/s in legal profession.
6. FORENSIC PATHOLOGIST A specialist doctor who has knowledge and special skill in forensic pathology. Discipline + ist = a specialist in that particular field.
7. LEVEL OF EXPERTISE House Officer Medical Officer Registrar Specialist Consultant Senior Consultant N/B: Medical Officer in law is a doctor from M.O. onward. N/B: Different in academic post.
8. POSGRADUATE DEGREE IN FORENSIC PATHOLOGY DFM = Diploma in Forensic Medicine DMJ(Path) = Diploma in Medical Jurisprudence (Pathology) MSc(Forensic Sci) = Master of Science (Forensic Science) MPath(Forensic) = Master of Pathology (Forensic) MRCPath (Forensic Path) = Member of Royal College of Pathologists
9. PATHOLOGIST A specialist doctor in any field of pathology, i.e. Histopathology, Haematology, Chemical Pathology, Microbiology, Cytopathology, Forensic Pathology. Most Pathologist has undergone all 4 postings. Pathologist to the public is almost synonymous to a Histopathologist.
10. HISTOPATHOLOGIST Conduct Clinical Autopsy. Objective is to study the extent and severity of the disease process. Eg. patient died of cancer colon; autopsy to find complications and metastases. The cause is already known. Require consent from the next of kin. Other duty is to read histopathology slide.
11. ROLE OF FORENSIC PATHOLOGIST Confirm death has occurred. Estimate time since death. Ensure positive identification. Record and interpret injuries and natural disease if any. Determine cause of death. Form an opinion on possible manner of death through recontruction of event.
12. CONFIRMATION OF DEATH No pulse or heartbeat. No respiration. Pupils fixed and dilated. Fragmentation of column of blood in retinal vessels. Primary flaccidity of the limbs.
13. ESTIMATION TIME SINCE DEATH Body or rectal temperature. Postmortem hypostasis. Rigor mortis. Biochemistry of vitreous humour. Decomposition and entomology. Adiposere formation. Skeletalisation.
14. POSITIVE IDENTIFICATION Characteristic must be unique, attached to the body and comparable with antemorten record. Usual method : Visual identification. Major criteria : Fingerprint, Dental data, DNA fingerprinting. Minor criteria : Clothings, personal affects, anthropometry, medical anomaly, etc.
15. INTERPRETATION OF INJURIES Type of injury : abrasion, contusion, laceration, incised wound, stab wound, gunshot wound, burn, fracture. Fatal injury : an injury which on its own without medical intervention may cause death.
16. INTERPRETATION OF INJURIES Defence injury : injury sustained by victim while trying to ward off an on coming weapon during an assault. Injury inflicted by other person : involving painful area and beyond the victim’s reach. Self-inflicted injury : involving less painful area and within the victim’s reach.Pattern is “regular”.
17. INTERPRETATION OF INJURIES Age of injury : colour changes, scab and scar formation. Pattern reflect Intent : More than one similar injury = intention to cause harm; Gunshot to temple, roof of mouth, under the chin or over praecordium = suicide; Multiple shallow incisions and single deep incision on the wrist = suicide; etc.
18. INTERPRETATION OF INJURIES Pattern reflect nature of offending weapon : Incised wound caused by sharp weapon; bruise caused by blunt and hard object; bruise and fracture caused by blunt, hard and heavy object;singeing of hair caused by flame; downward burn without singeing of hair caused by corrosive fluid; stab wound caused by sharp and pointed object, etc.
19. NATURAL DISEASE If absent : the deceased person did not die of natural death. If present , deceased person may die of natural death. Disease may accelerate but not cause death, eg. Fatal MVA with moderate heart disease. If no mark of violence and no natural disease, think of poisoning or vagal inhibition.
20. CAUSE OF DEATH Initial event which triggers a train of events leading to a person’s death. Differentiate this from mode of death. Meaning of cause of death in section 328 CPC. Cause of death is an OPINION!
21. CAUSE OF DEATH Can only be given by the examining doctor! Eg. A Chemist is an analytical expert. He testify on the accuracy and reliability of certain laboratory result, BUT the interpretation of that particular result in relation to the cause of death is in the domain of the EXAMINING DOCTOR!
22. MANNER OF DEATH I s how a person come about to his death. Natural Accidental / misadventure Suicidal Homicidal
