Spanish Journal of Legal Medicine最新文献

{"title":"Online sexual violence in childhood and adolescence: A forensic and victimological perspective","authors":"Aina M. Gassó","doi":"10.1016/j.remle.2026.500526","DOIUrl":"10.1016/j.remle.2026.500526","url":null,"abstract":"","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 2","pages":"Article 500526"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148528818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality indicators for penitentiary medical reports supporting the adoption of alternative measures to imprisonment on health grounds","authors":"Nahia Aia,&nbsp;Itsaso Bengoetxea,&nbsp;Benito Morentín,&nbsp;Inmaculada Arostegui,&nbsp;Luis F. Callado,&nbsp;Enara Garro","doi":"10.1016/j.remle.2026.500504","DOIUrl":"10.1016/j.remle.2026.500504","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>Humanitarian release from prison on health grounds is a measure to preserve human dignity, recommended by international human rights bodies and enshrined in the legislation of many countries. A medical report is required for such a judicial decision. The objective of this study was to analyse the quality, content and variability of medical reports used for early release from prison on health grounds.</div></div><div><h3>Methods</h3><div>A retrospective observational descriptive study was conducted on 164 medical reports for the early release of persons deprived of liberty obtained in the Basque Autonomous Community (BAC) and Catalonia. Structural aspects, clinical content, compliance with the standards of clinical reports in the health system, and relevant medico-legal aspects were evaluated.</div></div><div><h3>Results</h3><div>The study revealed that there was a high degree of variability, that the importance of the temporary life prognosis for the granting of this type of measure was significant in Spain, and that the health baseline situation of the subjects studied was advanced. Analysis of the quality of the reports revealed significant technical deficiencies and the frequent absence of basic clinical elements. Barriers to accessing information sources limit research.</div></div><div><h3>Conclusions</h3><div>The absence of standardised guidelines or protocols at the national and international levels for the drafting of this type of report leads us to propose further advancement in this important area of human rights.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 2","pages":"Article 500504"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148528819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of capacity in complex clinical decision-making: A clinical case","authors":"Sandra Puyal González,&nbsp;Marta Navas Tejedor","doi":"10.1016/j.remle.2026.500517","DOIUrl":"10.1016/j.remle.2026.500517","url":null,"abstract":"<div><div>An 87-year-old woman with a history of chronic delusional disorder who attended the emergency services after a fall with a left subcapital femur fracture and subsequent anemia. The patient rejects the treatment despite the negative consequences that it entails. At the request of the medical team, two capacity assessments were performed to evaluate her competence in two consecutive decisions. Firstly, regarding the refusal of blood transfusion, and secondly, regarding the decision about surgical intervention.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 2","pages":"Article 500517"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148528817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Legislative reforms and medico-legal problems related to permanent disability as a cause for termination of employment contracts","authors":"M. Teófila Vicente-Herrero ,&nbsp;Pilar Moreno-Torres ,&nbsp;Carmen Muñoz Ruipérez ,&nbsp;Luisa Capdevila García ,&nbsp;M. Victoria Ramírez Iñiguez de la Torre ,&nbsp;José Ignacio Torres Alberich ,&nbsp;Alfonso Torres Vicente ,&nbsp;Santiago Delgado Bueno","doi":"10.1016/j.remle.2026.500498","DOIUrl":"10.1016/j.remle.2026.500498","url":null,"abstract":"<div><div>The recent amendment to Article 49 of the Workers' Statute, driven by a ruling from the Court of Justice of the European Union, eliminates the automatic termination of the employment contract due to permanent disability. Companies must now assess and document the possibility of making reasonable accommodations or reassigning the worker to a compatible position, unless this represents an undue burden. The occupational physician plays a central role by evaluating work capacity and proposing adaptations. Termination of the contract will only be lawful if it is demonstrated that no viable alternatives exist and the entire process is properly justified. This reform aims to prevent discrimination based on disability, protect the rights of affected workers, and balance employer obligations with labor inclusion, requiring preventive and coordinated management between medical services and human resources.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 1","pages":"Article 500498"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147551548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medico-legal perspective on criminal responsibility in individuals with mental disorders","authors":"Ruth Salmón Maroto","doi":"10.1016/j.remle.2026.500499","DOIUrl":"10.1016/j.remle.2026.500499","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze, from a medico-legal perspective, the relationship between mental disorders and criminal responsibility, identifying clinical-criminal patterns and judicial assessments in cases involving serious offenses.</div></div><div><h3>Material and methods</h3><div>A descriptive study was conducted, combining a specialized literature review with the analysis of judicial decisions. The study included rulings issued in Spain in which the presence of a clinically diagnosed mental disorder was recognized. Each case was examined in relation to the type of offense, psychiatric diagnosis, degree of criminal responsibility, and the penalty imposed.</div></div><div><h3>Results</h3><div>Psychotic disorders were more frequently associated with homicide, while personality disorders predominated in sexual offenses. Most defendants were deemed fully responsible, even in the presence of severe mental disorders. Semi-responsibility did not lead to a significant reduction in sentences, and psychiatric hospitalization was applied only in cases of non-responsibility. Although psychopathy could be identified in some clinical-criminal profiles, it did not appear as a formal diagnosis in any of the rulings.</div></div><div><h3>Discussion</h3><div>Findings reveal a restrictive application of mental disorder exemptions within the Spanish judicial system, consistent with the mixed (biological-psychological) model of criminal responsibility. Despite the recognition of psychopathology, ordinary imprisonment was prioritized over therapeutic measures. The results highlight the need for more specific diagnostic tools and adequate forensic and penitentiary resources to integrate both clinical and legal perspectives in the assessment of criminal responsibility.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 1","pages":"Article 500499"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147551627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide with propofol: A case report","authors":"Esperanza Navarro Escayola ,&nbsp;Clara Vega Vega","doi":"10.1016/j.remle.2026.500506","DOIUrl":"10.1016/j.remle.2026.500506","url":null,"abstract":"","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 1","pages":"Article 500506"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147551615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative study between post mortem computed tomography and autopsy: Experience at an institute of legal medicine and forensic sciences","authors":"David Martínez-Esquiva ,&nbsp;Juan Pedro Hernández del Rincón ,&nbsp;Cristina Sánchez Pérez ,&nbsp;Eulalia Moya Cánovas ,&nbsp;Úrsula María Gil Martínez ,&nbsp;Eduardo Osuna","doi":"10.1016/j.remle.2026.500503","DOIUrl":"10.1016/j.remle.2026.500503","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Post mortem</em> computed tomography (PMCT) is a non-invasive complementary tool that enables triage and three-dimensional reconstruction in forensic pathology. The objective of this study is to evaluate the diagnostic efficacy of PMCT compared to traditional autopsy at the IMLCF of Murcia, the first center in Spain with a dedicated forensic computed tomography unit.</div></div><div><h3>Materials and methods</h3><div>A retrospective observational study (2020–2023) was conducted, analyzing 44 cases where PMCT was performed prior to the necropsy. A total of 560 forensic findings were categorized, and statistical analysis was applied using the McNemar test, with significance set at a value of <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>PMCT demonstrated statistically significant superiority in detecting skeletal injuries (<em>p</em> &lt; 0.001), with particular relevance in the skull (<em>p</em> = 0.001) and the pelvic ring (<em>p</em> = 0.031). However, autopsy maintained a significant advantage in identifying pathology in soft tissues, parenchyma, the vascular system, and fluids in cavities (<em>p</em> &lt; 0.001). A progressive improvement in the accuracy of PMCT reports was observed, linked to the team’s learning curve.</div></div><div><h3>Conclusions</h3><div>PMCT is superior for diagnosing bone trauma, especially in anatomical regions that are difficult to dissect. Its routine integration requires the implementation of standardized reporting protocols and specialized technical training in forensic imaging for medical examiners.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 1","pages":"Article 500503"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147551545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality in institutes of legal medicine and forensic sciences","authors":"Rosa Ana Marcos Ramos ,&nbsp;Mar Pastor Bravo ,&nbsp;Marta Grijalba-Mazo","doi":"10.1016/j.remle.2026.500507","DOIUrl":"10.1016/j.remle.2026.500507","url":null,"abstract":"","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 1","pages":"Article 500507"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147551546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregabalin use in drug-facilitated sexual assault cases","authors":"Lokmane Dali Braham ,&nbsp;Feriel Hadji ,&nbsp;Abderrahmane Kori Yahia ,&nbsp;Imane Bekkouche ,&nbsp;Souad Nagoudi ,&nbsp;Dalanda Benchrik ,&nbsp;Nour El Yakine Keraghel ,&nbsp;Mohamed Amine Kerdoun ,&nbsp;Djamil Azzouz ,&nbsp;Rachid Belhadj","doi":"10.1016/j.remle.2026.500492","DOIUrl":"10.1016/j.remle.2026.500492","url":null,"abstract":"<div><h3>Background</h3><div>Pregabalin, a gamma-aminobutyric acid (GABA) analog, is increasingly misused for its sedative, euphoric, and disinhibitory effects. Although not traditionally listed among classic drug-facilitated sexual assault (DFSA) agents, its pharmacological profile raises concerns about its potential use in chemical submission.</div></div><div><h3>Objective</h3><div>To describe and analyze a series of DFSA cases in which pregabalin was identified through forensic toxicological investigations, and to evaluate its implications as a chemical submission agent.</div></div><div><h3>Methods</h3><div>This case series includes nine DFSA victims assessed at the Department of Forensic Medicine, Mustapha Pasha University Hospital, between September 2023 and September 2024. Biological samples were collected promptly and analyzed using immunoassays followed by confirmatory gas chromatography–mass spectrometry (GC–MS). The qualitative GC–MS method was validated according to SFBC-SFTA 2019 recommendations.</div></div><div><h3>Results</h3><div>Pregabalin was detected in all urine samples and in one blood sample. It was the only common substance across all cases, though MDMA and tramadol were also identified in three and one cases, respectively. Victims (aged 13–18) were predominantly female, and all presented with marked drowsiness and confusion. Genital injuries were observed in 55% of cases, and anal or other bodily injuries in 100%. In six cases, the substance was administered without consent.</div></div><div><h3>Conclusion</h3><div>This is the first documented case series in North Africa implicating pregabalin as a primary agent in DFSA. Its psychoactive effects including sedation, confusion, amnesia, and disinhibition make it particularly conducive to chemical submission. These findings support the systematic inclusion of pregabalin in DFSA toxicology screenings and highlight the need for heightened clinical and forensic awareness.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 1","pages":"Article 500492"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147551614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful strategies for digital transformation in the Institutes of Legal Medicine and Forensic Sciences","authors":"Mar Pastor-Bravo ,&nbsp;Ezequiel Domínguez-Lucena ,&nbsp;Marta Grijalba-Mazo ,&nbsp;Eneko Barbería-Marcalain ,&nbsp;Rosana Marcos-Ramos ,&nbsp;Alfonso Colorado-Casado de Amezua ,&nbsp;Carmen Negre-Muñoz","doi":"10.1016/j.remle.2026.500502","DOIUrl":"10.1016/j.remle.2026.500502","url":null,"abstract":"<div><div>Digital transformation represents a strategic opportunity to modernize the Institutes of Legal Medicine and Forensic Sciences (IMLCF) and align them with the current challenges of the Administration of Justice. This article proposes a generalizable model to drive such transformation from a comprehensive perspective, not only technological but also organizational, cultural, and data-oriented. Based on an internal and external analysis of the institutional environment, which each institute must undertake, the main strengths, weaknesses, opportunities, and threats can be identified, as well as the possibilities that technological advances offer to legal medicine and forensic sciences. This diagnosis enables the definition of the digital strategic vision of each institute. A progressive roadmap is proposed, grounded in best practices and focused on leadership, staff involvement, and sustainability of actions. Digital transformation is not an end in itself but a means to deliver a more effective, human, transparent, and citizen-centered forensic public service.</div></div>","PeriodicalId":101178,"journal":{"name":"Spanish Journal of Legal Medicine","volume":"52 1","pages":"Article 500502"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147551547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}