Journal of forensic and legal medicine最新文献

{"title":"Psychological autopsy: Overview of equivocal deaths, suicides and homicide-suicides","authors":"Roy Amritha,&nbsp;P. Parvana,&nbsp;K.S. Riza,&nbsp;Isukapatla Arjun Rao","doi":"10.1016/j.jflm.2025.102813","DOIUrl":"10.1016/j.jflm.2025.102813","url":null,"abstract":"<div><div>Psychological autopsy studies are a method to understand the causes of equivocal deaths. Suicides and homicide-suicide are the result of various events. The understanding of an individual's life before their death, by interviewing the next of kin, provides some insight into the causes. The research articles dealing with psychological autopsy studies through case studies of suicide or homicide-suicide instances, obtained from different search engines, shed light on the mental health, Alcohol use disorder (AUD), and Drug use disorders (DUD) of individuals before death. The primary characteristic of suicides in a population of late twenties to early fifties was romantic relationship conflicts. In contrast, suicides in the teenage years and early twenties were characterized primarily by a lack of familial acceptability and, to a lesser extent, self-acceptance. Simultaneously, there was a high risk of suicidal behavior and commission of acts among the DUD patients, getting treatment without psychiatric diagnosis and therapy. Over time, the psychological autopsy technique has shown to be quite helpful in determining the risk factors for suicidal behavior. The study helps to develop multiple rehabilitation and mental awareness that need to be created among various populations so that the suicide and homicide-suicide rates can be reduced.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102813"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mechanism of serum cell-free DNA release in postmortem subjects and novel markers to estimate the postmortem intervals","authors":"Junko Fujihara","doi":"10.1016/j.jflm.2025.102814","DOIUrl":"10.1016/j.jflm.2025.102814","url":null,"abstract":"<div><div>Cell-free DNA (cfDNA) is DNA released from dying cells into the serum. The aim of the present study is to elucidate the mechanism of cell-free DNA (cfDNA) release in postmortem subjects by assaying Cytokeratin 18 (M30 and M65), cyclophilin A (CyPA), and myeloperoxidase (MPO) levels and to evaluate whether these levels are useful as markers for estimating postmortem intervals. Serum (<em>n</em> = 54) was sampled from postmortem autopsied Japanese subjects. cfDNA was extracted and M30, M65, CyPA, and MPO in serum were assayed by enzyme-linked immunosorbent assay. Significantly higher serum levels of M30, M65, and MPO were observed in postmortem subjects than in living subjects. Although the difference was smaller, CyPA was also significantly higher in postmortem subjects than in living subjects. In addition, serum M30 and MPO levels were significantly correlated with cfDNA concentrations in postmortem subjects. Furthermore, M30 levels slightly increased according to the postmortem interval, and MPO levels at 2.5 days were significantly higher than those at &lt;2 days. The result of regression analysis revealed a significant difference between M30/MPO levels and postmortem intervals. These findings suggested that elevated levels of cfDNA in postmortem subjects are released by apoptosis and neutrophils via NETosis and that M30 and MPO levels can be used as markers to estimate postmortem intervals.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102814"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine leiomyosarcoma as a rare cause of fatal retroperitoneal haemorrhage due to compression and rupture of the renal vein","authors":"Giorgia Lodetti ,&nbsp;Stefano Tambuzzi ,&nbsp;Salvatore Andreola,&nbsp;Guendalina Gentile,&nbsp;Riccardo Zoja","doi":"10.1016/j.jflm.2025.102804","DOIUrl":"10.1016/j.jflm.2025.102804","url":null,"abstract":"<div><div>Abnormal uterine bleeding (AUB) can be caused by uterine tumors, both benign and malignant, although they rarely lead to fatal vascular complications. We present a case of a woman found dead in her home, in which the autopsy highlighted a massive retroperitoneal haemorrhage extending to the left renal lodge and a voluminous uterine tumor of stony consistency and exophytic growth weighing 2250g. The histopathological examination identified the mass as a leiomyosarcoma and demonstrated the presence of a dilation with rupture of the left renal vein, in the absence of neoplastic cells infiltrating the vascular wall.</div><div>On these findings, it was concluded that the neoplastic mass had caused external compression of the left renal vein, leading to its rupture and to a fatal retroperitoneal haemorrhage. The case was considered of interest as it involved a peculiar etiopathogenetic mechanism causing a lethal complication from uterine leiomyosarcoma which has not yet been reported in the literature.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102804"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study on forensic diagnostic biomarker combination for acute ischemia heart disease based on postmortem biochemistry","authors":"Xing-yu Ma ,&nbsp;Tian-qi Wang ,&nbsp;Ke-shuang Tang ,&nbsp;Ya-qi Yang ,&nbsp;Zhi-xin Bai ,&nbsp;Xuan Zhang ,&nbsp;Dong Zhao","doi":"10.1016/j.jflm.2025.102825","DOIUrl":"10.1016/j.jflm.2025.102825","url":null,"abstract":"<div><div>Sudden cardiac death (SCD) caused by ischemia heart disease (IHD) has traditionally been identified through autopsy and microscopic examination. However, these methods are limited in diagnosing cases of acute ischemia heart disease (AIHD) without typical myocardial necrosis and excessive reliance on the subjective experience of experts. Postmortem biochemistry is crucial in the assisted diagnosis of SCD in forensic medicine. We evaluated the expression levels of six sensitive biomarkers of myocardial injury in the training-set comprising 78 cases of acute ischemia (AI), 23 cases of acute myocardial infarction (MI), and 37 cases who died of high falls. The results showed that CK-MB, cTnI, BNP, LDH, and HBDH may be of great significance in diagnosing sudden death of AIHD. Among these, BNP, LDH, and HBDH are particularly useful for distinguishing between AI and acute MI. Using receiver operating analysis, we identified that the combination of five biomarkers-BNP, cTnI, CK-MB, LDH, and HBDH-achieved a significantly higher diagnostic accuracy for AIHD, with an AUC of 0.910. This combination outperformed the traditional three-biomarker combination (CK-MB, cTnI, BNP), which was considered highly accurate but only had an AUC of 0.857. Additionally, a three-biomarker combination (BNP, HBDH, and LDH) demonstrated clear advantages in differentiating between AI and acute MI, with an AUC of 0.794. Validation-set results proved that the strategy of finding the unique combination based on postmortem biochemistry is effective. It can provide valuable information for the discrimination of AIHD and the identification of AI and acute MI.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102825"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143194660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographics and characteristics of acute sexual assault presentations to a sexual assault service within metropolitan Sydney","authors":"Kate Willmot ,&nbsp;Rachael Thomas ,&nbsp;Radhika Seimon ,&nbsp;Naomi Derrick ,&nbsp;Michael M. Dinh ,&nbsp;David J. Templeton","doi":"10.1016/j.jflm.2025.102834","DOIUrl":"10.1016/j.jflm.2025.102834","url":null,"abstract":"<div><h3>Background</h3><div>Emergency Departments (ED) are a primary avenue for the initial assessment of sexual assault presentations in Australia. The aim of this study was to outline demographics and assault characteristics of people presenting to a Sexual Assault Service (SAS).</div></div><div><h3>Methods</h3><div>A retrospective review of 1218 presentations to the SAS in an ED of a tertiary referral centre in metropolitan Sydney between January 2020–May 2024 was conducted using the Medical Forensic Examination Record and electronic Medical Record. Variables related to nature of the assault, injuries, the ingestion of drugs or alcohol, sexually transmitted infections, and nature of the relationship with the perpetrator were assessed.</div></div><div><h3>Results</h3><div>Of all presentations, 89 % of cases identified as female, with a median (interquartile range) age of 26.8 (13.7) years. Victims reported that they consumed alcohol (n = 553, 45.4 %) and/or drugs (n = 368, 30.2 %) around the time of assault in a manner where it may have impacted their level of consciousness at the time of the assault. Penile-vaginal penetration was the most common mode of assault (54.6 %), while 37.4 % of cases were found to have bodily injuries documented. Chlamydia and gonorrhoea were detected in 4.5 % and 0.8 % of presentations respectively. Of all assaults 14.6 % were perpetrated by an intimate partner.</div></div><div><h3>Conclusion</h3><div>Most victims of sexual assault were young females and involved penile-vaginal penetration. Intimate Partner Violence accounted for a large number of sexual assault presentations. Our findings will improve local understanding of sexual assault amongst Forensic Medical Examiner (FMEs) and Emergency physicians and inform future staffing, resourcing and research.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"110 ","pages":"Article 102834"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143436386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing the detection and characterization of bruises using multispectral imaging","authors":"Leah S. Wilk ,&nbsp;Richelle J.M. Hoveling ,&nbsp;Maud F.A.M. van Velthoven ,&nbsp;Huub G.T. Nijs ,&nbsp;Maurice C.G. Aalders","doi":"10.1016/j.jflm.2025.102811","DOIUrl":"10.1016/j.jflm.2025.102811","url":null,"abstract":"<div><div>The detection and visualization of sub-dermal hematoma (bruises) plays a key role in suspected physical abuse cases, as it aids in the evaluation of both victim and suspect statements. Current methods rely on visual inspection, frequently aided by alternate light sources (ALS). Ideally, ALS increase visual contrast by exploiting differences in light absorption (due to the formation and clearance of chromophores within the bruise). However, in practice the achievable contrast is often limited by light-scattering: the short-wavelength region of the spectrum (comprising most of the chromophore-specific absorption peaks), is also strongly scattered by the dermal tissue. This, in turn, limits achievable penetration depths, effectively obscuring deep-lying bruises. ALS-based contrast enhancement is further complicated by bruise healing; diffusion and enzymatic activity alter the chromophore concentrations as well as their 3D-distribution within the tissue. To overcome these critical limitations, we employ a multi-spectral camera (8 wavelengths simultaneously) in conjunction with both observer-based scoring and a contrast-quantification algorithm to determine the optimal wavelength for the detection and characterization of bruises over time. We show that (i) bruise contrast significantly increases at 480 nm, 620 nm and 850 nm and (ii) the wavelength achieving optimal contrast gradually changes from 850 nm to 578 nm–480 nm as the bruise heals.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"111 ","pages":"Article 102811"},"PeriodicalIF":1.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143465351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The forensic implications of lonely deaths (Kodokushi) – A South Australian study","authors":"Roger W. Byard","doi":"10.1016/j.jflm.2024.102799","DOIUrl":"10.1016/j.jflm.2024.102799","url":null,"abstract":"<div><div><em>Kodokushi</em> is a Japanese term where ‘a person dies without being cared for by anyone, and whose body is found after a certain period’. These cases have also been called ‘lonely deaths’. Few forensic studies exist. Using decomposition as a surrogate marker for social isolation the following study was undertaken. Pathology files from Forensic Science SA (FSSA), Adelaide, South Australia were reviewed for all cases aged ≥60 years where death had occurred at home and where there was moderate to marked decomposition. Two five-year time periods were selected for comparison. There were 27 cases from 2000 to 2004, out of a total of 1673 autopsies (1.6 %), (M:F = 21:6; age range 60–90 years, ave. 72.8; post mortem intervals 3–60 days, mean 10.7 days). The majority of deaths were due to natural causes (N = 22), with 2 suicides and 3 undetermined. There were 67 cases between 2019 and 2023, out of a total of 696 autopsies (9.6 %), (M:F = 52:15; age range 60–91 years, ave. 69.4 years; post mortem intervals 3–240 days, mean 21 days). The majority of deaths were due to natural causes (N = 55), with 3 suicides and 9 undetermined. Comparing the two time periods showed a predominance of males (78 %) dying of ischaemic heart disease in each cohort (67 and 60 % respectively). The average ages were similar (72.8 and 69.4 years respectively). There was a significant increase in the number of cases over the two decades of the study: 27 to 67 (p &lt; 0.001), with an increase in the post mortem interval from 10.7 to 21 days. It appears that increasing numbers of socially isolated elders are occurring in an Australia population. These individuals have higher rates of certain mental and physical disorders and may present unique diagnostic challenges.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102799"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of IgG and IgM antibodies to Toxoplasma gondii in forensic blood samples from different causes of death in central Andes region in Colombia","authors":"Nathalia Marulanda-Orozco ,&nbsp;Keishla Colon-Montanez ,&nbsp;Morgan Ramirez ,&nbsp;Jennifer Nessim ,&nbsp;Elizabeth Torres-Morales ,&nbsp;Juan Carlos Medina ,&nbsp;Ofelia del Socorro Hincapie ,&nbsp;Miguel Baquero ,&nbsp;Jose Fernando Marín ,&nbsp;Jorge E. Gomez-Marin","doi":"10.1016/j.jflm.2024.102795","DOIUrl":"10.1016/j.jflm.2024.102795","url":null,"abstract":"<div><h3>Introduction</h3><div>The objective of this study was twofold: first, to evaluate the method of sample collection that would enable the measurement of anti-<em>Toxoplasma</em> antibodies in forensic samples, and second, to report the prevalence of antibodies in deceased individuals due to traffic accidents, homicides, and suicides who are brought to the National Institute of Legal Medicine and Forensic Sciences, Western Regional Office (INMLCF) in Armenia, Manizales and Pereira, cities located in the center andes region of Colombia.</div></div><div><h3>Methods</h3><div>Initially, we assessed the feasibility of measuring antibodies on filter paper or in Vacutainer tubes. Serum samples from 15 voluntary individuals were collected as controls, and the measurement of antibodies on filter paper was compared with the same samples collected in Vacutainer tubes after two days at room temperature. Subsequently, 42 blood samples were collected from forensic cases involving various causes of death in Manizales, Armenia, and Pereira. Measurement of anti-<em>Toxoplasma</em> IgG and IgM antibodies was performed using the VIDAS II kit from Biomerieux®.</div></div><div><h3>Results</h3><div>The volunteer samples consistently tested negative when using filter paper, whereas their positivity was preserved when collected in Vacutainer tubes and before 48 h after death. Therefore, the forensic samples were collected using Vacutainer tubes. Out of the 42 forensic blood samples, 19 (45.2 %) tested positive for IgG anti-<em>Toxoplasma</em> antibodies. All samples tested negative for IgM anti-<em>Toxoplasma</em> antibodies. A significant association was observed between antibody positivity and the city of origin, while deaths due to traffic accidents showed a negative association with toxoplasmosis.</div></div><div><h3>Conclusions</h3><div>We found that filter paper was unsuitable for collecting samples for <em>post-mortem</em> serological studies. The positivity of antibodies varied significantly depending on the city, and in Manizales, deaths resulting from traffic accidents were not associated with toxoplasmosis.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102795"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life-threatening spontaneous splenic rupture in congenital afibrinogenemia: Two case reports and systematic literature review","authors":"Oumeima Brahim ,&nbsp;Mohamed Amine Mesrati ,&nbsp;Hiba Limem ,&nbsp;Marwa Boussaid ,&nbsp;Rakia Soiniya ,&nbsp;Nouha Ben Abdeljelil ,&nbsp;Nesrine Jammeli ,&nbsp;Mahjoub Bahri ,&nbsp;Abdelfattah Zakhama ,&nbsp;Abir Aissaoui","doi":"10.1016/j.jflm.2025.102808","DOIUrl":"10.1016/j.jflm.2025.102808","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Spontaneous splenic rupture is a rare life-threatening finding with a challenging diagnosis which is largely ignored in the literature. Hematological disorders such as afibrinogenemia are reported to cause bleeding disorders mostly cerebral hemorrhage. Despite being a life-threatening condition, data about spontaneous splenic rupture in patients with Afibrinogenemia remain scarce. Such fatal incidents should warrant diligent efforts to establish and adopt prevention measures in this particularly vulnerable population.&lt;/div&gt;&lt;div&gt;We report two new cases of spontaneous splenic rupture in two siblings, diagnosed with congenital afibrinogenemia since early childhood. In addition, we report the results of a systematic review of the literature of cases that have reported the occurrence of splenic rupture in afibrinogenemia, with the aim of filling the gap in the clinical course of such an uncommon event.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conduced a systematic review of English and French language publications cataloged in Pubmed, and Google Scholar up to December 2022. We opted to include articles written in other languages if an English language abstract was available and contained the information needed for our report. The following MeSH (medical subject heading) search criteria were used: ''splenic rupture'' AND ''afibrinogenemia.'' The above search strategy was further combined with a supplementary strategy that included the MeSH terms ''spleen'', AND ''rupture'' AND ''Afibrinogenemia''. In order to reduce the selection bias in searching on the Google Scholar database, we searched for articles containing these MeSH terms in their titles.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We reported two cases of splenic rupture in two family members who were diagnosed with afibrinogenemia at the age of 1 year. The splenic rupture was misdiagnosed by clinicians in the brother's case, resulting in his death and presenting as a forensic case. However, the sister underwent a splenectomy one week before her brother's death following the onset of asthenia and acute abdominal pain.&lt;/div&gt;&lt;div&gt;Then we conducted a literature review of relevant studies of spontaneous splenic rupture in Afibrinogenemia. A selection of 13 relevant studies was included in the final review, describing a total of 25 cases of spontaneous splenic rupture in Afibrinogenemia. One paper was an international cross-sectional study across 25 different countries involving 211 patients with fibrinogen disorders, showing that 11 patients with afibrinogenemia had developed spontaneous splenic rupture. The remaining 12 articles were case reports or case series, describing a total of 14 cases of atraumatic splenic rupture in afibrinogenemia, ranging from 0 to 28 years old, with a median age of 14.5 years, where the majority were infants (age inferior to 18) with the most cases occurred in the age group of 10–15 years old.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Congenital af","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102808"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The legal requirements for patient consent in Poland: A survey of doctors’ level of knowledge","authors":"Kamila Kocańda ,&nbsp;Zbigniew Siudak ,&nbsp;Michał Chrobot","doi":"10.1016/j.jflm.2025.102803","DOIUrl":"10.1016/j.jflm.2025.102803","url":null,"abstract":"<div><div>The legality of providing any medical intervention needs to be guarded by the requirement of a conscious and informed consent given by the patient. The legal requirements of granting such a consent in practice should apply not only to typical situations, when the patient is able to manifest his medical decision consciously, but also to more complicated cases where a patient cannot provide such a consent himself by the time the provision of service is given. This implies the need for the doctor to take actions specified by law, such as, but not limited to obtaining the consent of the guardianship court or intervene without the consent. The purpose of this study was to determine the level of knowledge of the currently in force Polish statutory requirements for legitimizing medical decisions in the relationships between physicians and patients. The study used anonymous surveys designed by the authors for the purpose of this study to test the level of knowledge of legal requirements regarding the principles under which patients provide consent to healthcare services and was conducted in two hospitals in Poland and Polish medical university. The survey results indicated that respondents do not possess sufficient understanding of the legal requirements for legitimizing acts or omissions of the physicians in the diagnostic and therapeutic process.</div></div>","PeriodicalId":16098,"journal":{"name":"Journal of forensic and legal medicine","volume":"109 ","pages":"Article 102803"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}