Medicine, Science and the Law最新文献

{"title":"Letter to the Editor regarding the article \"Double suicide in Japan in the post-war reconstruction period, with reference to contemporary Japan\".","authors":"Tambuzzi Stefano, Gentile Guendalina, Galante Nicola, Zoja Riccardo","doi":"10.1177/00258024231152183","DOIUrl":"10.1177/00258024231152183","url":null,"abstract":"We read with great interest the paper published by Satoh et al. on double suicides in Japan in the postwar period, comparing their findings with those of contemporary Japan. The authors addressed a phenomenon of great forensic interest by placing it in the context of a geographic reality in which the number of suicide pacts has been high since ancient times. We have also been dealing with this topic for some years. We agree that, although suicide pacts were more common in Asia than in the West, this difference is much less evident today. These cases also exist in Italy. In our recent retrospective analysis at the Institute of Forensic Medicine in Milan (one of the main cities in northern Italy), six suicide pacts were recorded between 1993 and 2020. Our case history, although numerically smaller, is consistent with the suicide couples described by Satoh et al. Specifically, we recorded a young couple of lovers, two couples of older spouses, and two couples of friends. In addition, we also had a pair of identical twins. There were also similarities in the causes of death: acute carbon monoxide poisoning, drug ingestion, and inhalation of gas combined with plastic bag suffocation (these latter can be considered complex suicides). However, in two suicide pairs, the cause of death was gunshot injury. In light of these findings, it is very important to compare case histories from different geographic areas, as this may reveal differences related to different sociocultural settings and, at the same time, unexpected similarities. However, we would like to highlight an aspect that we believe plays an indispensable role in the proper framing of suicide pacts. Indeed, this terminology refers to all situations in which two people decide to end their lives by mutual consent. Thus, double suicides certainly fall under this definition, but so do cases of homicide–suicide with the explicit consent of the homicide victim. Therefore, the terms “double suicide” and “pact suicide” should not be understood as synonyms, but the former as a subcategory of the latter. Obviously, cases of murder–suicide without the victim’s consent are excluded. As a result, suicide pacts pose a real challenge from a medico-legal perspective, with significant interpretative problems. In this field, multidisciplinary skills are therefore required. The on-site inspection can provide essential information: the mutual position of the victims’ bodies, the condition of the clothing, the location of bloodstains, and the order and cleanliness of the room. Special attention should also be paid to the finding of a weapon near the bodies, which does not always necessarily indicate a suicide. Finally, information should be obtained about the personal background of the victims by interviewing family members and friends. Often they know about family problems, financial difficulties, or health problems that may have triggered the suicide pact. The victim’s medical history is also crucial, as it may in","PeriodicalId":18484,"journal":{"name":"Medicine, Science and the Law","volume":"63 4","pages":"337-338"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10566886","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":"Alec Samuels (1930-2022).","authors":"Denise Syndercombe Court","doi":"10.1177/00258024231182590","DOIUrl":"10.1177/00258024231182590","url":null,"abstract":"","PeriodicalId":18484,"journal":{"name":"Medicine, Science and the Law","volume":"63 4","pages":"341"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10220175","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 UK's Illegal Migration Bill: Human rights violated.","authors":"Paul Arnell, Olayinka Lewis, Erika Kalocsányiová, Andrew Forrester","doi":"10.1177/00258024231186736","DOIUrl":"10.1177/00258024231186736","url":null,"abstract":"","PeriodicalId":18484,"journal":{"name":"Medicine, Science and the Law","volume":"63 4","pages":"267-269"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10219237","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":"Specific measures to enhance suicide prevention in Japan.","authors":"Ken Inoue, Yasuyuki Fujita, Tatsushige Fukunaga, Noriyuki Kawano","doi":"10.1177/00258024221142660","DOIUrl":"https://doi.org/10.1177/00258024221142660","url":null,"abstract":"The General Principles of Suicide Prevention, which are Japanese guidelines on measures to prevent suicide, were devised in 2007 and then revised in 2012 and 2017. In addition, the Cabinet approved new general principles of suicide prevention on 14 October 2022. 1 The new general principles of suicide prevention include Enhanced Support for Women, Enhanced Measures to Prevent Suicide by Children and Young People, Enhanced Community Efforts to Prevent Suicide, and Enhanced General Measures to Prevent Suicide, indicating that efforts will be particularly directed at enhanced assistance to prevent suicide by women, children, and young people. 2,3 The COVID-19 pandemic, which started in 2020 and con-tinues at the time of writing, has had an effect. Suicides in Japan decreased annually from 32,845 in 2009 to 20,169","PeriodicalId":18484,"journal":{"name":"Medicine, Science and the Law","volume":"63 3","pages":"262-263"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9915483","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 \"Right\" to refuse treatment.","authors":"Benjamin Andoh","doi":"10.1177/00258024221140660","DOIUrl":"https://doi.org/10.1177/00258024221140660","url":null,"abstract":"<p><p>The \"right\" of an adult patient with capacity to refuse treatment has been very well recognized by the courts over the years. Recently, it was the central issue in this recent case, PH (by his litigation friend, the Official Solicitor) <i>v</i> Betsi Cadwaladr University Health Board ([2022] EWCOP 16). This paper briefly reviews the case and goes on to present the author's views on the general \"right\" to refuse treatment and the meaning of \"right\" in the expression, \"the right to refuse treatment\". It then points out other relevant matters worth noting.</p>","PeriodicalId":18484,"journal":{"name":"Medicine, Science and the Law","volume":"63 3","pages":"253-255"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9632933","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 dilemma and outlet of judicial determination of medical liability in China.","authors":"Sunzhe Weng","doi":"10.1177/00258024231154816","DOIUrl":"https://doi.org/10.1177/00258024231154816","url":null,"abstract":"<p><p>Medical damage liability is directly related to the diagnosis and treatment behavior of medical institutions. It is the most basic form of liability because patients enter the doctor-patient relationship with the expectation that they will receive highly professional medical services from the medical institution. This paper outlines the features of the development of China's medical damage liability system, points out the problems of the system in practice, and proposes improvements. It explores how to solve the legal dilemma of identifying medical liability in China from three perspectives: perfecting the formation and adoption procedures of expert opinions, standardizing the identification of fault by medical institutions, and standardizing the application of the rules of reducing liability for the cause.</p>","PeriodicalId":18484,"journal":{"name":"Medicine, Science and the Law","volume":"63 3","pages":"237-242"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9965124","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":"Emerging issues in the approach to submerged bodies: Water-related deaths in Friuli, northeastern Italy (1993-2020). Analysis of post-mortem reports and some unusual cases.","authors":"Francesco Simonit,&nbsp;Antonio Colatutto,&nbsp;Fabiola Giudici,&nbsp;Ugo Da Broi,&nbsp;Orazio Sciarappa,&nbsp;Lorenzo Desinan","doi":"10.1177/00258024221127574","DOIUrl":"https://doi.org/10.1177/00258024221127574","url":null,"abstract":"<p><p>When analysing bodies recovered from a watery environment, all manners of death, a variety of causes of death and the possibility of body disposal have to be considered. Unclear circumstances of death, unidentified victims and body decomposition may hamper a forensic investigation. The lack of specific and sensitive drowning-related autopsy findings and post-mortem blood alcohol levels (blood alcohol concentrations (BACs)) may also lead to erroneous conclusions. We reviewed the autopsy records for all bodies recovered from water in Friuli, northeastern Italy, over a 28-year period, focusing on death circumstances, autopsy findings and blood alcohol levels. Some unusual cases were examined separately. Among the 69 cases, there were 32 accidents, 13 suicides, 4 homicides, 6 natural and 14 undetermined deaths. Causes of death included 51 drownings, 6 undetermined, 5 cardiac deaths and 7 non-drownings. Six deaths in a bathtub and one diving-related death were also included. Acute alcohol intoxication was ascertained in 22 of 40 victims. Some significant limitations in the approach to water-related deaths have been highlighted: although emphysema aquosum and external foam resulted to be the most reliable indicators, a determination of drowning based exclusively on autopsy findings cannot be ascertained with certainty. Furthermore, it was found that the standard definitions of wet and dry drowning in the literature differ widely from a morphological perspective and this may lead to misleading outcomes. Post-mortem BAC changes have been critically analysed only in bodies found in cold water, and, in the absence of an alternative to blood specimens, the use of pre-set cut-off values is still necessary.</p>","PeriodicalId":18484,"journal":{"name":"Medicine, Science and the Law","volume":"63 3","pages":"187-194"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9596347","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":"Seat belt injuries and external markings at autopsy in cases of lethal vehicle crashes.","authors":"Siobhan O'Donovan,&nbsp;Corinna van den Heuvel,&nbsp;Matthew Baldock,&nbsp;Melissa A Humphries,&nbsp;Roger W Byard","doi":"10.1177/00258024221127845","DOIUrl":"https://doi.org/10.1177/00258024221127845","url":null,"abstract":"<p><p>A study was undertaken to determine what injuries are associated with the wearing of seat belts and if the presence of cutaneous seat belt markings observed on victims of lethal vehicle crashes increased the likelihood of underlying injury. Autopsy reports from the files at Forensic Science South Australia were reviewed for all fatal motor vehicle crashes from January 2014 to December 2018. A total of 173 cases were included for analysis with 127 occupants wearing seat belts at the time of impact (73.4%) (age range = 18-93; mean = 45 M:F = 81:46). Of these, only 38 had external seat belt markings (29.9%) (age range = 19-83; mean = 49 M:F = 20:18). Logistic regression modelling showed that occupants who were wearing seat belts were more likely to experience closed head injury without skull fractures in addition to mesenteric and gastrointestinal injury. Increasing body mass index increased the incidence of seat belt markings (<i>p</i> < 0.01) and markings were more likely to be found in the presence of bilateral pelvic fractures. Thus, external seat belt markings were observed in only a minority of seatbelt wearers, and more often in individuals with higher BMIs and with bilateral pelvic fractures (possibly associated with greater momentum and impact force).</p>","PeriodicalId":18484,"journal":{"name":"Medicine, Science and the Law","volume":"63 3","pages":"195-202"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9584694","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":"Misconnected chest tube: An extremely unusual fatal complication of secondary pneumothorax.","authors":"Veronika Heckmann,&nbsp;Gábor Simon,&nbsp;Tamás F Molnár","doi":"10.1177/00258024231165960","DOIUrl":"https://doi.org/10.1177/00258024231165960","url":null,"abstract":"<p><p>A rare and fatal complication of suction drainage of secondary spontaneous pneumothorax is reported. The patient, likely by a mistake, arbitrarily connected the oxygen supply tube to the thoracic drain. The sharp increase of intrapleural pressure combined with the atmospheric intraalveolar environment caused diffuse lung injury and cardiopulmonary collapse without a direct lung injury. The conflicting interests of patient autonomy and patient safety require further consideration.</p>","PeriodicalId":18484,"journal":{"name":"Medicine, Science and the Law","volume":"63 3","pages":"256-259"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9965640","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":"Supporting people with immigration issues in the context of the Mental Health Act 1983 and Mental Capacity Act 2005.","authors":"Brian Dikoff,&nbsp;Rukyya Hassan,&nbsp;Rohit Shankar,&nbsp;Cornelius Katona,&nbsp;Lucia Chaplin,&nbsp;Andrew Forrester,&nbsp;Piyal Sen","doi":"10.1177/00258024231171316","DOIUrl":"https://doi.org/10.1177/00258024231171316","url":null,"abstract":"Providing mental health support to migrants and asylum seekers with uncertain or unresolved immigration status and/or with ‘No Recourse to Public Funds’ (NRPF) can pose a distinct challenge for mental health practitioners within both hospital and community settings. As an outcome of the UK’s Hostile Environment policy, some migrants and asylum seekers are precluded from accessing statutory welfare support and services, such as when a person has been refused permission to stay in the UK but has not yet been able to lodge an appeal against this decision or to submit a fresh claim. Yet such support is integral to ensure holistic and effective care planning, particularly for people with serious mental illness. This includes people who are detained under the Mental Health Act 1983 (MHA), or treated under the Mental Capacity Act 2005 (MCA), who may lack capacity to conduct their immigration case, or challenge their proposed removal or deportation from the UK. When planning and conducting an assessment of migrants and asylum seekers under the MHA, difficulties may arise, including mistrust of professionals due to limited or adverse past experience with authorities, unstable accommodation, lack of knowledge of services, concerns about data sharing, lack of reliable collateral history and lack of access to reliable and consistent interpreters. During the period of detention under the MHA, these same issues are likely to persist, with additional concerns including access to legal advice on immigration and ability to maintain links with government agencies on immigration status. These are important additional factors that are likely to influence the detained individual’s care pathway and influence assessments of their prognosis and risk, which are key tasks for treating mental health professionals. In turn, this influences planning beyond the period of detention under MHA, because instability of postdischarge accommodation, uncertainty around supervising team and concerns around removal may combine to inhibit recovery, increase the likelihood of relapse and contribute to associated risk behaviours. These challenges persist even post-discharge, in the community. Migrants and asylum seekers with NRPF are unable to access welfare benefits, housing assistance and, often, support from social services. Further, those with uncertain immigration status are at risk of enforcement actions such as bail reporting conditions, electronic tagging and indefinite detention as well as forced removal and deportations, all of which are known to have a detrimental impact on mental health and wellbeing. Not all migrants are entitled to Home Office accommodation—this depends mainly on the nature of their immigration case, and on whether and if they are destitute. When they are, accommodation is offered on a no-choice basis across the country. This is known as the UK’s ‘dispersal’ policy. This policy has been in place since 2000 and refers to the practice of spreading asylum appli","PeriodicalId":18484,"journal":{"name":"Medicine, Science and the Law","volume":"63 3","pages":"183-186"},"PeriodicalIF":1.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10292613","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}