Police custodial healthcare
Jason Payne-James, Richard Jones in Simpson's Forensic Medicine, 2019
Delivery of healthcare to detainees in police custody varies across the world. Healthcare services in this context may include general medical services, and also more forensic and police-related processes such as forensic sampling of assault suspects and complainants, assessment of drivers suspected of driving under the influence of drugs and alcohol, documentation and management of injuries, review of restraint-related injury, determination of ‘fitness to interview’ and ‘fitness to be charged’. In the UK, doctors, nurses and paramedics may provide some of these functions. Irrespective of the reason for assessment of the detainee the duties of consent and confidentiality apply, with few exceptions. Any breach of these duties must be documented and the reasons for such a breach recorded. Doctors in this setting are referred to as forensic physicians (sometimes forensic medical examiners or forensic medical officers), nurses as custody nurses (sometimes custody or forensic nurse practitioners), and paramedics as custody paramedics (sometimes forensic paramedics). The term ‘clinical forensic medicine’ (forensic medicine in the living) is used to differentiate it from forensic pathology. In the UK, the Faculty of Forensic Legal Medicine of the Royal College of Physicians has been tasked with, and has established, quality standards for relevant healthcare professionals and provided guidance for the management of conditions and forensic assessments required in custody.
Austria 1
Arthur Newsholme in International Studies Volume 1, 2015
Each of the nine provinces of Austria has an appointed physician (Director of the Public Health Department) who does not practise private medicine. He supervises the medical officers in each district in the province. The provincial medical officers are appointed directly by the President of the Austrian Republic—a survival of the centralised control of the former Empire. There are 112 district medical officers. They are now required to have special training. They must, after receiving their medical qualification, have been internes in a hospital for two years, and must then pass a special examination in forensic medicine, hygiene, sanitation, psychology, pharmacy, chemistry, public health law, bacteriology, and the prevention of communicable diseases.
Corporate role of pathology
Michael Galloway, Suzanne Chapman, Peter Lees, Jenny Simpson in BAMM Clinical Directors’ Series Clinical Director of Pathology, 2018
Many histopathologists spend a significant proportion of their time engaged in work for HM Coroner and a minority take a specific interest in forensic medicine. Consequently, more than most hospital clinicians, the histopathologist is familiar with medico-legal processes and may be a valuable source of advice for clinical directors and medical directors. With the introduction of clinical governance,4 medico-legal issues are likely to acquire increased prominence. The histopathologist also has a specific ethical role in the use of autopsy-derived tissues. Traditionally, hospital autopsies have been a valuable source of teaching and research material for hospital clinicians. The use of such material is coming under scrutiny and the histopathologist in consultation with the hospital ethical committee may have to exercise considerable judgement over what may, or may not, be ethically permissible.
Practice of community-service doctors in the assessment and medico-legal documentation of common physical assault cases
Published in South African Family Practice, 2018
L Fouché, J Bezuidenhout, C Liebenberg, AO Adefuye
Forensic medicine is a specialty discipline that links medicine and law. It facilitates and influences legal cases by providing evidence in the form of documentation—the more thorough and robust the evidence contained in the documentation, the more useful it is in the legal process.11 In SA, efforts are being made to improve the practice of forensic medicine through the introduction of new training initiatives, such as the postgraduate diploma qualification developed by the University of the Free State.5,12 However, knowledge and skills provided at undergraduate level are not sufficient to equip medical graduates to deal with clinical forensics cases. Hence, this study assesses the practice of medical graduates who, during their community service year, dealt with medico-legal documentation of patients who reported having been physically assaulted, with a view to identifying knowledge gaps in the undergraduate clinical forensic medicine curriculum.
Radiographic evaluation of the mandible to predict age and sex in subadults
Published in Acta Odontologica Scandinavica, 2022
Forensic medicine involves the use of the human skeleton to identify human remains as well as living individuals. This data is also used by anthropologists to construct ethnographic profiles of specific communities. Regarding the estimation of age and sex as a part of identification, unlike direct measurement from dry mandibles, which are rarely used, clinical images (e.g. x-rays, ultrasonography, CT scans, and MRIs…) currently provide a great amount of complementary sources of information for forensic analysis through indirect measurement [9,12,15]. The high rate of prescription of panoramic radiographs, which are commonly used in routine dental practice to assess vital mandibular and maxillary structures, offers a useful tool for the study of morphological differences between males and females and the changes that occur with age. Although the panoramic radiographs have some limitations, like difficulties in controlling the magnification and geometric distortion of the images, the interference of superimposed images are not encountered and it provides an accurate and reproducible method of measuring the chosen points with contrast, brightness enhancement, and enlargement [19]. However, as suggested by some authors [20,21] distortion of measurements can be acceptable by positioned the patient’s head properly in the equipment. Thus, all radiographs in our study were made by the same experienced dental radiographer with the same apparatus and selected radiographs were of good enough image quality to reduce possible errors.
Medico-legal documentation of rape or sexual assault: are community-service doctors equipped for the task?
Published in South African Family Practice, 2018
L Fouché, J Bezuidenhout, C Liebenberg, AO Adefuye
According to the Health Professions Act (Act No 56 of 1974 [Government Notice. No R.688 as amended by G.N. R.498 of May 2000 and G.N. R.69 of 22 January 2002]), every South African medical graduate is compelled to do one year of community service after completing his/her medical internship training. During this time, they provide and improve healthcare delivery in their host communities and their duties include the delivery of primary health care, which includes clinical forensic medicine. One major component of clinical forensic medicine is the assessment/examination, documentation and treatment of patients who report having been sexually assaulted or raped. These examinations are also known as medico-legal examinations and they entail a very detailed history taking with regard to the incident, and a thorough general examination coupled with the collection of forensic samples.
Related Knowledge Centers
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