Presents a unique overview and critical commentary on the latest developments in forensic medical practice worldwide
The field of forensic medicine continues to evolve worldwide. In recent years, the amount of research has increased and new areas of forensic specialization have developed. Forensic practitioners need to keep pace with a range of international advances from innovative technologies to new or revised laws and regulations to emerging issues of controversy.
Current Practice in Forensic Medicine, Volume 3 provides an in-depth examination of key areas of the field. This timely and comprehensive resource addresses consent for forensic procedures, imaging for soft tissue injuries, working with victims of torture, non-accidental injury in the elderly, medical and toxicological aspects of chemical warfare, non-fatal strangulation, abusive head trauma in young children, and more. Each chapter contains a general overview of the area under discussion, references to published literature, and detailed discussion of significant changes and key points. - Offers new insights into false allegations of sexual assault, coercive control and the homicide timeline in partner abuse cases, and the needs of elderly persons in detention - Provides non-country specific information to guide international forensic medicine practitioners and healthcare professionals - Contains detailed yet concise chapters written by authors with particular expertise in the subject covered - Addresses the clinical and pathological aspects of forensic medicine and relevant areas in toxicology, forensic psychiatry and psychology, and forensic biology - Covers riot control weapons, chemical warfare, non-fatal strangulation, DNA in crime detection, and many other essential topics - Includes up-to-date information on the new Medical Examiner system in England and Wales
Supported by the most recent evidence-based research, Current Practice in Forensic Medicine, Volume 3 is a must-have for all those involved in various aspects of forensic medicine including doctors, dentists, forensic scientists, lawyers, law enforcement professionals, and forensic practitioners.
Table of Contents
List of Contributors
Preface xix
Chapter One: The new Medical Examiner System in England and Wales: its role in the medicolegal investigation of death 1
Introduction 1
Background 2
Structure and function of the Medical Examiner system in England and Wales 7
Medical Examiners 9
Medical Examiner Officers 11
How does a Medical Examiner Service work? 12
Relationships with other teams supporting the deceased and bereaved 16
Conclusion 16
References 17
Chapter Two: Who makes false allegations and why? The nature, motives, and mental health status of those who wrongly allege sexual assault 21
The nature of false allegations 21
Deliberate fabrication 22
Inadvertent allegations 27
Conclusion 33
References 34
Chapter Three: Disclosure of evidence in sexual assault cases 41
Introduction 41
Definition and interpretation 42
Disclosure and the medical professional 44
The Court of Appeal judgements in the context of forensic and legal medicine 49
Conclusion 51
References 52
Chapter Four: Current perspectives on the type and use of weapons used to police public assemblies around the world 55
Introduction 55
Less- lethal weapons 59
Kinetic impact projectiles 65
Conclusion 73
Acknowledgement 73
References 74
Chapter Five: Non- fatal strangulation 81
Introduction 81
Non- fatal strangulation and intimate- partner violence 81
Legal status of non- fatal strangulation 82
Non- fatal strangulation and assault 83
Symptoms and signs of non- fatal strangulation (acute and longer term) 86
Examples of findings and descriptions of NFS assaults 97
Management of non- fatal strangulation 104
Radiological imaging in non- fatal strangulation 104
Conclusion 106
References 106
Chapter Six: DNA: current developments and perspectives 109
Introduction 109
STR improved autosomal multiplexes used for criminal justice 110
Rapid DNA 113
DNA mixtures 116
Massively parallel sequencing 119
Forensic DNA phenotyping 124
Forensic genealogy 132
Conclusion 135
References 135
Chapter Seven: The utility of forensic radiology in evaluation of soft tissue injury 143
Introduction 143
Limitations 145
Types of cross- sectional radiological imaging 147
Types of injury 148
Injury patterns and causation 157
Gunshot injuries 160
Ligature soft tissue injuries 160
Conclusion 163
References 163
Chapter Eight: Abusive head trauma in children - a clinical diagnostic dilemma 167
Definitions 167
A brief history 168
Current hypothesis on the development of subdural haemorrhage, retinal haemorrhage, and hypoxic-ischaemic encephalopathy in AHT 170
The presentation and diagnosis of AHT 170
The development of a controversy 171
Clinical medicine and the medical diagnosis 173
Alternative hypotheses 173
Short- distance falls 174
The circular argument 175
Confession evidence 176
The missing biomechanical model 176
The clinician’s approach to a diagnosis of AHT 177
Terminology 179
Conclusion 182
References 182
Chapter Nine: The ageing population: needs and problems of the older person in prison 187
Overview 187
Introduction 187
Health and social care needs of older people in prison 188
Key steps in addressing the needs of the older person in prison 196
Where next? 201
References 201
Chapter Ten: Fitness to plead and stand trial - from the Ecclesfield Cotton Mill dam to Capitol Hill 205
Introduction 205
The application of the Pritchard test in England and Wales 212
Physical illness or disability and fitness to plead and fitness to stand trial in England and Wales 215
Related provisions in some other common law jurisdictions 215
A practical approach to assessment 220
Conclusion 220
Acknowledgements 221
References 221
Law reports 222
Chapter Eleven: Quality standards for healthcare professionals working with victims of torture in detention 225
Introduction 225
Why were quality standards needed? 226
Prevalence of torture 226
Clinical consequences of prior torture 226
Methods of torture 226
Detention in the United Kingdom and risks for patients’ health 228
Effects of detention on victims of torture 229
Professional responsibility 230
Outcomes 230
Conclusions 235
References 236
Chapter Twelve: A forensic approach to intimate partner homicide 239
Introduction 239
The ‘crime of passion’ discourse 241
Coercive control discourse 242
Medical narratives and discourse 243
IPH and IPA as expert knowledge 244
Response practices 245
Conclusions 249
References 250
Chapter Thirteen: Non- lethal physical abuse in the elderly 253
Failure to diagnose 254
The ageing process 254
Acknowledgement 275
References 276
Chapter Fourteen: Physical intervention and restraint 279
Introduction 279
The organisational approach to managing challenging behaviour, aggression, and violence 279
Minimising the risk of injury and death 281
Use of force in therapeutic environments 282
The use- of- force hierarchy 282
Organisational approaches to managing challenging behaviour and violence 283
Physical interventions in other (non- policing) environments 284
The range and risks of physical interventions 286
Conclusions 291
Acknowledgement 292
References 292
Chapter Fifteen: Medical and toxicological aspects of chemical warfare: the nature, classification, and management of chemical agents used in warfare 293
Introduction 293
OPCW and control and schedules 294
Hazard/threat assessment 294
Environmental indicators and detection overview 294
Bioanalytical detection overview 295
Classes of chemical weapons and casualty management 297
Pulmonary agents: chlorine and phosgene 305
Asphyxiants: cyanide and hydrogen sulphide 309
Blistering agents/vesicants: sulphur mustard chlorine and lewisite 311
Other chemical warfare agents 315
Opiates and opioids 317
Perfluoroisobutene (PFIB) 319
Bioregulators 320
Endorphins and enkephalins 321
Neurokinins, including substance P 321
Endothelins 321
Bradykinin 322
Angiotensin 322
Neurotensin 322
Other Bioregulators 323
Summary 323
References 323
Index 327
