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A UNIQUE STUDY: DOES GENERAL AMNESTY SOLELY AGAINST COMMON CRIMES INCREASE THE NUMBER OF FORENSIC APPLICATIONS TO EMERGENCY SERVICE? ABSTRACT Introduction: Seeking both justice and pragmatism in strategies of amnesties against common crimes have never been studied. A great majority of any population would think a nonpolitical amnesty might be impressive rather than logical since it protects minority versus majority. Materials and methods: A retrospective study was planned in an education and research hospital to evaluate the effects of a nonpolitical amnesty. Patients’ files (n:1137, mean age:29.83 years) with forensic admissions between 01.01.1991 and 12.31.2010 of 20 years, divided into two decades as the initial 10 years without amnesties (Group-1) and the following 10 years with amnesties and rewritten laws for global adaptation (Group-2), were compared. All patients with forensic based injury (FBI) with at least one complaint of strike, stab wound or gunshot were evaluated. Non-forensic emergency (NFE) cases (n:36366) were also noted for control. Patients without emergency complaints, who did not belong to neither FBI nor NFE, were excluded. Age, gender, application time, mortality and type of FBI were statistically analyzed using chi-square and Fisher exact tests. Results: The percentage of forensic applications, degree of crime, rate of female victims, and timing (day time) of the crime deteriorated in a statistically significant manner in the second decade, however the increased rate of mortality and 2.13 years older age of the victims did not reach the level of significance. Conclusion: Amnesty solely against common crimes was not in favour of peace. Keywords: amnesty, crime, emergency, forensic INTRODUCTION Peace versus justice is a real debate for all populations. Crime and its consequences and results of its trauma have always been studied unfortunately only in regard to medicine worldwide and gained more attention than before [1-3]. A great majority of any population would think that a general amnesty might be impressive rather than logical since it protects a minority versus majority. There have been conflicts whether issues to establish general amnesties increased the number of criminal affairs and we aimed to answer the dilemma in the light of statistics. A general pardon including the offenders who had been against government is a political choice of concern, which has well-known consequences in favour of peace [4-10]. However, amnesty for infamous (nonpolitical) crimes, both simple and major, can damage public conscience. Since documented amnesties worldwide in the near and past history did not contain pure nonpolitical offences, it could have never been studied whether a pure nonpolitical pardon would rise criminal affairs in a population [6-11]. Although being a European country; and because of antidemocratic laws written during years of military coups, which defend goverment against citizens instead of defending humans against goverment, consecutive pardons usually caused a mass liberation of only tough and nonpolitical criminals probably for a last and ultimate time in the Republic of Turkey, especially in the near past. There has been always a debate whether both those criminals and the normal population benefit if prisoners are released, since most of them return to prison in a short period of time because of new crimes committed against innocent citizens. A peaceful transition period may or may not be recommended to public according to scientific results. A retrospective study was planned in an education and research hospital located in Istanbul, which is the most crowded city of Turkey with almost 20 millions of city dwellers, to evaluate the real effect of such a nonpolitical amnesty on a population to answer the rightful or unjust speculations of conscience by a scientific way. Haseki Education and Research State Hospital, located in one of the most haunted vicinities of İstanbul, provided a reliable, alive and cosmopolitan social laboratory and the present study seems to be a unique one because of many aspects according to our wide and multilingual search in the literature. General amnesty for infamous crimes, which had been declared in 12.22.2000 and the new Turkish Criminal Code which had been rewritten and executed in 06.01.2005 according to European Union adjustment laws for global adaptation resulted in releasing of more than 200.000 nonpolitical criminals consisting of mainly murderers, deforcers, rapists, and robbers who in fact had been sentenced for a longer duration of punishment time according to the previous Turkish Criminal Code. MATERIALS and METHODS A retrospective study was planned in an education and research hospital to evaluate the real effect of a nonpolitical amnesty to answer speculations of conscience by a scientific way. Patients’(n:1137,mean age:29.83 years) files with forensic admissions and bookkeeping entries of the emergency service as hard copies in addition to computer records were the mainstays of the data collection between the dates of 01.01.1991 and 12.31.2010. The documentation of 20 years, divided into two decades as the initial 10 years without amnesties (Group-1) and the following 10 years with amnesties and rewritten laws for global adaptation (Group-2), were compared with each other using some selected parameters. All patients with forensic based injury (FBI) with at least one complaint of strike, stab wound and gunshot were evaluated. Non-forensic emergency (NFE) cases (n:36366) were also noted for control. Patients without emergency complaints,who did not belong to neither FBI nor NFE, were excluded. The rationale of the evaluation of the selected two decades was to provide a farreaching observation period insofar as to be devoid of defaults. The degree of violence was deemed as high if it had been committed by with stab or firearm or both, since incidence of violence has been measured as the total count of the crime events with any arm per a given period worldwide by investigators. Age, gender, application time, type of FBI and mortality were retrospectively and statistically analyzed using chi-square and Fisher exact tests. Since it is a retrospective evaluation, the local ethic committe approval has not been taken. But all patients applying our emergency service sign an informed consent form (also written in English if necessary) which also includes that their data could be used for scientific reasons in future, in addition to items of medical outcomes and malpractice. RESULTS The mean age of the patients, who constituted the forensic victims of both groups (1137 patients) was 29.83 years and there was no difference between the groups in regard to age. The statistical data of the patients have been listed in Tables 1-5. The percentage of forensic applications, the degree of the crime (more with tools), the rate of female victims (crime on females inreased), and the timing (more in day time) of the crime changed in a statistically significant manner, however the increased rate of mortality and 2.1 years older age of the victims of the second decade did not reach the levels of significance. Although stabbing or bullet injuries have statistically increased in number in the second decade, mortality did not statistically increase in the latter. However, a small rise was noticed in the mortality rate in Group-2 (3.97%) when compared to Group-1 (3.53%) as expected. The degree of violence was deemed as high if it had been committed by stab or firearm. There was not any significant difference between the groups in regard to age despite the mean age of the victims of the second group had been 2.13 years higher than the former. We think that the small age difference was because of the changed population pyramid of Turkey from younger to older type within two decades. Loss of significance in the mortality rate can be attributed and speculated to the usage of penetrating tools onto extremities for arrogation crimes committed by the rotters. DISCUSSION Unfortunately there are 3 types of amnesties which do not represent the one (de facto for common crimes only) we had studied: 1. Illegimative, inclusive amnesty (blanket amnesty against every crime since it covers everybody such as Chilean amnesty after Pinochet) 2. Locally legitimized, limited immunity (political amnesty such as Khmer Rouge in Cambodia) 3. Internationally legitimized immunity (excluding crimes against humanity as well as torture or genocide,etc) Our study seems to be a unique one adding a 4th category to amnesty subgroups and their results to the literature. According to our results; both justice and peace were violated by a series of amnesty and adaptation based rewritten codes against common crimes. According to the literature; blanket and other types of amnesties have resulted in better outcomes as expected according to publications [2,5-7]. Death penalty and pregnant women in prisons had been the rationale for some amnesties [12,13]. The preparations of the turkish amnesty in 12.22.2000 had also begun in regard to pregnant women in prisons. One may think that why we did not mention about the results between the years of 2011 and 2014 which seems to be a limitation of the study. The rate of crime still continues to increase though insignificantly, however the population of the city has increased with a rate which had never been before and poulation characteristic of the city has also changed extraordinarily in the last years especially because of almost 2 millions Syrian refugees in Istanbul, which deserves another similar study. Either the poor homeless immigrants with many children usually are the victims or committers of the crime is a tough question to answer. Hence, we did not mention the new data related to the present study because of the mass migration from the Middle East to the city during the last years. Unfortunately; amnesty programs do not reduce undocumented immigration to other countries [14]. Another limitation of the study was its retrospective manner, which had resulted in analysis of only some rough parameters (unfortunately less than necessary). In conclusion; the romanticism of an amnesty, solely against common crimes, was not in favour of peace. It can be speculated that even a blanket (inclusive) amnesty which might have covered also political prisoners, with their more intellectual background when compared to other criminals, would have resulted in a better outcome for the welfare of the population. We think that the results of the present study in reaching all related scientists would be interesting and helpful not only for medical scientists but also even for the social investigators. REFERENCES 1. Atci IB, Yilmaz H, Kara D, Yilmaz N, Bitlisli H, et al. Retrospective analysis of 3524 head trauma patients admitted to the emergency department as epıdemiological approach to head traumas in our regional. Acta Medica Mediterranea, 2015, 31: 825-8. 2. Erol V, Uğurlu L, Kuzukiran D, Bozbiyik O, Unver M, et al. Non-operatıve management of solıd organ laceratıon caused by blunt trauma. Acta Medica Mediterranea, 2015, 31: 323-7. 3. Basile G, Evola G, Branciforte M, Nicolosi N, Leonardi A, et al. Blunt abdominal trauma: clinical aspects and diagnostic-therapeutic strategies. Acta Medica Mediterranea, 2013, 29: 195-200. 4. Moreno-Ocampo L. The international criminal court: Seeking global justice. Case Western Reserve Journal of International Law 2007-2009; 40: 215-226. 5. Snyder J, Vinjamuri L. Trials and errors: Principle and pragmatism in strategies of international justice. International Security 2003-2004; 28: 5-44. 6. Dugard J. Dealing with crimes of past regime: Is amnesty still an option. Leiden Journal of International Law 1999; 12: 1001-1015. 7. Smidt ML. The international criminal court: An effective means of deterrence? Military Law Review 2001; 167: 156-240. 8. Akhavan P. Are international criminal tribunals a disincentive to peace? Reconciling judicial romanticism with political realism. Human Rights Quaterly 2009; 31: 624. 9. D’Amato A. Peace vs accountibility in Bosnia. American Journal of International Law 1994; 88: 500. 10. Goldsmith J, Krasner SD. The limits of idealism. Daedalus 2003; 13: 247-263. 11. Eaton L. Amnesty says human rights have been eclipsed by "war on terror". BMJ 2006; 332: 1231. 12. Welsh J. The death penalty. Lancet 2003; 362 Suppl: 24-25. 13. Ferszt GG. Who will speak for me? Advocating for pregnant women in prison. 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Table-1: Forensic versus nonforensic applications Criminal affairs Non-criminal Total (patients with at (nonforensic) total least one of the emergency following: B,S,F) applications Group-1 255 9563 9818 Group-2 882 26803 27685 Total 1137 36366 B: beaten up without stab or firearm, S: penetrating tools such as stab, F: firearm Chi square (with Yates correction)=8.341, p=0.0039 (statistically very significant) Chi square (without Yates correction)=8.54, p=0.0035 (statistically very significant) Table-2: Degree of the crime (violence) Beaten (B) up At least stabbing Total without any (S), firearm (F) or penetrating tool both Group-1 221 34 255 Group-2 703 179 882 Total 924 213 1137 Fischer exact: p=0.0136 (P<0.5), B: beaten up only, S: stabbing, F: firearm Table-3: Mortality Group-1 Group-2 Total Death Alive 9 246 35 847 44 1093 Fischer exact: p=0.8551 (P>0.5) Total 255 882 1137 Table-4: Gender preference of the criminal Group-1 Group-2 Total male female 224 31 643 239 867 270 Fischer exact: p<0.0001 (statistically very significant) Total 255 882 1137 Table-5: Timing of the crime Group-1 Group-2 Total 24:00-08:00 08:00-24:00 239 16 785 97 1024 113 Fischer exact: p=0.0317, p<0.05 Total 255 882 1137