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Introduction to Forensic Medicine and Pathology Paul M. Ng’walali, MD, PhD At the end of the lecture should be able 1. Define what is forensic medicine/Pathology 2. Differentiate between forensic med & forensic pathology 3. Define terms commonly used in forensic practice 4. Explain the significance of forensic practice in our daily living Forensic Medicine Branch of medicine concerned with resolution of legal issues by the application of scientific medical knowledge to the end that injustice shall not be done to any member of the society In investigation several forensic specialists may work together 1. Forensic criminalist 2. Forensic Pathologist 3. Forensic Toxicologist 4. Forensic Odontologist 5. Forensic Anthropologist 6. Forensic Psychiatrist Forensic Pathology Practice of medicine produces evidence useful in the public administration of justice, public health, and public safety How ? the medical principles derived from the study of diseases and injury the scientific study of the effect of disease and injury on the human body in the context of; matters of public interest, the untoward or adverse effects of the dynamic interaction that occurs between persons, the person and the environment Forensic Pathology; a study of the patterns of social behavior, anatomic injury, and death. Cause of death Disease, injury, or abnormality that alone/in combination is resp for initiating the sequence of functional disturbances whether brief or prolonged, that eventually ends in death This is the underlying, proximate, or initiating cause of death It may precede death immediately and be both the underlying and immediate cause of death It may produce other serious sequelae and complications that may be the immediate cause of death, In documentation of the cause of death: The underlying cause takes precedence over the immediate cause or any other complications; Should be the answer to the question: “What is the cause of death but for which death would not have occurred?” A contributing cause of death is any important disease or condition that was present at the time of death and that may have contributed to death but was not related to the immediate cause. Manner of death A classification of the way in which the cause of death came about with special reference to; social relationships and personal causation whether by: force of natural events accidental suicidal self-infliction The usual classifications: natural homicide accident pending suicide undetermined Mechanisms of death The process causes vital organs/systems to fail when a fatal disease, injury, abnormality, or chemical insult occurs. It is the functional or structural change that makes independent life no longer possible after a lethal event has occurred. Example: gunshot wound to the chest, may cause death by: 1. cardiac standstill 2. hemorrhagic shock 3. less frequently: infection and sepsis It may be difficult/impossible to define the mechanism of death in instances of multiple forms of trauma such as beating, stabbing, and disposal of the body in water. Multiple mechanisms also can be the result of a single event such as in strangulation Suffocation Brain ischemia Purpose of medico-legal investigation of death 1. Satisfy the needs of public health and safety and the courts 2. Ascertain medical facts relevant to the cause of death 3. Integrate the findings with the investigation facts in order to establish the manner of death 4. Evaluate the mechanisms and times of injury and death, and to collect medical and physical evidence Recommended Reading Materials 1. Bernard Knight; Simpson’s Forensic Pathology 2. Narayan Reddy KS; The Essentials of Forensic Medicine & Toxicology 3. Kerr DJA; Forensic Medicine 4. The internet searches