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Medical jurisprudence or legal medicine is the branch of science and medicine involving the study and application of scientific and medical knowledge to legal problems, such as inquests, and in the field of law. [1] As modern medicine is a legal creation, regulated by the state, and medicolegal cases involving death, rape, paternity, etc. require a medical practitioner to produce evidence and appear as an expert witness, these two fields have traditionally been interdependent. [2]
Forensic medicine, which includes forensic pathology, is a narrower frontline field which involves the collection, documentation, analysis and presentation of objective information (medical evidence) for use in the legal system. [3]
When investigating a death, forensic pathologists:
The Australian Museum shows in a step by step virtual demonstration what happens during an autopsy procedure. [5]
Song Ci (1186–1249) was probably the first forensic scientist. He recorded all the known forensic techniques at the time in his book known as the Collected Cases of Injustice Rectified.
Andreas Vesalius (1514 – 1564), imperial physician to the court of Emperor Charles V, revolutionized the practice of medicine by providing detailed descriptions of the anatomy of the human body, which were based on his dissections of cadavers and autopsies. In 1537, aged just 22, Vesalius performed public dissections to show how the human body worked, and became professor of medicine at Padua University. He insisted that his medical students should perform dissections. [6] His work "De Humani Corporis Fabrica" was groundbreaking in the history of medical publishing and is considered to be a major step in the development of scientific medicine. [7]
Paul Zacchias was also one of the earliest figures of medical jurisprudence, with association with the Papal States and Catholic church. [8] Zacchias was the personal physician to Pope Innocentius X and Pope Alexander VII, as well as legal adviser to the Rota Romana. [9] His most well known book, Quaestiones medico-legales (1621-1651) established legal medicine as a topic of study. [10] Zacchias work contains superstitious views on magic, witches, and demons which were widely held at the time. [11]
Medical jurisprudence had a chair founded at the University of Edinburgh in 1807, first occupied by Andrew Duncan, the younger. It was imposed on the university by the administration of Charles James Fox, and in particular Henry Erskine working with Andrew Duncan, the elder. [12]
In the 19th century, two new tools appear : Forensic psychiatry (to determine the mental health and blameworthiness of a suspect), and forensic toxicology (giving evidence in cases as intentional poisonings and drug use). [13]
In the United Kingdom, the Faculty of Forensic and Legal Medicine was established as a Faculty of the Royal College of Physicians in 2006 to develop and maintain the highest possible standards of competence and professional integrity in forensic and legal medicine. The specialty covers professionals working in three related disciplines: forensic medical practitioners (forensic physicians, forensic pathologists, sexual assault examiners, and child physical and sexual assault examiners); medico-legal advisers; and medically qualified coroners. [14]
Medical jurisprudence is concerned with a broad range of medical, legal, and ethical issues, as well as human rights and rights of individuals.
Physicians have a duty to act in their patients best interest and can be charged in a court of law if they fail to do so. On the other hand, a physician may be required to act in the interest of third parties if his patient is a danger to others. Failure to do so may lead to legal action against the physician.
Medical jurisprudence includes:
Under the second heading, there are many aspects, including:
Under the third heading, there are also many aspects, including:
Pathology is the study of disease and injury. The word pathology also refers to the study of disease in general, incorporating a wide range of biology research fields and medical practices. However, when used in the context of modern medical treatment, the term is often used in a narrower fashion to refer to processes and tests that fall within the contemporary medical field of "general pathology", an area that includes a number of distinct but inter-related medical specialties that diagnose disease, mostly through analysis of tissue and human cell samples. Idiomatically, "a pathology" may also refer to the predicted or actual progression of particular diseases, and the affix pathy is sometimes used to indicate a state of disease in cases of both physical ailment and psychological conditions. A physician practicing pathology is called a pathologist.
Forensic pathology is pathology that focuses on determining the cause of death by examining a corpse. A post mortem examination is performed by a medical examiner or forensic pathologist, usually during the investigation of criminal law cases and civil law cases in some jurisdictions. Coroners and medical examiners are also frequently asked to confirm the identity of remains.
A coroner is a government or judicial official who is empowered to conduct or order an inquest into the manner or cause of death. The official may also investigate or confirm the identity of an unknown person who has been found dead within the coroner's jurisdiction.
An autopsy is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death; or the exam may be performed to evaluate any disease or injury that may be present for research or educational purposes. The term necropsy is generally used for non-human animals.
The Royal College of Physicians of London, commonly referred to simply as the Royal College of Physicians (RCP) is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination, and now also Physicians Assistants without examination. Founded by royal charter from King Henry VIII in 1518, as the College of Physicians, the RCP is the oldest medical college in England.
Dissection is the dismembering of the body of a deceased animal or plant to study its anatomical structure. Autopsy is used in pathology and forensic medicine to determine the cause of death in humans. Less extensive dissection of plants and smaller animals preserved in a formaldehyde solution is typically carried out or demonstrated in biology and natural science classes in middle school and high school, while extensive dissections of cadavers of adults and children, both fresh and preserved are carried out by medical students in medical schools as a part of the teaching in subjects such as anatomy, pathology and forensic medicine. Consequently, dissection is typically conducted in a morgue or in an anatomy lab.
The medical examiner is an appointed official in some American jurisdictions that investigates deaths that occur under unusual or suspicious circumstances, to perform post-mortem examinations, and in some jurisdictions to initiate inquests. They are necessarily trained in pathology.
Michael M. Baden is an American physician and board-certified forensic pathologist known for his work investigating high-profile deaths and as the host of HBO's Autopsy. Baden was the chief medical examiner of the City of New York from 1978 to 1979. He was also chairman of the House Select Committee on Assassinations' Forensic Pathology Panel that investigated the assassination of John F. Kennedy. Baden's independent autopsy findings are often in conflict with the local authorities' opinions; as such, many consider him to be a headline-seeking physician as opposed to a legitimate source of information.
Thomas Tsunetomi Noguchi is the former Chief Medical Examiner-Coroner for the County of Los Angeles. Popularly known as the "coroner to the stars", Noguchi determined the cause of death in many high-profile cases in Hollywood during the 1960s, 1970s, and 1980s. He performed autopsies on Marilyn Monroe, Albert Dekker, Robert F. Kennedy, Sharon Tate, Inger Stevens, Janis Joplin, Gia Scala, David Janssen, Divine, William Holden, Natalie Wood, and John Belushi.
Cyril Harrison Wecht is an American forensic pathologist. He has been the president of both the American Academy of Forensic Sciences and the American College of Legal Medicine, and headed the board of trustees of the American Board of Legal Medicine. Wecht served as County Commissioner and Allegheny County Coroner and Medical Examiner, serving the Pittsburgh metropolitan area. He is perhaps best known for his criticism of the Warren Commission's findings concerning the assassination of John F. Kennedy.
Joshua Perper was a noted forensic pathologist and toxicologist. He served as the Chief Medical Examiner of Broward County, Florida for seventeen years, during which time he conducted autopsies on a number of famous individuals, including Anna Nicole Smith. Prior to his appointment to that position, he served as Allegheny County's Coroner serving metro Pittsburgh.
Cedric Keith Simpson was an English forensic pathologist. He was Professor of Forensic Medicine in the University of London at Guy's Hospital, Lecturer in Forensic Medicine at the University of Oxford and a founding member and President of the Association of Forensic Medicine. Simpson became renowned for his post-mortems on high-profile murder cases, including the 1949 Acid Bath Murders committed by John George Haigh and the murder of gangster George Cornell, who was shot dead by Ronnie Kray in 1966.
A cadaver or corpse is a dead human body. Cadavers are used by medical students, physicians and other scientists to study anatomy, identify disease sites, determine causes of death, and provide tissue to repair a defect in a living human being. Students in medical school study and dissect cadavers as a part of their education. Others who study cadavers include archaeologists and arts students. In addition, a cadaver may be used in the development and evaluation of surgical instruments.
Paul Stuart Appelbaum is an American psychiatrist and a leading expert on legal and ethical issues in medicine and psychiatry.
Steven Timothy Hayne is a pathologist from the US state of Mississippi who attracted significant controversy surrounding his medical practices and testimony in criminal trials, most notably those of Cory Maye, Jimmie Duncan, and Tyler Edmonds.
Sir Henry Duncan Littlejohn MD LLD FRCSE was a Scottish surgeon, forensic scientist and public health official. He served for 46 years as Edinburgh's first Medical Officer of Health, during which time he brought about significant improvements in the living conditions and the health of the city's inhabitants. He also served as a police surgeon and medical adviser in Scottish criminal cases.
Paul Zacchias or Paolo Zacchia (1584-1659) was an Italian physician, teacher of medical science, forensic medicine, medico-legal jurist, philosopher, and poet. He is said to have been personal physician to Pope Innocentius X and Pope Alexander VII. Zacchias was also legal adviser to the Rota Romana, the highest Papal court of appeals, and head of the medical system in the Papal States. His most well known book in three volumes, Quaestiones medico-legales (1621-1651) established legal medicine as a topic of study.
In many legal jurisdictions, the manner of death is a determination, typically made by the coroner, medical examiner, police, or similar officials, and recorded as a vital statistic. Within the United States and the United Kingdom, a distinction is made between the cause of death, which is a specific disease or injury, versus manner of death, which is primarily a legal determination versus the mechanism of death which does not explain why the person died or the underlying cause of death and can include cardiac arrest or exsanguination. Different categories are used in different jurisdictions, but manner of death determinations include everything from very broad categories like "natural" and "homicide" to specific manners like "traffic accident" or "gunshot wound". In some cases an autopsy is performed, either due to general legal requirements, because the medical cause of death is uncertain, upon the request of family members or guardians, or because the circumstances of death were suspicious.
The lung float test, also called the hydrostatic test or docimasia, is a controversial autopsy procedure used in determining whether lungs have undergone respiration. It has historically been employed in cases of suspected infanticide to help determine whether or not an infant was stillborn. In the test, lungs that float in water are thought to have been aerated, while those that sink are presumed to indicate an absence of air.
The Swiney Prize, a British award made every five years by the Royal Society of Arts with the Royal College of Physicians, was set up by the will of George Swiney, an English physician who died in 1844.