Essential Forensic Medicine

478 Pages·2019·43.761 MB·English

by  Peter Vanezis

Essential Forensic Medicine
Essentials of Forensic Science
Titles in the series
1. An Introduction to Forensic Genetics, Second Edition
William Goodwin, Adrian Linacre and Sibte Hadi
2. Forensic Botany: A Practical Guide
David Hall and Jason Byrd
3. Wildlife DNA Analysis: Applications in Forensic Science
Adrian Linacre and Shanan Tobe
4. Forensic Approaches to Buried Remains
John Hunter, Barrie Simpson and Caroline Sturdy Colls
5. The Forensic Examination and Interpretation of Tool Marks
David Baldwin, John Birkett, Owen Facey and Gilleon Rabey
6. Foundations of Forensic Document Analysis: Theory and Practice
Michael Allen
Essential Forensic Medicine
Edited by
Peter Vanezis
Emeritus Professor of Forensic Medical Sciences, Queen Mary University of London
This edition first published 2020
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Library of Congress Cataloging-in-Publication Data
Names: Vanezis, Peter, author.
Title: Essential forensic medicine / Peter Vanezis.
Description: First edition. | Hoboken, NJ : Wiley, [2020]. | Series:
Essentials of forensic science | Includes bibliographical references and
index. |
Identifiers: LCCN 2019016116 (print) | LCCN 2019017012 (ebook) | ISBN
9781119186885 (Adobe PDF) | ISBN 9781119186892 (ePub) | ISBN 9780470748633
(paperback)
Subjects: | MESH: Forensic Medicine–methods | Wounds and Injuries–pathology
Classification: LCC RA1151 (ebook) | LCC RA1151 (print) | NLM W 700 | DDC
614/.1–dc23
LC record available at https://lccn.loc.gov/2019016116
Cover image: Courtesy of Peter Vanezis
Cover design: Wiley
Set in 10.5/13pts Times Ten by SPi Global, Pondicherry, India
10 9 8 7 6 5 4 3 2 1
Contents
List of Contributors xix
Series Foreword xxi
Preface xxiii
Acknowledgements xxv
1 The Legal System, Courts, and Witnesses 1
Peter Vanezis
1.1 Introduction 1
1.1.1 Common law 2
1.1.2 Civil law (Roman law) 2
1.2 British courts 2
1.3 The Supreme court of the United Kingdom 2
1.4 English and Welsh courts 3
1.4.1 Court of Appeal 3
1.4.2 High Court 3
1.4.3 County Courts 3
1.4.4 Crown Court 3
1.4.5 Magistrates’ Courts 4
1.4.6 Tribunals 4
1.5 Scottish Courts 4
1.5.1 The court of session 4
1.5.2 The High Court of Justiciary 4
1.5.3 The Sheriff Court 4
1.5.4 Justice of the Peace Courts 4
1.6 Northern Ireland Courts 6
1.7 Other courts 6
1.7.1 The Court of Justice of the European Union 6
1.7.2 The European Court of Human Rights 6
1.7.3 Court martial (military court) 6
1.7.4 International Courts 6
1.7.5 Coroner Courts 7
1.8 Types of witnesses and evidence 7
1.8.1 Ordinary witness 7
1.8.2 Professional witness versus the expert witness 7
1.8.3 Expert evidence 8
1.8.4 Common knowledge rule 10
1.8.5 Basis rule 10
1.8.6 Ultimate issue rule 11
References 11
vi CONTENTS
2 Investigation of the Deceased and Their Lawful Disposal 13
Peter Vanezis
2.1 Introduction 13
2.2 Certification of details of death by the Registrar of births and deaths and lawful disposal of the body 13
2.3 Death certificate 14
2.4 When may a doctor issue a death certificate? 14
2.5 The form of the certificate in England and Wales 14
2.6 Legal procedures in the coroner system 14
2.6.1 Notification of cases to the coroner 18
2.7 Deaths abroad 19
2.8 Inquests 19
2.8.1 Scope of the inquest 20
2.8.2 Inquest conclusions 20
2.9 Registration of death 21
2.10 Burial 21
2.11 Cremation 21
2.11.1 Introduction 21
2.11.2 The current cremation procedure 23
2.12 The Human Tissue Act 2004 and Human
Tissue (Scotland) Act 2006 24
2.12.1 Existing holdings 25
2.13 Exhumation is discussed in detail in Chapter 5 25
2.14 Legal procedures in death investigation: Other systems 25
2.14.1 Scotland 25
2.14.1.1 View and grant 25
2.14.1.2 Full autopsy 25
2.14.1.3 Fatal accident inquiry 26
2.14.2 Medico‐legal death investigation in the United States 26
2.14.3 The generic criminal investigation and judicial system 26
References 27
3 The Duties of a Registered Medical Practitioner and the General Medical Council 29
Peter Vanezis
3.1 Medical Acts 29
3.2 Role of the GMC 30
3.3 Consent 32
3.4 Decisions involving children and young people 33
3.5 Consent and capacity 34
3.6 Medical confidentiality 35
3.7 Consent for disclosure 35
References 36
4 General Principles of Scene Examination 37
Peter Vanezis
4.1 Concept of the scene 37
4.2 Scene investigation and Locard’s principle 38
4.2.1 Management of the scene 38
4.2.2 Health and safety 39
4.2.3 Climatic conditions 40
4.3 Scene location and associated problems 40
4.3.1 Types of scenes encountered 40
4.3.2 Indoor location 41
4.3.3 Outdoor location 43
4.3.4 Outdoor location with Case study 44
4.3.5 Recovery of buried remains from clandestine graves 45
4.3.6 Attendance at a scene where a decomposed body is found 45
CONTENTS vii
4.4 Type of incidents 46
4.4.1 Number of deceased persons 46
4.5 The forensic pathologist and other medical personnel at the scene 47
4.5.1 Introduction 47
4.5.2 The pathologist 47
4.5.3 The pathologist’s approach 48
4.5.4 Examination of the body and its environment 49
4.5.5 Ascertaining the fact of death 50
4.5.6 Assessing the post‐mortem interval (time of death) 50
4.5.7 Artefacts due to resuscitation attempts 51
4.5.8 Retrospective scene visit 51
4.5.9 Documentation of the scene 52
References 52
Further reading 53
5 The Medico‐legal Autopsy 55
Peter Vanezis
5.1 Introduction 55
5.2 Historical background 55
5.3 Types of autopsy 57
5.4 Types of autopsy in the Coroner system 58
5.5 Autopsy procedure 60
5.5.1 Review of the circumstances surrounding death and other information 60
5.5.2 Identification procedure 60
5.5.3 Documentation of the post‐mortem examination 61
5.5.4 External examination of the body 62
5.5.5 Internal examination of the body 63
5.5.6 Other Investigations 66
5.6 Examination of the exhumed body 67
5.6.1 Exhumation of legally interred remains 67
5.6.2 Investigation of single or multiple clandestine graves 67
5.7 Safety in the mortuary and dealing with high‐risk cases 69
References 70
Further reading 71
6 Interpretation of Injuries: General Principles, Classification, and Age Estimation 73
Peter Vanezis
6.1 Introduction 73
6.2 General aspects 73
6.2.1 Mechanism of injury 73
6.2.2 Strength of force at impact 74
6.2.3 Types of injuries 74
6.2.4 Development and ageing of injuries 75
6.2.5 Factors affecting the development of bruises 76
6.2.5.1 Site of injury 76
6.2.5.2 Type of agent inflicting injury and force used 76
6.2.5.3 Age of the subject 77
6.2.5.4 Sex 77
6.2.5.5 Skin pigmentation 77
6.2.5.6 Conditions in which bruising occurs more easily or spontaneously 77
6.3 Timing of bruises 77
6.3.1 Dating bruises at the post‐mortem examination 78
6.3.2 Gross naked eye and photographic assessment 78
6.3.3 Microscopical changes in bruises 79
6.3.3.1 Histological changes 79
6.3.3.2 Histochemical changes 80
6.3.3.3 Biochemical methods 80
viii CONTENTS
6.4 Colour measurement of bruising 80
6.4.1 Colorimetry 81
6.4.2 Spectrophotometry 82
6.5 Differentiation from artefacts and other post‐mortem appearances 82
6.5.1 ‘Post‐mortem bruising’ 83
6.5.2 Hypostasis and congestion 83
6.5.3 Post‐mortem injuries 83
6.5.4 Resuscitation injuries and handling after death 85
6.6 Decomposition 85
References 86
Further reading 87
7 Blunt Impact Trauma 89
Peter Vanezis
7.1 External surface injuries 90
7.1.1 Abrasions 90
7.1.2 Bruises 90
7.1.3 Lacerations 95
7.2 Types of incidents in which blunt impact trauma is the predominant feature 97
7.2.1 Road traffic collisions and other transportation‐related incidents 97
7.2.1.1 Incidence 97
7.2.1.2 Types of injuries and their assessment in road users 97
7.2.1.3 Injuries to vehicle occupants 97
7.2.1.4 Types of injuries sustained by different body regions 98
7.2.1.5 Injuries from motorcycle collisions 98
7.2.1.6 Injuries to pedestrians 99
7.2.1.7 Injuries to pedal cyclists 99
7.2.1.8 Injuries from train collisions 100
7.2.2 Other incidents that involve blunt impact injuries 100
7.2.2.1 Serious assaults involving beating with objects, kicking, and punching 100
7.2.2.2 Falls from a height 101
7.2.3 Head injuries from blunt impact trauma or non‐impact forces on the head 102
7.2.3.1 Injuries to the head from blunt trauma 104
7.2.3.2 Types of fractures to the skull 104
7.2.3.3 Intracranial injuries 104
7.2.3.4 Focal head injuries 104
7.2.3.5 Diffuse injuries 105
7.2.3.6 Diffuse axonal injury 106
7.2.3.7 DAI in children 106
7.2.3.8 Intracranial haemorrhage 106
References 110
8 Sharp Force Trauma 111
Peter Vanezis
8.1 Introduction 111
8.2 Characteristics of sharp force trauma scenes 112
8.2.1 Location 112
8.2.2 Blood distribution 112
8.2.3 Homicide or suicide? 112
8.3 Incised (slash) wounds 113
8.3.1 Incised wounds to the neck (cut throat wounds) 113
8.3.2 Incised wounds to the wrists 115
8.3.3 Incised wounds to other parts of the body 115
8.4 Stab wounds and their assessment 116
8.4.1 Forces causing injury 116
8.4.2 Examination of clothing 117