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The History of Legal Medicine

Cyril H. Wecht, MD, JD

J Am Acad Psychiatry Law 33:24551, 2005

Before discussing legal medicine and forensic sci-ence, it would be helpful to have a general definitionof terms. Forensic science is a broader term than legalmedicine. The former actually encompasses the lat-ter. The term forensic is used as an adjective toidentify a growing group of subspecialties in scienceand medicine, all of which convey the fundamentalconcepts of methods, hopefully both scientifically valid and legally admissible, for the presentation of evidence in courts of law.1 Legal medicine is consid-ered to be the field of study and accumulation of materials that deals with the application of medicalknowledge to the administration of justice.2 For thepurposes of this article, forensic medicine should beconsidered synonymous with legal medicine.3

Medicine and law have been related from the ear-liest times. The bonds that first united them werereligion, superstition, and magic. The functions of the physician and the jurist were united in the priest,

the intermediary between God and man. In early civilizations, primitive legal codes, religious doc-trines, and social precepts were often ill distin-guished, and laws with a medical content were oftenfound within their context.4 Ecclesiastical courts andcanon law were concerned with much that relatednot only to religious matters but also to medicinefor example, impotence, divorce, sterility, preg-nancy, abortion, period of gestation, and sexual de-viations. The oldest of these written records, theCode of Hammurabi, includes legislation pertaining to the practice of medicine, dating back to the year

2200 B.C.5

It covered the topic of medical malprac-tice and set out for the first time the concept of civiland criminal liability for improper and negligentmedical care. Penalties ranged from monetary com-

pensation to cutting off the surgeons hand. Fees also were fixed. The Code discussed various diseases of aslave that would invalidate a contract. Also included were references to incest, adultery, and rape.

In ancient Egypt, the acts of the medical man werecircumscribed by law. Stab wounds were differenti-ated in the 17th century B.C. The Egyptians had a

thorough knowledge of poisons. There is evidencethat priests made determinations regarding the causeof death and whether it was natural or not.6

The Chinese published information about poi-sons, including arsenic and opium 3000 years B.C.In ancient Persia, wounds were put into one of sevenclasses, ranging from simple to mortal. In ancientGreece, there was a knowledge of poisons and lawsagainst abortions. However, autopsies were not per-formed, since a dead body was regarded as sacred.7

In Rome 600 years B.C., a law was passed requir-ing that a woman who died in confinement should beimmediately opened to save the child. The inves-tigators of murder were selected from the citizenry. When Julius Caesar was assassinated in 44 B.C.(March 15), the physician Antistius examined hisbody and concluded that only one of the 23 stab wounds was mortal.8

The legal code in ancient Greece (about 460 B.C.) was very elaborate. In addition, it was a time of greatadvances in medicine. Though there is no clear evi-dence that medical knowledge was officially madeuse of in establishing proof in courts of law, it isknown that Hippocrates and others discussed many genuine medicolegal questions. These questions in-cluded the relative fatality of wounds in differentparts of the body, the average duration of pregnancy,the viability of children born before full term, andother matters. Moving across the Mediterranean,there is in existence a papyrus, found in Egypt anddated from pre-Christian times, in which a medicalofficer in Alexandria submitted a report on a suicide

Dr. Wecht is Coroner of Allegheny County, Pittsburgh, PA, and is inprivate practice at Cyril H. Wecht and Pathology Associates, Pitts-burgh, PA. Address correspondence to: Cyril H. Wecht, MD, JD,Office of the Coroner, Allegheny County, 542 Fourth Avenue, Pitts-burgh, PA 15219. E-mail: [email protected]

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about which there had been some suspicion of murder. 5

The Justinian Code, whichmade itsappearance inRome between 529 and 564 A.D., included withinits provisions a precept that indicated that a medicalexpert would not be used to proper or greatest advan-tage if he were to be simply regarded as an ordinary witness, appearing for one side or the other. TheCode, with much wisdom, stated that the function of such an expert was really to assist the judiciary by impartial interpretation and opinion, based on hisspecialized knowledge.5

There was also the recognition of medicolegalproblems in the Far East. In China, in approximately 1236 A.D., a volume entitled the Hsi Yuan Lu(freely translated, Washing Away of Wrongs ) was compiledthat outlined procedures to be followed in investigat-ing suspicious deaths. The book urged the medicalexaminer to make a thorough and systematic exami-nation of every corpse, however unpleasant its con-dition. The book discussed the difficulties caused by decomposition and even advised the examiner aboutthe problems associated with counterfeit wounds.Sections were devoted to wounds caused by blowsfrom fists or from kicking and to deaths caused by strangulation or drowning. Means for distinguishing between the bodies of drowned persons and thosethrown into the water after death were discussed, as were the distinctions between ante- and postmortemburning. The examiner was also cautioned that noth-ing in the inquest should be regarded as being unim-portant. Considering its era, this volume was amaz-ingly thorough.5

European Legal Medicine

In 1553 the Germanic Emperor, Charles V, pub-lished and proclaimed the Caroline Code, whichclearly stated in its pertinent sections that expertmedical testimony must be obtained for theguidanceof the judges in cases of murder, wounding, poison-ing, hanging, drowning, infanticide, and abortion

and in other circumstances involving injury to theperson.8

France also had an early start among Europeannations in the cultivation of a medicolegal system.From 1570 to 1692, France enacted laws that, likethose of Germany, favored the development of legalmedicine as an academic discipline. However, by 1690, medicolegal offices became corrupt, andprogress in legal medicine actually regressed, not to

start on a forward march again until after the FrenchRevolution in the next century.9

Meanwhile, in Italy, a physician named FortunatoFedele published in 1602 a fairly comprehensive vol-ume on forensic medicine entitled, De Relationes Medicorum. Another Italian, Paola Zacchia, a papalphysician, published the huge Questiones Medicina-Legales , which quickly overshadowed Fedeles work.Zacchias book discussed in detail questions of age,legitimacy, pregnancy, death during delivery, resem-blanceof children to their parents, dementia, poison-ing, impotence, feigned diseases, miracles, rape, mu-tilation, and the matters concerning public health.Thework has deficiencies that caneasilybe explainedby the era in which it was written; for instance, theknowledge of anatomy and physiology was sketchy and erroneous. The book also contains sections onthe different methods of torture then in existence,and it has a section that deals with miracles. Despitethese shortcomings, it was a worthwhile and influen-tial volume.10

Legal medicine was not treated as being just a the-oretical pursuit. It was eventually brought into thecourtroom. For example, in 1667 Schwammer-damm, in Germany, claimed that the lungs of a new-born baby would float in water if the baby had actu-ally breathed. That is, if it was not stillborn and hadlived and subsequently died, either by natural causesor by homicide. In 1681, the German physicianSchreger used this test forensically, and secured theacquittal of a girl who hadbeen accused of murdering her illegitimate child.6

Legal medicine began to be promoted within for-mal educational circles. In 1650, Michiaelis, in Ger-many, delivered lectures on legal medicine. By 1720,professorships concerning the subject were foundedby the state. Germany, in fact, established the firstknown medicolegal clinic in Vienna in about 1830and a second one in Berlin in 1833. France estab-lished its first clinic in 1840. France has also pro-vided, since 1803, that judges appoint medical ex-

perts who must be graduates in medicine and musthave attended a course (in earlier days this require-ment was fulfilled by going to one or more lectures)and have passed an examination in legal medicine.Franceestablished its first professional Chair in LegalMedicine in 1794. Great Britain, in 1803, estab-lished its first Chair of Forensic Medicine at the Uni-versity of Edinburgh. By 1876, there were chairs inall of its medical schools.9

History of Legal Medicine

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These academic recognitions should not lead oneto believe that legal medicinehad entered into a thor-oughly enlightened era. Its development was alwaysacademically turbulent and against the intellectualcurrent of the times. For example, during the periodfrom 1620 to 1720, a serious topic of conversation inboth medical and medicolegal circles was whether a woman could be impregnated by the devil or in a dream.9 In fact, in one case French judges actually legitimized an infant in a case in which the husbandhad been separated for four years from the mother,on the grounds that the child owed its paternity to a dream. Until 1726, it was taught that in the presenceof the murderer, his victims wounds would opentheir congeald mouths and bleed afresh. Courts would accept the testimony of medical experts as tothis miraculous bleeding of the corpse. Unearthedbones of animals would serve to convict men of mur-der. The highest medicolegal authorities advocatedbelief in ghosts, witches, and possession by the devil.They united with the clergy until 1752 in denounc-ing all disbelievers in these precepts as heretics andatheists. The authorities also recommended perse-cuting, drowning, and burning thousands of the in-sane, since they were, after all, firebrands of hell who were moved and seduced by instigation of thedevil. The going was not smooth, indeed.7

In the 5th century, when the Germanic and Slavicpeoples took over Western Europe, they instituted a system of indemnity to replace the primitive systemof personal vendetta. The person responsible for theinjury would pay an amount to the injured party or,in the case of death, to his relative. Since the paymentvaried with the severity of the wound, it was impor-tant to classify the wounds in the code and to be ableto call on experts to testify as to the damages. In theVisigothic and Bavarian Codes, mention is made of injury to pregnant women, to the child in utero, poi-soning of prisoners, and penalties of negligent doc-tors if the patient died.11

Charlemagne attempted to give some unity to the

laws of the empire. There was recognition of thenecessity of adducing all relevant evidence in judicialcases. There were articles discussing the direct inter-vention of physicians and instructions to judges toseek all relevant medical evidence, especially in casesinvolving questions of wounds, infanticide, suicide,rape, bestiality, and divorce on the grounds of impo-tence. The assizes of Jerusalem, in 1100, provided forthe courts to order medical examinations. In the case

of murder, the corpse had to be examined, and a report made as to what had been found, the locationof the injuries, and the likely mechanism that hadcaused them.11

In Italy, in 1249, Hugo de Lucca took his oath asa medicolegal expert. Medical reports from this timeshow that autopsies were performed to determine thecause of death. Pope Innocent III, in 1209, providedfor appointment of doctors to the courts for the de-termination of wounds. In Germany, in 1507, a comprehensive penal code was established that calledfor proof of cause in all violent deaths. It allowed theopening of bodies and represented progress towardthe practice of medicolegal autopsies and the devel-opment of legal medicine as a separate professionaldiscipline. It became a subject for special instructionin the 17th century and, by the start of the 18thcentury, designated chairs in legal medicine were cre-ated in German universities. Around this time, theearliest applications of medical observations de-signed solely to aid justice were made. The hydro-static test to see whether a child had been born alive was used in cases of suspected infanticide.11

The first book on legal medicine written in En-glish was authored by Samuel Farr in 1788 and wasentitled Elements of Medical Jurisprudence , a succinctand compendious description of findings in the hu-man body that were required for judgment by coro-ners and courts of law in cases of divorce, rape, andmurder, among others. The first British teacher of legal medicine was Andrew Duncan, a professor of physiology, who gave a course of lectures on legalmedicine and public health, beginning in 1789. Hisson, Andrew Duncan, Jr, became the first professoron this subject at the University of Edinburgh, wherethe first Chair in Legal Medicine in the English-speaking world was established. Alfred Taylor(18061880), Professor of Medical Jurisprudence atGuys Hospital Medical School, wrote Principles and Practice of Medical Jurisprudence . The British Associ-ation in Forensic Medicine was established in 1950,and later the British Academy of Forensic Sciences was created in 1960.4

American Developments

In the United States, the first lecturer on legalmedicine was Dr. J. S. Stringham, who gave his lec-tures in New York beginning at around 1804.12 In1813, the first Chair of Medical Jurisprudence wasestablished by the College of Physicians and Sur-

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geons of New York City and was filled by this sameDr. Stringham. In 1815, the College of Physiciansand Surgeons of the Western District of New York appointed Dr. T. R. Beck as the Professor of theInstitutes of Medicine and Lecturer on Medical Ju-risprudence.13 In the same year, the Medical Depart-ment of Harvard University appointed Dr. WalterChanning as the Professor of Midwifery.14

Dr. Benjamin Rush is credited with emphasizing the significance of the relationship between law andmedicine in the early 1800s. As the nations firstsurgeon general and a signatory of the Declaration of Independence, Rush established American legalmedicine with his published lecture Onthe Study of Medical Jurisprudence, which he delivered to med-ical students at the University of Pennsylvania inPhiladelphia in 1811. The lecture dealt with homi-cide, mental disease, and capital punishment.15

The works of Stringham and Rush inspired theteaching of medical jurisprudence in other Americanmedical schools. Among the early teachers were Dr.Charles Caldwell in Philadelphia and Dr. WalterChanning at Harvard. In 1819, Dr. Cooper, a legalofficer of distinction and president of the College of South Carolina, published Tracts on Medical Juris- prudence . This volume contained almost all availableliterature written in English on legal medicine.16

In 1815 Dr. T. Romeyn Beck was appointed lec-turer on medical jurisprudence at Western MedicalCollege in New York state. In 1823, Beck publishedthe Elements of Medical-Jurisprudence , which definedthe field of legal medicine for about half a century of American medical practice. Becks two volumes in-cluded impressive topics, such as rape, impotenceand sterility, pregnancy and delivery, infanticide andabortion, legitimacy, presumption of survivorship,identity, mental alienation, wounds, poisons, per-sons found dead, and feigned and disqualifying diseases.17

In 1838, Isaac Ray published A Treatise on Medical Jurisprudence of Insanity . In 1855, the year that Beck

died, Francis Wharton, an attorney, and Dr. More-ton Stille, a physician, collaborated to publish ATreatise on Medical Jurisprudence . In 1860, Dr. John J. Elwell, a physician and an attorney, published a book entitled A Medico-Legal Treatise on Malpractice , Medical Evidence , and Insanity Comprising the Ele-ments of Medical Jurisprudence , which highlighted theissue of malpractice in the medical jurisprudence lit-erature. Elwells book presented excerpts from con-

temporary cases for the purpose of teaching physi-cians what to expect from malpractice litigation. Dr. John Odronaux, also a physician and an attorney,published Jurisprudence of Medicine in 1867 and Ju-dicial Aspects of Insanity in 1878. In 1894, Randolph A. Witthaus and Tracy C. Becker published Medical Jurisprudence, Forensic Medicine and Toxicology .18

For medical students and physicians, medical ju-risprudence assumed the position of central impor-tance in U.S. schools of medicine throughout mostof the 1800s. During the course of the 19th century,the institutions, laws, and judicial decisions in Amer-ica reflected the increasing influence of sound medi-colegal principles, especially those pertaining tomental disease and criminal lunacy.

After the Civil War, however, things changeddrastically. Legal medicine became temporarily dor-mant. American Professor and Dean Stanford Emer-son Chaille expressed his view of the deplorable con-dition of medical jurisprudence in the United States.Chaille demonstrated how the teaching of medical jurisprudence had deteriorated by noting that insome medical colleges the course had been droppedaltogether.9 In others, it had been attached to someother subject, and in many colleges the teaching of medical students was entrusted to an attorney withno formal training in the medical field.2

Even in the early 20th century, the teaching of medical jurisprudence was relegated to a position asan occasional subject taught outside the main-stream.19 However, by the middle of the 20th cen-tury, legal medicine underwent a renaissance, as evi-denced by the establishmentof theAmerican Collegeof Legal Medicine (ACLM), the founding of theLaw-Medicine Institute at Boston University, andthe rekindling of contemporary interest in a vast ar-ray of legal medicine issues, medical ethics, physicianand patients rights, and business and professionalaspects of medical practice.

In 1867, the Medico-Legal Society was organizedinNew York. It was the first society in the world to be

organized for the purpose of promoting the princi-ples that an attorney could not be fully equipped forthe prosecution or the defense of an individual in-dicted for homicide without some knowledge of anatomy and pathology and that no physician orsurgeon could be a satisfactory expert witness with-out some knowledge of the law. Harvard University established a separate professorship in legal medicinein 1877.2



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Organizations

In 1955, recognizing the growing impact of legis-lation, regulations, and court decisions on patientcare and the generaleffect of litigationand legal med-icine on modern society, a group of physicians and

surgeons, some of whom were educated in the law,organized what would later become the aforemen-tioned American College of Legal Medicine(ACLM). The college was incorporated on Septem-ber 23, 1960, by nine doctors of medicine, three of whom were attorneys. Of the 36 physicians who weredesignated founding fellows, 10 had earned law degrees.

The ACLM is the oldest and most prestigious U.S.organization devoted to problems at the interface of medicine and law. Its membership is made up of professionals in medicine, osteopathy, and allied sci-

ences, including dentistry, nursing, pharmacy, podi-atry, psychology, and law. The ACLM has publisheda scholarly journal, the Journal of Legal Medicine ,since 1973. In 1988, the ACLM also published thefirst edition of the textbook,Legal Medicine ; the sixthedition was published in 2004.10

In 1972, a physician and two attorneys foundedthe American Society of Law and Medicine (Ethics was added in 1992; ASLME) as a successor organi-zation to the Massachusetts Society of Examining Physicians. Its founding president was cardiologistDr. Elliot Sagall, who also co-taught the law andmedicine course at Boston College Law School withGeorge J. Annas, an attorney. The organizationquickly became the largest medicolegal organizationin the world dedicated to continuing education, as well as the publisher of the two leading medicolegal journals: the Journal of Law , Medicine , andEthics andthe American Journal of Law and Medicine . The latteris published as a law review at Boston University Law School. The ASLME also has sponsored interna-tional meetings in locations around the world in aneffort to bring physicians, attorneys, ethicists, andothers interested in health law together.20

Education

From World War II until the late 1960s, the fieldof legal medicine was defined by law school coursesthat were almost exclusively concerned with forensicpsychiatry and pathology and were properly consid-ered advanced courses in criminal law. In the late

1960s, some law and medicine courses began con-centrating on broader medicolegal questions faced inthe courtroom, including disability evaluation andmedical malpractice. These courses were properly considered either advanced tort or trial practicecourses.10

In the 1970s the concerns of at least some law andmedicine courses expanded to include public policy,including access to health care and the quality of thatcare. At the same time, advances in medical technol-ogy created new legal areas to explorefrom braindeath and organ donation to abortion and in vitrofertilization. These topics were increasingly incorpo-rated into law and medicine courses, which werethemselves becoming known by the broader term of health law.10

Teachers of health law in law schools and med-

ical schools, together with health law teachers inschools of public health and schools of manage-ment, began meeting on a regular basis in 1976, when the first national health law teachers meet-ing took place at Boston University under the aus-pices of the law schools Center of Law and HealthSciences (the successor organization to the Law-Medicine Institute). The purpose was to help de-fine the expanding field and develop necessary teaching materials.20 In 1987, the American Asso-ciation of Law Schools sponsored its first teaching workshop on health law. Although this narrowergroup only recently convened, its program andproceedings offer useful insight into the currentstate of health law in law schools. As the organizersof the workshop saw it, law and medicine (fieldsprimarily concerned with medical malpractice, fo-rensic medicine, and psychiatric commitment)had become subdivisions of the new field of healthlaw. Health law itself has three additional subdivi-sions: economics of health care delivery, publicpolicy and health care regulation, and bioethics.These three subdivisions are actually three differ-ent approaches to the same subject matterthehealth care industry. Health law is applied law,much the way medical ethics is applied ethics.21

In an effort to bridge the gap between law andmedicine, some attorneys enroll in medical school orin dual-degree MD/JD programs. The number of medical school courses extraneous to a legal practicespecializing in medicine also discourages attorneysfrom pursuing a formal medical education.22

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In 1993, Harry Jonas, Sylvia Etzel, and Barbara Barzansky noted that students can earn combineddoctor of medicine and doctor of jurisprudence(MD/JD) degrees in only 9 of 125 degree-granting U.S. medical schools fully accredited by the LiaisonCommittee on Medical Education (LCME). Pres-ently, there are 15 such programs. In contrast, stu-dents can earn combined doctor of medicine anddoctor of philosophy (MD/PhD) degrees in 113 of the 125 U. S. medical schools. Most individuals whocurrently have MD/JD degrees, however, earnedtheir doctorate degrees separately, with most of themearning the MD first.23

In 1985, EugeneSchnellerand Terry Weinerpub-lished their findings regarding individuals whoearned MD/JD dual degrees and noted that cross-professional education in lawand medicine remains a relatively rare phenomenon in the United States.They concluded that

. . .without the development of institutionalized career linesand the acceptance of cross-disciplinary approaches to problemsolving MD/JDs must negotiate their jobs and job descriptions within an occupational structure that rewards disciplinary ef-forts. The marginal status of the interprofessional specialist per-sists in the decade of the 1980s [Ref. 24, p 337].

A combined MD/JD program is probably not themost effective way to teach medical concepts to law students, and it is doubtful that many students are willing to pursue such a long period of training.Moreover, there is more than enough to learn ineither field.24

These reasons probably explain the increasingly popular movement toward providing a health law concentration in many law schools and offering joint JD/MPH degree programs (such as those at BostonUniversity and Georgetown University) for studentsinterested in health law. Practicing attorneys need a working knowledge of the health care industry, butdo not need to know most of the material taught inmedical schools. A well-developed health law pro-gram designed to fit into the law school curriculumcan prepare an attorney to handle medical matterscompetently. Existing programs, such as health law concentrations at Boston University, Georgetown,Case Western, St. Louis University, and Loyola of Chicago, are still few in number.25

In 1982, the American Board of Legal Medicine was established to administer examinations to indi-viduals with both legal and medical degrees. Since

then, this Board has certified approximately 250MD/JDs in legal medicine. These examinations aregiven annually. Other specialty groups that may havesome relevance to MD/JDs are theAmerican Collegeof Physician Executives and the American College of Quality Assurance.10

The teaching of medicolegal problems in ourcountrys medical schools has not, however, been asswift or as comprehensive as one would desire. Al-though many respected authorities in the field haveurged for a long time that the active teaching of fo-rensic medicine should be a responsibility and duty of our medical schools to their medical students,most medical schools have been slow in paying heedto this advice. In 1951, onerespected authority in thefield, Dr. William E. B. Hall, stated before the Acad-emy of Forensic Sciences that Americas medicalschools had been, for the most part, derelict in theirduty.26 Hall felt that medical students received only a cursory indoctrination in the rights and duties of the physician, the rights of the patient, the variousaspects of malpractice, and the functions of thecourts. Hall stated:

We ask that our medical schools train our students, that they may at best recognize something of the medicolegal aspects of the various contacts in this practice, that they be better able toavoid misinterpretations of the facts and observations of a case,that they recognize when more capable advice and assistance areneeded, so that the innocent may not needlessly be subjected toprosecution, and theoperations of justicewill be furthered [Ref.26, p 555].

We have come a long way in the past 25 yearstoward meeting Halls criteria.27 The output of liter-ature on medicolegal subjects has increased year by year, and, in general, forensic medicine in America, with regard to teaching and research, appears to beprogressing. However, there is a still a long way to gobefore we can be intellectually satisfied with the levelof understanding, acceptance, and utilization of thisextremely important field of study.

References

1. Moritz AR:The need of forensic pathology foracademic sponsor-ship. Arch Pathol 33:3826, 19422. Curran WJ: Titles in the medicolegal field: a proposal for reform.

Am J Law Med 1:111, 19753. Wecht CR: Relationships of the medical examiner. Marshall Law

Rev 14:427, 19654. Smith S: The development of forensic medicine and law-science

relations. J Public Law 3:3056, 19885. Smith S: The history and development of legal medicine, in Legal

Medicine. Edited by Gradwohi RBH. St. Louis: CV Mosby;1954, pp 119



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6. OliverJR: Legal medicine in EuropeandAmerica.ABAJ 18:40511, 1932

7. Camp FE (editor): Gradwohls Legal Medicine (ed 2). Baltimore: Williams & Wilkins, 1968

8. Spitz WU (editor): Medicolegal Investigation of Death (ed 3).Springfield: Charles C Thomas, 1993

9. Chaille SE: Origin and progress of medical jurisprudence. J CrimLaw Criminol 40:397402, 1949

10. Sanbar SS: Legal medicine: historical roots and current status, inLegalMedicine (ed6). Edited bySanderSS. St.Louis: CVMosby,2004, pp 311

11. Smith SS: The history and development of legal medicine, inLegal Medicine.Edited by Gradwohl RBH. St.Louis: CVMosby,1954, pp 119

12. Stewart GH: Legal Medicine. Indianapolis, IN: Bobbs-MerrillCo., 1910, pp 16

13. Burns CR: Legacies in Law and Medicine. Canton, OH: ScienceHistory Publications, 1977

14. Curran WJ: History and development, in Modern Legal Medi-cine, Psychiatry, and Forensic Science. Edited by Curran WJ,McGarry AL, Petty CS. Philadelphia: FA Davis Co., 1980, pp126

15. Rush B: Introductory Lectures Upon the Institutes and Practices

of Medicine. Philadelphia: Bradford and Innskeep, 1811, p 36316. Cooper T: Tracts on Medical Jurisprudence. Philadelphia: James Webster, 1819

17. Beck T: Elements of Medical Jurisprudence (ed 5). London:Longman, 1836

18. Ray I: A Treatise on the Medical Jurisprudence of Insanity. Bos-ton: Little Brown Company, 1860

19. Curran WJ: Medicine and law at the Harvard Law School. Har-vard Law School Bull 17:910, 1966

20. Annas GJ:Health lawat theturn of thecentury: from white dwarf to red giant. Comm L Rev 2;55169, 1989

21. Havighurst C: Health care as a laboratory for the study of law andpolicy. J Legal Educ 38:499504, 1988

22. Wecht CH, Koehler SA: Case studies in forensic epidemiology. JLegal Med 24:58797, 2003

23. Barzanski B, Jonas HS, Etzel SI: Educational Programs in U.S.Medical Schools, 19992000. JAMA 270:10618, 1993

24. Schneller ES, Weiner TS: The MD/JD revisited: a sociologicalanalysis of cross-educatedprofessionals in thedecade of the1980s. J Legal Med 6:33759, 1985

25. French AJ: The history and significance of the issuance of certifi-cates in forensic pathology by the American Board of Pathology,in Legal Medicine Annual. Edited by Wecht CH. New York: Appleton Century Crofts, 1969

26. Hall WEB: A proposal to introduce forensic science in the uni-versity curriculum. J Crim Law 42:5509, 1951

27. Miles SH, Lane LW, Bickel J, et al : Medical ethics education:coming of age. Acad Med 64:70514, 1989

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