Prelection by Vasile Șarpe

MD, MS, PhD, assoc. Professor

S.U.M.Ph. "Nicolae Testemiţanu" Department of Forensic Medicine

2013/2014

Lecture items

• The forensic medicine as a discipline, its tasks and connections with other medical and paramedical subjects

• The history of forensic medicine • The service of forensic medicine in the Republic of Moldova • The procedural basis of the forensic expertise:

– the obligatory performing of the forensic expertise – the objects of medico-legal examination – the expert’s duties, rights and responsibilities – the kinds of forensic expertise – the forensic documentations and requirements confronted

by them

Forensic medicine, legal medicine, and forensic pathology are terms that have been used interchangeably around the world

Forensic medicine is a branch of medicine that applies

the principles and the knowledge of the medical sciences to solve problems in the field of law

• To solve medico-biological causes in juridical activity • To assist law enforcement in correct incrimination of the

offenses against human • To improve and support the quality of medical care (e.g.

medical deficiencies, malpractice)

• To develop and to propose measures of prevention the morbidity and mortality due to vulnerable external factors

Connections

with medical subjects

anatomy, pathology, trauma, neurology, obstetrics, gynecology, radiology, toxicology

with paramedical subjects

all forensic sciences, criminology, chemistry, physics, biology, law

The subjects of medico-legal examination

• Persons (alive)

• Cadavers

• Biological samples (e.g. blood, sperm, hair, tissues)

• Medical and law files

The main constituents of the forensic medicine

• the object and history of forensic medicine

• procedural base and organization

• injuries and death due to external factors

• forensic examination of persons

• forensic examination of cadavers

• forensic examination of biological samples

• forensic examination based on law and medical files

History

Early • Imhotep (2667 BC - 2648 BC) Grand Vizier, Chief Justice, Physician to King Zozer (Djeser/Joser), architect of the first great Pyramid at Sakkara, etc.

• Code of Ur-Nammu The oldest known surviving law code (Mesopotamian laws written in the Sumerian Language (2100-2050 BC))

• Code of Hammurabi (1790 BC) • Code of the Hittites (1650-1100 BC) • Hippocrates (460 BC – 370 BC) Greek physician, the ‘Father of Medicine.’

History

Republic of Moldova • Vasile Lupu law (1646)

• Matei Basarab law (1652)

• Other laws (based on the rules of the occupying country)

after the Second World War • 1945 Department of Forensic Medicine

• 1951 Bureau of medico-legal expertise (BMLE)

• 1996 BMLE was changed to Center of Forensic Medicine

History

Department of Forensic Medicine of SUMPh „Nicolae Testemitanu”

• Was founded in 1945

• Chiefs of department – E. Chiuchimariova (1945-1949)

– P. Areshev (1950-1966)

– Gh. Botezatu (1966-1995)

– Gh. Baciu (1995-2008)

– A. Pădure – from 2008

The forensic medicine in Moldova

Center of Forensic Medicine • Administration

– Director – deputy Director – the board of administration

• clinical sector (examination of persons and corpses) – municipal and district levels

• laboratory sector – histology – toxicology – biology – medico-criminalistical

Department of Forensic Medicine

of SUMPh „Nicolae Testemitanu”

Medico-legal scientific activity in Moldova

Traumatology

• P. Areshev

– Hemorrhage in the brain and its membranes, 1964

• N. Volkova

– Forensic examination of the limb trauma, 1968

• Gh. Botezatu

– Forensic examination of the teeth damage in diseases of the dental system, 1970

Medico-legal scientific activity in Moldova

Traumatology

• Gh. Baciu

– Forensic examination of the violent death in patients with preexisting diseases, 1971

– Resistance and injuries of the chest at its compression, 1981

• Gh. Baciu, A. Pădure, V. Șarpe

– Mechanical traumatisms in forensic aspect, 2006

Medico-legal scientific activity in Moldova

Thanatology

- The postmortem interval -

Gh. Botezatu, S. Ungurean, V. Tetercev, A. Nastas,

E. Balitzki, I. Cuvshinov

• Gh. Botezatu

– Forensic diagnosis of the time of death, 1975

Medico-legal scientific activity in Moldova

Mechanical asphyxia

• G. Mutoi – Asphyxia, 1983

Etiopathogenesis of violent death

• A. Pădure – Homicides among children and adolescents, 2003

• V. Șarpe – Suicidal phenomenon among children and

teenagers, 2005

Medico-legal scientific activity in Moldova

Medical professional deficiencies and crimes

• S. Ungurean

– Medical deficiencies: Causes and impacts, 2001

• A. Pădure

– Forensic assessment of deficiencies in medical surgical care, 2011

The procedural basis of the forensic expertise

• The Penal Code (PP)

• The Penal Procedure Code (PPC)

• The Civil Code (CC)

• The Law regarding the forensic expertise, technical-scientific and forensic examinations

• Other national regulation and rules (e.g. Regulation of assessment of the degree of injury severity)

• International legislative acts

The expertise and expert

The expertise is a practical and scientific research which aim is to bring to a conclusion of a concrete problem

The person who does this research and has special or peculiar knowledge acquired from practical and scientific experience is called expert

The forms of expertise

• primary

• supplementary

• contraexpertise

• commission (board)

• complex expertise

The obligatory performing of the forensic expertise

(art. 143 of Penal Procedure Code of R.M)

The forensic expertise is compulsory to establish • the cause of death • the degree of injury severity • the physical and mental condition of the suspect or accused • the physical and mental condition of the victim, witness • the physical and mental condition of the victims of torture,

inhuman or degrading treatment • the age of the suspect, culprit or the victim • other cases

The expert’s duties (art. 88 of Penal Procedure Code of R.M)

• to give an objective conclusion • to refuse to make conclusions if the questions fall outside

his area of competence or if examined materials are not sufficient for the conclusions

• to turn up at the enforcement body office or at the court and to provide them documents confirming his special qualifications

• to submit, at the request of the law bodies or the court, about his professional experience and his relations with people involved in the present case

• to comply with the legal provisions of the enforcement body or the court

• to respect the order and demands established in court • to keep confidentiality of the information acquainted with

studied cases

The expert’s rights

(art. 88 of Penal Procedure Code of R.M)

• to be in the know about the case in connection with the expertise

• to demand additional materials, required for conclusions

• to participate, with the approval of the prosecution or the court at juridical actions (e.g. interview, experiment)

• to make conclusions on unrequested questions (within his area of competence)

• to receive compensation for performed work • other rights (within law limits)

The expert’s responsibility

(article 312 of Penal Code)

False declaration, false conclusion or incorrect translation

The knowingly presentation of the false declaration by the witness or the victim, the false conclusion by the specialist or expert, the incorrect translation or interpretation by the translator or interpreter is penal punishable

The forensic documentation

After autopsy the forensic pathologist composes two main documents:

• the death certificate or medical death certificate

• the autopsy report

The death certificate is a standard form (blank) which includes personal data of the dead, time, cause and manner of death.

The medico-legal report

According to art.151 of P.P.C. after performing the necessary investigations, the expert prepares a written report, signs and stamps it.

There are two kinds of medico-legal reports:

• Medico-legal report of expertise is performed only upon a written order issued by the police officers, prosecutors or court decision

• Medico-legal report of examination is done following a written request from the law enforcement officials (prosecutors, police, and court)

The medico-legal report

Based on the requirements of P.P.C. report is structured in three parts: introductory, descriptive and final The introductory part includes: • when, where and who (name and surname of the expert,

function, scientific degree and title, work experience) performed the expertise

• who ordered or requested the expertise (examination) • data about subject of examination • questions that have been addressed The introductory part (expertize) closes up with the statement that the expert’s obligations and rights (art. 88 P.P.C. R.M.) have been explained and that the expert had been warned about the penal responsibility in accordance with the art. 312 of P.C. R.M.

The medico-legal report

The descriptive part includes all the data found during examination (e.g. description of external and internal examination during autopsy).

This part starts with circumstances of the case which are collected from request or order papers, death scene, etc.

The end of descriptive part is forensic diagnosis, that concludes it.

The medico-legal report

The final part consists of answers to questions of the expertise and is also called “conclusions”.

The requirements of expert's conclusions are:

– objective reasons

– the scientific argumentation

– exhaustive arguments

– complete conclusions

– within the area of competence

– accessible