Expert evaluation of the correctness of medical care is one of the most complex problems for experts. A total of 303 expert evaluations of this kind were carried out in the Moscow regional Bureau during the recent 11 years. Expert evaluation of surgical care were the most numerous. The percentage of cases when grave defects of medical care were detected is rather high: 58-88%. The authors consider that a universal scheme of expert evaluation concerning infringement of the law by medical workers is to be developed for forensic medical service of the Russian Federation. They propose a table, which takes account of the type of error (diagnostic, strategic, medical, management), causes of errors (objective or subjective), causes of improper actions of physicians, relationship between death and the error, probability of survival if medical care had been proper, data on bringing an action against the physician, etc.
To evaluate medical statement conclusions in the criminal-legal process in suspected cases of child sexual abuse (CSA).
An observational study of a random sample of 130 medically examined, police reported CSA suspected cases during 2001-2009. Medical statements were evaluated and their conclusions were analyzed with an end-point in the legal process. The data consists of official investigation documents from the University Hospital records, the Police, crime laboratories, the State Prosecutor, and the Courts of Law.
The median age of the children was 5.3 years (range 11 months-17.3 years) at the time of the suspected sexual abuse. In most cases (76.2%, 99/130) medical statement conclusions neither supported nor excluded the suspicion of CSA. Twenty-one (16.2%) medical statements supported and in 10 cases (7.7%) the conclusion did not support the suspected CSA. Of the suspected CSA cases a hundred (76.9%) proceeded to the Prosecutor. The charge filing rate was 41.5% (54/130). The final conviction rate was 30.8% (40/130) and 74% in the charged cases. Medical statements were mentioned as evidence in the Prosecutor's decision to file charges in 18 (33.3%) of suspected CSA cases and in 15 (36%) of verdicts. A child's clear disclosure of CSA (p
332 persons, who in 1987 received sanctions for sexual offences, were observed in freedom for five years, or until recidivism at an earlier stage. 82 (24.7%) committed new crimes during the observation period. Sexual offences comprised about 1/3 (8.4%) of the crimes committed. Rapists had the highest degree of recidivism. There was no significant difference between the various subgroups of sexual offenders (sexual offences against minors, rapists and other offenders) with regard to the frequency of recidivism into sexual offences. Registered sanctions for sexual offences before 1987, and sexual abuse and obscene conduct toward minors registered i 1987, were found to be significantly correlated to sexual recidivism after 1987. Problems regarding the evaluation of the effects of treatment to forestall recidivism into sexual crimes are discussed.
The author performed the analysis of the essence and patogenetic structure of diagnosis in forensic medical practice, the similarities and differences between forensic medical, pathological morphological, and clinical diagnoses, and their significance for the forensic medical expert conclusion.
An investigation was made of the presence of drugs and narcotics in samples from Danish drivers having violated the Danish Road Traffic act in 1993. Four hundred and twenty-five cases were received, but only 317 cases were analysed for drugs or narcotics. In 256 cases drugs or narcotics were found present with a total of 531 findings. In 112 of the cases only one compound was found present. Benzodiazepines, morphine, methadone, cannabinoids and amphetamine were the most frequently occurring compounds with 239, 52, 42, 32 and 28 findings, respectively. The study has shown that especially the benzodiazepines together with the illicit drugs seem to constitute a threat to traffic safety. For two countries very much alike, namely Denmark and Norway this study has shown a remarkable difference in the number of samples analysed and the results found.