Forensic Medicine

lecture 2 & 3

Dr. Abdirahman Moalim Hassan

GREEN HOPE UNIVERSITY

(BSc in MBBS, BSc in GN, Master of Health service Mgt , Candidate PhD of Nursing Science )
 TERMS USED IN FORENSIC
MEDICINE
HOMICIDE

• It means the killing of a human being.

• It is defined legally as the destruction of the human life by the act, agency, and culpable omission of
some other person or persons.

Act: kill (someone) by covering their nose and mouth so that they suffocate.

Agency: A person who agrees to act on behalf of and instead of his or her principal

Omission: to provide food to children – failure to prevent from exposure (Maltreated child syndrome)

An drunk doctor killing a person when operating

Homicides are
a) criminal
b) non- criminal.
Criminal homicides are legally classified as
(a) murder
(b) assassination.

Non criminal homicide is classified into

(b) justifiable homicide and

(c) (b) excusable homicide.
 Justifiable homicide

• Execution on legal orders

• Self defense when there is imminent danger of death or serious injury and
that only way to prevent is to kill his attacker. The achiever must not have
provoked the quarrel or been the aggressor in creating danger.
 Excusable homicide

Excusable homicide A homicide is excusable when accident results in an

unanticipated and unintended death of some other person.

This must have occurred as a result of a official act carried out in a official way
with legal means.

For example, in the event of cardiac arrest occurring during anesthesia when
everything is perfect there is no medical negligence.
SUICIDE
• Suicide means the killing of oneself.
CONSENT
• Consent is voluntary agreement, compliance or permission.
Consent may be
a) Informed
b) Implied.
Informed consent means consent obtained after explaining the need to perform
an act.
Implied consent means consent obtained for an act for which the patient
normally would agree to, like holding out the arm for an injection, or the patient
would normally do if he/she were in a sound state, like treating a case of
psychosis with antipsychotics despite the patient’s refusal.
 EUTHANASIA (MERCY KILLING)

Euthanasia is bringing about a gentle and painless death for a person suffering from an
incurable painful disease or a debilitating condition which leads to miserable existence.

• Euthanasia can be:

A. Active - It is a positive merciful act to end useless suffering or a meaningless

existence brought about by an act of commission like giving large doses of drugs to
bring about death.

B. Passive - It is discontinuing life sustaining measures to prolong life, which involves

acts of omissions like failure to resuscitate a terminally ill patient.
Euthanasia can also be:

A. Voluntary, given according to will of person

B. Involuntary, against the will of the person

C. Non voluntary, referring to persons incapable of making their choices

known like a person with coma
• EVIDENCE

Evidence is information that gives a reason for believing something or proves

something, and it includes any statement or document a court of law permits or
requires in relation to the case.

Evidences are

A. Direct- Any fact that is seen, heard, perceived or confirmed by witnesses orally

B. Indirect- Readings drawn in relation to events and circumstances

C. Hearsay- Evidence gathered from someone else

D. Documentary- Evidence which have been documented i.e. written.

WITNESS
Witness is a person giving evidence or confirming evidence in a court of law.
Witnesses can be

A. Common– A person giving evidence observed by himself or known to

him

B. Expert– A person trained to/skilled in technical aspects and capable of

reasoning opinions and inference from facts observed

C. Hostile- A person who gives false evidence or conceals part or whole of

truth with some motive
The end lecture 2
Lecture 3

Legal systems
 Legal systems

Most countries have two main legal systems:

1. Criminal courts: deals predominantly with disputes between the State and
individual.

2. Civil courts: deals with disputes between individual including those of

confirmed negligence, contractual failure, debt.

 Decisions made by judges are referred to as ‘common law’ or ‘case law’.

 Criminal law

 Criminal law deals with relationships between the state and the individual
and as such is probably the area in which forensic medical expertise is most
commonly required.

 Criminal trials involve offences are ‘against public interest’; these include
offences against the person (e.g. murder, physical attack, dangerous bodily
harm, rape), property (e.g. theft, robbery), and public safety and security of the
state (terrorism).
Prosecution:

The institution and conducting of legal proceedings against someone in

respect of a criminal charge.

The more serious the offence or the offender’s record of criminal behaviour, the

more likely it is that a prosecution will be required in the public interest.

 The penalties that can be imposed in the criminal system commonly include
financial (fines), imprisonment and community-based sentences.

Community based sentences are non-custodial sentences. This means the

offender is in the community and is allowed to move around (sometimes with
restrictions).

Some countries allow for corporal punishment(beatings), mutilation

(amputation of parts of the body) and capital punishment (execution).
Corporal punishment or physical punishment is a punishment intended to
cause physical pain to a person.

Capital punishment, also called death penalty, execution of an offender

sentenced to death after conviction by a court of law of a criminal offense. 

Special courts are utilised for those under 18 years of age.

Note

• In both civil and criminal trials, the person against

whom the action is being taken is called the
defendant; the accuser in criminal trials is the state
and in civil trials it is the plaintiff.
Professional witness: A professional witness is one who gives accurate
evidence. This role is equivalent to a simple witness of an event, but occurs
when the doctor is providing factual medical evidence.

Expert witness: An expert witness is one who expresses an opinion about

medical facts.

An expert will form an opinion, for instance about the cause of the fractured leg
or the laceration.
The role of an expert witness should be to given independent and unbiased
assessment or interpretation of the evidence that they have been asked to
consider.
 Evidence for courts:
Statements and reports

A statement in a criminal case is a report that is prepared in a particular form so

that it can be used as evidence.

A statement provided when acting as a professional witness will be based on the

contemporaneous notes (notes or records made at the time of examination),
and it is important that the statement fairly reflects what was seen or done at
the time.
 A statement may be accepted by both defence and prosecution, negating the
need for court attendance.

 Attending court: If a citizen is asked to appear as a witness for the court, it is

the duty of all to obey.
 The process of giving evidence:

Whether called as a witness of fact, a professional witness of fact or an expert

witness, the process of giving evidence is the same.

When called into court, every witness will, almost undergo some formality to
ensure that they tell the truth.

Regardless of how it is done, the effect of the words is the same: once the
promise has been taken, the witness is accountable for the penalties of perjury
(lie).
Whoever has ‘called’ the witness will be the first to examine them under

promise; this is called the ‘examination in chief’ and the witness will be asked

to confirm the truth of the facts in their statement(s).

When this questioning is completed, the other lawyers will have the

opportunity to question the witness; this is commonly called ‘cross-

examination’. This questioning will test the evidence that has been given.
The final part of giving evidence is the ‘reexamination’. Here, the

original lawyer has the opportunity to clarify anything that has been

raised in cross-examination but he cannot introduce new topics.

 Doctors in court:
Preparation of medical reports

 A report may be requested by the police, prosecutors, Coroners, judges, medical

administrators, government departments, city authorities or lawyers of all types.

NB

Coroner an officer, as of a county or municipality, whose chief function is to

investigate by inquest, as before a jury, any death not clearly resulting from natural
causes.
• A good rule of thumb is to ensure that, when medical records will need to be
reviewed, written permission to access and use those records has been given,
either by the individual themselves, or by an individual or body with the
power to give that consent.

• The fact of a request, even from a court, does not mean that a doctor can
necessarily ignore the rules of medical confidentiality.

• Mandatory reporting of medical issues may be relevant in some countries;

often these relate to terrorism, child abuse, use of a gun and other violent
crime.
 Structure of a statement or report:

• The basis of most reports and statements lies in the contemporaneous notes
made at the time of an examination

• A simple professional witness statement, Included may be the doctor’s

professional address and qualifications should follow. The date of the report is
essential and the time(s), date(s) and place(s) of any examination(s) should be
listed, as should the details of any other person who was present during the
examination(s).
• Medical abbreviations should be used with care and highly technical terms,
especially those relating to complex pieces of equipment or techniques,
should be explained in simple, but not condescending, terms.

• Autopsy reports are a specialist type of report and may be commissioned by

the Coroner, the police or any other legally competent person or body.

• An autopsy report is confidential and should only be disclosed to the legal

authority who ordered the examination.
• Doctors must resist any attempt to change or delete any parts of their report
by lawyers who may feel those parts are damaging to their case; any requests
to rewrite and resubmit a report with alterations for these reasons should be
refused.
The end
Thanks allot