Current practice in forensic medicine

Although forensic medicine has been in existence for centuries in one guise or another, it is only with the recent growth in international research that it has begun to be acknowledged as a specific discipline in its own right. Many areas of progress are being made and this text aims to provide a unique, in-depth and critical update on selected topics that are of direct relevance to those practicing in the field including lawyers, police, medical and dental practitioners, forensic scientists and postgraduate/undergraduate medical students and undergraduate law students preparing for forensic medicine examinations.

This volume is designed to cover the wider aspects of forensic medicine, including the law, science, medicine (forensic pathology, clinical forensic medicine and forensic psychiatry) and dentistry. Topics covered include subjects of debate and/or uncertainty in areas where significant advances have been made and in those of current relevance to the forensic profession, Chapters provide a variety of approaches to the areas under discussion with reviews of current knowledge, information on significant changes and pointers to the future that the reader should be aware of.

Features:

• An authoritative review, for forensic medicine practitioners throughout the world, from leading international experts in the field.
• Provides critical commentary and updates on current practice.
• Topics include: a guide to the presentation of forensic medical evidence, bioterrorism, the paediatric hymen, assessment and interpretation of bone trauma in children, adult sexual assault, genital photography, forensic photography, common errors in injury interpretation, self-inflicted injuries and associated psychological profiles, bite marks and the role of the pathologist in aviation disasters.
• Includes a wealth of four colour figures to illustrate key points discussed within the text.

List of Contributors.

Foreword.

Preface.

Chapter One: Expert evidence and healthcare professionals.

Introduction.

The adversarial system of justice.

Expert reports.

Evidentiary exclusionary rules.

Pre-trial preparation for expert witnesses.

Appearance.

Timeliness.

Giving of evidence.

Managing cross-examination.

Summary.

References.

Chapter Two: Forensic investigation of biological weapon use.

Introduction.

A choice of words.

Threat assessments.

Presenting features.

Forensic microbiology or microbial forensics?

Assembling evidence from emerging infectious disease biology.

Current constraints.

References.

Appendix.

Chapter Three: The paediatric hymen.

Introduction.

Studies of normal anatomy.

Studies of genital findings in sexually abused girls.

Studies of acute injuries as they heal.

A consideration of test reliability.

Putting it all together.

References.

Chapter Four: Assessment and interpretation of bone trauma in children.

Introduction.

How should I evaluate suspected bone trauma in children?

What radiological investigations identify bone trauma?

How do X-rays detect fractures?

How does ultrasound detect bone injury?

How do nuclear medicine scans detect bone injury?

How does MRI detect bone injury?

How are medical images presented and shared?

What forces cause bones to fracture?

Are some bone injuries diagnostic of child abuse?

What do we know about bone healing in children?

What tests detect fragile bones?

Neonates with fractures: what are the special considerations?

Can the time of bone injury be determined?

Why might an X-ray be reported as normal when bone trauma exists?

Why might an ultrasound appear normal when bone trauma exists?

Why might a nuclear medicine scan appear normal when bone trauma exists?

Why might an X-ray appear abnormal when no bone trauma exists?

Why might a nuclear medicine scan appear abnormal when no bone trauma exists?

How do I deal with correctly interpreted but discordant imaging findings?

Why might an X-ray appear normal and bone scan 'hot' when bone trauma exists?

Why might a fracture seem obvious on plain X-ray but bone scan is "cold" when bone trauma exists?

When and why should I repeat x-rays?

How does the process of forming a forensic medical opinion differ from the process of diagnosis in clinical medicine?

Why do I need to be aware of my level of confidence in my medical diagnosis?

What factors should I consider when forming a diagnostic opinion about the cause of a child's fracture?

References.

Chapter Five: Adult sexual assault.

Introduction.

Sexual assault settings and characteristics.

Findings after sexual assault.

Toxicology and sexual assault.

Forensic science and sexual assault.

Treatment after sexual assault.

Summary.

References.

Chapter Six: The ethical and medical aspects of photo-documenting genital injury.

Introduction.

Sexual assault.

Imaging the body in the history of medicine.

Photography.

The evolution of the photography of genital injury.

A particular Australian"s experience.

Ethics of care.

Why no ethical objection to children being photographed?

The...