Forensic Medicine: An Aid to Criminal Investigation

Forensic medicine is medicine as applied to the problems of the law. The origins of both are hidden in the mists of antiquity, dating from the beginnings of family and tribal life. Recorded human history goes back for 6000 years. Sumeria, Babylon and Egypt all contributed to the development of forensic medicine. Imhotep was probably the first real medicolegal expert. Hippocrates, the Greek physician, and Galen, the Roman, made considerable contributions. Little advance was made during the millenium of the Dark Ages. But Renaissance medicine gave this branch of medicine an impetus in the seventeenth, eighteenth and nineteenth centuries, and in the twentieth, interest in forensic medicine is worldwide. The physician, the coroner, the pathologist, the medical specialist and the forensic laboratory contribute to the investigation of crimes against the person, and to the solution of such problems as identification, untoward deaths, apparent drowning and many others.     

Metastasizing keratoacanthomas? The difficulties in differentiating keratoacanthomas from squamous cell carcinomas

The problem in diagnosis of keratoacanthoma versus squamous cell carcinoma has been reviewed, and 13 patients are presented to illustrate the difficulties in differentiating between these two lesions. If the pathologist is in doubt, the lesion should be called "probable keratoacanthoma, but squamous cell carcinoma cannot be ruled out." We should all be aware that even the most careful pathologist, using all the information and material available, may still erroneously diagnose a lesion as a benign keratoacanthoma--one which, if inadequately treated, may metastasize or recur as a squamous cell carcinoma. Therefore, it is important for the clinician to treat most keratoacanthomas by adequate removal and close follow-up.     

11例吸毒死亡法医学鉴定回顾性研究分析

目的：奉文时吸毒及体内藏毒死亡法医学尸体检验与鉴定中的相关问题进行回顾性研究。强调该类法医学鉴定中应该特别注意的问题。方法：将2003年初至2006年底昆明市及周边地区11例吸毒死亡法医学鏊定案例进行回顾性研究分析,同时对毒品作用机理、死亡原因、吸毒流行病学特征、吸毒死亡者的病理组织学特征、体内藏毒死亡特征、吸毒死亡法医学尸体检验与鉴定应注意的问题等进行论述。结果：吸毒或体内藏毒死亡的法医学尸体检验与鉴定具有一定的形态学特征,吸毒死亡法医学检验与鉴定工作具有相当的难度。结论：吸毒及体内藏毒死亡法医学尸体检验与鉴定,必须在充分进行尸体剖验的基础上并结合毒物检验、现场勘验、案情调查、临床表现和死亡经过等资料进行充分的案情研究并排除其他原因致死,才能得出正确的结论。     

The Part-time Prosector: A Personal Experience of Medico-Legal Autopsies

This article examines the medico-legal autopsies performed in a period of nine years in a community and teaching hospital; there was a total of 900 such examinations. It records the experience of a pathologist without specialized forensic training, and suggests that much medico-legal pathology will continue to be performed by general pathologists. Recommendations are made for expansion of ancillary services, for postgraduate and refresher training, and for modifications in the legal and police system.     

Sexual dimorphism of root length on a Greek population sample

Sexual dimorphism in teeth has been an area of research for osteoarchaeologists and forensic anthropologists studying human skeletal remains. As most studies have been based on the mesiodistal and buccolingual crown measurements, sexual dimorphism from root length dimensions remains “neglected” by comparison to crown dimensions. The aim of the present study was to test the existence of sexual dimorphism in the root length of single-rooted teeth with the purpose of investigating whether maximum root length can be reliably used to determine sex. A total of 774 permanent teeth in 102 individuals (58 males and 44 females) from the Athens Collection were examined. The maximum root length of each tooth was measured on the mesial, distal, buccal, and lingual side. Almost all teeth presented a high degree of sexual dimorphism with males showing numerically higher values in root length than females. The most dimorphic teeth were the maxillary second incisors followed by maxillary canines. The percentage of sexual dimorphism reached 16.56%, with maxillary teeth showing the highest degree of dimorphism. The classification results show that the overall correctly specified group percentage ranged from 58.6% to 90.0%. The data generated from this study suggest that root length measurements offer a reliable method for determining sex and are therefore useful in osteoarchaeological studies, particularly in cases of fragmented or cremated material, but also in forensic contexts. Moreover, root length can be used to separate the remains of female and male subadult individuals with a high level of accuracy thus addressing one of the most problematic issues in human osteoarchaeology and anthropology as immature skeletons are the most difficult to sex.     

Moral considerations in body donation for scientific research: a unique look at the University of Tennessee's anthropological research facility

This paper discusses keys to the moral procurement, treatment and disposition of remains used for scientific research, specifically those donated to the University of Tennessee's Anthropological Research Facility (ARF). The ARF is an outdoor laboratory dedicated to better understanding the fate of human remains in forensic contexts, and focuses its research on decomposition, time since death estimates, body location and recovery techniques, and skeletal analysis. Historically, many donations were unclaimed bodies received from medical examiners (although it will be shown that this trend is changing), and it has been argued that the use of the unclaimed bodies for medical or scientific purposes is a violation of autonomy since no consent was given by the individual. It is argued here, however, that the domain of autonomous choice extends to one's own corpse only insofar as expressed wishes are made known prior to one's death, and that in the absence of expressed intent toward final disposition, it is acceptable for institutions to receive donations from medical examiners or family members. This paper also discusses other philosophical issues related to donation, consent and autonomy, and the forensic benefits of research conducted at the Anthropological Research Facility.     

Estimation of sex from the hyoid body in skeletal individuals from archeological sites

Recent forensic studies have shown that the hyoid bone is a sexually dimorphic element of the human skeleton. Given the advanced techniques of collecting human remains in archeological and forensic contexts, the recovery of hyoid bones is now more frequent in skeletal samples. For that reason the authors propose a new method for estimating sex based on hyoid bodies from archeological sites.     

Basic research in evolution and ecology enhances forensics

In 2009, the National Research Council recommended that the forensic sciences strengthen their grounding in basic empirical research to mitigate against criticism and improve accuracy and reliability. For DNA-based identification, this goal was achieved under the guidance of the population genetics community. This effort resulted in DNA analysis becoming the 'gold standard' of the forensic sciences. Elsewhere, we proposed a framework for streamlining research in decomposition ecology, which promotes quantitative approaches to collecting and applying data to forensic investigations involving decomposing human remains. To extend the ecological aspects of this approach, this review focuses on forensic entomology, although the framework can be extended to other areas of decomposition.     

Correlation of DNA fragment sizes within loci in the presence of non-detectable alleles

At present most forensic databases of DNA profiling of individuals consist of DNA fragment sizes measured from Southern blot restriction fragment length polymorphism (RFLP) analysis. Statistical studies of these databases have revealed that, when fragment sizes are measured from RFLP analysis, some of the single-band patterns of individuals may actually be due to heterozygosity of alleles in which fragment size resulting from one allele remains undetected. In this work, we evaluate the effect of such allelic non-detectability on correlation of fragment sizes within individuals at a locus, and its impact on the inference of independence of fragment sizes within loci. We show that when non-detectable alleles are present in a population at a locus, positive correlations of fragment sizes are expected, which increase with the proportion of non-detectable alleles at the locus. Therefore, a non-zero positive correlation is not a proof of allelic dependence within individuals. Applications of this theory to the current forensic RFLP databases within the US show that there is virtually no evidence of significant allelic dependence within any of the loci. Therefore, the assumption that DNA fragment sizes within loci are independent is valid, and hence, the population genetic principles of computing DNA profile frequencies by multiplying binned frequencies of fragment sizes are most likely to be appropriate for forensic applications of DNA typing data.Editor's commentsThe presence of non-detectable alleles for VNTR loci has plagued the use of these highly-discriminating systems in human identification. The authors take explicit account of these alleles, and are able to show independence of the frequencies of detectable alleles. They raise the troubling issue of how to account for occasional significant results when multiple tests are performed. By invoking Bonferroni corrections, they regard all tests, even those performed on different loci, as addressing the same hypothesis—the absence of dependence at any VNTR locus.     

Forensically relevant SNP classes

Forensic samples that contain too little template DNA or are too degraded require alternate genetic marker analyses or approaches to what is currently used for routine casework. Single nucleotide polymorphisms (SNPs) offer promise to support forensic DNA analyses because of an abundance of potential markers, amenability to automation, and potential reduction in required fragment length to only 60-80 bp. The SNP markers will serve an important role in analyzing challenging forensic samples, such as those that are very degraded, for augmenting the power of kinship analyses and family reconstructions for missing persons and unidentified human remains, as well as for providing investigative lead value in some cases without a suspect (and no genetic profile match in CODIS). The SNPs for forensic analyses can be divided into four categories: identity-testing SNPs; lineage informative SNPs; ancestry informative SNPs; and phenotype informative SNPs. In addition to discussing the applications of these different types of SNPs, this article provides some discussion on privacy issues so that society and policymakers can be more informed.     

Newfoundland pathologist driving force as province finally adopts medical examiner's act.

Newfoundland''s former chief forensic pathologist is pleased that the provincial government has adopted a new medical examiner''s act that he helped develop. He hopes the new act will help clear up confusion about who does what when a body is found in the province.     

Diurnal variation in stature - Is it more in children or adults?

Stature is the most often used anthropometric measure in the nutritional, growth and development, anthropological and forensic oriented studies. Its estimate is considered to be an important assessment in the identification of unknown human remains and its medico-legal significance is obvious in forensic examinations. Diurnal variation in stature is a biological norm in the human body and its effects can be reflected in the reliability of height data in these studies. We hypothesize that the extent of diurnal variation is more in children as compared to adults in a population.     

Using scapular measurements in regression formulae for the estimation of stature

There are very few papers in forensic literature in which scapular dimensions have been used for estimation of living stature. Allowing the forensic duty to estimate the living stature of skeletal remains, using intact or fragmented scapulae, the Authors have performed multiple regression analysis between the measurements taken from 80 scapula (40 male and 40 female) belonging to a skeletal collection with anthropometric known data. Seven parameters (max length, max breadth, max acrocoracoid distance, length of acromion, max length of coracoid, length of glenoid cavity, width of glenoid cavity) have been recorded. By statistical analysis multiple and linear regressions have been obtained. The results show that living stature may be determined by using regression formulae of single or associated parameters taken from whole or fragmented scapulae. In absence of intact or fragmented long limb bones, scapula sample can be reliably employed for the estimation of stature in forensic practice.     

Likelihood ratios for evaluating DNA evidence when the suspect is found through a database search

A crime has been committed, and a DNA profile of the perpetrator is obtained from the crime scene. A suspect with a matching profile is found. The problem of evaluating this DNA evidence in a forensic context, when the suspect is found through a database search, is analysed through a likelihood approach. The recommendations of the National Research Council of the U.S. are derived in this setting as the proper way of evaluating the evidence when finiteness of the population of possible perpetrators is not taken into account. When a finite population of possible perpetrators may be assumed, it is possible to take account of the sampling process that resulted in the actual database, so one can deal with the problem where a large proportion of the possible perpetrators belongs to the database in question. It is shown that the last approach does not in general result in a greater weight being assigned to the evidence, though it does when a sufficiently large amount of the possible perpetrators are in the database. The value of the likelihood ratio corresponding to the probable cause setting constitutes an upper bound for this weight, and the upper bound is only attained when all but one of the possible perpetrators are in the database.     

Moral sensibilities and moral standing: Caplan on xenograft "donors"

[I]nterest in animals as a source of organs and tissues for human beings remains strong. New developments in immunosuppression technology promise to lower the technical barriers to a routine use of nonhumans as organ donors, and the image of colonies of animals kept at the ready for supplying the growing human need for new organs seems a much more plausible scenario now than it did when broached by transplantation specialists in the Sixties. As Arthur Caplan has powerfully argued, the prospects that other sources of organs may resolve the supply problem are grim.... In the face of these "pro-xenograft" pressures, it becomes all the more signficant to assess arguments against the practice that rest on considerations of the moral status of the nonhumans from whom the organs are taken. To be sure, xenograft faces other moral difficulties -- for example, concerns about the quality of informed consent obtained for recipients, worries about the possibility that xenografting will serve as a vector by which new and possibly virulent viruses become established in humans, and problems about whether such spending is equitable in the light of other unresolved human needs. Yet whether we morally wrong animals in taking their organs and their lives remains a decidedly central issue here, one that cannot be finessed away by developing better informed consent procedures, better anti-viral strategies, or by situating transplantation medicine in a just health care system.     

Whole genome amplification using single-primer PCR

Comprehensive genomic molecular analyses require relatively large DNA amounts that are often not available from forensic, clinical and other crucial biological samples. Numerous methods to amplify the whole genome have been proposed for cancer, forensic and taxonomic research. Unfortunately, when using truly random primers for the initial priming step, all of these procedures suffer from high background problems for sub-nanogram quantities of input DNA. Here we report an approach to eliminate this problem for PCR-based methods even at levels of DNA approaching that of a single cell.     

The Medical Investigation of Alleged Rape

The web of human entanglement resulting from the cry “rape” may twist and disrupt the lives of the persons involved. The physician who is prepared and able to deal with the forensic medical aspects of the problem can play a vital role in the determination of innocence or guilt. And, if he is prepared to recognize and deal with the psychologic problems, the emotional distress and the anxiety, the physician can provide invaluable help.     

Comparison of VNTR allele frequencies and inclusion probabilities over six populations

There is considerable debate about the methodologies used to estimate VNTR (Variable Number of Tandem Repeats) multi-locus genotype frequencies or odds of inclusion in forensic cases. To compare two of the methods in use, allele frequency distributions among six populations were compared and the effect of population heterogeneity on VNTR multi-locus genotype frequency estimation was examined. Genotype frequencies estimated from single population data were one or two orders of magnitude smaller than those estimated by picking the highest allele frequency in a group of subpopulations to estimate genotype frequencies using a ceiling principle. The average change does not appear to be very sensitive to the set of subpopulations used; four locus frequencies still give inclusion odds of one in a million or less. We think that use of the ceiling principle solves both the statistical problem engendered by subpopulation heterogeneity and the legal problem of assuming that the prepetrator and suspect belong to the same subpopulation. The counterintuitive fact of human genetic polymorphism is that it is easier to identify an individual than it is to identify the subpopulation, ethnic group or race to which that individual belongs.     

The Investigation of Obscure Deaths

Unexpected death from obscure causes places a responsibility on the coroner which is delegated to the police, the pathologist and the laboratory. Important insurance and civil litigation issues may be at stake and crime must not be overlooked. This article stresses the importance of (a) powers of observation, (b) awareness of possibilities, (c) a flexible mind and (d) competence in forensic pathology. Cases quoted and illustrated show mistakes which have caused error—and injustice.The importance of discussion with clinical colleagues is emphasized; painstaking autopsy and meticulous laboratory examinations are vital. Poisoning is particularly easily overlooked.