LEGAL MEDICINE- a brief history -

Assoc. Prof. Beatrice Ioan

Legal Medicine – border between law and medicine

Developed in parallel with:

Development of law

Development of medicine

Development of criminal law

• Evidences with pre-established value

↓• Evidences that work together to establishing the

truth- their value is established according to particularities of each case

↓• Evidences:

- related to the case

- give the solution to the case

Development of medicine• Death investigation → modern techniques to find the truth

• Dissection/autopsy → development of anatomy and progressive elimination of errors

• Autopsy – forbidden in many countries till the 19th century

• Autopsy- a ”violently popular punishment”↓

• Grave roberry- body snathching

• Burke & Hare, Edinburgh, 1827- 1828

(Ruth Richardson. (2001). Death, dissection and the destitute. University of Chicago Press)

Development of legal medicine

• Hammurabi Code (1728-1686 B.C.)

- Mandatory scientific expertise in cases of violent death or body trauma

- Medical responsibility – medical activity was evaluated and punished according to results

• Ancient Jews, the Bible- references to wounds, homicide, suicide, diagnosis of death, pregnancy, rape etc.

• Ancient Egyptians- mandatory examination of a women condemned to death by a midwife

Development of legal medicine• Ancient Greece – public autopsy

• Hipocrates- lethal wounds

• Iulius Cezar’s autopsy (Antistus)→ only one out of the 22 wounds discovered during the autopsy was lethal

• Iustinian’s Code- the role of the physicians in the judicial trials

• Plinius the Old – sudden death and suicide.

• Sun- Tsi, China (1247)- the first medico-legal book - Lethal and non-lethal trauma- Autopsy- Asphyxiation, sudden death, death during accupuncture

Development of legal medicine

Founded by:

Ambroise Pare (1510-1590)- surgeon, anatomistOn medico-legal reports

Paul Zachias (1602 – 1675)- renaissance scholar

Medico-legal issues- medico-legal psychiatry↓

The relevance of the medical knowledge in the judicial trials

Developments in the field → medical discoveries that have been accepted as evidences in the judicial trials

Development of legal medicine

Autopsy

Johannes Bohn (1640-1718)

- The autopsy technique- all the body cavities should be opened and all the organs examined

- Examination of the lethal violence injuries

Forensic toxicology

•1836- James Marsh- toxicological detection of the arsenic – it was no longer the ”perfect poison”

•1840- Mathieu Joseph Bonaventure Orfila – Father of the forensic toxicology- the begining of the scientific forensic toxicology

↓Laffarge case- detection of the arsenic in the organs

of a human body using the Marsh method

Collection of soil from the surroundings of the coffin in cases of exhumation when an intoxication is suspected

Forensic anthropology

•Alphonse Bertillon (1853-1914)– antropometry – physical measurements and particular signs- portraits of the felons in a database

• William Herschel (1738- 1822) - fingerprints

• Francis Galton (1822- 1911), Juan Vucetich (1858-1925) - systematization → 4 main types → dactiloscopy

- Francisca Rojas Case

- Argentina – the first country in the world to accept dactiloscopy as an identification method

Alexandre Lacassagne (1843-1924)- founder of forensic anthropology

- The value of the tatoos for identification purposes

- Identification based on the aspect of the victim’ s hairMillery case – hair aspect and bone disease

- Signs of death

- Estimation of the postmortem interval according to cadaveric discoloration of the skin, rigor mortis and algor mortis

Forensic serology

•1901- Landsteiner – blood groups

•Paul Uhlenhuth – differentiation between the human blood and animal blood

Tessnow Case

•Alec John Jeffreys – genetic profile September 10, 1984

↓•1986- Leicestershire – the first murder elucidated using the genetic profiling

Colin Pitchfork case-double rape and murder (1983, 1986)-the first person convicted of a crime based on DNA fingerprinting evidence /

the first to be caught as a result of mass DNA screening

Legal Medicine in RomaniaDates back to the 16th century- official documents on:- Juridical irresponsibility of the mentally ill- The attitude towards the victims of rape- The value of the medico-legal documents from juridical perspective

Evaluation performed by:

→ Wounds- quacks, barbers

→ Poisoning, madness - quacks

→ Sexual offences- midwives, quacks

Examination methods: visual, palpatory, examination of the gastric content

Legal Medicine in Romania

1811- mandatory autopsy in cases of violent death

1806-1812- the autopsy can be performed after 24 hours from death

February 6, 1832- the first medico-legal autopsy

Legal Medicine in Romania

Mina Minovici - organized the field on scientific principles - the value of photographs in the medico-legal

examination

Nicolae Minovici - self-hanging experiments- institutions for re-educating the minors- emergency services

Ştefan Minovici - toxicology laboratory- Faculty of Pharmacy

The first National Institute of Legal Medicine– the muzeum

The first INML- autopsy room

The first National Institute of Legal Medicine -INML Bucharest

• 1898 – Bucharest and Iaşi → the first forensic pathologists – subordinated to the Ministry of Justice – mostly autopsies

Iasi• Autopsy and dissection- permitted since 1685• Autopsy- 4 days; once every 5 years the public access

was permitted• Maria C. Ropala – the first women in the world who

worked as a forensic pathologist

1860- Legal Medicine taught at the Law Faculty

1882- Legal Medicine transffered from the the Law Faculty to Medical Faculty

Medico-legal activities • Autopsy

• Expertise of the living persons (clinical legal medicine)

→ examination and evaluation of the gravity of traumatic injuries (short, mid and long term consequences)

→ evaluation of the mental state

→ filiation expertise- the relationship between parents and children (most frequent presuposed father- child)

• Toxicological examination

Legal Medicine- Criminal law

• Legal Medicine- evidences about various felonies according to the injuries on the victim’s and aggressor’s body

- cause of death

- mechanism

- causal relationship between the injuries and death/ handicap etc.

Legal Medicine- Civil Law

• Examination of the injuries

• Evaluation of health status

• Estimation of the handicap

• Mental health and capacity to sign a selling/donation act

• Legal representative- guardianship

Legal Medicine- Family Law

• Filiation expertise

• Custody of children after divorce- psychiatric expertise

• Cancellation of a marriage

Medico- legal evidence

•Means - according to the scope/objective;

•In due time;

•The conclusion must be supported by scientific evidence;

•The conclusion is checked against the history of the case;

•Limits of the methods must be officially declared;

•Prudence – when the medical aspects can be interpreted in both ways (guily/no guily) - In dubio pro reo!

„You need to know to doubt”... (Lacassagne)