Nishimura A, Takatsu A, Misawa S, Takahama K, Fukunaga T, Nishi K
Department of Legal Medicine, Shiga University of Medical Science, Ohtsu, Japan.
Nihon Hoigaku Zasshi. 2000 Nov;54(3):387-98.
We conducted a questionnaire survey of police surgeons and emergency physicians, inquiring about their experience of medicolegal investigation of death and their willingness to join a death investigation team in a major disaster. The questionnaire also asked about their knowledge about and interest in the forensic specialist system established by the Japanese Society of Legal Medicine. Police surgeons were generally willing to join an investigation team only if a disaster occurred in or close to their hometown, because they could not afford more than several days away from patient care. Although many of the emergency physicians were willing to join a death investigation team, they had difficulty in doing so without permission or orders from their employer or the authorities concerned. The survey found that the percentage of aged police surgeons was increasing among those surveyed. This fact, in combination with the current emphasis of postgraduate education on specialty training, threatens to cause a substantial lack of physicians available for medicolegal investigation of death. Therefore, it is urgently necessary to establish a system of training resident and emergency physicians in medicolegal investigation of death. In addition to providing postgraduate training in medicolegal investigation of death to prospective trainees who are emergency physicians at major hospitals in potential disaster-stricken areas, the medical school should incorporate forensic medicine in postgraduate training programs so that they can actively perform death investigation on disaster victims dying before or after arrival at their hospitals. Furthermore, the forensic community should make every effort to increase the number of autopsies in each department of forensic medicine and to expand the medical examiner system throughout Japan that is currently in practice only in the Metropolis of Tokyo and Yokohama, Nagoya, Osaka and Kobe Cities in order to incorporate forensic training in the postgraduate clinical training programs that will become compulsory in 2004.
我们对法医和急诊医生进行了问卷调查，询问他们在涉及死亡的法医学调查方面的经验以及在重大灾难中加入死亡调查团队的意愿。问卷还询问了他们对日本法医学协会建立的法医专家系统的了解和兴趣。法医通常只有在自己家乡或家乡附近发生灾难时才愿意加入调查团队，因为他们无法离开患者护理工作超过几天时间。虽然许多急诊医生愿意加入死亡调查团队，但未经雇主或相关当局许可或命令，他们很难这样做。调查发现，接受调查的法医中，年龄较大者的比例在增加。这一事实，再加上当前研究生教育对专科培训的重视，有可能导致可用于涉及死亡的法医学调查的医生严重短缺。因此，迫切需要建立一个对住院医生和急诊医生进行涉及死亡的法医学调查培训的体系。除了对潜在受灾地区主要医院的急诊医生这一未来受训人员进行涉及死亡的法医学调查的研究生培训外，医学院校还应将法医学纳入研究生培训项目，以便他们能够积极对在抵达医院之前或之后死亡的灾难受害者进行死亡调查。此外，法医界应尽一切努力增加各法医学部门的尸检数量，并在全日本扩大目前仅在东京都、横滨市、名古屋市、大阪市和神户市实施的法医鉴定人制度，以便将法医培训纳入2004年将成为必修课的研究生临床培训项目中。
