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[日本法医毒理学实践中的持续挑战:实现特定目标的策略]

[Continuous challenges in Japanese forensic toxicology practice: strategy to address specific goals].

作者信息

Kageura Mitsuyoshi

机构信息

Department of Forensic Medicine, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan.

出版信息

Nihon Hoigaku Zasshi. 2002 Sep;56(2-3):219-28.

Abstract

In this paper, the status quo of forensic toxicology in Japan and the West is surveyed and a strategy to address future goals of Japanese forensic toxicology is proposed. Forensic toxicology in the West consists of three main areas--post-mortem forensic toxicology, human-performance forensic toxicology and forensic urine drug testing. In Japan, post-mortem forensic toxicology is practiced in university forensic medicine departments while most of the human-performance forensic toxicology is carried out in police laboratories. However, at least at present, strictly controlled workplace urine drug testing is not being performed, despite the abuse of drugs even by uniformed members of the National Defence Forces and police. For several years, the author has been introducing Western forensic toxicology guidelines and recommendations, translated into Japanese with the help of Western forensic toxicologists, to Japanese forensic toxicologists. Western forensic toxicology practice is at an advanced stage, whereas Japanese practice is in a critical condition and holds many problems awaiting solution, as exemplified by the urine drug testing in police laboratories. There is never any sample left for re-examination by the defence in all cases, though the initial volume of the urine sample available for examination is 30-50 ml. Only one organisation carries out everything from sampling to reporting and, in addition, the parent drug and its metabolites are not quantified. It is clear that the police laboratories do not work within good laboratory practice guidelines, nor do they have quality manuals or standard operating procedures manuals. A basic change in Japanese forensic toxicology practice is now essential. The author strongly recommends that, first of all, Japanese toxicologists should prepare forensic toxicology guidelines based on the Western models. The guidelines would progress the following objectives for forensic toxicology laboratories: 1) to have documented good laboratory practice standards; 2) to have a quality control system including a quality manual and standard operating procedures manual; 3) to have some degree of compulsion to implement quality assurance both through their own internal efforts and by appropriate remedial actions based on the results of an external proficiency testing scheme. For forensic toxicologists, the implications are that they should be: 1) responsible for ensuring that laboratory practices are performed under satisfactory conditions and 2) required to be certified as a forensic toxicology specialist in order to prove their forensic toxicology ability. For their part, governments should: 1) carry out administrative reforms related to forensic toxicology; 2) simplify the procedure for obtaining certified reference materials; 3) introduce a strict workplace urine drug testing programme for government employees, at least for those related to law enforcement. When all of these objectives have been realised, the specific goal will be achieved through which Japanese forensic toxicology is able, in practice, to fulfill its responsibility to society.

摘要

本文调查了日本和西方法医毒理学的现状,并提出了实现日本法医毒理学未来目标的策略。西方的法医毒理学包括三个主要领域——尸体法医毒理学、人体性能法医毒理学和法医尿液药物检测。在日本,尸体法医毒理学在大学法医学系开展,而大多数人体性能法医毒理学工作在警察实验室进行。然而,至少目前,尽管国防军和警察中的制服人员也存在药物滥用现象,但严格控制的工作场所尿液药物检测并未实施。多年来,作者一直在向日本法医毒理学家介绍西方法医毒理学指南和建议,这些指南和建议在西方法医毒理学家的帮助下被翻译成了日语。西方法医毒理学实践处于先进阶段,而日本的实践则处于危急状况,存在许多有待解决的问题,警察实验室的尿液药物检测就是一个例子。在所有案件中,尽管可供检测的尿液样本初始体积为30至50毫升,但从来没有留下任何样本供辩方重新检测。只有一个机构负责从采样到报告的所有工作,此外,母体药物及其代谢物没有进行定量分析。很明显,警察实验室没有按照良好实验室规范开展工作,也没有质量手册或标准操作程序手册。日本法医毒理学实践现在必须进行根本性变革。作者强烈建议,首先,日本毒理学家应根据西方模式制定法医毒理学指南。这些指南将推动法医毒理学实验室实现以下目标:1)拥有成文的良好实验室规范标准;2)拥有包括质量手册和标准操作程序手册在内的质量控制体系;3)通过自身内部努力以及基于外部能力验证计划结果采取的适当纠正措施,在一定程度上强制实施质量保证。对于法医毒理学家而言,这意味着他们应:1)负责确保实验室操作在令人满意的条件下进行;2)需要获得法医毒理学专家认证,以证明其法医毒理学能力。就政府而言,应:1)进行与法医毒理学相关的行政改革;2)简化获取认证参考材料的程序;3)至少针对与执法相关的政府雇员,引入严格的工作场所尿液药物检测计划。当所有这些目标实现后,日本法医毒理学将能够在实践中履行其对社会的责任这一具体目标就将达成。

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