Lunetta Philippe, Smith Gordon S, Penttila Antti, Sajantila Antti
Department of Forensic Medicine, P.O. Box 40 (Kytösuontie 11), University of Helsinki, 00300-Helsinki, Finland.
Med Sci Law. 2003 Jul;43(3):207-14. doi: 10.1258/rsmmsl.43.3.207.
Drowning is one of the leading causes of death when the manner of death remains undetermined. In the present study, we examined the epidemiological and medico-legal profile of 276 undetermined deaths (M:F=3.4:1; mean age 41.9+/-16.0 SD) among 1,707 consecutive bodies found in water and autopsied at the Department of Forensic Medicine, University of Helsinki, from 1976 to 2000. We also describe the differences between the police investigator's initial opinion and the forensic pathologist's death certification, and the different approaches among forensic pathologists when determining the cause of death. There was considerable variation among individual pathologists in the percentage of deaths considered undetermined but these differences were not significantly related to their level of training. Medico-legal training should focus on a standardised diagnostic approach to borderline cases, in which essential factors in determining the manner of death are often ambiguous.
当死亡方式仍无法确定时，溺水是主要死因之一。在本研究中，我们调查了1976年至2000年期间在赫尔辛基大学法医学系对1707具在水中发现并进行尸检的连续尸体中276例死因不明的案例（男:女 = 3.4:1；平均年龄41.9±16.0标准差）的流行病学和法医学特征。我们还描述了警方调查员的初步意见与法医病理学家的死亡证明之间的差异，以及法医病理学家在确定死因时的不同方法。在将死亡判定为不明的比例方面，个别病理学家之间存在相当大的差异，但这些差异与他们的培训水平没有显著关系。法医学培训应侧重于对临界案例采用标准化的诊断方法，在这类案例中，确定死亡方式的关键因素往往模糊不清。
