Ong Beng Beng, Milne Nathan
Forensic Pathology, Queensland Health Scientific Services, 39 Kessels Road, Cooper Plains, QLD, 4108, Australia,
Forensic Sci Med Pathol. 2007 Sep;3(3):188-93. doi: 10.1007/s12024-007-0021-6. Epub 2007 Oct 2.
A complete post-mortem examination is required in most medicolegal investigation systems. Though uncommon, some jurisdictions allow limited post-mortem examination if it is adequate to fulfil the death inquiries. One such jurisdiction is the state of Queensland with the commencement of the new Coroners Act. It permits the Coroner to order limited post-mortem examination confined to a specific region or regions of the body based on the circumstances received from the investigating police.There is a paucity of literature comparing the completeness of limited post-mortem examination compared with complete examination. We aim to study whether limited post-mortem examination can partially replace complete examination in specific circumstances. Archival post-mortem reports with history are obtained. Cases where obvious complete post-mortem examination is required [e.g., sudden infant death syndrome (SIDS), homicide, medicolegal hospital cases, pregnancy deaths], decomposed and skeletonized cases are excluded from the study. The region or regions (head, neck, chest, or abdomen) most appropriate for examination are derived from studying the circumstances given.Three hundred and fifty-one cases were reviewed, of which 136 were found to be suitable to be incorporated into the study. Discrepancies were present in 17.7% (n = 24) of the cases (15 cases due to different cause of death, seven due to changes in interpretation, and two where pathology may be significant to the family). When classified according to mode of death, the percentages were 46.4%, 11.1%, and 9.3% for the accident, natural, and suicide groups, respectively. When compared to region examined, the discrepancies were 9 out of 18 for head, 1 out of 20 for neck, 5 out of 70 for chest, none of out 2 for extremities, and 3 out of 4 for abdomen.The study showed a significantly high percentage of discrepancies when limited post-mortem examination was performed. The missed information may impede medicolegal inquiries, police investigation, and interfere with the course of justice. Significant information about familial disease may be missed.
在大多数法医学调查系统中,都需要进行完整的尸检。虽然不常见,但有些司法管辖区允许在尸检足以满足死因调查需求时进行有限的尸检。昆士兰州随着新《死因裁判官法》的生效就是这样一个司法管辖区。它允许死因裁判官根据从调查警方获得的情况,下令对仅限于身体的一个或多个特定区域进行有限的尸检。与完整尸检相比,比较有限尸检完整性的文献很少。我们旨在研究在特定情况下,有限尸检是否可以部分替代完整尸检。获取了有病史的存档尸检报告。明显需要进行完整尸检的病例(如婴儿猝死综合征、凶杀案、法医学医院病例、妊娠死亡)、尸体已腐烂和已成骨架的病例被排除在研究之外。通过研究给定的情况来确定最适合检查的一个或多个区域(头部、颈部、胸部或腹部)。共审查了351例病例,其中136例被认为适合纳入研究。17.7%(n = 24)的病例存在差异(15例是由于死因不同,7例是由于解释变化,2例是病理学可能对家属有重大意义)。按死亡方式分类时,意外、自然和自杀组的差异百分比分别为46.4%、11.1%和9.3%。与检查区域相比,头部18例中有9例存在差异,颈部20例中有1例,胸部70例中有5例,四肢2例中无差异,腹部4例中有3例。研究表明,进行有限尸检时差异比例显著较高。遗漏的信息可能会妨碍法医学调查、警方侦查,并干扰司法程序。可能会遗漏有关家族性疾病的重要信息。