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法医分类学、定义、范围及作用的多样性综述:对循证实践的启示

A review of the diversity in taxonomy, definitions, scope, and roles in forensic medicine: implications for evidence-based practice.

作者信息

Meilia Putri Dianita Ika, Freeman Michael D, Zeegers Maurice P

机构信息

Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center+, Universiteitssingel 40, 6229, ER, Maastricht, the Netherlands.

Department of Forensic Medicine and Medicolegal Studies, Faculty of Medicine, University of Indonesia, Jl. Salemba Raya No. 4, Salemba, Jakarta Pusat, 10430, Indonesia.

出版信息

Forensic Sci Med Pathol. 2018 Dec;14(4):460-468. doi: 10.1007/s12024-018-0031-6. Epub 2018 Oct 2.

Abstract

The scope, roles, and tasks of forensic medicine and forensic medical experts currently vary widely between countries and legal systems, which has resulted in barriers to organization, standard setting, and quality assurance for practice in forensic medicine, including for reporting. The legal fact finder is thus confronted with variability in the quality, structure, and content of forensic medical reports. We sought to define and categorize the scope, methods, and practices that fall under the description of forensic medicine, the various issues encountered in current forensic medical practice, and the potential role of evidence-based practice in forensic medicine. We searched electronic databases and reviewed relevant articles, as well as conducting personal correspondences with forensic medical practitioners around the world, to obtain a description of current forensic medical practice. The terms forensic medicine, legal medicine, medical jurisprudence, medico-legal services, forensic pathology, and clinical forensic medicine are used with mixed interpretations in different countries. The systems and services rendered are not uniform either. The methods used by forensic medical practitioners are not always evidence-based, or based on standardized methods, and vary greatly between experts and centers. There are also no universally accepted guidelines to prepare a standard and admissible report. The lack of a uniform system in forensic medicine creates difficulties in assessing the development and performance of forensic medicine as a distinct discipline. To prepare evidence-based forensic medical reports, generally accepted guidelines are necessary.

摘要

目前,法医学及法医专家的范围、角色和任务在不同国家和法律体系之间差异很大,这给法医学实践(包括报告撰写)的组织、标准制定和质量保证带来了障碍。因此,法律事实认定者面临着法医报告在质量、结构和内容方面的差异。我们试图对属于法医学范畴的范围、方法和实践进行定义和分类,梳理当前法医学实践中遇到的各种问题,以及循证实践在法医学中的潜在作用。我们检索了电子数据库,查阅了相关文章,并与世界各地的法医从业者进行了个人通信,以了解当前法医学实践的情况。在不同国家,“法医学”“法医科学”“法医学理学”“法医学服务”“法医病理学”和“临床法医学”等术语的解释各不相同。所提供的系统和服务也不统一。法医从业者使用的方法并不总是基于证据或标准化方法,而且专家和中心之间差异很大。也没有普遍接受的准则来编写标准且可采信的报告。法医学缺乏统一的体系,这给评估法医学作为一门独立学科的发展和表现带来了困难。要撰写基于证据的法医报告,普遍接受的准则是必要的。

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