Masters Degrees (Forensic Medicine)

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Browsing Masters Degrees (Forensic Medicine) by Subject "Dissertations -- Medicine"

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    Opname van opinie van regslui ten opsigte van doeltreffendheid van geregtelike post mortems in die Wes-Kaap
    (Stellenbosch : Stellenbosch University, 2001) Pienaar, J. P.; Brouwer, I. G.; Barnes, J.; Stellenbosch University. Faculty of Medicine & Health Sciences. Dept. of Pathology. Forensic Medicine.
    ENGLISH ABSTRACT: The main purpose in doing forensic post mortems is to supply information to the judicial system. Medical personnel involved in doing post mortems seldom get feedback regarding efficiency. Numerous allegations have been made regarding the work of district surgeons in terms of forensic post mortems, often suggesting that the work is substandard. In South Africa district surgeons do post mortems mostly in the rural areas, and training centre personnel do forensic post mortems in urban areas. Training centre personnel include specialized forensic pathologists, registrars and medical officers working in the Departments of Forensic Medicine, affiliated to universities. The South African Police Service mostly manages government mortuaries. The South African forensic medico-legal system is unique, and does not correspond in with the four main systems used worldwide. Research was done by sending 200 questionnaires to a representative group from the legal fraternity of the Western Cape (including judges / magistrates, state prosecutors, private lawyers) and also the South African Police Service investigating officers. The judiciary, as the users of the information generated through forensic post mortems, are therefore in a suitable position to determine the efficacy of forensic post mortem. The questionnaire was structured to determine the general perception, as well as comments, regarding 9 different aspects involved with doing forensic post mortems. These include the thoroughness and completeness of reports, standard of academic knowledge, efficacy of verbal testimony in court, length of time in releasing the report, general attitude, efficacy of sketches and diagrams, efficacy of photography, sufficient taking of toxicology samples and sufficient utilization of special laboratory investigations. The last question was an open question to allow for general comments and anecdotes. For each aspect it was also determined whether there was a difference in efficacy noted between the two groups. The effect of this, if any, on the judicial criminal justice system was also assessed. A different questionnaire was sent out to all forensic pathologists in the Western Cape. The standard of work of the district surgeons was hereby assessed. General comment regarding academic knowledge, and findings at post mortem made by district surgeons was assessed. The pathologists were also questioned regarding the general attitude of district surgeons, and imput were asked regarding continued medical education programs. An area for general comment was also supplied. The main findings were as follows: a. The legal fraternity in the Western Cape is generally satisfied with the efficiency of forensic post mortems, except the use of laboratory investigations and also the length of time to release reports. b. The legal fraternity could determine a difference in the efficiency of post mortems done by district surgeons and training centre personnel. Training centre personnel were generally regarded as more effective. c. The difference between the two groups, due to ineffective district surgeon post mortems, had a negative effect on the criminal justice system. The following recommendations were made: a. Training centre personnel: Serious consideration should be given to appointing qualified forensic pathologists in the rural areas. Training centre personnel should also be more involved in training the district surgeons. b. District surgeons: The training, re-training and continued medical education of district surgeons in the Western Cape should be prioritized. The service conditions should also be reviewed. c. Administrative: Audit of post mortem reports. The efficiency regarding court appearances should be audited through the Department of Justice. Administrative power will be necessary to oversee the above-mentioned recommendations.
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    Sudden and unexpected deaths in adults : an investigation of cases reported to Tygerberg Forensic Pathology Services from January 2001 - December 2005
    (Stellenbosch : University of Stellenbosch, 2010-12) Tiemensma, Marianne; Burger, Elsie Helena; University of Stellenbosch. Faculty of Health Sciences. Dept. of Pathology. Forensic Medicine.
    ENGLISH ABSTRACT: Background - The workload of the forensic pathologist and Forensic Pathology Services staff is increased by the referral of potentially unnecessary natural cases to the Forensic Pathology Services. The primary aims of the medico-legal autopsy are limited to establishing a cause of death in presumed unnatural cases, and to exclude criminality or negligence. Objective – To determine the final outcomes of forensic post-mortem examinations in “sudden and unexpected” adult deaths over a 5 year period. Methods - An observational, retrospective, descriptive study was conducted. ”Sudden and unexpected” adult deaths referred to Tygerberg Forensic Pathology Services between 1 January 2001 and 31 December 2005 were reviewed. Data was collected from the autopsy reports, contemporaneous notes and hospital records. Findings – A total of 816 adult cases of sudden and unexpected death were referred to Tygerberg Forensic Pathology Services over the 5 year period studied. Complete autopsies had been performed in 74% (601/816) of cases. The presumed manner of death was natural in 79 % of cases, and an increase in the number of natural cases autopsied per year was noted over the 5-year study period. Diseases of the cardiovascular, respiratory and central nervous systems were responsible for the majority of natural deaths. Infectious diseases were responsible for most deaths in the youngest age group studied (18-29 years). Acute alcohol poisoning was responsible for the deaths of 35 (6%) cases, with an average blood alcohol concentration of 0.38g/100mL in these cases. Eight deaths were drug-/substance related. Waiting times for blood alcohol and toxicology results increased over the 5-year study period. No cause of death was found in 10.6% of cases. Conclusions -The questionnaire and interviewing structure could possibly be improved in order to obtain better pre-autopsy information and to reduce the number of “unnecessary” medicolegal autopsies, thereby reducing the burden of cost on the Forensic Pathology Services.