Lecture 2

Legislative bases AND nSTRUCTURE of FORENSIC medicAl examination in Ukraine .

FORENSIC AUTOPSY

This chapter introduces the field of nexpertise in which the law and medical science interface: legal medicine. Enormous nopportunities exist in this relatively little known but burgeoning scientific narea. However, the sacrifices necessary to become an expert in legal medicine nare considerable. To be truly qualified, a person must earn degrees in a nscientific specialty and law. Once the person has obtained the requisite ncredentials, battle must be done with anachronistic political systems and nmethods of investigation in order to use the hard-learned modern techniques.

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The picture is not, however, bleak. nSubstantial and satisfying rewards accrue to the successful practitioner. The nmedicolegal expert will be increasingly in the forefront as society grapples nwith the wide multiplicity of new problems encompassed by this discipline. Only nwith the combined knowledge of the medical and legal professions can these nproblems be solved.

Investigative nSystems

To one degree or another, all ncivilizations have recognized the need for medicolegal investigation in their ncivil and criminal justice systems.

The Code of nHammurabi, written in 2200 B.C., dealt in part with what is now ncalled medical nmalpractice.

 

The ancient Egyptians developed a system nto determine whether a death was natural and what its causes were. The Chinese ncompiled a volume titled Hsi Yuan Lu(the washing away of the wrong), ndescribing different procedures for investigating suspicious deaths.

 

In the Middle Ages, nmedicolegal investigation developed within two major systems. In continental Europe, medicolegal investigation always maintained nitself free from political influence; objectivity and true expertise were nmaximized by the resultant autonomy of the discipline. By the eighteenth and nnineteenth centuries, many European universities developed curricula in legal nmedicine. In sharp contrast, the English system of medicolegal investigatiowas always an integral part of the political system. The office of coroner was nestablished in 1194. Although initially not one of its functions, the ninvestigation of death soon became a function of the coroner. For a time the duty was usurped by the justices of the peace but nwas reacquired in late nineteenth century. At that time the njurisdiction, which continues today, was first defined, and the coroner was to ninvestigate the sudden, violent, or unnatural deaths and all deaths of nprisoners.

 

Exercising their early numerical superiority in the n“new land”, the English established the coroner system in the U.S. The heritage of being related nto government naturally caused the coroner’s position in the democratic U.S. nto be an elected one. In many instances this has been unfortunate. Few njurisdictions have any requirement for this office. Therefore, a large number nof elected coroners often have absolutely no legal or medical qualifications! nFurthermore, some of the above-mentioned anachronisms can be attributed to npolitical influence in coroner’s positions. As in many areas where government nis involved, the coroner’s office is slow to change. By not adopting rapidly nchanging science and technology, coroners do not provide all the knowledge and nservices that modern forensic science can provide. This inherent inertia found nin many elected coroner systems is compounded by the fact that even if lay ncoroners were so disposed, most of them simply lack the background to master nexisting technology, let alone emerging techniques.

Starting in Suffolk nCounty in Massachusetts nin 1877, and New York City nin 1915, the antiquated, politically oriented coroner system has been slowly nyielding to the more appropriate medical examiner system, which is patterned nafter the nonpolitical European systems of objective scientific investigation. nMedical examiners are appointed rather than elected and must have certain professional nqualifications. In fact, under most state laws modern medical examiner systems nare professionally oriented nonpolitical offices, headed by board-certified nforensic pathologists.

The Model Medical nExaminer’s Act , npromulgated by the National Municipal League with the help of Dr. Richard Ford n(then Medical Examiner of Suffolk County, Boston), ndescribed the role of the medical examiner. Jurisdiction is to be assumed iall cases of sudden, violent, suspicious, unexpected, unexplained, and medically nunattended deaths. Medical examiners also assume jurisdiction in cases of nperioperative deaths, fatalities occurring in industrial employment, all motor nvehicular accidents, and all deaths arising from known, suspected, or alleged ncriminal acts.

It is truly a travesty of justice to allow so crucial na position to be staffed by people untrained in the complex and ever-expanding nfield of forensic pathology. Fully half of the elected coroners in the U.S. nhave no scientific background.

Examining the earlier mentioned jurisdiction of nmedical examiners and even coroners, it becomes apparent just how important and ncomplex medicolegal investigations can be. Two examples will illustrate the nimpact of a coroner’s or a medical examiner’s findings.

In December 1970, 38 coal miners died in an explosioin the Hyden Mine disaster in Leslie County, Kentucky. A physician at the scene nof the accident determined that five of the miners survived the initial nexplosion and later succumbed to carbon monoxide poisoning. However, the nphysician’s findings were never admitted into evidence because she was not ncalled to testify. Instead, the findings of the Leslie County ncoroner were heard at the hearing conducted by the U.S. Bureau of Mines. The ncoroner, a funeral-home operator, listed all the deaths as resulting from the noriginal explosion. The significance of the disparity between the physician’s nand the coroner’s findings came out at the hearing: the mine’s operators had nnot supplied their employees with adequate “self-rescuers”, which are small gas nmasks that give the wearer about an hour’s extra breathing time. Had the ndoctor’s testimony been admitted, the mine operators may well have faced ncriminal sanctions for their failure.

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Such testimony would have strongly indicated the npropriety of an action in tort for wrongful death, pain and suffering of the ntrapped miners, and other civil damages. A more famous example of the nconsequences of a poor medicolegal investigation occurred after the nassassination of President Kennedy; in my opinion, a woefully inadequate nautopsy was performed on the President’s body, and the entire postmortem report nis a textbook example of how not to conduct a medicolegal investigation. It nmust be noted that simply changing the system from that of a coroner to a nmedical examiner does not guarantee expert service; nor should it be assumed nthat the coroner system precludes the highest grade of medicolegal ninvestigation. Cuyahoga County in Ohio (Cleveland) and Allegheny nCounty in Pennsylvania n(Pittsburgh) nare examples of well run medicolegal investigative units that still function as nelected coroner’s systems.

The thrust of the above discussion of coroner vs. nmedical examiner is that the coroner system offers less probability that the nneeded forensic experts will be provided. Causes of death have become as subtle nand complex as society itself. Only a medically trained person has the nexpertise required to function competently in the position of either medical nexaminer or coroner. Going one necessary step further, the medical nexaminer/coroner must also be well versed in the law in order to determine the nlegal cause of death, as physical and legal causes of death do not always ncoincide. The best solution is a medical examiner system headed by a qualified nforensic pathologist. The medical examiner should have broad authority to ndecide when he is to assume jurisdiction, rather than wait for another party to nrequest his intervention as is common in coroner systems. The medical examiner, nhowever, will be most even coroners, it becomes napparent just how important and complex medicolegal investigations can be. Two nexamples will illustrate the impact of a coroner’s or a medical examiner’s nfindings.

The importance of legal medicine is best understood by nattorneys. It has been estimated that 70 to 80% of all civil cases need some nmedical or scientific proof, either in pretrial preparation or expert testimony nin the courtroom.

 

Attorneys, insurance agencies, and government nconstantly need the unique expertise of forensic scientists. An aspiring nmedicolegal practitioner must realize, however, that educational background nalone will not meet the requirements of an effective expert witness. Command of nthe English language and the ability to clearly and simply present complicated nmedical findings are also essential. In addition, the desirable expert witness nwill express firm opinions on the witness stand; undue vacillation can be fatal nto a particular legal endeavor.

The most common and important forum for a medicolegal nexpert continues to be the criminal courtroom. The testimony of a forensic nexpert may be the determining factor in a case of homicide, involuntary nmanslaughter, voluntary manslaughter, first or second degree murder, or iother criminal actions. In a case in which I was involved, a man was charged nwith the serious crime of rape. Testing showed that the accused’s blood type nwas O, while the seminal fluid removed from the victim fell into a type AB group. nThese findings conclusively proved that the accused was not the rapist. nAlthough not always as dramatic, the forensic expert’s findings oftecontribute to the direction of a criminal trial.

As society grows more complex and new civil causes of naction appear, the demand for experts will continue to increase. Demand will nalso increase as forensic scientists enlarge their sphere of influence here, as nthey have in the industrial and environmental areas. The need for forensic nscientists is great; our task is to increase the available educational nopportunities and upgrade and then maintain the quality of available employment nopportunities.

The pathologist should have near prime access to the nscene of a suspicious death. The body should not be moved or touched by ninvestigating officers until the pathologist arrives. The only other persons nwho should approach the body are paramedics who have been called to ensure that nlife is extinct. Although prime consideration is given to preserving the scene nof a crime, this of course takes second place if there is any possibility that nthe victim is not dead and might benefit from emergency medical attention. nUnfortunately, paramedics tend to err on the side of finding signs of life noften when these signs are invisible to all others. This leads to conflicts nbetween paramedics and death investigators. As time progresses and the futility nof out-ofhospital cardio-pulmonary resuscitation of trauma victims becomes more nclearly understood, the paramedics will respond, fail to perceive signs of nlife, and then immediately leave the scene to the expert pathologist. The only nother investigating officer who should have priority over the pathologist is nthe photographer, and in many jurisdictions the detective officers and npathologists have a system worked out in advance to ensure that priorities are nin the right sequence.

At the scene the maifunction of the pathologist is to look and observe, making such notes and ntaking such photographs as are appropriate. Another function is to try to make nsome estimate of the time since death by feeling the body’s heat and degree of nstiffness and possibly by taking the temperature at the scene.

The pathologist usually has the responsibility of nmoving the body in order to look underneath at the previously covered surface. nSeeing that the body is properly transported to a mortuary without the loss of nany trace evidence or any interference that would negate the subsequent nexamination is usually the responsibility of the pathologist.

 

Legislative basis of forensic activities and nhistory of forensic medicine as a science

 

The Central Intelligence Agency (CIA) is the intelligence nagency of the United States government. It is an executive agency and reports ndirectly to the Director of National Intelligence, with responsibility for nproviding national security intelligence assessment to senior United States npolicymakers. Intelligence-gathering is performed by non-military commissioned ncivilian intelligence agents, many of whom are trained to avoid tactical nsituations. The CIA also oversees and sometimes engages in tactical and covert nactivities at the request of the President of the United States. Often, whesuch field operations are organized, the U.S. military or other warfare ntacticians carry these tactical operations out on behalf of the agency while nthe CIA oversees them. Although intelligence-gathering is the agency’s maiagenda, tactical divisions were established in the agency to carry out nemergency field operations that require immediate suppression or dismantling of na threat or weapon. The CIA’s headquarters is located in Langley, McLean, nFairfax County, Virginia, a few miles west of Washington, D.C..

 

The CIA succeeded the Office of Strategic Services (OSS), nformed during World War II to coordinate secret espionage activities against nthe Axis Powers for the branches of the United States Armed Forces. The nNational Security Act of 1947 established the CIA, affording it “no police nor law enforcement functions, either at home or abroad”. Through ninteragency cooperation, the CIA has secret locations. These locations are ncalled “lily pads” by the Air Force. The primary function of the CIA nis to collect information about foreign governments, corporations, and nindividuals, and to advise public policymakers, but it does conduct emergency ntactical operations and carries out covert operations, and exerts foreigpolitical influence through its tactical divisions, such as the Special nActivities Division.

 

There has been considerable criticism of the CIA relating nto: security and counterintelligence failures, failures in intelligence nanalysis, human rights concerns, external investigations and document releases, ninfluencing public opinion and law enforcement, drug trafficking, and lying to nCongress. Others, such as Eastern bloc defector Ion Mihai Pacepa, have defended nthe CIA as “by far the world’s best intelligence organization,” and nargued that CIA activities are subjected to scrutiny unprecedented among the nworld’s inThe CIA has an executive office and several agency-wide functions, nand four major directorates:

    The Directorate nof Intelligence, responsible for all-source intelligence research and analysis

    The National nClandestine Service, formerly the Directorate of Operations, which does clandestine nintelligence collection and covert action

    The Directorate nof Support

    The Directorate nof Science and Technology

 

Executive nOffice

 

The Director of the Central Intelligence Agency (D/CIA) nreports directly to the Director of National Intelligence (DNI); in practice, nhe deals with the DNI, Congress (usually via the Office of Congressional nAffairs), and the White House, while the Deputy Director is the internal nexecutive. The CIA has varying amounts of Congressional oversight, although nthat is principally a guidance role.

The Executive Office also facilitates the CIA’s support nof the U.S. military by providing it with infor

mation it gathers, receiving information from military nintelligence organizations, and cooperating on field activities. Two senior nexecutives have responsibility, one CIA-wide and one for the National nClandestine Service. The Associate Director for Military Support, a senior nmilitary officer, manages the relationship between the CIA and the Unified nCombatant Commands, who produce regional/operational intelligence and consume nnational intelligence; he is assisted by the Office of Military Affairs iproviding support to all branches of the military.

In the National Clandestine Services, an Associate Deputy nDirector for Operations for Military Affairs deals with specific clandestine nhuman-source intelligence and covert action in support of military operations.

The CIA also makes national-level intelligence available nto tactical organizations, usually to their all-source intelligence group.

Executive staff

Staff offices with several general responsibilities nreport to the Executive Office. The staff also gather information and thereport such information to the Executive Office.

General publications

The CIA’s Center for the Study of Intelligence maintains nthe Agency’s historical materials and promotes the study of intelligence as a nlegitimate discipline.

In 2002, the CIA’s School for Intelligence Analysis begapublishing the unclassified Kent Center Occasional Papers, aiming to offer n”an opportunity for intelligence professionals and interested ncolleagues—in an unofficial and unfettered vehicle—to debate and advance the ntheory and practice of intelligence analysis.”

General Counsel and Inspector General

Two offices advise the Director on legality and proper noperations. The Office of General Counsel advises the Director of the CIA oall legal matters relating to his role as CIA director and is the principal nsource of legal counsel for the CIA.

 

The Office of Inspector General promotes efficiency, neffectiveness, and accountability in the administration of Agency activities, nand seeks to prevent and detect fraud, waste, abuse, and mismanagement. The nInspector General, whose activities are independent of those of any other ncomponent in the Agency, reports directly to the Director of the CIA.

Influencing public opinion

See also: CIA influence on public opinion

The Office of Public Affairs is often in charge of ncreating state funded propegander for the masses. Such as the 9/11 counter nterror administration advises the Director of the CIA on all media, public npolicy, and employee communications issues relating to this person’s role. This noffice, among other functions, works with the entertainment industry.

Directorate of Intelligence

The Directorate of Intelligence produces all-source nintelligence investigation on key foreign and intercontenital issues relating nto powerful and sometimes anti-goverment sensitive topics. It has four regional nanalytic groups, six groups for transnational issues, and two support units.

Regional groups

There is an Office dedicated to Iraq, and regional nanalytical Offices covering:

    The Office of nMiddle East and North Africa Analysis (MENA)

    The Office of nSouth Asia Analysis (OSA)

    The Office of nRussian and European Analysis (OREA)

    The Office of nAsian Pacific, Latin American and African Analysis (APLAA)

 

Transnational groups

The Office of Terrorism Analysis supports the National nCounterterrorism Center in the Office of the Director of National Intelligence. nSee CIA transnational anti-terrorism activities.

The Office of Transnational Issues assesses perceived nexisting and emerging threats to US national security and provides the most nsenior policymakers, military planners, and law enforcement with analysis, nwarning, and crisis support.

The CIA Crime and Narcotics Center researches informatioon international crime for policymakers and the law enforcement community. As nthe CIA has no legal domestic police authority, it usually sends its analyses nto the FBI and other law enforcement organizations, such as the Drug nEnforcement Administration and the Bureau of Alcohol, Tobacco, and Firearms.

 

The Weapons Intelligence, Nonproliferation, and Arms nControl Center[35] provides intelligence support related to national and nnon-national threats, as well as supporting threat reduction and arms control. nIt receives the output of national technical means of verification.

The Counterintelligence Center Analysis Group identifies, nmonitors, and analyzes the efforts of foreign intelligence entities, both nnational and non-national, against US government interests. It works with FBI npersonnel in the National Counterintelligence Executive of the Director of nNational Intelligence.

The Information Operations Center Analysis Group. deals nwith threats to US computer systems. This unit supports DNI activities.

Support and general units

The Office of Collection Strategies and Analysis provides ncomprehensive intelligence collection expertise to the Directorate of nIntelligence, to senior Agency and Intelligence Community officials, and to key nnational policymakers.

The Office of Policy Support customizes Directorate of nIntelligence analysis and presents it to a wide variety of policy, law nenforcement, military, and foreign liaison recipients.

National Clandestine Service

Main article: National Clandestine Service

The National Clandestine Service (NCS; formerly the nDirectorate of Operations) is responsible for collecting foreign intelligence, nmainly from clandestine HUMINT sources, and covert action. The new name nreflects its having absorbed some Department of Defense HUMINT assets. The NCS nwas created in an attempt to end years of rivalry over influence, philosophy nand budget between the United States Department of Defense and the CIA. Ispite of this, the Department of Defense recently organized its own global nclandestine intelligence service, the Defense Clandestine Service, under the nDefense Intelligence Agency.

The precise present organization of the NCS is nclassified.

Directorate of Science and Technology

Main article: Directorate of Science & Technology

The Directorate of Science & Technology was nestablished to research, create, and manage technical collection disciplines and nequipment. Many of its innovations were transferred to other intelligence norganizations, or, as they became more overt, to the military services.

 

For example, the development of the U-2 high-altitude nreconnaissance aircraft was done in cooperation with the United States Air nForce. The U-2’s original mission was clandestine imagery intelligence over ndenied areas such as the Soviet Union. It was subsequently provided with nsignals intelligence and measurement and signature intelligence capabilities, nand is now operated by the Air Force.

 

Imagery intelligence collected by the U-2 and nreconnaissance satellites was analyzed by a DS&T organization called the nNational Photointerpretation Center (NPIC), which had analysts from both the nCIA and the military services. Subsequently, NPIC was transferred to the nNational Geospatial-Intelligence Agency (NGA).

The CIA has always shown a strong interest in how to use nadvances in technology to enhance its effectiveness. This interest has nhistorically had two primary goals:

    harnessing ntechniques for its own use

    countering any nnew intelligence technologies the Soviets might develop.

In 1999, the CIA created the venture capital firm nIn-Q-Tel to help fund and develop technologies of interest to the agency. It nhas long been the IC practice to contract for major development, such as nreconnaissance aircraft and satellites.

Directorate of Support

Main articles: Organizational structure of the Central nIntelligence Agency Directorate of Support and Directorate of Support

The Directorate of Support has organizational and nadministrative functions to significant units including:

    The Office of nSecurity

    The Office of nCommunications

    The Office of nInformation Technology

Training

The Office of Training begins with the Junior Officer nTraining program for new employees before going on to conducting courses in a nwide range of specialized professional disciplines. So that the initial course nmight be taken by employees who had not received final security clearance and nthus were not permitted unescorted access to the Headquarters building, a good ndeal of basic training has been given at office buildings in the urban areas of nArlington, Virginia.

 

For later stage of training of student operations nofficers, there is at least one classified training area at Camp Peary, near nWilliamsburg, Virginia. Students are selected, and their progress evaluated, iways derived from the OSS, published as the book Assessment of Men, Selectioof Personnel for the Office of Strategic Services intelligence agencies.

 

One of nthe tasks of the forensic medicine , as na specific branch of the medical science, is to get acquaint the future doctors with its bases and teach them  to nemploy conceived knowledge ipractical activity: to help law enforcement authorities and  law-court attached to dissection and assize nof crimes, directed mainly  against life, nhealth , person dignity and will. Though  those work in our country is nexecuted  overwhelmingly by nspecialists-forensic medical examiners, in accordance to prevailing legislatiothe investigation organs whether law-court can oblige to do a medical doctor examination the physician of any specialities irrespective of his desire and the faculty he finished. nForensic medical researches (examinations) are allowed to realize only by the doctors, but not the other medical workers.

Doctor entices to participation in nforensic medical researches only by ninvestigation organs, procurator’s office whether law-court. It is nprohibited to charge him any forensic medical nwork by other founding, organization whether nofficial person and leaders of medical nestablishments. Thats why for the doctor, ninvited as a medical expert, is necessary to have conception about system and inquest organs work organization,  previous outcome, about procurator’s office nfunction,  about judicial state nsystem,  about debts, rights, responsibility and expert competence.

In Ukraine struggle against  criminality is laid on inquest norgans,  organs of previous outcome, nprocurator’s office and law-court.

Inquest nOrgans.  Inquest   is a nkind of the previous investigation, which the inquest organs realize.  nInquest   organs – organs and nofficial persons, which face out necessary efficient-searching arrangements nwith view crime signs exposure  and persons, that it accomplished. nIn accordance to a. 101 Ukraine of CJC nthe inquests organs are : 1) militia; 2) organs of state safety; 3) the ncommanders of military parts, compounds, superiors of military nestablishments  –  in businesses about all  crimes, committed by subordinates by nservicemen and liable for military service under passing time of meeting by nthem; 4) superiors of correctional-labored founding   in businesses about crimes against fixed service carrying order;  5) organs nof state fire supervision   in businesses about conflagrations and nviolations of fire-fighting regulations; 6) organs of boundary guard   in businesses about violation of state nboundary; 7) captains of sea boats abiding nin distant swimming.

There nare two types of cargo: 1) in businesses, where the previous outcome is nobligatory, inquest, as elementary nstage of previous investigation, is in execution of the only pressing investigator actions (examination, search, detention, ninterrogation and etc.). after execution of those nactions criminal business goes to investigator ; 2) in criminal businesses nabout crimes, which do not present by oneself considerable social danger, an inquest is a nfull done previous investigation. After its noutflow criminal business on the strength nof public prosecutor is inherited into nlaw-court or ceases. Such inquest takes into date to 1 month. From previous noutcome an inquest differs in that way nthat a defender in inquest does not take part, business materials for nacquaintance to victim,  ncivil plaintiff,  civil ndefendant are not produced. There are some other distinctions. A supervision for ninquest legality realizes a public nprosecutor.

At 1995 in nUkraine nthe inquest workers functions is widened in the question of the pre-law-court materials preparatiofor protocol form. Protocol form of nmaterials preparations is a special form of npre-law-court process. Its gist nis that the materials collection on made ncrime without execution of investigator nactions (interrogation, search, taking of examination), and criminal business disturbs and considers a law-court. nEstablishment of the circumstances of realizable crime and materials about ndelinquent is holding by inquest organs by  reception of the explanations from ndelinquent, witnesses, victim. A term of pre-law-court materials preparatiofor protocol form lasts  nno more than 10 days.

Organs nof previous outcome. Previous noutcome is a kind of the previous investigation, which materializes for crime detection,  exposure criminals and comprehensive, full and objective research of the nall  business circumstances.  It is made by investigators, who carry out nall decisions about case and carry for them full responsibility. Iaccordance to a. 102 Ukraine CJC to norgans of previous outcomes belong: n1) investigators of procurator’s noffices; 2) investigation organs of internal cases; 3) investigator services of national safety.

Carrying of previous noutcome is necessary in all cases, except crimes, investigation of which limits nby inquest. In businesses of private accusation a previous noutcome whether inquest does not take place, except of the cases, when a npublic prosecutor accounts necessary to affect nsuch business. Usual term of previous outcome is 2 months. This date cabe continued by higher public nprosecutor, but no more, than for the 2 months. A supervision for legality of previous noutcome is realized by a public nprosecutor.

In tie nwith reforming of law enforcement authorities in April 1997 Ukraine President put his name nunder decree about creation of the National investigation bureau,  which is nsubordinate to President. It consists of n1,5 thousand. men and will nattend to only outcome. A Bureau should nwork from January the1st, 1998, however regulation nabout its activity is not learned by rote, financing, other nlegislative and organizational questions till 1.04.1998 are still not solved.

Procurator’s office is  norganizationally nindependent state-legal organ. It is nthe complete system, which compose General procurator’s office, procurator’s noffices ARE Crimea, regions, Kyiv and Sevastopol (on regional rights), other nprocurator’s offices equaled to them ninter-district, district, urban,,  and also nmilitary procurator’s offices. A highest system link is a General procurator’s noffice, which a General Ukraine public prosecutor heads.  The lower public prosecutors subordinate to higher, and all the public prosecutors nare to the General Ukraine public prosecutor subordinated.  Procurator’s office unity means, that it functions as independent central state norgan.

On the nprocurator’s office rely (a. 121 of nConstitution):

0        nsupporting of state accusation in nlaw-court. It is the important and responsible function of the procurator’s noffice in the struggle against ncriminality. Backing up state accusation prosecutor nas equal-in-rights takes npart in proofs examination, and in accusatory speech gives to law-court voice to its reasoning, as nfor application of criminal law and punishment measure to prisoner. In case, when attached to business nconsideration a public prosecutor will arrive to the conclusion, that givejudicial outcome do not bear out accusation prisoner he beholden to pass up the naccusation. Function of supporting the nstate accusation stipulates also public prosecutor participation in revision nof judicial decisions, using of narrangements to remove the law violations;

1        ncitizen interests representative office or state in law-court in cases definite by law. Under nthis a procurator’s office acts within the pale of authorities allotted to it and may apply to law-court for citizens rights defense,  and also nlegal state interests,  its organs, state enterprises and norganizations. A public prosecutor presents in nlaw-court his actions (statements). He can apply to suit supervision for observing laws attached to execution of njudicial decisions in criminal businesses, and also attached to application of other arrangements of the forced ndisposition, citizens associated with limitation of personal freedom.  nRealizing this function, a nprocurator’s office supports by charity nfor observing  laws in insulators of temporary holding, investigator isolators, quads, ncorrectional-laboured colonies, and also nin psychiatric hospitals with strict and reinforced supervision, because citizens remain nthe least protected from point of view of movement nof their rights and legal interests.

Proceeding from p.9 part nIV of the Ukraine Constitution,  before introduction laws into action regulating activity of the state norgans  for controlling  observing  nlaws, and before forming the system of pre-law-court outcome and nbringing into action  laws, that regulate its functioning, a procurator’s office also supervise upoobserving the laws by all organs, enterprises, founding, organizations, official npersons and citizens and investigation of acts containing the crime signs.

Arrest nthe person,  that had done a crime whether is nsuspected in its realization, search, naccused removals from post, transmission of criminal business, followed by ninquest organs whether previous noutcome into law-court and so on., can be nrealizable only by public prosecutor sanction.

The nPresident of Ukraine sets on general Ukraine public prosecutor post on consent of Supreme Soviet of Ukraine. Term of offices of General public prosecutor  is  n5 years. He can appropriate for the second ndate. The President of Ukraine retires general public prosecutor from the post nand   consent of Supreme Soviet is not nnecessary.

Organizatioand Ukraine nprocurator’s office organs activity order is determined nby law «About procurator’s office”.

Law-court  is the organ of judicial authority, which in according nwith a. 6 Ukraine Constitution acts irrespective of executive nand legislature branch of authority. The Exceptionally nlaw-courts face out forced authorities of state authority and in legal order acknowledge a person guilty into committed to crime and expose to him criminal npunishment. A law-court competence diffused on all  legislative nrelationships arising in state. While  realization of njustice judge is independent and submit nonly to the law. A Ukraine Constitution fastened off basic judges independence nguarantees,  among which important is new judges election order of all links by nSupreme Soviet and embrace by them  posts nwith no fixed term (exclusive of judges, which chair for the first time, and nalso judges of constitutional law-court).

New for realization of justice is participation in it npeople on the strength of juror. A Constitution does not indicate, which nbusinesses will consider for participation juror, that nwill be foreseen by separate law.

A nConstitution fastened off important law-courts organization principles: regionality nand specialization, local law-courts will be nat most approximate to population, and businesses of concrete categories will consider by competent judges.

Law-courts nof general jurisdiction are the operating district (urban) law-courts, ngarrisons courts martial, Supreme Law-court ARE Crimea, urban law-courts of  nKyiv and Sevastopol,  regions ncourts martial and militarily-sea forces, domains courts of arbitration, ARE nCrimea, Kyiv and Sevastopol, Higher court of arbitration, Supreme Ukraine nLaw-court.  These law-courts consider all npractical and administrative cases, civil, criminal, practical,  carried away by law nto their competence. The Judicial decisions gathering legal force, nare obligatory for all organs without exception of state authority, founding, nofficial persons, separate citizens and are subject to execution on the all territory of Ukraine.

Law-court nof first instance –  nlaw-court, which considers large majority, criminal and nadministrative businesses and may pass judgement whether decision on business. nThe Higher specialized law-courts are to be by appellate and cassation instance  for the nspecialized law-courts of lawer link. Supreme Ukraine Law-court is competent to nlook through any judicial law-courts decision of lower links. Into its turSupreme Law-court acts in Plenum storage of SL and specialized judicial ncolleges from separate cases categories.

By nConstitution the creation of extraordinary and special law-courts is nprohibited. This means also, that nobody can be lost of the  consideration of his business by that nlaw-court, to cognizance of which it is carried away by law. Any interferences with law-court activity on realization of njustice inhibits from and drags for oneself responsobility in obedience to nlegislation.

 Oath demands from judge  honestly and conscientiously face out ndebts, realizing justice, to submit to only law, to be objective and just. The nprofessional judge caot belong to political parties and trade unions, to ntake part in any political activity, to put arms round any paid posts whether nto execute any paid work, exclusive of scientific, teaching and creative.

Opost of judge can be recommended a citizen of Ukraine nnot younger 25 years, who has higher juridical education and work length of nservice in right industry not less than 3 years, resides in Ukraine not less than 10 years and nspeaks Ukrainian. The necessary condition for occupying the post of of judge iany law-court is  npassing the qualifying  nexamination. It is passed by the persons, who for the first time come nforward for chairing of gentlemen of robe. First chairing professional to ngentlemen of robe by date on 5 years materializes by Ukraine President.  The other gentlemen of robe, exclusive of njudges of Constitutional Ukraine Law-court,  are nchaired by Supreme Soviet of nUkraine with no fixed term.

Professional ngentlemen of robe and popular assessors are independent from nchairman and one from second in nresearch of proofs and reception of ndecisions for its own persuasion. A legal proceeding takes by judge personally, nby judges college whether njudge juror.

Basic legal proceeding features are: 1) nlegality; 2) equality of all participants of lawsuit in front of law and nlaw-court; 3) convincing of blame ntruth;  4) championship nof  sides and freedom in nassignment of law-court of its proofs nand into finishing in front of law-court of their cogency; 5) supporting the nstate accusation in law-court by npublic prosecutor; 6) guaranteeing to accused nrights on defense; 7) publicity of lawsuit for exclusion of cases, when this contraindicate to guard interests of state nsecret whether to person (eg, victim attached to raping) interests and nhis full fixing by technical methods; n8) guaranteeing of law-court decision appeal appellate and cassation,  exclusive of ncases, fixed by law; 9) law-court ndecisions necessarity.  Exists also na judges conference secret (a. 322 CJC of Ukraine).

Advocacy is na  voluntary leaguing lawyers n(advocates), which give help to citizens,  nenterprises,  establishments,  organizations,  founding, peasant associations etc. by dint nof: participation in previous outcome whether nlaw-court in defenders quality whether spokesmen; realization of nrepresentative office in law-court whether arbitration; assignment of nconsultations, advices, stowage of ndocuments of legal disposition and etc. Advocates go into college, which league nlawyers, that attend to advocate activity. Advocates ncommission creates its offices   legal naid bureaus. To structure and system of judicially-investigator organs advocacy has no attitude .

Now advocate admits to participation on criminal nbusiness from accusation producing moment,  nand in person detention once,  nsuspected in commitment of crime, or application of preservative narrangement in taking appearance under guard – from announcement moment to it protocol about detentions or decisions nabout application of preservative arrangement, but not later 24 hours from ndetention moment.

To any physician, nspecially to specialist in branch of nforensic medicine  – to forensic medical nexaminer, for conscious and correct execution of his debts is necessary to acquaint circumstantially with some juridical nregulations and that laws,  which are frequently to meet with in his practical activity. Expert within the nrange of his speciality must know separate regulatioof criminal, criminally-judicial, ncivil and civil-judicial Ukraine Codes.

The legal bases of  forensic-expert nactivity with view of justice guaranteeing by skilled and objective examinatio, independent, competent on maximum science and technique achievements. In it nis directed notion about judicial examination, are laid out principles of judicially-expert activity, are definite nthe persons, which can be the judicial nexperts, are regulated the basic debts, nrights and expert responsibility,  is foreseen the labour payment and its social defense etc.

Ninth part of n«Legislative Bases about health protection in Ukraine» is devoted to medical nexamination. Beside of medicolegal nloss examination and militarily-medical examination one of articles (a. 71) ncontains the general taking bases of nforensic medical and judicially-psychiatrical examination, and a. 73 is devoted nto alternative medical examination. Underlined, that organizational guidance services of the forensic medical and njudicially-psychiatrical examination realizes nthe Health Protection Ministry Ukraine, and an order and taking conditions of alternative medical nexamination is determined by the Ukraine nMinisters Study.

A systematized report of nlegal laws is contained in codes (Lat. codex is a book), which  are setted nand become firmly established by the nSupreme Soviet of Ukraine.

Criminal  Code  nUkraine (CC) – statute-book,  that ndetermine the reasons, conditions and principles of criminal responsibility, nsigns of socially dangerous acts (crimes) and punishment measure,  nwhich are to be employed to the guilty persons.  Each narticle of special part of CC (whether nits separate part) breaks down under disposition and nsanction. Article disposition is attributive part of law, which contains the nname and determination of the crime, its nsigns. A sanction is a punishment measure nfor the done crime, foreseen by law, responsibility measure for violation of disposition. For nexample, “a. 126. Offence, aforethought honour making and persodignity,  expressed  in nindecent form, is punished by correctional works on date to one year, or npenalty…  whether public nreproof”. Here disposition and sanction are parted between oneself by comma and dash.

From CC of Ukraine for the doctor is necessary to know the majority ndispositions from chapter articles 3 n”Crimes against life, health, will and person dignity “, because it contained the determination of such nnotions, as infanticide, raping, nhomosexuality, are laid out the ncriterions of the terrible, middle heaviness nand light corporal damages  netc., without which to give correcting forensic medical deductiois impossible.

Criminally-judicial nCode of Ukraine (CJC) – statute-book,  in which in nsystematized form are contained norms, nrules, regulating inquest organs activity,  nprevious outcome, procurator’s office and law-court on dissection of ncrimes, to setting, to exposure and to npunishment guilty, and which determine the rights and duties of all of nparticipants of criminal legal proceeding. Specially necessary for CJC article expert,  which determine the features nfor destination of examination (a. 75), cases, when it is ought to be nappointed obligatorily (a. 76), a. 77, where are brought the basic debts nand expert rights,  and also chapter n18 “Taking of examination”.

The CJC articles ndo not subdivide on parts. Is laid out  how the official npersons of law enforcement authorities whether nlaw-court should function,  not to disturb the law. For nexample, “a. 201. Expert Interrogation.  Acquainting with expert deduction,  investigator can interrogate aexpert with the aim to  receipt explanatiowhether addition to deduction. About nthe expert interrogation the protocol is made”.

Civil Code of Ukraine (ÑÑ) – statute-book,  in nwhich in concrete system are grouped nand disposed basic norms of civil rights, that regulate property and some personal nrelationships. CC contains nthe detailed regulations about legal capacity and citizens activity,   nprivate property,  nhire of housing workplaces, about legacy, about invention, purchase-sale, granting and etc.

Civil judicial Code of nUkraine (CJC) – statute-book nregulating a consideration order of civil businesses in law-court.

How skilled and nexperienced the investigator is, ninvestigating criminal business, he is not  able and must not be “encyclopaedist” in all  branches of science.  He can’t solve nspecial questions, for example, medical, technical, financial and economic.  nThat’s why in law, specifically in a. 75 CJC Ukraine,is foreseen, that “in cases, when for settlement nof concrete questions in the case  technical or other special scientific knowledges nare necessary,  examination is set”, nproofs research process with ndeductions country-house.  A Specialist, nwhich takes part in settlement of some nquestions, is called the expert.

According to the a. 1 of the nlaw of Ukraine “About forensic examination”, forensic examination is na research by expert on base of special knowledge of material objects, nphenomena and processes, which contain information about circumstanses, that abides in inquest organs investigation,  previous outcome whether law-court.

It is nuseful to know, that the specialist becomes the expert on given case only then, when there is a ndecision about this by investigation organs or law-court approval.  That’s why it is necessary to distinguish an expert as official person, nand expert – judicial figure. A doctor, nwhich occupies na regular post of forensic medical examiner, in ordered to be an expert on concrete business, must be in suitable nrank judicial formalized by decisioof investigation organs whether by nlaw-court approval about destination of forensic medical examination. A regular nforensic medical bureau expert of forensic medical examination is only aofficial person.

By written invitation of ninquest organs,  investigator, public prosecutor, nlaw-court may be fulfilled forensic nmedical researches and forensic medical examinations which has the aim to ndetect signs of crime,  which serve as a reason for violation of criminal case. If nsuch researches whether examination are made by doctors of medically-prophylactic founding, nthen, putting name to deduction, they are ought to name oneself correctly (name, surname), because he does not come forward in expert quality,  he nis not appointed as the expert on the case. Doctor, nthat is not in post of forensic medical examiner, but takes examination for decision of investigation organs whether by law-court approval,  is called n”doctor-expert”.

 

Forensic nmedicine is the subject nconcerned with the appli­cation of medical scientific knowledge to certaibranches of law, both civil and criminal. It is a special medical discipline nwhich studies and decides definite biological, medical and medico-cri­minalistic nquestions for requirements of law practice, legislation and health care. Ishort, it deals with medical aspects of law.

 

 

 

Forensic Medicine as a nspecial medical discipline investigates the following objects:

· Dead bodies;

· Alive persons (victims, the suffering, accused and other)

· Case materials (medical documents, forensic papers, investigator’s nmaterials);

· Material evidences of biological origin (blood, semen, saliva, hair netc.) and non biological origin (traumatic instru­ments)

The main task of the ndiscipline is to help the court of law court in disclosing crimes against humahealth and life. Forensic medicine plays a great role in health care because it npromotes better diagnostics and prophylactics of traumatism, poisonings, sudden death.

Research methods used in forensic nmedicine:

· General (materialistic)

· Morphological (autopsy, histological, cytological)

· Clinical (examination of victims)

· Immunological (investigation of biological fluids)

· Medico-criminalistic (X-ray examination, stereomicroscopy, ntrassological, inspection of scene of death etc.)

 

 

Structure nof forensic-medical service in Ukraine.

Ministry of Health Care nguides medico-legal service in Ukraine. nUkrainian forensic service is based on the instance principle and submitted by na great network of the special medico-legal establi­sh­ments known as the nBureaus of Forensic-Medical Examination. There are 27 forensic bureaus in Ukraine itotal. Instance principle consists of 3 levels in the structure of the service. nThe 1st instance is formed by the experts fulfilling their duties in the towns nand districts of Ukraine. nThe heads of medico-legal service in the regions, the republican expert of nAutonomic Republic of Crimea, and the major medico-legal expert of Kiev and Sevastopol nguide forensic medical service in these territories and make the 2nd instance. nThe Main medico-legal expert of the Ministry of Health Care guides all forensic nmedical service in Ukraine nand represents the 3rd instance, and leads the Main Medico-legal Bureau of nUkraine as well.

Every Bureau of Forensic nMedical Examination consists of the following basic departments:

· Department of examination of dead bodies;

· Department of examination of alive persons;

· Department of commission examination;

· Department of examination of material evidences (forensic medical nlaboratory);

Article 75 CPC of Ukraine: n«Examination is assigned when scientific, technical or other kinds of special nknowledge are necessary for decision on certain investigation cases.»

Forensic examination — nis a research by an expert on the basis of special knowledge of material nobjects, phenomena and processes in which there is information about ncircumstances of the case. Shortly it means practical activity of an expert.

Article 242 CPC of Ukraine: n«Examination is necessary» in the following cases:

· To determine the cause of death;

· To determine the degree of severity;

· To determine the psychiatric status (mental condition);

· To determine the sexual status of a victim

· To determine the age (as referred to criminal liability).

Forensic medical examination — is the kind of forensic examination assigned to nanswer special medical questions which can occur in practical activity of njudicial bodies or court. It is only performed under an official writtesanction of an inves­tigator or judge.

Rights of forensic medical expert:

· to get acquainted with the case materials;

· to apply for additional resources, nnecessary to draw a conclusion;

· to question the court, the lawyer, the naccused and the witnesses;

· to be present during interrogation (with nthe sanction of the person making inquiry);

· to question the interrogated persons;

· if other experts are invited for a judicial nsitting, they can confer with each other and make a common conclusion;

· to consult experts of all medical branches;

· to receive a compensation for expertise nservices (in definite cases);

· to refuse of examination:

— if the questions aren’t related to his competence;

— if nthe case materials are insufficient for investigation;

— if nan expert does not have necessary knowledge to complete the examination.

Independence of a forensic medical expert. It is com­monly guaranteed in Ukraine by the followings:

· legislative order of the assignment of a nforensic expert;

· general independence of all forensic nestablishments in relation to law court or police departments;

· presence of all participants involved into nlaw sitting during forensic examination (in cases allowed by Ukrainialegislation);

· criminal responsibility of forensic medical nexperts.

Responsibility of a forensic medical nexpert:

According to CC of Ukraine ncriminal liability of a forensic expert is forecasted in the following cases:

· Refusal of the expert to perform his duties (Article 385);

· Disclosure of information about the investigation or inquiry (Article n387);

· Knowingly false testimony (Article 384).

In title a. 76 CJC Ukraine about obligatory nexamination destinatioot indicated “forensic medical examination”, nhowever all 5 points of this law bear nupon medicine. From here follows exceptionally important sense of forensic nmedical examination as one of proof nappearances in investigation whether judicial processes attached to ninvestigation of crimes, directed against life, health, will and persodignity.

A nForensic medical examiner whether doctor-expert nhave concrete legal status, definite by Ukraine Law “About njudicial examination” and criminal, criminally-judicial and civil judicial nCodes of Ukraine.  To him belongs the debts, rights and expert responsibility,  that compose as whole his judicial position. If keep together the nlegal expert activities, cret;

in case of misinterpretation of expert deductions by one nof sides to declare about this to law-court;

to give consultations to workers of law enforcement nauthorities whether law-court on the nsubject of examination.

 

However by highest expert responsibility measure is nmoral responsibility, heartfelt responsibility internal, in front of oneself, nin front of its conscience.

A Criminally-judicial Ukraine ncode provides for circumstances excluding nan expert participation possibility from criminal legal proceeding. an expert Demurrer is making away him nfrom execution of examination or participation in business. For law a demurrer can be realizable in such cases: if expert is victim, witness, civil plaintiff or civil defendant obusiness; if he is relative to victim,  accused, advocate, investigator nand other persons being a party to case; if expert is found in official whether nmaterial dependence on process participants,  nand on the contrary, if process nparticipants are found in such dependence on it; if appears nexpert incompetence.  Asking nabout demurrer of expert. decides a person, which takes nan inquest, investigation, public prosecutor, and from law-court -judge whether law-court, which leads the case. nPrevious expert participation on business in nspecialist quality attached to troupe nexamination in adventure place go oto be the  reason for demurrer.

Types of assignment of nforensic-medical examination in Ukraine:

 

 

· Official — is provided by a forensic pathologist of the Bureau of nMedico-Legal Examination. Such a specialist is named as a forensic-medical nexpert (widely spread).

· Free examination — is assigned in cases when there are no nopportunities to involve a forensic pathologist, therefore, any doctor can be nengaged by the inspector or court to perform the examination (rarely).

Kinds of medico-legal nexamination:

· Individual — is performed only by one expert and it can be initial nand additional;

— Initial — is fulfilled nfirstly;

— Additional — is ncarried out in cases of incomplete initial examination, also with the nappearance of new data of preliminary investigation;

· Repeated examination — if the conclusions of the initial exami­natiois inconsistent or doubtful (it is performed by another expert);

· Commission — takes place in difficult criminal cases with nparticipation of several specialists in medical field (not only nforensic-medical experts but doctors of different medical specialties caassist with the examination also);

· Complex — is carried out with the participation of experts of ndifferent branches of knowledge (criminalists, toxicologists, technicians netc.).

Previous n(primary) examination is  nmedical examination with stowage nof expert deductions for its results. nPrimary research often is and ndefinitive. Primeval examination can be nheld for one moment (research of nobject is deduction) and for two moments n(research of object is taking of laboratory analyses, specialists consultation etc. – deduction).

Additional examination is set nin cases, when primary examination was nincomplete, when insufficiently clearly are laid nout deductions, are not reflected nanswers on all question of the investigator, nnot all of objects were explored, and also when during previous outcome are opened the new medical whether investigator ndata, not taken to account attached to ntaking of primeval examination. Expert nin such cases specifies or broadens before done deductions. Additional examination is charged  nto the same or other expert.

Repeated examination is set nfor settlement of the same questions and usually is bottomed on research of the nsame objects, that primeval examination, but takes nin cases of unreasoned conclusion by nexpert, when primary examination was. insufficiently skilled, brings on scruples in its objectivity, loyalty, controversy to other proofs, which are in business and etc. Such examination is noften charged to some other experts n(commissions) and caot be taken by nexpert, which faced out primeval examination. For example, if primary nexamination on given business took by ninter-district forensic medical examiner, then second is charged to nregional forensic medical examiner, and etc.

Commission examination – is the examination, which is taken by few experts (by commission) for nsettlement of the one  nquestion.  Into commission enter the specialists of one professio(doctors), one or different specialities. Commission examination takes in ncomplicated cases, when an expert caot give answer on put questions. nConsequently, forensic medical examinations: 1) in businesses about attracting to ncriminal responsibility medical workers for professional delinquencies; 2) second, in nthat number for materials criminal whether ncivil cases; 3) on determination of ndegree of steady capacity loss;  4) nprimary in specially complicated cases n–should be ought to take for nparticipation of few experts and specialists. Commission belongs to face out also examinations of affected and artificial illnesses, nsuicides, members mutilation etc. Personal experts storage is determined by the bureau of forensic medical nexamination superior or his deputy, if nsuch storage not promoted to investigation whether nlaw-court.

Complex – nit is also commission examination, but nit is taken on one business by several nspecialists of different knowledge industries (professions). For example, obusiness about car-driveway adventure complex examination can take forensic medical examiner and engineer; nin case of fire wound – nforensic-medical expert, expert-criminalist and forensic chemist. Under this ncan be one general deduction, which nall of experts sign,  nor each specialist ncomposes and puts name to his deduction. Complex examination isn’t foreseen by njudicial norms.

Exclusive of realizatioof forensic medical examination a forensic medical examiner whether doctor-specialist can be invited by nperson taking an inquest, ninvestigation, public prosecutor for active participation in investigator actions :interrogation of some persons, in adventure place nexamination,  troupe examination in event place, in search, in recreation of nfurniture and event circumstances,  nwithdraval of proofs, troupe exhumation etc. In this case a doctor nwhether forensic medical examiner npersonate specialist in medicine nindustry,  help, consult investigation from nmedical questions.

For law attached to ninvestigation of crimes against life, health whether nman dignity,  nprofessional delinquencies of medical workers forensic medical nexaminer can take part in interrogations of accused nand other persons suspected, in nspecialist quality.  Under this expert nfrom investigator’permission  nwhether law-court caspecify in interrogated victim pose ninto infliction moment him the traumas and his nnext state, to clear up the concrete signs and trauma implement peculiarities etc. Doctor’ nhelp under time of previous outcome irreplaceable attached to victim interrogation from raping, attached to interrogation of suspected nperson attached to infanticide, nattached to investigation of criminal abortion and etc.

 Forensic medical examiner, being present on interrogation and actively nbeing a party to questions raising,  that behave to his competence, analysing testimony ninterrogated, contributes to setting nof new data, which supplement nmaterials and proofs on business.

Under investigation time nof criminal business with view crime traces exposure ndeath whether suspicion on it, attached to criminal abortion, raping and other crimes against life whether health. And forensic expert (whether nother doctor) participation in external ncorpse examination in its exposure place acknowledges a. 192 CJC Ukraine nis obligatory.

One of nthe important doctor’s tasks under nexamination time – to help investigation to find, to estimate, to fix, right withdraw nand to direct on research proofs, nwhich frequently have an important role in crime detection and crime exposure.

 Forensic medical examiner or doctor can be ninvited by investigator for participation in recreation of furniture and event n(in investigation experiment) circumstances with view verification of and nspecification of witness interrogation results,  nvictim, accused whether nsuspected as for trauma mechanism attached to falling nfrom height, transport trauma, blowing damages by sharp whether stupid objects and execution etc. Realization of these nactions admits attached to condition, when they do not derogate from persons ndignity participating in them,  and is not dangerous for their health. nAfter outflow of furniture recreatioinvestigation composes protocol, in nwhich the conditions lay out of its taking, amount of cut back experiments, nmotion of each from them and results.

Examinatioin law-court. Any examination, nin that number forensic medical., exclusive of taking nof it in act of previous investigation, can be fulfilled and in judicial nsitting.  Order of its bowing is definite nout by decision ¹3 of Plenum of Supreme Ukraine Law-court from may the 30th, 1997 y.  n“About judicial examination in criminal and civil nbusinesses”.

In decision is underlined, nthat the expert deduction does not have in advance fixed force and superiority nover other proofs sources,  is subject to nverification to estimation for internal law-court persuasion,  which is to be bottomed on full objective nconsideration comprehensive, of all of case circumstances in aggregate, that nthe law-courts have no authority to carry decision without taking of nexamination, if for examination destination law is obligatory. Is paid nattention on impermissability of examination destination in cases, wheclearing up of concrete circumstances does not need special knowledges, and nviolation in front of expert legal questions, settlement of which carried out nby law to law-court competence (specifically as for blame, diminished nresponsibility whether person incapacity and so on).

Taking of nexamination in law-court one should materialize with observing of regulations, nforeseen a. a. 310, 311 CJC, a. a. 57-61 and 190 Ukraine CLC.  Under this law-court ought: to clear up the ncircumstances being in right for  expert ndeduction; to offer  participants to npresent the written questions, which they care to affect in front of experts; nto declare these questions, and also questions, offered by law-court; to hear nparticipants thoughts of assize on the subject of given questions; in soviet nroom to deliberate all the questions, to turn out that from them going beyond nexpert competence scopes or do not bear upon article of telling, to formulate nthe questions, which he disturbs in front of expert from owinitiative, definitively to define circle questions, that dart out on settlement of examination, and nto take away approval (decision) about its ndestination; to declare from judicial sitting approval (decision) about ndestination of examination and to hand it nto expert; after taking researches by nexpert, stowage announcement of expert deduction to connect it to case; to interrogate an expert with nview elucidation of addition to his deduction. Determination of examination taking method is in expert competence.  nExpert’ deduction in law-court mounts the same as and on previous outcome. nDeduction copy trace to hand into forensic medical examination bureau for nregistration and keeping in archives. An expert’ interrogation in law-court with view of elucidation and naddition of deduction chronicles to judicial sitting (question of sides and nexpert answer ).

If to see out expert research in judicial sitting is impossibly, nlaw-court, being guided a. a. 273 and n310 Ukraine CJC,  takes away approval about taking of examination and directs it with necessary materials to njudicially-expert founding for execution in order, foreseen a. 198 CJC. Under this dependency on duration of nexpert researches and case complication a law-court is able to begin the interruption, or to lay aside audition of business, or to go ojudicial outcome and to inquire other proofs.

Being a party to nrecreation of furniture and event circumstances, doctor not only redounds to investigation with greater plenitude to face out these actions, nbut under this he frequently accords ninformation, meets with facts, which ngive him possibility in further more nscrupulously, with greater cogency to ngive answers on investigation’ nquestion, if to the doctor is charged nthe forensic medical examination whether nresearch. Sometimes solicitor about recreation of furniture disturbs himself doctor, whose, in pursuance of forensic medical examination, nsatisfies of impossibility to give exhaustive answers on question of outcome nwithout recreation of furniture and event circumstances.

Under taking time of investigator actions widely uses photographing, painting, tape-recorder records, cinema- whether video survey. As nparticipant of investigator actions doctor does not compose any documents reflecting his activity.

So-and-so,  being a party to investigation actions, the doctor ndoes not take forensic medical nexamination whether forensic medical nresearch, he is invited as specialist, nspecial knowledge of whom are enable to do investigator’ nactions more qualitative and more effective.

Organizatioof forensic medical service in different countries is various. There are three nbasic types of organizational bases nof forensic medical examination: free, juror and official.

If noutcome organs whether law-court in accordance to law can charge taking of examination to any doctor, nthat is free type of forensic nmedical examination. For such type is formed nforensic medical examination in many countries of Western Europe, Asia and America.

In some countries of Western Europe, for example – in France, exists a juror type, when the investigation norgans whether law-court in choice of nmedical expert are limited by special doctors n(on departments) list adopting oath, and which learned by rote by authority organs in experts quality.  Into nsuch lists drop in only the nspecialists, which accord with concrete demands as for nationality, nreligion, age, length of service, special preparation, property state and etc.

The most progressive ntype of forensic medical examination is official n(or state) examination, when almost all of researches is nfulfilled by specialists – by forensic medical examiners, which were naccorded special preparation and occupy nthe regular expert posts. In Ukraine nfunctions chiefly official forensic medical examination state,,  but meets still free, because not everywhere nregular experts posts busy with specialists on the strength of their ndeficiency, and it does not conflict nwith legislative country acts.

State (official) nforensic medical examination in Ukraine nhas a clear organizational structure and materializes nby three instances:

 

 

The I  instance is the urban, district and inter-district forensic nmedical examiners.  The district, ninter-district and urban experts of bridges nof regional submission head the suitable bureau compartments of forensic medical examination. The Posts of nforensic medical examiners are set nfrom computation: in towns – one post on 110-120 th. populations, in nvillage locality – one post on 2-3 regions, nin dependence on territory size and work volume;

The II  instance is the regional forensic medical examiners, republicaforensic medical examiner of Autonomous Republic of Crimea and elder forensic medical examiner of Kyiv. Now they are called the main specialists from nforensic medicine of health protection management of regional state nadministration, MHP ARE Crimea and Kyiv urban state administration;

       The (regional  bureau), in capital of Autonomous Republic Crimea (republican bureau) and in Kyiv (urban bureau and Maibureau of forensic medical examination of MHP of Ukraine). A Bureau of forensic nmedical examination head by the experts of second and third instances.  The bureau leaders are called the superiors.

Guidance by all forensic medical service of MHP of Ukraine also organizationally-methodical work laid on main forensic medical country examiner.

For service of military njustice organs in Military forces Ministry exists a system of forensic nmedical establishments, dirigible by main forensic medical examiner of nMinistry.

A bureau of forensic nmedical examination is a state medical founding, appointed to give special nscientifically-expert help to inquest organs,  nprevious outcome, to procurator’s office and to law-court in realization by them of law and order guard tasks and movement of legality attached to settlement of questions, which ncall for knowledges in branch of forensic medicine . A bureau consists of nfollowing structural subdivisions:

department nof forensic medical victims examination,  nsuspected, accused and other persons (out-patient’ clinic);

department nof forensic medical corpses examination (thanatological department or morgue) with forensic-histological department;

department nof forensic medical research of proofs (or forensic medical laboratory). To nlaboratory storage enter 4 compartments:

forensic nmedical immunology,

forensic nmedical cytology,

forensic nmedical criminalistics,

forensic medical toxicology;

district and inter-district departments; nurban departments (bridge of regional nsubmission);

administrative part and office.

Activity of forensic nmedical examination bureau is regulated by suitable ndepartmental regulations and ndirections.

From previous text nfollows, that forensic medical activity, as nno other work from medicine, in concrete measure nis regulated by legal whether nlegislative acts, because ought to submit nby general jurisprudence regulation.  Only attached to such condition medical ndeductions acquire provident and stand nat the same level with other proofs icases, which investigate by organs of previous outcome whether consider by law-court.

In Ukraine nforensic medical activity regulates by such official legislative documents, regulations, regulations whether directions:

By nUkraine n«Law About judicial examination” from February the 25, 1994 n.

By nUkraine nlegislation Bases about health protection from November the 19, 1992 .

By criminally-judicial nUkraine Code.

By criminally nUkraine Code.

By Civil-judicial Ukraine Codes.

By Directions about taking nof forensic medical examination of MHP of Ukraine.

By Regulations of forensic medical heaviness degree determination of corporal ndamages.

By taking nRegulations of forensic medical corpses examination (researches) in bureau of nforensic medical examination.

By taking Regulations nof forensic medical examinations (inspections) on the subject of sexual states nin bureau of forensic medical examination.

By taking nRegulations of forensic medical examinations (researches) of proofs in compartments nof forensic medical bureau criminalistics of forensic medical examination.

By taking nRegulations of forensic medical examinations (researches) of proofs in compartments nof forensic medical bureau toxicology of forensic medical examination.

By taking nRegulations of forensic medical examinations (researches) of proofs in compartments nforensic medical immunology of bureau nof forensic medical examination.

By nOther departmental documents.

Directions nabout bowing of forensic medical examination and all of examinations taking regulations out learned by rote by MHP order of Ukraine nfor ¹ 6 from January the 17, 1995 y. and from then act in Ukraine.

So-and-so,  in Ukraine nforensic medical doctor activity is nclearly regulated in legal attitude, his judicial state is marked by concrete ndebts, rights and responsibility. Exist different appearances and types of forensic medical nexamination. A forensic medical examiner whether ndoctor personate important positive attached to participation in concrete investigations action. Forensic nmedical service in Ukraine has a clear organizational nstructure, due to which gets along with work scope and its debts.

 

Block of Informatio(Terminology)

 

Forensic medicine is nthe subject concerned with the application of medical scientific knowledge to ncertain branches of law, both civil and criminal. It is a special medical ndiscipline which studies and decides definite biological, medical and nmedico-criminalistic questions for requirements of law practice, legislatioand health care. In short, it deals with medical aspects of law.

 

Such objects are ninvestigated by forensic medicine:

•        Dead bodies;

•        Alive persons (victims)

•        Case materials (medical documents, nforensic papers, investigator’s materials);

•        Material evidences of biological origin.

 

The main task of the ndiscipline is to help of  law court idisclosing of crimes against human health and life. Forensic medicine plays a ngreat role in health care because of promotes better diagnostics and prophylactics nof traumatism, poisonings, sudden death.

 

Research methods used nin forensic medicine:

•        General (materialistic)

•        Morphological (autopsy, histological, ncytological)

•        Clinical (examination of victims)

•        Immunological (investigation of nbiological fluids)

•        Medico-criminalistic (X-ray examination, nstereomicroscopy, trassological, inspection of scene of death etc.)

 

Article 75 CPC of nUkraine: «Examination is assigned when scientific, technical or other kinds of nspecial knowledge are necessary for decision on certain investigation matters.»

 

Forensic examination – nresearch by the expert on the basis of special knowledge of material objects, nphenomena and processes in which  there nis an information about circumstances of the case. Shortly it means practical nactivity of an expert.

 

Article 76 CPC of nUkraine: «Examination is necessarily» in follow cases:

•        For determination of cause of death.

•        For determination of severity degree

•        For determination of psychiatric status n(mental condition)

•        For determination of sexual status of nvictim

•        For determination of age (as referred to ncriminal liability).

 

Forensic medical nexamination   – the kind of forensic nexamination assigned for decision of special medical questions which can occur nin practical activity of  judicial bodies  or court. It is only performed under a nwritten official sanction of investigator or judge.

 

Duties of forensic nmedical expert:

•        to be on call of the person making ninquiry (investigator, public prosecutor, judge);

•        to perform completed examination and nmake an objective written conclusion

•        to explain own conclusion if ainvestigator needs it

•        to consult an investigator

•        do not investigate an object when aexpert is a relative of victim or offender

•        to keep an investigator’s secret etc.

 

Rights of forensic nmedical expert:

•        to get acquainted with the case nmaterials;

•        to declare a petition for granting of nadditional materials, necessary for conclusion;

•        to put the questions to court, the nlawyer, the accused, the witnesses;

•        to be present during interrogation (with nthe sanction of the person making inquiry);

•        to put the questions to interrogated npersons;

•        if some experts are invited for judicial nsitting, they can  confer with each other nand make common conclusion;

•        to consult experts of all medical nbranches;

•        to receive a compensation for expertise nservices (in definite cases);

•        to refuse of examination:

       if the nquestions aren’t related to his competence;

       if case nmaterials are insufficient for investigation;

       if an expert ndoes not have necessary knowledge for examination.

 

Responsibility of nforensic medical expert:

According to CC of nUkraine the criminal liability of forensic expert is forecasted in follow ncases:

•        Refusal of the expert to perform his nduties (Article 385);

•        Disclosure of information about ninvestigation or inquiry (Article 387);

•        Knowingly false testimony (Article 384).

 

Types of assignment of nforensic-medical examination in Ukraine:

•        Official – is provided by a forensic npathologist of the Bureau of Medico-Legal Examination. Such specialist is named nas forensic-medical expert (widely spread).

•        Free examination  – is assigned in cases when there are not any nopportunities to involve forensic pathologist therefore any doctor can be nengaged by the inspector or court for examination (rarely).

 

Kinds of medico-legal nexamination:

•        Initial – it is performed firstly;

•        Additional – is carried out in cases of nincompleteness of the initial examination or new data of preliminary ninvestigation;

•        Repeated – if the conclusions of initial nexamination is inconsistent or doubtful (it is performed by another expert);

•        Commission – takes place in difficult ncriminal cases with participation of several specialists in medical field (not nonly forensic-medical experts but doctors another medical specialities caprovide the examination also);

•        Complex  n– it is carried out with participation of the experts of different nbranches of knowledge (criminalists, toxicologists, technicians etc.).

 

Structure of forensic-medical nservice in Ukraine.

Ministry of Health nCare guides medico-legal service in Ukraine.  nUkrainian forensic service is based on the instance principle and nsubmitted by a great network of the special medico-legal establishments knowas the Bureaus of Forensic Examination. Instance principle refers 3 levels ithe structure of the service. The Ist instance is formed by the experts nfulfilling there duties in towns and districts of Ukraine. The heads of nmedicolegal service in the regions, republican expert of Autonomic Republic nCrimea, the major medicolegal expert of Kiev and Sevastopol guide forensic nmedical service in these territories and make the IInd instance. The Maimedicolegal expert of the Ministry of Health Care guides all forensic medical service nin Ukraine and means the IIIrd instance. He leads the Main Medicolegal Bureau nof Ukraine also. Therefore 27 forensic bureaus are totally in Ukraine.

Every Bureau of nForensic Medical Examination consists of the following basic departments:

•        Department of examination of dead nbodies;

•        Department of examination of alive npersons;

•        Department of commission examination.

 

 

Forensic Autopsy

 

As nstated, the primary (but not sole) function of the pathologist is to determine nthe cause of death, the extent of the injuries, and the presence of natural ndisease or poisoning and, apart from making a factual record of these matters, nto offer deductive opinions as to the mechanism and possible time of the naction. He or she should confine himself or herself to the medical aspects and nnot “play detective,” which is the function of the rest of the team. However, nthe pathologist is entitled to offer any deductions he or she thinks valid, nsubject to the provision that he or she delineates his or her limits of error nas clearly as possible. For instance, the detective officers will inevitably nask the time of death. This should be given with a “bracket” of the limits nwithin which the death probably could not have happened and the possibility of ndeath having occurred out of these ranges.

The autopsy itself follows a standard npattern and should be a full autopsy in every case video  .

The practice of examining only the nobvious injuries or only the diseased organs is to be deprecated, because the nexperienced pathologist never fails to be surprised at the multiplicity of nunexpected injury and disease that is found in so many cases.

In criminal cases, especially those due nto mechanical violence, the external examination of the body is frequently as nimportant — if not more important than — the more classic dissection. Where nsomeone has been beaten with a blunt instrument or stabbed many times, a ndescription of the external appearances is vital. The same holds true for ngunshot wounds, where much information concerning distance and direction of the nweapon to the body is to be gained from an external examination rather thafrom internal dissection of the organs.

Thus, the first part of the autopsy will nbe a careful evaluation of the body surface, but even before this there are nimportant preliminaries. First, the identity of the body must be confirmed. If nthe pathologist has attended the scene of the crime he or she knows that this nis the body that was examined at the scene. However, at some point in time the nactual identity of the deceased must be established by someone who knew the nperson in life.

The reason for this step is that should the death come nto criminal trial, in  Ukraine the nprosecution must prove beyond and to the exclusion of every reasonable ndoubt that the person is deceased and that the death was caused by criminal ndesign. The pathologist shall be an important witness in the proof of the ncriminal design part of the prosecution’s case. However, unless the pathologist nknew the deceased personally, he or she cannot testify about the autopsy until nit is shown that the deceased autopsied is the deceased the defendant is ncharged with killing. Until the above is proved, the testimony of the npathologist is irrelevant. Historically, someone who knew the deceased was nshown the body and made a formal identification. Then that person could come to ntestify that he or she saw the deceased at the mortuary and made an official nidentification. Then the pathologist could testify that the body so identified nwas the one he or she was now testifying about. Oon-decomposed bodies, this nprocess of formal identification has become much less necessary with the use of nphotographs and unique case numbers.

FIGURE 1.  Decomposed body

Postmortem examination must be taken in autopsy room:

 

FIGURE 2. Autopsy room : Examination table nused when performing an autopsy.

 

Before the external examination is begun, the body nshould be carefully measured, both the height from heel to crown of head and nthe weight. These matters are relevant in many cases, especially where there is nsome argument as to whether a small assailant could have damaged a large victim nor where the height of injuries above the ground in stabbing, gunshot, and ntransportation injuries are at issue. It also helps to assist in the nidentification of the body if the postmortem dimensions can be compared with nthe known physical characteristics of the deceased when alive.

An examination of the deceased’s clothing by the npathologist is often of great importance, although it will be minutely examined nby the criminalistics laboratory as well video  . However, it is nwithin the pathologist’s authority to look for bullet holes or stab nperforations and compare these with the position of the wounds on the body.

FIGURE 3 . nStab wound with features nof squaring and a sharp edge consistent with a single-edged knife.

 

FIGURE 4. Stippling or npowder tattooing around a close-range gunshot wound.

 

It is also appropriate for the npathologist to examine for powder residues on the clothing of gunshot wound nvictims so as to better correlate the autopsy findings in estimating the range nand direction of the gun from the deceased at the time of the gunshot. Other nexaminations of clothing may be made for the presence of blood, vomitus, semen, nfecal material, foot imprints, and many other features which, although they nwill be subjected to subsequent detailed study by the forensic laboratory video  , have definite medical aspects that can be nincorporated into the opinions and interpretations expressed by the npathologist.

The general physique and state of nnutrition of the deceased should be evaluated, with the extremes from obesity nto emaciatiooted. These observations may be of importance in a number of ncases, especially in children or handicapped adults for whom nneglect to the point of starvation may be a point at issue. Also, the general ncleanliness of the body may be important, as in self-neglect, child neglect, nmental disorders, drug dependency, and senile dementias; there may be nconsiderable neglect of the skin surface, with dirt, skin infections, and nparasite infestations noted.

All injuries, whether recent or old, nmust be carefully noted, described, and photographed. The size of such injuries nmust be measured, and their location on the body noted, so that later reading nof the report can pinpoint their position. The usual method is to give the ndistances, usually in metric units, from major anatomical landmarks. For ninstance, a stab wound of the chest may be described by its length and breadth nand also by its distance right or left of the midline of the body and its nlocation below the top of the head or above the heel. Distances from such nlandmarks as the nipple, sternal notch, umbilicus, chin, and nose are also nhelpful additions, but the most important are the distances which allow one to nestimate the position in relation to the world as well as in relation to the ndeceased.

The state of the body regarding nstiffness (rigor mortis) should be noted. However, it is much more important to nknow the state of rigor when the body was first found than when it is in the nmortuary some hours later.

Post mortem hypostasis, which is ngenerally and somewhat inaccurately called livor mortis or lividity, is the ndiscoloration of the most dependent parts of the body where blood settles after ndeath due to the force of gravity. It is of some use in determination of the ntime of death.

FIGURE 5.  Postomortem nLividity (PML).

 

Sometimes hypostasis may be an indicator that the body nwas moved after death if some or all of the discoloration is found in a nnon-dependent position. The color of hypostasis is useful, as well as it may nindicate carbon monoxide or cyanide poisoning or poisoning by strongly reducing ncompounds which produce methemoglobin in susceptible individuals.

FIGURE 6. Carbon monoxide poisoning ( red ncolor of the skin).

When injuries or other abnormalities are present othe body surface the forensic pathologist will record them by words, drawings, nand photographs.

FIGURE 7. A photoflood lamp setup with an overhead camera. The photoflood lamps provide the needed nlighting for taking pictures.

 

Preprinted body diagrams are commonly employed upowhich the position and size of various injuries or abnormalities may be nrecorded. Well taken photographs should also supplement these diagrams. The nease of use and inexpensive nature of modern color photography has made nphotography routine. Digital images are replacing chemically developed nphotographic film as the preferred medium.

Radiographs (X-rays) are frequently used nin the practice of forensic pathology. In cases where there is body mutilation, nin all cases of gunshot wounds, and in all knife wounds, radiographs are nroutinely taken before any internal examination is made. The radiograph will ndocument the relationship of internal organs to any metallic foreign body. The nprediction of the path and final resting place of a bullet is extremely ndifficult from an external examination alone. Countless hours and excessive nmutilation of the body can be avoided by the use of radiographs. In addition, nin cases of possible electrocution, the X-ray examination of possibly defective nelectrical equipment is invaluable.

In all cases of child deaths, complete nskeletal X-rays should be taken to find subtle evidence of old trauma such as nis seen in the battered baby syndrome. Finally, the external examination may nreveal surface fragments of material that may be trace evidence, such as paint nflakes in injuries from traffic accidents, glass fragments from windshields, nfibers, blood, semen, and extraneous hairs present on the surface or embedded nin wounds on the body. In assault cases, foreign material may be present under nthe fingernails and may include hair, fiber, skin fragments, or blood from the nassailant. These may be vital to the investigation, and normally the nfingernails are either trimmed off with sharp scissors and nretained in separately labeled containers or they are scraped out by means of a nsharpened clean instrument such as a toothpick, the contents again being nseparately retained and labeled. Ordinarily the criminalistic laboratory will nhandle the analysis of these materials, although commonly the forensic npathologist will photograph and examine any suspicious material. The yield from nfingernail scrapings is distressingly low. However, with polymerase chaireaction (PCR) amplification of any deoxyribose nucleic acid (DNA) containing nmaterials, it is possible from submicroscopic amounts of tissue to positively nidentify an assailant, if there has been transfer from the assailant to the victim nand if it is properly collected and analyzed.

         

 

FIGURE 8. DNA genetic nanalyzer An ninstrument that can separate small fragments of DNA either by using gel nelectrophoresis or by using capillary electrophoresis

 

Such DNA evidence is more commonly found in sexual noffenses where the pubic hair of the victim may have hair from the assailant as nwell as transfer of blood and semen. Careful search, collection, and npreservation of these materials may lead to the identification of the assailant nusing analysis of the DNA molecule. Pulled hair with the bulb or base, as well nas all bodily fluids, generally have sufficient DNA to amplify with PCR and nanalyze for individually unique areas. With blood and semen, if the amount is nvisible to the eye, it is usually not necessary to perform PCR amplificatiobut direct analysis, thus reducing the probability of contamination. All of nthese techniques, however, are based upon careful identification, collection, nand preservation, which is done by the forensic pathologist.

The internal examination follows and is basically a ndetailed exercise in morbid anatomy, a name applied to the exposure and nrecognition of abnormal morphologic features within the body. In the first ninstance, this is done by dissection and naked-eye inspection. Further nexamination is conducted by microscopic examination of the tissues along with ntoxicologic, biochemical, biologic, or immunologic investigation as may be nappropriate.

FIGURE 9. Transmitted-light compound microscope.

 

FIGURE 10. Scanning nelectron microscope (SEM) A microscope that is used to study the surface morphology of different types nof samples. The images produced are nstriking and often give the illusion of being three dimensional. A microscope that utilizes an accelerated nfocused electron beam to image particulate nsamples (e.g., gunshot residue) at high magnification, with great depth-of-field, while providing nsize, shape, morphology, and chemical informatioin both manual and automated modes.

 

As stated before, a full autopsy should be conducted nin every case and no shortcuts taken merely because the cause of death seems nobvious from the history or appearances. Although the cause of death is nimportant, it is not the only issue, and matters such as the collateral npresence of natural disease that might have contributed to the death and other nmore subtle injuries or poisonings may be equally or even more important. For ninstance, in a case where a person dies during a fight, the assailant may nalready have been arrested and charged with murder. However, a careful npostmortem examination can alter the legal aspects of the case considerably. nAlthough at first the body may show signs that a severe injury is present othe back of the head, internal examination may reveal a recent heart attack nthat may have caused the deceased to collapse and strike his or her head evebefore any significant injury was caused by the fight. Alternatively, there may nbe signs of brain membrane hemorrhage due to the rupture of a natural ballooning nor aneurysm of one of the blood vessels at the base of the brain, a relatively ncommon occurrence. Although, in these cases the legal aspects may not ncompletely absolve the alleged assailant, the gravity of the charge may well be nreduced from murder to manslaughter or even less.

To ascertain all these facts, a standard autopsy is nperformed. This entails opening the front of the body from the neck region to nthe pubis. In the United States, it is common to make a “Y” shaped nincision to avoid any visibility of the incision when the body is viewed and to npreserve the large arteries in the neck for use to inject embalming fluid. In Europe, it is more common to take the incision on the nfront of the neck up to the larynx (voice-box). In either case the object is to nexamine the contents of the head, neck, thorax, and abdomen for abnormalities. nIn addition, the brain is examined by cutting the scalp over the vertex of the nhead from behind each ear, the cut traversing the upper part of the scalp. The nscalp is reflected back from the skull, and the top of the skull sawed and nremoved exposing the brain for examination.

After all of the cranial, neck, thoracic, nand abdominal organs have been examined, they are replaced, and all of the nincisions are sewn closed leaving no disfiguration of the body. After a ncompleted autopsy, the fact that an autopsy was done is not discernable by npersons viewing the clothed body.

Samples of blood are taken in all deaths. Blood nsamples are preferably taken from peripheral veins such as those at the armpit nor groin or in the neck. Blood should not be taken from the general pool in the nchest or abdomen, as this area may be contaminated by substances from the nintestines or stomach. After death the walls of the alimentary canal become npermeable, and therefore some substances such as alcohol and barbiturates may ndiffuse passively into adjacent organs such as the heart chambers, so that nblood taken from these sites may have a false-positive level of chemical nsubstances which were not present during life.

Blood is usually taken for chemical and serologic npurposes. For the latter, refrigerated, unpreserved blood is preferred. For nalcohol analysis it is routine to collect the blood in a tube containing sodium nfluoride, which reduces microbiologic action that may increase or reduce the nalcohol content after collection. It has been shown that after death, nmicroorganisms — especially yeast and some bacteria — nmay produce appreciable quantities of alcohol, and thus create an artificially nhigh level of alcohol. This is particularly true if the interval between death nand autopsy (the post-mortem period) is prolonged.

Fluoride causes the process to be slowed following the ncollection of the blood, although of course nothing can be done to avoid nalcohol production within the body.

Stomach contents are frequently taken, both for ntoxicologic analysis and sometimes to identify the nature of the last meal. nThis is done by recognition of muscle fibers, starch grains, vegetable cellular nelements, and other features.

In passing, it should be noted that estimation of the ntime of death from the state of digestion of the stomach contents is nunreliable. The digestion process can be completely arrested when some severe ninjury, or even emotional shock, occurs; this happens most notably in cases of ncoma from head injuries. I have seen the stomach contents of a motorcyclist who nhad been in a coma for five days following an accident. The contents appeared nas fresh as if the food had been just swallowed. The value of examining stomach ncontents apart from chemical and toxicologic analysis is to ascertain the nnature of the last meal so that if it was known that a person had eaten rice nand beans at a particular meal and if these elements were recognized, it would nbe logical to suppose that death had occurred after that meal, but before a nsubsequent meal.

Other samples taken at autopsy may be samples of head, npubic, eyebrow, and eyelash hair. These are necessary for use as negative ncontrols in distinguishing between foreign hair found on the body and the ndeceased’s hair.

Urine, if available, is an important sample and is nusually collected as part of the autopsy examination. Generally it is drawinto a syringe directly from the exposed bladder. Urine being nearly free of nprotein is an extremely good sample to use for screening for drugs of abuse.

Ocular fluid, the clear fluid found within the eye, is nextremely important as a sample. Analysis of ocular fluid for chemical nconstituents provides the closest estimation of values near the time of death. nBile, drawn from the gall bladder with a syringe, is also commonly taken for ntoxicologic testing. Both urine and bile tell more about what drugs were takein the days prior to death than what was intoxicating a person at the moment of ndeath. Ocular fluid is a reasonable representation of drugs and alcohol a few nhours before death. All of the organs are studied by the naked eye n(macroscopically) for the presence of injuries or natural disease, and, as nstated, it is customary to take specimens for microscopic examination.

In criminal cases, or potentially criminal cases, this nis done routinely by most forensic pathologists even if the organ showed no nmacroscopic abnormality. It is always safer to take tissues that are not needed nthaot to take tissues that later become an important medicolegal issue. nMicroscopic examination is performed after the tissue is processed in the nhistology laboratory, and the report is generally appended to the macroscopic nautopsy report. Similarly, the results of toxicologic and serologic reports are nappended. The final autopsy report may have to be delayed until the results of nall of the ancillary examinations are completed, so that a complete overview of nthe case may be made and a reasoned interpretation and conclusion offered.

The autopsy report varies greatly ilength according to the nature of the case. A simple unexpected death from nnatural disease may require merely completing a page or two. However, icriminal deaths or cases where there is civil litigation it is preferable to nwrite a report with all of the details, including negative findings of normal norgans. It is unsatisfactory to fail to mentioormality, because the long ndelay between the autopsy and the subsequent court proceedings may make it nimpossible to remember details of the examination. A blank in the report may be ntaken to indicate that the organ was normal, or alternatively that it was not nexamined or that it was examined but was not reported upon. It is therefore nessential that negative findings be noted. This can be done without making nexcessively long reports by merely reciting a list of normal organs and noting nthat they were examined, weighed, and found to be normal. After a descriptioof all injuries, abnormalities, and disease and ancillary investigation, a ncause of death is listed. In some deaths, the exact cause of death cannot be nascertained after complete investigation and autopsy. In such cases this is nnoted in place of the cause of death.

In addition to the cause of death, nseparately recorded and identified, should be a report concerning ainterpretation of all of the investigation and autopsy findings to try to nexplain why the death occurred. This is often the most important part of the nreport, in that the pathologist’s training and experience is called into play nto interpret the findings for the benefit of the reader of the report.

The pathologist is cautious not to nover-interpret findings. The opinions must be backed up by fact and established nscience in the field of legal medicine and must not extend into speculation or nfantasy. The opinions may well be challenged by expert witnesses called by aopposing party. The expectation of this tends to make the forensic pathologist nmore cautious and more painstaking in reaching conclusions. This is a healthy nsituation and a vindication for the adversary system used in the nEnglish-American legal system.

This method is often criticized by those nfrom the inquisitional system where reliance is placed upon a consensus of expert nopinion given independently to the court without further challenge.

This, then, is the primary function of nthe forensic pathologist, to see every aspect of a case from attendance at the nscene of the death through completion of a report and presentation of evidence nin court. The duty is onerous and not to be undertaken lightly. When the expert nwitness rises in court to give testimony, he or she is usually questioned nconcerning his or her training, experience, and aptitude for the job. The nweight of the evidence, as far as the court and jury are concerned, will be nmodified by the experience and training. In fact, major cases often become the n“battle of the experts,” with numerous expert witnesses of varying degrees of nfame being called to prove or disprove some of the controversial aspects. Ithis respect, care must be taken to identify the correct fields of expertise, nbecause a most eminent professor of general pathology may not know much at all nabout forensic pathology. The opposing expert witness may be a relatively nobscure but proficient assistant medical examiner whose knowledge of nmedicolegal matters may far exceed that of his prominent general colleague. nUnfortunately, not all juries understand the distinction, and the attorneys may nnot take pains to point out the difference. With a declining number of nfull-time forensic pathologists, more and more general pathologists are nbecoming involved in medicolegal issues, and although many are competent, this nis by no means a uniform situation.

In any event, the pathologist must npresent the truth no matter which side of a case calls him or her as a witness. nThe pathologist should be there to help the judge and jury to arrive at a just ndecision. The pathologist must reveal all of the facts of the case, even those nwhich are disadvantageous to the party calling him or her. Any attempt to bend, ndistort, or conceal relevant evidence will only lower his or her status in the neyes of the judge, jury, and professional colleagues. The worst condemnation of nan expert is that his or her opinion may be bought by the highest bidder.

The forensic pathologist, by educatioand training, is entrusted to utilize science to understand the cause of ndisease or injury and is called upon to explain this to judges and juries.

Juridical principles of the regulation of nforensic autopsy in Ukraine.

Dead body is the most difficult nforensic-medical object and its investigation is the most compound and nimportant part of legal- medical activity.

During forensic-medical investigatio(examination) of dead body forensic pathologist must be guided of definite narticles of Criminal Procedural Code (CPC) – 75, 76, 192, 196. «Instructions nabout performance of forensic- medical investigation» (1995), «Rules of nforensic- medical autopsy in medicolegal bureaus» (1995) and other normative ndocuments.

There are two types of forensic autopsy naccording to Ukrainian legislation: forensic examination and forensic ninvestigation of dead body.

Forensic- medical examination means such nforensic autopsy which is performed by a doctor under the resolution of ninvestigator or law-court. Doing this activity the doctor as legal angle is ncalled as «expert», has got definite expert’s rights, duties and responsibility n(presented before). The results of such autopsy must be noted in the special ndocument named as «Expert conclusions». As a rule an investigator appoints aexamination when crime occurred (in cases of violent death).

Forensic-medical investigation. If a persodied not violently and a crime didn’t occur forensic medical investigatioshould be appointed. The document which is composed by the doctor is called as n«Report of forensic medical investigation». Forensic pathologist in this cases nis named as «specialist» and has not got the expert’s duties, rights and responsibility. nBut at practice there are no differences between an examination of a corpse and nits investigation because of all methods and technique used during the autopsy nare the same.

 

Basic rules of forensic-medical autopsy.

1.      Any nforensic autopsy (examination or investigation) must be conducted by the npathologist under the written permission (official order) of the investigator, ninquest organs, procurator or law-court.

2.      Before nthe autopsy forensic pathologist must be informed about the dead person (its nname, surname, age, home address, profession, previous diseases, complains, nmethods of treatment etc.) and circumstances of death. Inquest report consists nsuch information usually.

3.      One nexpert as usual performs an autopsy. But in some complete cases (exhumation, nfragmented corpse, finding of human remains etc.) an autopsy can be fulfilled nby two and more experts.

4.      Forensic nautopsy takes place in mortuary only and never in private room.

5.      Ainvestigation (or examination) should be conducted in daililight as far as npossible, because color changes in PML (post mortem lividity), bruises, etc., ncaot be appreciated in artificial light. But in immediate situations aartificial light can be used..

6.      Investigator, nprocurator, medical students can visit the autopsy. Any strangers, relatives nand unauthorized persons caot be present in mortuary.

7.      Forensic-medical nexpert or physician who makes an autopsy uses his own methods of the investigatioand he is the main person in autopsy room. An investigator caot indicate to nhim how to do an autopsy.

8.      Forensic nexamination (investigation) of the body starts while eraly changes in the body nappear: PML, rigidity, changes in the skin etc. Dissection is inadmissible if nless then 30 minutes after death have elapsed.

9.      All nwear on the decedent must be carefully examined and described by the expert nbecause it is very important as forensic angle object and different traces or nevidences can be observed in it.

10.    The nautopsy must be complete, every inner organs and cavities must be examined.

Reasons of forensic autopsy.

Forensic medical examinatio(investigation) is necessarily appointed by inquest bodies in following cases:

•        Violent ndeath or its suspicion.

•        Suddedeath.

•        Unknowcause of death.

•        Death nin result of forbidden treatment methods by the person who has not the right to ndo it.

•        Death nin hospital:

      If ndeath is connected with violence or suspicion of it.

      If nthe diagnosis is unascertained.

      If nthere are complaints of the relatives on wrong actions of the medical npersonnel.

 

Requirements for forensic-medical ndocumentation.

«Expert’s conclusions» (Testimony) and n«Report of forensic-medical investigation» are the basic forensic documents. As nlegal angle all these forensic official papers have a great importance that’s nwhy they must be written by the expert very seriously according to follow nrules:

•        Style nand language of these documents must be simple, without special medical terms. nThe documents must be clear for understanding in court sitting.

•        The ndocuments must be printed not less than in two copies (for investigator, for narchive of Forensic Bureau and for personal archive of the expert).

•        The ntext is writing without paragraphs.

•        Any nforeign or special terms should be explained

•        Aexpert signs the document two or three times (it depends on kind of the ndocument – testimony or report), stamp of the Bureau is put in the end also.

 

The scheme of the Report of Forensic nAutopsy

 

 

Principles of composing and matter of nconclusions at corpse’s dissection.

Expert’s conclusions” and “Act of nforensic-medical investigation of corpse” have almost identical contents and nwrite for the same scheme: entry part, examination (protocol) part, diagnosis nand conclusions. Protocol part is dictated or wrote exactly during the ndissection and reflected founded changes and stage of organs and tissues.

 

PRACTICAL CLASS № 1

 

SUBJECT AND TASKS OF FORENSIC MEDICINE. nLEGISLATIVE BASES OF FORENSIC MEDICAL EXAMINATION IN UKRAINE

 

Тhemes: 1. nForensic Medicine, its contents and tasks.

2. Legislative nbases and structure of forensic medical service in Ukraine.

3. Forensic nexamination of dead body: order, rules, conditions, documents.

Objectives: to nknow the legislative status of a forensic expert, cases when medico-legal nexamination is required, and the structure of forensic service in Ukraine; nalso, to know the basic rules of a forensic autopsy, and the necessary nrequirements for medical documents.

 

Introduction. nDuring the investigation of cases connected with a crime against the life and nhealth of a person, the inquest raises some questions, the answer of which is nconnected to medical and biological knowledge. The solution of such questions nis to be provided by a forensic medical examination and by the specialists n(called forensic experts or forensic pathologists). According to the Ukrainialegislation, cases with the need to execute medico-legal actions, may involve a ndoctor of any specialty; therefore, the knowledge of legislative bases of nforensic medical examination and knowing the procedural regulations about nmedico-legal activity is necessary for a doctor of any specialty.

 

Basic level of nknowledge and skills

•        To know about Criminal Code (CC) and nCriminal Procedural Code (CPC) of Ukraine, the questions regulated by them.

•        To know the maiotes of the «Bases of nthe Health care Legislation of Ukraine» (1992).

•        To differentiate the particularities betweean ordinary (pathomorphological) and forensic-medical autopsy.

•        To be able to indicate any topographic nregions of a human body.

•        To know the morphological structure and ntopography of inner organs and tissues.

 

Visual Aids and nMaterial Tools:

Different ninvestigator’s documents, forensic medical papers, tables and photos are used nduring the training.

 

I. Students’ nIndependent Study Program

 

Тheme № 1 of the npractical class.

1.     Definition, content, tasks and nsignificance of Forensic Medicine.

2.     Forensic Medicine as a discipline, short nhistory of its development.

3.     Foundation of forensic medical service iUkraine.

 

Тheme № 2 of the npractical class.

1.  The structure of legislative departments, nprocurator’s office and law-court in Ukraine, their main tasks and functions.

2.  The basic principles of the Law of Ukraine n«About Forensic examination», concepts about Criminal Code, Criminal-Procedural nCode, Civil and Civil -Procedural Codes of Ukraine.

3.  Cases when forensic examination is assigned nand is necessarily (according to art. 75, 76 of CPC of Ukraine).

4.  Judicial position of the expert (his duties, nrights and responsibility).

5.  Objects, kinds and types of medico-legal ninvestigation.

6.  The structure of medico-legal service in Ukraine.

 

Тheme № 3 of the npractical class.

1. Reglamentatioof forensic autopsy in Ukraine.

2. The main rules nof a forensic autopsy.

3. Notions of the n«medico-legal examination» and «medico-legal investigation» of a dead body: ncommon and different particularities between them.

4. Contingent of ndead bodies which need forensic autopsy (reasons of forensic autopsy).

5. Requirements nfor forensic documentation.

6. The maiprinciples and contents of a «Report of forensic autopsy».

 

Block of Informatio(Terminology)

 

Forensic medicine nis the subject concerned with the application of medical scientific knowledge nto certain branches of law, both civil and criminal. It is a special medical ndiscipline which studies and decides definite biological, medical and nmedico-criminalistic questions for requirements of law practice, legislatioand health care. In short, it deals with medical aspects of law.

Forensic Medicine nas a special medical discipline investigates the following objects:

•        Dead bodies;

•        Alive persons (victims, suffering, naccused and other)

•        Case materials (medical documents, nforensic papers, investigator’s materials);

•        Material evidences of biological origi(blood, semen, saliva, hair etc.) and not biological origin (traumatic instruments)

The main task of nthe discipline is to help the court of  nlaw court in disclosing  crimes nagainst human health and life. Forensic medicine plays a great role in health ncare because it promotes better diagnostics and prophylactics of traumatism, npoisonings, sudden death.

Research methods nused in forensic medicine:

•        General (materialistic)

•        Morphological (autopsy, histological, ncytological)

•        Clinical (examination of victims)

•        Immunological (investigation of nbiological fluids)

•        Medico-criminalistic (X-ray examination, nstereomicroscopy, trassological, inspection of scene of death etc.)

Article 75 CPC of nUkraine: «Examination is assigned when scientific, technical or other kinds of nspecial knowledge are necessary for decision on certain investigation matters.»

Forensic nexamination – is research by an expert on the basis of special knowledge of nmaterial objects, phenomena and processes in which  there is  ninformation about circumstances of the case. Shortly it means practical nactivity of an expert.

Article 76 CPC of nUkraine: «Examination is necessary» in the following cases:

•        To determine the cause of death;

•        To determine the degree of severity;

•        To determine the psychiatric status n(mental condition);

•        To determine the sexual status of victim

•        To determine the age (as referred to ncriminal liability).

Forensic medical nexamination   – is the kind of forensic nexamination assigned to answer special medical questions which can occur ipractical activity of  judicial bodies  or court. It is only performed under aofficial written sanction of an investigator or judge.

Duties of nforensic medical expert:

•        to be on call of the person making the ninquiry (investigator, public prosecutor, judge);

•        to perform a complete examination and to nmake an objective written conclusion

•        to explain the conclusion if ainvestigator requires it

•        to consult an investigator

•        do not investigate an object when the nexpert is a relative of the victim or offender

•        to keep the investigator’s secret etc.

Rights of nforensic medical expert:

•        to get acquainted with the case nmaterials;

•        to petition for additional resources, nnecessary to draw a conclusion;

•        to question the court, the lawyer, the naccused and the witnesses;

•        to be present during interrogation (with nthe sanction of the person making inquiry);

•        to question the interrogated persons;

•        if other experts are invited for a njudicial sitting, they can  confer with neach other and make a common conclusion;

•        to consult experts of all medical nbranches;

•        to receive a compensation for expertise nservices (in definite cases);

•        to refuse of examination:

      if the nquestions aren’t related to his competence;

      if the ncase materials are insufficient for investigation;

      if aexpert does not have necessary knowledge to complete the examination.

Independence of nforensic medical expert. It is commonly guaranteed in Ukraine by the nfollowings:

•        legislative order of the assignment of nforensic expert;

•        general independence of all forensic nestablishments in relation to law court or police departments;

•        presence of all participants involved ninto law sitting during forensic examination (in cases allowed by Ukrainialegislation);

•        criminal responsibility of forensic nmedical experts.

Responsibility of nforensic medical expert:

According to CC nof Ukraine criminal liability of a forensic expert is forecasted in the nfollowing cases:

•        Refusal of the expert to perform his nduties (Article 385);

•        Disclosure of information about the ninvestigation or inquiry (Article 387);

•        Knowingly false testimony (Article 384).

Types of nassignment of forensic-medical examination in Ukraine:

•        Official – is provided by a forensic npathologist of the Bureau of Medico-Legal Examination. Such a specialist is named nas forensic-medical expert (widely spread).

•        Free examination  – is assigned in cases when there are no nopportunities to involve a forensic pathologist, therefore, any doctor can be nengaged by the inspector or court to perform the examination (rarely).

Kinds of nmedico-legal examination:

•        Individual –  is performed only by one expert and it can be ninitial and additional;

      Initial n–  is fulfilled firstly;

      Additional n– is carried out in cases of incomplete initial examination, also with the nappearance of new data of preliminary investigation;

•        Repeated examination – if the nconclusions of the initial examination is inconsistent or doubtful  (it is performed by another expert);

•        Commission – takes place in difficult ncriminal cases with participation of several specialists in medical field (not nonly forensic-medical experts but doctors of different medical specialties caassist with the examination also);

•        Complex  n– is carried out with the participation of experts of different branches nof knowledge (criminalists, toxicologists, technicians etc.).

Structure of nforensic-medical service in Ukraine.

Ministry of nHealth Care guides medico-legal service in Ukraine.  Ukrainian forensic service is based on the ninstance principle and submitted by a great network of the special medico-legal nestablishments known as the Bureaus of Forensic-Medical Examination. There are n27 forensic bureaus in Ukraine in total. Instance principle consists of 3 nlevels in the structure of the service. The 1st instance is formed by the nexperts fulfilling their duties in the towns and districts of Ukraine. The nheads of medico-legal service in the regions, the republican expert of nAutonomic Republic of Crimea, and the major medico-legal expert of Kiev and nSevastopol guide forensic medical service in these territories and make the 2nd ninstance. The Main medico-legal expert of the Ministry of Health Care guides nall forensic medical service in Ukraine and represents the 3rd instance, and nleads the Main Medico-legal Bureau of Ukraine as well.

Every Bureau of nForensic Medical Examination consists of the following basic departments:

•        Department of examination of dead nbodies;

•        Department of examination of alive npersons;

•        Department of commission examination;

•        Department of examination of material nevidences (forensic medical laboratory);

•        Department of duty forensic medical nexperts;

•        Organizational and methodical ndepartment.

There are also nthe following sub departments in Forensic medical bureau: forensic-medical nhistological, forensic-medical cytological, forensic-medical immunological, nforensic-medical toxicological and medico-criminalistic.

Juridical nprinciples of the regulation of forensic autopsy in Ukraine.

A dead body is nthe most difficult forensic-medical object, and its investigation is the most ncompound and important part of legal- medical activity.

During the nforensic-medical investigation (examination) of a dead body, the forensic npathologist must be guided by the definite articles of Criminal Procedural Code n(CPC) – 75, 76, 192, 196. «Instructions about performance of forensic- medical ninvestigation» (1995), «Rules of forensic- medical autopsy in medico-legal nbureaus» (1995) and other normative documents.

There are two ntypes of forensic autopsies according to Ukrainian legislation: forensic nexamination and forensic investigation of a dead body.

Forensic- medical nexamination is a forensic autopsy which is performed by a doctor under the nspecial resolution («decision») of an investigator or law-court. Performing the nexamination, the doctor, as a legal angle, is called as «expert», and has the ndefinite expert’s rights, duties and responsibility (presented before). The nresults of such an autopsy must be noted in the special document named «Expert nconclusions» or «Testimony». As a rule, an investigator appoints an examinatiowhen a crime has occurred (in cases of violent death).

Forensic-medical ninvestigation. If a person did not die violently and a crime didn’t occur, a nforensic medical investigation should be appointed. The investigator gives a ndifferent official document for the autopsy which is termed as «direction». nForensic pathologist, in this case named as «specialist», does not have the nexpert’s duties, rights and responsibilities. The document which is composed by nthe doctor is called a «Report of forensic medical investigation». In practice nthere are no differences between an examination of a corpse and its ninvestigation, because all the methods and technique used during the autopsy nare the same.

Basic rules of nforensic-medical autopsy.

1.      Any forensic autopsy (examination or ninvestigation), must be conducted by a pathologist under the written permissio(official order) of an investigator, inquest organs, procurator or law-court.

2.      Before the autopsy, the forensic pathologist nmust be informed about the dead person (his or her name, surname, age, home naddress, profession, previous diseases, complaints, methods of treatment etc.) nand circumstances of death. The inquest report usually contains this ninformation.

3.      Usually, one expert performs the autopsy; nbut in some complete cases (exhumation, fragmented corpse, finding of humaremains etc.) an autopsy can be fulfilled by two or more experts.

4.      Forensic autopsy takes place in a mortuary nonly and never in a private room.

5.      An investigation (or examination) should nbe conducted preferably in daylight if conditions permit, because color changes nin PML (post mortem lividity), bruises, etc., caot be appreciated iartificial light. But in immediate situations an artificial light may be used.

6.      Investigator, procurator, medical students ncan attend the autopsy. Any strangers, relatives and unauthorized persons canot be present in mortuary.

7.      Forensic-medical expert or physician who nmakes the autopsy uses his own methods of investigation and he is the persocharge of the autopsy room. An investigator cannot dictate how to perform the nautopsy.

8.      Forensic examination (investigation) of nthe body starts while early changes in the body appear: PML, rigidity, changes nin the skin etc. Dissection is inadmissible if less than 30 minutes have nelapsed after death.

9.      All of the clothing on the decedent must nbe carefully examined and described by the expert, because it is very important nas a forensic angle object and different traces of evidence can be observed oit.

10.    The autopsy must be complete, every inner norgan and cavity must be examined.

Reasons of nforensic autopsy..

Forensic medical nexamination (investigation) is necessarily appointed by  inquest bodies in following cases:

•        Violent death or its suspicion.

•        Sudden death.

•        Unknown cause of death

•        Death of unknown persons.

•        Death as a result of forbidden treatment nmethods by the person who does not have the right to do it.

•        Death in hospital:

      If death nis connected with violence or suspicion of it.

      If the ndiagnosis is unascertained.

      If there nare complaints of the relatives on malpractice of the medical personnel.

Requirements for nforensic-medical documentation. «Expert’s conclusions» (Testimony) and «Report nof forensic-medical investigation» are the basic forensic documents. As legal nangle, all of these forensic official papers have a great importance, that’s nwhy they must be written by the expert very carefully, according to the nfollowing guidelines:

•        The style and language of these ndocuments must be simple, without special medical terms. The documents must be nclear and understandable in a court sitting.

•        The documents must be printed in at nleast two copies (for the investigator, for the archive of Forensic Bureau and nfor the personal archive of the expert).

•        The text is written without paragraphs.

•        Any foreign or special terms should be nexplained

•        An expert signs the document two or nthree times (depending on the kind of document – testimony or report), a stamp nof the Bureau is placed in the end as well.

The scheme of the nReport of Forensic Autopsy. There are 3 main compound parts in the structure of nthe report: general data of the examination, research part, medicolegal ndiagnosis and forensic conclusion (testimony).

I. General Data nof the examination (is stated on the title):

•        Date and hour of examination.

•        Conditions which are important for the nexamination – light (natural or artificial, temperature of air).

•        Reason of autopsy (direction or ndecision).

•        Place of examination.

•        Name of the expert and his qualifying nposition.

•        Full name and age of the decedent.

•        Persons who are present at the autopsy.

•        The list of the investigator’s nquestions.

•        Circumstances of case and death.

II. Research nPart. This includes the external and internal findings revealed during the nautopsy. They are: external examination – description of the clothes and shoes nworn by the decedent (type, color, degree of deterioration, contents of npockets, damage, dirtiness, blood stains etc); general data about the body n(sex, age, length); Common conditions of the skin (color, elasticity, presence nof blood stains or ground); Post-mortem phenomena (temperature of the body, npost-mortem lividity, cadaveric rigidity, late changes if present); after this, nthe body is examined very thoroughly up and down. The forensic pathologist ncontinues his examination from the decedent’s head and describes the hair, nface, eyes, contents of oral cavity (teeth, lips, tongue). Then, the ears, nneck, thorax, mammary glands, abdomen, genitals, back and extremities are ninvestigated. External investigation is accomplished with full description of nexternal injuries. Internal examination consists of medico-legal section of ncranial, thoracic and abdominal cavities and includes a complete investigatioof all inner organs and their morphological properties and injuries.

This part of the nreport includes the results of laboratory research as well.

III. Forensic nmedical diagnosis  and forensic nconclusion (complete answer to investigator’s questions).

General nPrinciples of forensic diagnosis and forensic conclusion (testimony).

Forensic medical ndiagnosis consists of the 3 main parts: 1. Basic injury or disease, must be nconfirmed by the list of attributes. 2. Complications of the basic injury or ndisease causally connected with approach of death. 3. Accompanying changes, nwhich aren’t connected with cause of death.

Forensic nconclusion (testimony) is the most important chapter of the report. It is aexpert opinion concerning the investigator’s or court’s questions. Forensic ntestimony is a very important source of evidence in court sitting too; because nit helps decide specific questions and ascertain the truth in the case being ninvestigated. That’s why a forensic expert must make his conclusion carefully nusing modern scientific knowledge in forensic pathology. Common answers which nmust be given in the testimony are: cause of death, presence of injuries, nmechanism of their infliction, instrument used, marks of violence upon the body, nwhether the observed injuries were caused before or after death, severity of nthe injuries, time of death etc. All of the expert’s answers must be completed nas a scientific angle and perfectly motivated.

 

II. Меthodology nof the practical activity (9.00-11.15a.m.):

 

Тopics № 1-3.

Рractical nactivity 1.  .  During preparation, every student should nstudy the basic normative-legal acts regulating legal procedure and performance nof forensic medical examination in Ukraine. Special attention must be paid to nthe maiotes of Law «About Forensic examination», «Bases of the Health Care nLegislation of Ukraine»  and «Order № 6 nDevelopment and improvement of medico-legal service of Ukraine». It is nnecessary to know the difference between the notions «medico-legal examination» nand «medico-legal investigation» of a dead body.

 

Рractical nactivity 2.  Forensic autopsy is nperformed by the teacher (if a dead body is present in the autopsy room). The ncorrect order of investigation and creation of the autopsy report is demonstrated nduring the autopsy.

Practical nactivity starts with the protocol part of the report being filled in. The date, ncity, name and surname of the physician, number and date of investigator’s nrequirement, place of investigation, examined object and investigator’s nquestions are noted in the introduction. The next chapter of the report is ncalled «Previous information», and includes the main information about the naccident. The «Investigation part» is the last and most important chapter of nthe report; and is where the autopsy technique is demonstrated for the nstudents. An external and internal investigation of the body is shown as well. nForensic particularities of the description of the clothes, order of its ninvestigation, techniques of the examination of post-mortem changes, and all nmorphologically presented features of the injuries are demonstrated next. They nnote properties of the injuries such as: localization, their types, shapes, nsizes, features of edges, ends and surfaces, their color, signs of healing, properties nof surrounding tissue are also noted. The description should be accompanied by na schematic picture of the injuries on the body. An internal examination of ninner organs and cavities is performed afterwards.

At the end, the nteacher summarizes the data found during the autopsy and demonstrates how to ncorrectly take specimens of dead tissue, blood, urine for laboratory ninvestigation. The certificate of death is filled in as well. The morphological ndiagnosis and forensic conclusions should be made by the students nindependently.

 

Practical nactivity 3: If dead body is absent in the autopsy room the students must nrewrite «Report № 1» from the «Appendix» of the book.

 

Discussion about ntheoretical questions and practical activity (11.45a.m.-02.00 p.m.):

At the end of the nlesson, all the information presented before (forensic examination, its types, nobjects, structure of forensic-medical service in Ukraine etc.) are discussed nwith active participation of all students of the group.

 

Exit level of nknowledge and abilities.(2.15 – 3.00 p.m.)

It is checking by ntests.

 

Tests and nreal-life situations for self-assessment:

 

1. The kind of nexamination assigned for solution on matters of medical or biological character nduring a case investigated by the bodies of prejudicial inquiry, police ndepartment and court is called:

A. Forensic nmedical examination

B. Forensic nexamination

C. Criminal nexamination

D. Juridical nexamination

E. Humaexamination

 

2. What is the ndifference between Forensic medicine and Forensic examination?

A. Forensic nmedicine is a medical discipline, but forensic examination means a practical nexpert activity

B. Forensic nexamination is a medical discipline, but forensic medicine means a practical nexpert activity

C. They are the nsame

D. Forensic nexamination doesn’t  have any relations nto medicine

E. They are ndifferent fields of sciences

 

3. nForensic-medical expert may investigate the following objects:

A. Instrument ncaused the injury

B. Blood spots

C. Patient card

D. Dead body

E. All of them

 

4. The following nsub departments are present in the Bureau, except:

A. Forensic ncytological

B. Forensic nballistic

C. Forensic nimmunological

D. Forensic nhistological

E. All are true

 

5. The following nare kinds of forensic examination, except:

A. Repeated

B. Initial

C. Additional

D. Special

E. Commission

 

6. Official nforensic-medical examination is performed by

A. A doctor of nhospital

B. A doctor of npoliclinics

C. Pathologist

D. Investigating npolice-officer

E. Expert

 

7. Forensic nmedical Expert has the following rights:

A. To get nacquainted with case materials

B. To be on call nof the investigating police-officer

C. To draw the nobjective conclusion

D. To carry out nthe expert examination

E. To keep the ndata of inquiry

 

8. Which of the following nbelow is an expert’s duty:

A. To petitiofor additional resources

B. All those nanswers are false

C. To question to nlaw-court

D. To be present nduring interrogation

E. To confer with nanother experts if they are invited by investigator

 

9. Postmortem nexamination is indicated in the following, except:

A. Exhumation

B. External nExamination

C. Internal nexamination

D. Malignancy

E. Informative ngeneral details

 

10. A pedestrian was knocked-down by a lorry. Who must nassign the examination?

A. Chief of medical ndepartment

B. Forensic npathologist

C. Investigating nofficer

D. Lawyer

E. Relatives of nthe victim

 

Answers to the ntests:

1-A; 2 – A; 3 – nE; 4 – B; 5 – D; 6 – E; 7 – A ; 8 – B; 9 – D; 10 – C.

 

After the npractical class every student

 

must know:

1. The structure nof legislative departments, procurator’s office and court in Ukraine, their nmain tasks and functions.

2. The basic nprinciples of the Law of Ukraine «About forensic examination», concepts about Criminal nCode, Criminal-Procedural Code, Civil and Civil -Procedural Codes of Ukraine.

3. Causes for nappointment of the examination and cases, when medico-legal examination is nnecessarily required (art. 76 of CJC of Ukraine).

4. Legislative nposition of the forensic medical expert (his duties, rights and nresponsibilities).

5. Objects, kinds nand types of legal-medical investigations.

6. The structure nof medico-legal service in Ukraine and the reglamentation of forensic autopsy nin Ukraine.

7. Contingent of ndead bodies being investigated in forensic medicine, the main rules of a nforensic autopsy, the requirements for forensic documentation and the basic nprinciples in creation of the «Report of forensic autopsy».

 

must be able to:

1. Recognize ntheir personal legislative position during a forensic examination;

2. Make expert njudgments according to the tasks of investigation;

3. Use knowledge nfrom a number of special articles of Criminal Code, Criminal-Procedural Code, nCivil and Civil -Procedural Codes of Ukraine during the examination.

 

References

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1:57-60, 1980.

3. Wadee, S.A., Forensic Pathology: a ndifferent perspective: investigative medicolegal

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4. Marwith, C., Pathologists request autopsy revival,

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help nwith death certificates,

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excitability of nskeletal muscle: preliminary investigations of an animal model,

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7. Hutchins, G.M., Practice guidelines for autopsy npathology: autopsy committee

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8. Vanezio, P. and Trujillo, O., Evaluation of hypostasis using na colorimeter measuring

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For. Sci. Int.,

78, 19-28, 1996.

9. Wright, R.K. and Gantner, G., Electrical injuries nand lightning, In: Froede,

R.C., ed.,

Handbook of Forensic nPathology,

Northfield IL: Collegeof American

Pathologists; 1990.

10. Katelares, A., Kencran, J., Duflon, J., and nHilton, J.M., Brains at necropsy: to

fix or nnot to fix,

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47(8), 718-720, 1994.

11. Takayasu, Tatsunori et al., Experimental studies non post-mortem diffusion of

ethanol-d-6 nusing rats,

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76:179-188, 1995.

12. Takayasu, Tatsunori et al., Post-mortem ndegradation of administered ethanol-

d-6 and nproduction of endogenous ethanol: experimental studies using

rats and nrabbits,

For. Sci. Int.,

76:129-140, n1995.

 

 

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