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Authors report on two cases of homicide and another case of suicide, all committed with captive-bolt livestock-stunners. The investigation of skull caps revealed roundish holes at the entry sites which were beveled-out in a paraboloid-like manner on the inner aspect. These defects were reproducible in test shots with various strengths of ammunition and different materials as targets.
After a brief introduction into the psychiatric problems of pathological gambling, the author presents a statistical study on 72 delinquents, amongst them 14 excessive gamblers. The special design of this investigation consists in two comparative studies between the gambling and the non-gambling subgroups, first within the total of delinquents secondly within the group of the drugs- and property-offenders. There is a great number of traits compared concerning e.g. family history, personal biography, social status, drug-consumption-behavior and clinical traits. It is clearly shown that excessive gamblers are markedly overrepresented in the last-mentioned group and that gamblers are to be distinguished by a number of characteristics from their group-mates even in this comparatively homogenous subgroup. Thus, they seem to be negatively loaded by the high prevalence of psychiatric abnormalities in their families, by a higher frequency of birth complications, infantile behavioral disorders and an even more marked seeking behavior for addictive drugs.
Criminal confessions made in response to custodial questioning are excluded from evidence unless a defendant voluntarily, knowingly and intelligently waived his Miranda rights. In Connelly, the Supreme Court erred by holding that, absent explicit police coercion, a mentally ill individual's waiver is valid. The Court failed to consider the defendant's subjective impairments that might invalidate his waiver. By contrast, the Patterson Court suggested that a defendant's right to counsel may attach at an early stage in a criminal proceeding if the defendant has a significant need for counsel. This Note addresses the special needs of a mentally retarded person in the criminal justice system. The Note argues that mentally retarded suspects require careful explanation of Miranda rights in order to understand them. The intellectual and adaptive deficiencies which characterize mental retardation also necessitate an inquiry into a valid waiver that accounts for these disabilities. Furthermore, the special needs of the mentally retarded mandate that the right to counsel attach as early as the precustodial stage of an investigation. Early access to counsel most effectively assures that a mentally retarded person's waiver of constitutional rights is voluntary, knowing and intelligent.
Forensic nursing, as a professional discipline, originally defined its role as a medical examiner's investigator in the field of death investigation. However, with the evolution of a new area of clinical practice, the application of forensic science to nursing reveals a wider role in the investigation of crime and in the legal process. Forensic nursing, as a clinical subspecialty, fills a complementary role to clinical forensic medicine. As an emerging discipline, clinical forensic nursing recognizes that health care providers must assume a mutual responsibility with forensic scientists and the criminal justice system in concern for the survivor of violent crime and perpetrators of criminal acts. The registered nurse can be a great asset in the forensic sciences. Death has become a respectable field of inquiry, demanding answers to satisfy the public need and demand to determine the cause and manner of death. Nurses can bring empathy and compassion--as well as excellent observation, clinical, and communication skills--to death investigation.
Pooling data from four samples in which 1,882 men were assessed for acts of interpersonal violence, we report on 120 men whose self-reported acts met legal definitions of rape or attempted rape, but who were never prosecuted by criminal justice authorities. A majority of these undetected rapists were repeat rapists, and a majority also committed other acts of interpersonal violence. The repeat rapists averaged 5.8 rapes each. The 120 rapists were responsible for 1,225 separate acts of interpersonal violence, including rape, battery, and child physical and sexual abuse. These findings mirror those from studies of incarcerated sex offenders (Abel, Becker, Mittelman, Cunningham-Rathner, Rouleau, & Murphy, 1987; Weinrott and Saylor, 1991), indicating high rates of both repeat rape and multiple types of offending. Implications for the investigation and prosecution of this so-called "hidden" rape are discussed.
We report 12 patients with osteogenesis imperfecta initially diagnosed with nonaccidental injuries. As a result, formal hearings, care proceedings, and criminal proceedings ensued and seven of the children were removed from their parents. The features suggestive of osteogenesis imperfecta at the time of the initial investigation included a positive family history in six patients, scleral discoloration in nine, abnormally large anterior fontanels in four, excessive numbers of wormian bones in four, abnormal bone texture in two, and abnormal biochemical findings in three. There were discrepancies between the fractures and other clinical evidence of inflicted trauma. The seven patients removed from their homes eventually were returned. Five patients remained at home. Information was available on the subsequent history of the patients for an average of 4.8 years. Although seven patients have had additional fractures, there have been no additional allegations of nonaccidental injury. When investigating children with unexplained fractures, it is important to review carefully their clinical history, family history, physical examination findings, and radiographic findings. Misdiagnosing patients with nonaccidental injuries causes substantial harm to the family and particularly to the child.
In the past two hundred years, views of the etiology of delinquency have developed from the extreme constitutional direction or line of thought through theories considering social factors to be solely responsible to the assumption of a combination of constitutional and social factors. Theses of social misadaptation as a source of delinquency, which were inaugurated by Soviet criminologists, could also be confirmed by the results of a large-scale investigation conducted in Poland. The combination of two factors (limited psychic power and negative social influences) was found to be the most frequent cause of criminal acts.
Finland has one of the highest homicide rates in western Europe but the clear-up rate is also exceptionally high. To create a detailed analysis of homicides (n=161) in a region of western Finland during the 20-year period from 1983 to 2002 all available information was collected retrospectively from multiple sources including medico-legal reports, reports of police investigations, and court proceedings. Among the data collected and analysed were location, time, circumstances, and motives of homicides, forensic pathologists' role at the scene-of-the-crime and in court, autopsy findings, demographics and substance abuse of both victims and offenders, criminal background, forensic psychiatric examinations, and the verdicts of the offenders. A typical homicide was committed without premeditation during the weekend by a drunken male with a knife at hand and with a history of violent crimes. The perpetrator was later found guilty of manslaughter and received a prison sentence. Some noted shortcomings both in the police and the medico-legal investigation procedures are discussed, as well as the forensic pathologist's role in the judicial process in Finland.
It is appreciated that there are national and jurisdictional variations in regard to post-mortem dissections following accidental death. The purpose of this paper is to plead that, since there will be nationals of many states involved in an aircraft disaster, there should be a uniform system of forensic investigation on a world wide basis. The justification for this recommendation is illustrated through the investigation of accident causes and through the solution of the many problems relating to the settlement of probate which arise in accidental death. The causes of accidents which may be discovered by autopsy include crew incapacitation and criminality of all types. The emergency status may also be revealed and the type of accident, particularly whether in a controlled or uncontrolled phase, may become clear. The medico-legal problems to be resolved include those concerning payment of insurance policies, including the degree of life expectancy, and especially the disposal of estates when members of a family apparently die together. The resulting payments to beneficiaries may be quite different depending on the quality of the autopsy. These investigations are complementary to, and do not interfere with, the identification process but they are time consuming and expensive.
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Many convicted offenders suffer from major mental disorders. These offenders commit crimes with great frequency. They do not receive mental health care and are often found in isolation cells of correctional facilities. The present investigation examined lifetime multiple disorders, measured by the DIS, among a representative sample of male penitentiary inmates. Pure forms of the major mental disorders were rare. All possible combinations of the major disorders were found to exist. No patterns of groupings of disorders were evident.
A total of 932 adolescent psychiatric in-patients were followed up 15-33 years after hospitalization by record linkage to the National Register of Criminality. On the basis of the hospital records the patients were rediagnosed according to DSM-IV and scored on data postulated to be predictors of later delinquency. The factors were investigated by Kaplan-Meyer survival analysis and Cox regression. Cox analysis showed that, in males, main diagnosis (relative risk (RR)=2.9, 95% confidence interval (CI)=2.0-4.2), verbal abuse at home (RR=1.5, CI=1.1-2.0), disciplinary problems at school (RR=1.7, CI=1.2-2.5), and violating ward rules during hospitalization (RR=1.6, CI=1.2-2.2) were strong and independent predictors of delinquency. In females, main diagnosis (RR=2.6, CI=1.6-4.2), concurrent psychoactive substance use disorder (RR=2.9, CI=1.9-4.2), verbal abuse at home (RR=1.5, CI=1.0-2.1), and disciplinary problems at school (RR=1.6, CI=1.1-2.5) were strong and independent predictors of delinquency. Among males who violated ward rules and received a diagnosis of disruptive behaviour disorder, psychoactive substance use disorder or personality disorder at index hospitalization, as many as 77.6% had a criminal record at follow-up.
BACKGROUND: Physicians frequently have to face an investigation of their work from a judicial point of view. Due to these proceedings the number of cases when they are reproached with malpractice is increasing. CASE REPORT: We report the rare case of a 76-year-old female patient who fell from a 68 cm high couch after a sedative was applied during gastroscopical examination. She died 24 hours after the incident. Forensic necropsy revealed a delayed aortic rupture as the cause of death. The preliminary proceedings against the physician involved for culpable homicide by criminal negligence were suspended after he paid a fine. The possible legal consequences under German law for physicians involved in such cases are discussed as well as strategies to avoid them. CONCLUSION: Physicians who are under investigation for malpractice should act carefully. They are advised to seek professional help at an early stage of preliminary proceedings. A public trial should be avoided if possible.
Men with polytropic and persistent delinquency constitute a core group of criminal offenders. Criminological research could establish a set of social characteristics for this group, but psychiatric, neurological and neuropsychological variables with importance to the formation of delinquent recidivism are rarely investigated. In this study we give a survey of the results concerning the relevance of genetic factors for delinquent behaviour. Then we review the development of the "minimal brain disorder" conception and its changes to "hyperkinetic syndrome", "attention deficit disorder" and to specific developmental disorders, which are all associated with a higher degree of conduct disorders and delinquent behaviour. We finally discuss the stability and relevance of nonfocal neurological ("soft") signs and depict a tentative model of the relations between the influential factors. Part II of this study (66) gives an account of the results of the "Heidelberg Delinquency Study" in this area.
Directly age standardized rates of first admission schizophrenia in Denmark (1991: 5.1 million inhabitants) decreased significantly with a slope of -0.16 and -0.13/100,000 inhabitants fifteen years and above for males and females respectively from 1971 to 1991 when examined by help of the Danish nation-wide psychiatric case register in the Institute of Psychiatric Demography, Aarhus. A control for changes in diagnostic delay/changing diagnostic patterns does not affect the findings. Various nosological factors might cause the decrease, e.g. changing structure in organization of treatment facilities, decreasing number of beds (50% in Denmark during the period investigated) and correlated with this: increasing suicide rates among pretreatment schizophrenics, increasing rates of schizophrenics not yet diagnosed in shelters for homeless and in institutions for criminals. The decrease might be genuine. In connection with this the theories about damage to the fetus during the gestation period are briefly discussed.
To describe lifetime mental disorders among perpetrators of severe inter-personal crimes and to identify the problem domains most closely associated with aggression and a history of repeated violent criminality, we used structured interviews, clinical assessments, analyses of intellectual functioning, medical and social files, and collateral interviews in 100 consecutive subjects of pretrial forensic psychiatric investigations. Childhood-onset neuropsychiatric disorders [attention-deficit/hyperactivity disorder (AD/HD), learning disability, tics and autism spectrum disorders] affected 55% of the subjects and formed complex comorbidity patterns with adult personality disorders [including psychopathic traits according to the Psychopathy Checklist (PCL-R)], mood disorders and substance abuse. The closest psychiatric covariates to high Lifetime History of Aggression (LHA) scores and violent recidivism were the PCL-R scores and childhood conduct disorder (CD). Behavioral and affective PCL-R factors were closely associated with childhood AD/HD, CD, and autistic traits. The results support the notion that childhood-onset social and behavioral problems form the most relevant psychiatric symptom cluster in relation to pervasive adult violent behavior, while late-onset mental disorders are more often associated with single acts of violent or sexual aggression.
Alcohol-impaired driving is a major issue confronting today's society. New legislation is emerging to help curtail this ongoing problem. To evaluate the legislative effects in terms of outcome pertaining to injured drivers, we analyzed the records of 116 consecutive motor vehicle drivers who were admitted to our trauma center over a 16-month period. Medical reports, police reports, and drivers' abstracts were reviewed. Of the 116 drives, 61 (53%) had blood alcohol concentrations that exceeded the legal limit (blood alcohol level greater than or equal to 100 mg/dL) on arrival at the emergency department. Only four of these patients were ticketed for driving under the influence and received the mandatory suspension of their driver's license. None was convicted of this offense, which carries criminal charges and a revocation of the driver's license. Mechanisms for efficient collection of blood specimens and mandatory occurrence reporting are two recommendations that merit investigation to obviate further escape of injured, intoxicated drivers from the legal net. In addition, alcohol rehabilitation and education cannot be overlooked and should warrant strong societal support.
Two experiments investigated the impact of DNA evidence in a child sexual assault (CSA) case involving a 6-year-old alleged victim. In Experiment 1, participants read criminal trial summaries of CSA cases in which only DNA evidence was presented, only the alleged child victim's testimony was presented, or both forms of evidence were presented. When DNA evidence was presented, there were more guilty verdicts and greater belief of the alleged victim than when only the alleged victim testified. In Experiment 2, DNA evidence was countered by an alibi witness testifying as to the defendant's whereabouts at the time of the alleged assault. The alibi witness reduced the influence of DNA evidence compared with when DNA evidence was presented without this witness. These results are discussed in terms of the comparative strengths of DNA evidence versus the testimony of the alleged victim.