INTRODUCTION TO BASIC FORENSIC PATHOLOGY

Basic introduction to forensic pathology

1. COURSE OUTLINE Kenyan legal system Forensic pathology Forensic medicine Clinical forensic medicine Medical law and ethics Inquest and medical evidence in court The Autopsy Death notification and documentation The crime scene Injuries 11. Human identification 12. Sexual offences 13. Domestic violence 14. Torture and death in custody 15. Asphyxia deaths 16. Death due to exposure to extremes of temperatures 17. Sudden unexpected death 18. Alcohol intoxication and poisoning

2. INTRODUCTION TO FORENSIC PATHOLOGY AND MEDICINE 2021 DR MUTUMA G Z

3. 1. Forensic pathology is pathology that focuses on determining the cause of death by doing post mortem (Autopsy) examinations . Rests largely on the principles of morbid anatomy 2. Deals with the interpretation of autopsy findings in a medico-legal investigation of death. 3. Application of medico-Legal knowledge to aid in the investigation of deaths in line with the court of law . 4. Legal organizations seeking help from medical experts . 5. Forensic Pathologists are employed to investigate unexpected or sudden deaths as a result of body trauma. 6. They are physicians who are highly trained and specialize in pathology i.e. diagnosis of diseases Forensic Pathology Concept and definition

4. Application of medico-pathology knowledge to aid in the investigation of deaths in line with the court of law . Legal organizations seeking help from medical experts . Pathologists are employed to investigate unexpected or sudden deaths as a result of body trauma. They are physicians who are highly trained and specialize in pathology i.e. diagnosis of diseases What is Forensic Pathology ?

5. studying cause and effects of injury or disease by lab experiments study tissue and body fluids of the human body apply medical facts to legal questions testify in court about medical findings identify drugs and poisons found in bodies in crimes scenes. Roles of Forensic Pathologists

6. Tasks by forensic pathologists: studying cause and effects of injury or disease by lab experiments study tissue and body fluids of the human body apply medical facts to legal questions testify in court about medical findings identify drugs and poisons found in bodies in crimes scenes. Forensic Pathologists

7. Forensic investigation using artificial light Lausanne Forensic Pathology approach to post-mortem imaging for natural and unnatural deaths. Forensic investigation of head skull EXAMPLES

8. A forensic pathologist at work

9. A forensic anthropologist examining the cranium exhumed from a mass grave.

10. FORENSIC MEDICINE - INTRODUCTION Concept and definition 1. Application of medical knowledge towards administration of justice. 2. Is essential for a medico-legal expert to have a fair knowledge of all the branches of medical and ancillary sciences. 3. Area of forensic medicine that relates to the medical examination and assessment of the living.

11. FORENSIC MEDICINE 4. Involves maintaining a fine balance between sound medical principles for the patient and the expectations of the justice system for probative evidence. 5, Forensic science is the scientific study of evidence to discover the facts in a criminal or civil matter . 6. It is the use of science and technology to enforce civil and criminal laws . 7. In medical practice it involves pathological study of corpses to aid in enforcement of civic and matters of law.

12. 2021 B FORENSIC MEDICINE RIEF INTRODUCTION Application of medical and paramedical knowledge to civil or criminal law in a bid to investigate suspicious or unnatural deaths. Primary approach in the living persons rather than autopsies It is key in identification of victims of disaster, serial offenders (rapist, murderers )

13. DNA Technology in forensic medicine involves the identification of persons in a mass disaster. Including: victims, assailants , rape, Incest, baby miss ups, abduction, inheritance , immigration , and criminal investigations among others. DNA technology in Forensic Medicine

14. CLINICAL FORENSIC MEDICINE . Aspect of examining a living person for medico-legal purposes Examination and first line treatment of victims of crimes against the person and the documentation and interpretation of their injuries . Examination and first line treatment of police detainees . Assessment of fitness to be interviewed . Assessment and medico-legal opinions involving traffic medicine . Assessment and expert opinions regarding the clinical effects of alcohol and drugs in a range of circumstances.

15. CLINICAL FORENSIC MEDICINE . Aspect of examining a living person for medico-legal purposes 1. Clinical Forensic Medicine also has a significant public health and safety role. 2. Research based on clinical forensic examination results can contribute to injury and death prevention, especially in the fields of interpersonal violence, drug usage and road trauma, and this can contribute significantly to public health and justice policy development.

16. Aspect of examining a living person for medico-legal purposes Examination and first line treatment of victims of crimes against the person and the documentation and interpretation of their injuries . Examination and first line treatment of police detainees . Assessment of fitness to be interviewed . Assessment and medico-legal opinions involving traffic medicine . Assessment and expert opinions regarding the clinical effects of alcohol and drugs in a range of circumstances.

17. QUESTIONS?

18. KENYAN LEGAL SYSTEM The Kenyan legal system is descended from the British Common Law system. A precedent is a judgment or decision of a court, normally recorded in a law report, used as an authority for reaching the same decision in a subsequent case.

19. Kenya legal system cont. Kenya is a pluralistic legal system. This means that there are several systems of law coexisting at the same time in the same jurisdiction among a common people. It is a mixed legal system of English common law, Islamic law, and customary law; judicial review in the new Supreme Court established by the new constitution. It includes sources of law and court system.

20. Sources of law cont. The Supreme Law-The Constitution All written laws-including delegated legislation/subsidiary legislation International law Common law, equity and statutes of general application Customary law Islamic law

21. The court system in Kenya

22. Court system cont. The court system is divided into 1. Superior courts and 2. Surbordinate courts- it is hierarchical in nature. 1. Superior courts- The Supreme Court, The Court of Appeal, The High Court 2. Subordinate courts- The Magistrate Court, The Court Martial, The Kadhis Court and any other local court or local tribunal established. 3. Tribunals- these are quasi-judicial bodies eg the HIV Equity Tribunal, Rental tribunal ….

23. N.B: Read more on sources of law

24. THE PRINCIPLE TYPES OF MEDICO-LEGAL SYSTEMS The medico-legal system is responsible for conducting death investigations and certifying the cause and manner of unnatural and unexplained deaths . Example of medico-legal cas es to be presented in courts - Police cases Homicides - criminal violence, apparent suicides, Suspected or evident Mass food poisoning Road Traffic accidents Death in Custody , Alcohol intoxication, Diseases outbreaks Medical Malpractice – Anesthetic deaths, Maternal deaths Burn injuries due to any cause Physical assault: Gun shots, stab wounds, lacerations cases Sexual assault such as Rape, child abuse, Granny abuse Domestic violence

25. Most countries have a rigid criminal code, which defines the procedure for the investigation of criminal or suspicious deaths. No inquiries into deaths comparable in most Countries outside the criminal trial. Medico-legal experts exist to assist the police in their investigation. Have no or little power to initiate an investigation in most of the Legal systems . Suspicious deaths referred by the police to legal medicine institutes for examination If the criminal activity is excluded the case is dropped The Standard of medical medicine respected.

26. IMPORTANT MEDICAL LAWS IN KENYA Several Acts in Kenya regulate or touch on the performance of autopsies. – forensic medicine and pathology The main ones relevant to medico-legal autopsies are as follows: Investigation of death (Inquest Act) – The Criminal Procedure Code of Kenya CAP 75 – The Inquest Act CAP 11 The National Police Service Act – The National Police Service Act 2011 Section 55

27. cont. Public Health Act – Public health Act of Kenya CAP 242 Human Tissues and Anatomy Act – Human Tissue Act of Kenya CAP 252 and Anatomy Act of Kenya CAP 249. -Provide for the handling of tissues from autopsies for research, teaching as well as cadavers for teaching. Births and Death Registration – Births and Deaths Registration of Kenya Act CAP 149

28. others include ; Medical Practitioners and Dentists Act-Cap 253 Nurses Act-Cap 255 Mental Health Act-Cap 248 Pharmacy and Poisons Act-Cap 244 Public Health Act-Cap 242 Narcortic Drugs and Psychotropic Substances Act-Cap 245

29. Bio-safety Act-Cap 321A Children Act-Cap 141 Food Drugs and Chemical Substances Act-Cap 254 Criminal procedure Act-Cap 75 Penal Code-Cap 63 Occupatio Safety and Health Act-Cap 514

30. THE END... QUESTIONS?