Forensic Medicine is the use of medicine in order to investigate cause of injury or cause of death.
Learning Goals and Objectives:
- what aspects of medicine are involved in a medicolegal practice?
- what are the duties and training for coroners and medical examiners (pathologists)?
- What is meant by manner or death, cause of death, and mechanism of death?
- What are the classifications for manner of death, and how are they determined?
- When are autopsies needed or required?
- What information can be gained from an autopsy and how are they performed?
- What are the major systems of the body investigated during an autopsy and what types of information can be learned from each?
- What is meant by the post-mortem interval, rigor mortis, livor mortis, and algor mortis?
- What are the major types of trauma and how are they characterized?
The role of a coroner and that of a medical examiner are very different, though often confused:
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Medical Examiners are required to compete a medical degree, along with several residencies and apprenticeships until they are able to work on their own to perform accurate and legal autopsies.
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Manner of Death, Cause of Death, and Mechanism of Death
Manner of death includes only several categories of legal determinations, as seen in the image below:
Cause of death includes the disease or injury that results in death. See the image below:
Mechanism of death provides the biochemical reason for death.
"For example, if a person sustains multiple impact injuries from an automobile accident, the cause of death could be determined to be blunt force trauma with the mechanism of death being exsanguination (loss of blood). The independent issue of manner of death could be determined to be homicide, accidental or suicide in this case, depending upon other evidence" (Spencer, Ch 8, p 11).
"For example, if a person sustains multiple impact injuries from an automobile accident, the cause of death could be determined to be blunt force trauma with the mechanism of death being exsanguination (loss of blood). The independent issue of manner of death could be determined to be homicide, accidental or suicide in this case, depending upon other evidence" (Spencer, Ch 8, p 11).
Determination of Post Mortem Interval
Rigor mortis is the stiffening of the joints and muscles of the body, starting a couple hours after death and remaining 1 to 4 days after death
Livor mortis is the pooling of blood in the lower portions of the body due to gravity, causing a purplish/reddish discoloration of the skin. "Livor" is a Latin term for blue-ish color.
Algor mortis is the decrease in body temperature, following death, until the body temperature reaches that of the ambient temperature.