Current Practice in Forensic Medicine, Volume 3

John A.M. Gall is a consultant forensic physician, Director of Southern Medical Services, Principal of Era Health, Senior Consultant with the Victorian Paediatric Forensic Medical Service, Royal Children’s Hospital and Monash Medical Centre, Melbourne, and an Associate Professor, Department of Paediatrics, The University of Melbourne. He is President of the International Association of Clinical Forensic Medicine and a member of the International Editorial Board of the Journal of Legal and Forensic Medicine. Jason Payne-James is a Specialist in Forensic & Legal Medicine & Consultant Forensic Physician. He is Honorary Clinical Professor at the William Harvey Research Institute, Queen Mary University of London. He is Lead Medical Examiner at the Norfolk & Norwich University Hospital, Norwich, UK. He is Chair of the UK Scientific Advisory Committee on the Medical Implications of Less-Lethal Weapons and an Executive Board Member of the European Council of Legal Medicine. He is Medical Director of Forensic Healthcare Services Ltd, Southminster, UK.

• List of ContributorsPreface xixChapter One: The new Medical Examiner System in England and Wales: its role in the medicolegal investigation of death 1Introduction 1Background 2Structure and function of the Medical Examiner system in England and Wales 7Medical Examiners 9Medical Examiner Officers 11How does a Medical Examiner Service work? 12Relationships with other teams supporting the deceased and bereaved 16Conclusion 16References 17Chapter Two: Who makes false allegations and why? The nature, motives, and mental health status of those who wrongly allege sexual assault 21The nature of false allegations 21Deliberate fabrication 22Inadvertent allegations 27Conclusion 33References 34Chapter Three: Disclosure of evidence in sexual assault cases 41Introduction 41Definition and interpretation 42Disclosure and the medical professional 44The Court of Appeal judgements in the context of forensic and legal medicine 49Conclusion 51References 52Chapter Four: Current perspectives on the type and use of weapons used to police public assemblies around the world 55Introduction 55Less- lethal weapons 59Kinetic impact projectiles 65Conclusion 73Acknowledgement 73References 74Chapter Five: Non- fatal strangulation 81Introduction 81Non- fatal strangulation and intimate- partner violence 81Legal status of non- fatal strangulation 82Non- fatal strangulation and assault 83Symptoms and signs of non- fatal strangulation (acute and longer term) 86Examples of findings and descriptions of NFS assaults 97Management of non- fatal strangulation 104Radiological imaging in non- fatal strangulation 104Conclusion 106References 106Chapter Six: DNA: current developments and perspectives 109Introduction 109STR improved autosomal multiplexes used for criminal justice 110Rapid DNA 113DNA mixtures 116Massively parallel sequencing 119Forensic DNA phenotyping 124Forensic genealogy 132Conclusion 135References 135Chapter Seven: The utility of forensic radiology in evaluation of soft tissue injury 143Introduction 143Limitations 145Types of cross- sectional radiological imaging 147Types of injury 148Injury patterns and causation 157Gunshot injuries 160Ligature soft tissue injuries 160Conclusion 163References 163Chapter Eight: Abusive head trauma in children – a clinical diagnostic dilemma 167Definitions 167A brief history 168Current hypothesis on the development of subdural haemorrhage, retinal haemorrhage, and hypoxic–ischaemic encephalopathy in AHT 170The presentation and diagnosis of AHT 170The development of a controversy 171Clinical medicine and the medical diagnosis 173Alternative hypotheses 173Short- distance falls 174The circular argument 175Confession evidence 176The missing biomechanical model 176The clinician’s approach to a diagnosis of AHT 177Terminology 179Conclusion 182References 182Chapter Nine: The ageing population: needs and problems of the older person in prison 187Overview 187Introduction 187Health and social care needs of older people in prison 188Key steps in addressing the needs of the older person in prison 196Where next? 201References 201Chapter Ten: Fitness to plead and stand trial – from the Ecclesfield Cotton Mill dam to Capitol Hill 205Introduction 205The application of the Pritchard test in England and Wales 212Physical illness or disability and fitness to plead and fitness to stand trial in England and Wales 215Related provisions in some other common law jurisdictions 215A practical approach to assessment 220Conclusion 220Acknowledgements 221References 221Law reports 222Chapter Eleven: Quality standards for healthcare professionals working with victims of torture in detention 225Introduction 225Why were quality standards needed? 226Prevalence of torture 226Clinical consequences of prior torture 226Methods of torture 226Detention in the United Kingdom and risks for patients’ health 228Effects of detention on victims of torture 229Professional responsibility 230Outcomes 230Conclusions 235References 236Chapter Twelve: A forensic approach to intimate partner homicide 239Introduction 239The ‘crime of passion’ discourse 241Coercive control discourse 242Medical narratives and discourse 243IPH and IPA as expert knowledge 244Response practices 245Conclusions 249References 250Chapter Thirteen: Non- lethal physical abuse in the elderly 253Failure to diagnose 254The ageing process 254Acknowledgement 275References 276Chapter Fourteen: Physical intervention and restraint 279Introduction 279The organisational approach to managing challenging behaviour, aggression, and violence 279Minimising the risk of injury and death 281Use of force in therapeutic environments 282The use- of- force hierarchy 282Organisational approaches to managing challenging behaviour and violence 283Physical interventions in other (non- policing) environments 284The range and risks of physical interventions 286Conclusions 291Acknowledgement 292References 292Chapter Fifteen: Medical and toxicological aspects of chemical warfare: the nature, classification, and management of chemical agents used in warfare 293Introduction 293OPCW and control and schedules 294Hazard/threat assessment 294Environmental indicators and detection overview 294Bioanalytical detection overview 295Classes of chemical weapons and casualty management 297Pulmonary agents: chlorine and phosgene 305Asphyxiants: cyanide and hydrogen sulphide 309Blistering agents/vesicants: sulphur mustard chlorine and lewisite 311Other chemical warfare agents 315Opiates and opioids 317Perfluoroisobutene (PFIB) 319Bioregulators 320Endorphins and enkephalins 321Neurokinins, including substance P 321Endothelins 321Bradykinin 322Angiotensin 322Neurotensin 322Other Bioregulators 323Summary 323References 323Index 327