Current Practice in Forensic Medicine

John Gall is a forensic physician in private practice, Director of Southern Medical Services, Principal of Era Health and is a staff specialist Forensic Physician in the Victorian Paediatric Forensic Medical Service, located at the Royal Children's Hospital and Monash Medical Centre, Melbourne. He is a member of the International Editorial Board of the Journal of Legal and Forensic Medicine and Internet Journal of Forensic Medicine and Toxicology. He has published widely in the field of clinical forensic medicine and has spent many years teaching forensic medicine to undergraduates and graduates. JASON PAYNE-JAMES is a forensic physician. He is Honorary Senior Lecturer, Cameron Forensic Medical Sciences, Barts & the London School of Medicine & Dentistry, University of London, UK. He is Director of Forensic Healthcare Services Ltd. He is external Consultant to the National Policing Improvement Agency and to the National Injuries Database in the UK. He is Editor-in-Chief of the Journal of Forensic & Legal Medicine. He has published widely in the field of clinical forensic medicine. He has also co-edited, co-authored and contributed to numerous books in the field including Black, Aggrawal and Payne-James: 'Age Estimation in the Living' 2010 (Wiley Blackwell).

List of Contributors. Foreword. Preface. Chapter One: Expert evidence and healthcare professionals. Introduction. The adversarial system of justice. Expert reports. Evidentiary exclusionary rules. Pre-trial preparation for expert witnesses. Appearance. Timeliness. Giving of evidence. Managing cross-examination. Summary. References. Chapter Two: Forensic investigation of biological weapon use. Introduction. A choice of words. Threat assessments. Presenting features. Forensic microbiology or microbial forensics? Assembling evidence from emerging infectious disease biology. Current constraints. References. Appendix. Chapter Three: The paediatric hymen. Introduction. Studies of normal anatomy. Studies of genital findings in sexually abused girls. Studies of acute injuries as they heal. A consideration of test reliability. Putting it all together. References. Chapter Four: Assessment and interpretation of bone trauma in children. Introduction. How should I evaluate suspected bone trauma in children? What radiological investigations identify bone trauma? How do X-rays detect fractures? How does ultrasound detect bone injury? How do nuclear medicine scans detect bone injury? How does MRI detect bone injury? How are medical images presented and shared? What forces cause bones to fracture? Are some bone injuries diagnostic of child abuse? What do we know about bone healing in children? What tests detect fragile bones? Neonates with fractures: what are the special considerations? Can the time of bone injury be determined? Why might an X-ray be reported as normal when bone trauma exists? Why might an ultrasound appear normal when bone trauma exists? Why might a nuclear medicine scan appear normal when bone trauma exists? Why might an X-ray appear abnormal when no bone trauma exists? Why might a nuclear medicine scan appear abnormal when no bone trauma exists? How do I deal with correctly interpreted but discordant imaging findings? Why might an X-ray appear normal and bone scan hot when bone trauma exists? Why might a fracture seem obvious on plain X-ray but bone scan is 'cold' when bone trauma exists? When and why should I repeat x-rays? How does the process of forming a forensic medical opinion differ from the process of diagnosis in clinical medicine? Why do I need to be aware of my level of confidence in my medical diagnosis? What factors should I consider when forming a diagnostic opinion about the cause of a child s fracture? References. Chapter Five: Adult sexual assault. Introduction. Sexual assault settings and characteristics. Findings after sexual assault. Toxicology and sexual assault. Forensic science and sexual assault. Treatment after sexual assault. Summary. References. Chapter Six: The ethical and medical aspects of photo-documenting genital injury. Introduction. Sexual assault. Imaging the body in the history of medicine. Photography. The evolution of the photography of genital injury. A particular Australian's experience. Ethics of care. Why no ethical objection to children being photographed? The difference that being a child makes and its relevance. Advancing the question of best ethical practice. Clinical forensic medicine and sexual assault. Conclusion. References. Appendix. Chapter Seven: The photography of injuries. Introduction. The image. Equipment. Illumination. Polarizing filters. Forensic scales. The photography of an injury. The colour control or reference. Cross-polarized photography. Reflected ultraviolet. Infrared. Long wave ultraviolet-induced fluorescence. Imaging file format. The audit trail. Conclusion. References. Further reading. Chapter Eight: DNA analysis: Current practice and problems. Introduction. DNA collection and storage. DNA extraction. DNA quantification. DNA amplification. DNA separation and detection. DNA genotyping. Standard loci sets and commercial STR kits. Statistical evaluation of a DNA match. Assessing STR profiles. Mixtures of DNA. Degraded DNA. Low-template DNA. Other genetic markers. Tissue identification. Use of DNA in the criminal justice system. References Chapter Nine: Injury interpretation: Possible errors and fallacies. Injury visualization. Nomenclature. Photography. Aging of injuries. Force of injury. Medical limitations and considerations. Genito-anal injuries in the adult. Child abuse. Self-inflicted injury. Other specialist opinions. Opinions. How to avoid errors. References. Chapter Ten: Self-inflicted injuries and associated psychological profiles. Introduction. Forensic aspects of self-harm. Psychiatric aspects of self-harm. Epidemiology. Classification of self-harm. The clinical dilemma. Management. Long-term outcome. Conclusion. References Chapter Eleven: Bite marks. Introduction and cautionary remarks. Animal bites. Other injuries mimicking bites. Bites in foodstuffs. Examination of injuries in the dead. Examination of the living. Examination of the suspect. Trends in bite-mark analysis. Acknowledgement. References. Further Reading. Chapter Twelve: Aviation disasters: The role of the forensic pathologist. Introduction. The scene. The autopsy. Establishing the cause of death. Circumstances surrounding death. Forensic pathology report. References. Index.