Raymond Poincare Hospital
The Department of Pathological Anatomy and Forensic Medicine of Raymond Poincare Hospital is responsible for the general pathological anatomy of the hospital and the forensic examination entrusted by three courts. Sometimes judges in other courts also entrust them to ask for appraisal.
Pathological examination: There are about 320 ~ 330 autopsies every year, among which 3 people are in charge, 1 is the department director and professor, and the other one is also engaged in outpatient examination besides pathological examination. Mr Fran? ois Palel, who introduced us, is also a pathologist. In addition, there are some part-time inspectors in the hospital, such as 1 famous neuropathologist (in terms of the change of nerve damage caused by AIDS), 1 physician assistant, 1 famous medical student and 1 technician. There is a laboratory attached to the Department of Pathological Anatomy and Forensic Medicine, which is engaged in immunopathology and other aspects. The laboratory leader 1 person, 2 technicians and 2 assistants. Other laboratories in the hospital, such as biochemical room, toxicology room, bacteria room and DNA room, all cooperate to carry out forensic examination.
Forensic clinic: There are 4 doctors and 2 physician assistants in charge of outpatient case examination. The clinic and pathology room are not in the same building, but in another building of the hospital. The work of the clinic is mainly to receive victims of violent injuries and rape cases entrusted by the above courts. After the examination, it is necessary to show the victim signs of violence and guide the victim to the relevant departments for treatment and treatment. Forensic clinics don't care about treatment. Another job of the forensic clinic is that sometimes when a murder scene is found, the forensic doctor needs to go to the scene for inspection. Of course, the staff of the forensic clinic sometimes go to the detention center to check the general situation of criminals and judge whether they meet the conditions of detention. This kind of examination includes both physical and mental. Because the French criminal procedure law stipulates that every detainee has the right to undergo a physical examination to see if he meets the conditions of detention.
Other business: according to the needs of judges, accept entrustment and conduct appraisal. Therefore, other tests, such as paternity test, are sometimes carried out. Responsible for forensic medicine teaching and resident training in University of Paris V.
In their view, it is very important that forensic doctors are independent and do not belong to the judicial department.
Jean Verdierde Hospital
The emergency room of forensic medicine in Jean Verdierde Hospital, located in Paris 19, is mainly used for the appraisal of police stations and related courts, and there are people on duty 24 hours a day to receive the appraisal. The appraisal contents include: victim examination of violence cases, victim examination of rape cases and physical examination of criminal detainees. This forensic doctor is only responsible for biopsy in an emergency, and there is no autopsy. About 1800 every month, of which 60% to 80% are minors. The staff includes 4 full-time doctors, 1 resident, 2 university interns and temporary doctors from time to time. Nurses and doctors in the whole emergency room can use it. There are no special beds, beds in all departments of the hospital can be used, and you can also ask a specialist for consultation. The contents of the report include: the damage situation and the number of days of rest, and attach a guiding material to advise them what to do.
They have a fixed format table for on-site inspection of victims of violence and a format table for inspection of rape victims. Practice for in vivo examination.
A considerable part of their cases are rape cases, mainly domestic rape cases, accounting for about 60%. For victims of sexual assault, it is necessary to use a set of drugs specifically for AIDS treatment. In this area, not only women, minors and some men were raped. Rape in the family accounts for more than 50%.
In addition, they are also responsible for the forensic medicine teaching of the University of Paris 13. According to Mr. Jean-Pierre BENAIS, the outline of his forensic training program has also been recognized and promoted by UNESCO. The education program is aimed at police, lawyers, judges and other personnel related to injury incidents.
God hospital
The emergency room of forensic medicine in God Hospital is a forensic appraisal institution that works closely with the police station. The God Hospital and the Paris Police Department are separated by a street, which is the natural advantage of their close cooperation. On the top floor of the hospital, there is also a completely closed prisoner ward, guarded and guarded by the police. The main working objects here are victims and criminals in criminal cases. * * * There are more than 30 doctors, some of whom are fixed, and most of them are not.
Forensic clinics mainly accept victims of violence and rape. There are many consulting rooms on the second floor of the emergency department, one of which is dedicated to gynecological examination, with special equipment for hymen examination, 1 Olypus stereoscopic microscope. There is no difference between other examination rooms and general consultation rooms. At the entrance of the second floor of the outpatient clinic, there is a guide card for criminal victims, and a poster for identification of criminal victims is posted on the wall. Involving mental examination, the psychiatrist in this hospital is responsible for the examination.
1 The clinic in the building is dedicated to the physical examination of criminals. The criminals here include drug dealers and addicts, drunk drivers and other people who commit misdemeanors for medical examination. At present, the most common drug cases are drug cases in which packaged drugs are swallowed into the body for sale. So there is a special toilet for criminals to defecate, and the flushing device is separated from the toilet. Doctors also have mesh plastic bags to collect excrement, which is convenient for flushing and collecting evidence. For this kind of drug traffickers, the situation of drugs in the body can be clearly shown by taking X-rays. During our visit, a drug dealer happened to be sent for inspection. According to the investigators, the criminal swallowed more than 10 tablets, and some finished products were caught before swallowing. The person in charge of the emergency room showed us the X-ray film just taken, and we could really see the oval cystic high-density image, which was concentrated in the ileum.
Provincial court of Versailles
The Provincial Court of Versailles is a local court. The deputy attorney general who received us introduced their work with forensic doctors. The Procurator-General is responsible for leading the police station and gendarmerie, tracking cases, reporting cases to judges, and suing the court on behalf of the people. In forensic medicine, he is responsible for inviting relevant experts to the scene of the accident, asking doctors to identify the degree of the victim's injury and whether it will affect his future work, and to identify the injuries of traffic accident victims. In criminal cases, the victim's injury is measured by the recovery period of working ability. A case of intentional crime, in which the recovery period of working ability is less than 8 days, is a crime against the police and is handled by the police station, usually by 1 judge. But there is one exception, that is, if the object of injury is a minor, or the injury occurs between husband and wife, it belongs to the category of misdemeanor. If the recovery period of working ability exceeds 8 days, it is a misdemeanor, which can be handled by 3 judges and sentenced to imprisonment or public welfare work. The longest sentence can reach 10 years. The recovery period of working ability caused by negligent injury is calculated as 3 months. Felony mainly refers to crimes such as murder and rape. Generally, it is tried by a jury composed of three judges and nine people. Once the judgment is made, the defendant has no right to appeal.
Case investigators must cooperate with forensic doctors, especially in cases involving corpses. The doctor's report on the corpse is very convincing for the investigation of the case. Doctors can go to the scene to participate in the on-site investigation, submit the on-site investigation report, and determine the trajectory through anatomy; Doctors can identify the victim's condition by examining the victim's tissues and organs and related laboratory tests. Bodies salvaged from the water are sometimes very corrupt. In order to determine the cause of death and identify the identity, forensic doctors need to identify the identity through dentists and scars, and then determine the cause of death.
The court has a pre-trial judge, whose main duty is to collect evidence purposefully, and it is mainly the job of the pre-trial judge to hire a forensic doctor for appraisal. Whether the defendant needs to make a mental state appraisal is also decided by the pre-trial judge. The public prosecutor has the right to decide whether to make an appraisal during the preliminary examination, and the public prosecutor also has the right to hire a doctor or a forensic doctor to conduct a physical examination or a mental examination of the defendant or the victim without going through the pre-trial judge. Holland or Holland is located in the northern part of Europe, near the North Sea. It is a country that has reclaimed land for thousands of years. It has a land area of 300× 150 square kilometers, 25 administrative regions and a population of about15.7 million, and its capital is Amsterdam. It is reported that the forensic science institutions in the Netherlands have now built three pyramid structures, with national research institutions at the top, regional institutions in the middle and local institutions at the grassroots level, including 600 different types of research units affiliated to the police.
The Dutch Forensic Medicine Research Institute has 250 staff members, including 200 researchers and the rest of the administrative staff. The institute is divided into several departments according to disciplines, and its main research fields are: pathology, toxicology analysis, serology (including DNA), hair and fiber, guns and ammunition, shooting range and residues, explosives, tools, shoes and clothing traces, court engineering and material science, fire investigation, fingerprints, environmental analysis, illegal drugs, handwritten and machine-printed documents, voice, traffic accidents and vehicle identification. The work of each department mainly includes two aspects: ① Case ② Research in one or more of the above fields. The main sources of cases are: police station, plaintiff, Ministry of Justice, Ministry of National Defense and some special investigation agencies. Ways of providing services and research: ① conducting objective inspection and issuing reports; ② Research new methods and organize training; (3) collect relevant information in professional fields; (4) assist in criminal investigation; (5) to testify in court. The budget of the Institute 1998 is150,000 guilders, including100,000 personnel and 5 million materials. 1998, * * * completed 48,234 samples of 65,438+02,847 cases and issued 65,438+0765,438+060 reports. The energy spent on the case accounts for about 70%.
In the toxicological analysis laboratory, alcohol and drug detection account for a considerable proportion of the cases detected in the laboratory. In the mid-1980s, the amount of blood alcohol test was three to four times that of other tests. In the mid-1990s, the number of drug tests increased. Therefore, the poison analysis department has relatively strong personnel and equipment. The department has 13 staff (1 business supervisor, 2 toxicologists, 3 senior technicians, 4 analytical chemists, 2 experimental assistants and 1 administrative assistant). 3,950 annual inspection cases.
We also visited its toxicological analysis laboratory.
Generally speaking, the laboratory does not involve doping test for athletes, drug abuse screening for prisoners and clinical work.
DNA Laboratory At present, the DNA laboratory of our hospital mainly uses DNA-STR analysis technology for case inspection. They used advanced DNA sequencing equipment (3 10 sequencer) to analyze DNA fragments, and the case was investigated quickly, with a recognition rate of one in a million. The DNA database has been established in this laboratory for two years, and the STR sites, analysis methods and instruments used in it all follow European standards, so as to realize quality control and information sharing among laboratories.
DNA testing is mostly used for rape (36. 1%) and murder (39.6%). This room does not accept paternity testing entrusted by individuals. About 10 cases need to testify in court a year.
Its laboratory environment and facilities are good, and laboratory personnel wear working caps, overalls and gloves when working, which not only ensures the health of testers, but also avoids the pollution of samples.
Pathology room This room has 6 pathologists, 1 histologist, 5 assistants and a secretary for half a working day. 1998, there were 548 autopsies in the Netherlands, and 327 cases were completed by this room. These cases are entrusted by the police. Institute of Forensic Medicine and Traffic Medicine, University of Heidelberg
The Institute of Forensic Medicine and Traffic Medicine of the University of Heidelberg is affiliated to the Department of Theoretical Medicine of the University of Heidelberg and was formally established independently on 1927. At present, there are more than 40 full-time staff, including professionals 17. According to the nature of the work, it is mainly divided into three parts: forensic medicine, forensic toxicology analysis and traffic medicine. To undertake the tasks of forensic examination and identification, scientific research and teaching in the Rhine-Naika region (population about 2 million). The research focus of this institute is: trauma mechanism and reconstruction of traffic accident model, Forensic Toxicology analysis, estimation of injury and death time through injury analysis, forensic information management and traffic medicine.
This paper focuses on the mechanism of trauma. The study of trauma mechanism is an independent subject in basic science, which has its special problems, methods and purposes. Its content is to study and divide the mechanical characteristics of human body. Every part of the human body has its own mechanical properties, which come from congenital inheritance and acquired, and can be described by technical parameters and mechanical parameters. When the load exceeds the limit, damage will occur. For example, when an external force acts on people's legs, when the force level acts, if it exceeds the limit, a fracture will occur; When the force acts vertically, if it exceeds the limit, it will produce stretching, bending, shearing and torsion. The basic task of the study is to reconstruct the accident model according to the damage situation, and analyze and judge the accident process and unknown factors. At the same time, the theory of trauma mechanism is also used to prevent and reduce accidents. In the development of road traffic safety system, relevant research results have promoted the revolution of traffic safety legislation and automobile manufacturing industry. Such as airbags, child protection systems and helmets. When working in special occupation and harsh environment, the application of trauma mechanism theory can reduce the operation. Analysis of traumatic mechanism of mechanical action type and intensity; The type and severity of the injury; Personal tolerance for injury. The study of cadaver model is the best way to determine these necessary parameters.
Traffic medical analysis was established in 1965, with nearly 10 employees, mainly focusing on judging the physiological and psychological state of vehicle drivers and driving ability. Pathohistology laboratory is responsible for autopsy and 10 staining, including immunohistochemistry, and examines about 80 cases every year. The DNA laboratory mainly does paternity testing, with about 50 cases per year. There are 6 analytical laboratories in Forensic Toxicology, with staff 10, and more than 3,500 cases are tested every year, including more than 2,000 cases of alcohol content determination. Autopsy poisoning is mainly carbon monoxide, eye drops and drugs. Scientific research mainly focuses on the identification of poisons in hair and the analysis of alcohol addiction components.
Institute of Forensic Medicine, University of Munich
The Institute of Forensic Medicine of the University of Munich is affiliated to the Department of Medicine of the University of Munich, and was formally established independently on 1880. At present, there are official forensic experts 15, toxicology analysis professionals 15, traffic injury engineers and technicians 2, forensic biologists 2 and some doctoral students. According to the nature of work, it is mainly divided into three parts: forensic medicine, forensic toxicological analysis and traffic injury biomechanics.
Forensic examination, more than 2000 autopsies, more than 250 cases of sexual violence and injuries, more than 5000 cases of alcohol test and about 9000 cases of poison analysis (including drug test) every year; There are about 400 cases of DNA analysis, of which 150 cases are paternity testing, and the others are mainly to establish a DNA database of criminal suspects. Biomechanics research is different from the Institute of Forensic Medicine and Traffic Medicine of the University of Heidelberg, which focuses on human injuries in traffic accidents and has achieved mature research results.
It is worth mentioning that there are also some medical dispute appraisals every year, which are entrusted by the judicial department and by individuals. Medical experts are hired to make an appraisal. If the parties are not satisfied with the appraisal results, they can apply for re-appraisal, and the forensic doctor will hire new medical experts to conduct appraisal. If the two appraisal results are inconsistent, a third appraisal can be organized, that is, the final appraisal. This time, I visited 8 departments in 4 countries (including 6 forensic institutions). The overall impression is that the reception party is very warm, friendly and respectful to the China delegation, and has prepared detailed schedules and special materials. We not only learned good experience and technology through communication, but also broadened our horizons and obtained a lot of professional materials. The Institute of Forensic Medicine and Traffic Medicine of Heidelberg University in Germany also prepared English materials and Chinese translations for us, and the Italian National Industrial Accident Insurance Bureau produced computer slides printed with the national flags of China and Italy.
About forensic technology. From the investigation in France, it can be seen that the scope of forensic clinical appraisal is very wide and the amount of appraisal is very large. Its development and operation mode relies on the advantages of hospitals and is worth learning. The identification of forensic clinics in China has nothing to do with the health department, and the contradiction between forensic clinics and article 120 of the new criminal procedure law is increasingly prominent. It is urgent to study how to combine forensic doctors with hospitals and explore an appraisal model suitable for China's national conditions.
German forensic medicine focuses on the study of traffic accidents and traffic medicine, and has gained very valuable experience. However, in the management and research of traffic accidents in China, the role of forensic medicine is neglected, which is still blank in related fields, and the application of mature foreign theories and technologies is ignored, which should be highly valued by relevant departments.
On the system of judicial expertise. Looking at the situation in Europe, no matter which department the appraisal institutions belong to, their appraisal institutions are relatively concentrated. In addition to routine appraisal, research projects have their own emphasis and sufficient funds are guaranteed. China's public security and judicial organs are set up at different levels, and their funds are scattered, and their personnel are fighting alone. This should be the drawback of the current forensic appraisal system, which is not conducive to the research and development of forensic science in China.