Journal of forensic and legal medicine
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A prospective observational study of fatal road traffic collisions in south-east Scotland between 1993 and 2003 revealed 17 cases (2.8% of all road fatalities) which appeared to be the result of suicide. In all 17 cases the judgement that the death was the result of suicide reflected the combination of a consistent mechanism of injury with supporting background information. The 17 individuals comprised 13 car drivers and four pedestrians. ⋯ Analysis of the injuries revealed nine individuals to have unsurvivable injuries (defined by Abbreviated Injury Scale of six, Injury Severity Score of 75). The number of road traffic suicides may be generally underestimated. They appear to be difficult to prevent.
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Police services within England and Wales are required under the Police and Criminal Evidence Act 1984 to ensure appropriate healthcare to those detained in police custody (forensic medical services). Traditionally doctors have been used by police services to provide an appropriate level of care. Changes within the Act allowed other healthcare professionals (nurses and paramedics and emergency care practitioners) to be included in the provision of such services. The aim of this appears at least in part to have been to reduce the costs of providing such a service. In recent years police services within England and Wales have been outsourced to assorted commercial providers. There are now several different modes of delivery of forensic medical services, which are determined locally by separate police services. ⋯ The study shows that there was a complete lack of consistency in the recording and availability of information regarding forensic medical services for police services in England and Wales. The information that was obtained suggested that usage of such services varied greatly between police services and that costs of forensic medical services appear to be increased by the use of mixed healthcare professional service delivery and by using external commercial providers.