Forensic science international
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For the last number of years, when ethical problems were discussed in Germany in public, the hippocratic oath was quoted as the valid norm for medical ethics. Although no physician swears this oath in Germany, it is necessary to know its contents, its origin and its role in the history of medicine. And it is necessary to ask some questions: What are the ethical claims of the hippocratic oath? Does it really originate from Hippocrates? How and why did the hippocratic oath become the 'Magna Carta' of behaviour for physicians? Do specific medical ethics exist over time? Do specific medical ethics exist in general? And if it exists, can it be normative ethics? A short survey of the multiple dependences of medical situations shows that ethics in medicine must undertake a new beginning. ⋯ It has to respect rules and declarations, but it has also to compare the benefits and risks. In the center of such ethics stands the responsibility of the physician. To assume this responsibility, the physician needs knowledge, the ability to make decisions and a conscience.
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Suicidal gunshot wounds were reviewed for a 6 year and 6 month period with respect to age, sex, type of firearm, anatomical location of the entrance wound, alcohol use, location of the event and the presence of a suicide note. There was a total of 64 suicidal gunshot wounds, the majority of which were found in males. ⋯ Concomitant alcohol use was higher than in the overall suicide population. Most victims committed suicide in or around their dwelling and the majority failed to leave a suicide note.
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Three cases of missile injury to the neck are reported, two homicides and one suicide. In two fatalities, the autopsy revealed contusion of the spinal cord due to direct missile injury of the cervical spine but without laceration of the spinal dura. ⋯ The lack of vital signs such as blood aspiration, which was expected because of the injury of the pharynx, also indicates immediate occurrence of death owing to a reflex mechanism in this case. The underlying reflex mechanisms are discussed in the light of clinical experience in the treatment of paraplegics as well as the findings in experimental contusion and transection of the cervical cord.
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The excretion of methoxyphenamine (MOP) and methamphetamine (MA) into beards has been studied. Six healthy male subjects orally took 50 mg of MOP at a single dose and 7 doses for a successive 7 days. Their beard hairs were collected by an electric shaver every morning until MOP disappeared from the beard. ⋯ O-Desmethyl MOP, a major metabolite of MOP, was also detected in beard. The procedures were applied to the detection of MA in beard of MA abusers. It was realized that a beard sample was more useful than a urine sample assuming a longer detection.
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A total of 638 drug death autopsy cases in southern Bavaria from 1981 to 1992 were analysed, including epidemiological and toxicological investigations. The rate of HIV infections decreased during the last few years. Cocaine does not (yet) play a major role. ⋯ Heroin intoxications are the most frequent cause of death, mostly in combination with other drugs and alcohol. In 1992 we observed a sharp increase of the number of deaths associated with dihydrocodeine abuse. This seems to be a local phenomenon and has to be explained by uncritical and uncontrolled prescription of large amounts of this opiate by individual physicians.