Medicine and law
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Advancements in techniques of medical technology have made it possible to postpone death, which, in many situations, amounts to nothing more than a protracted process of dying rather than a prolonging of life. This, together with the fact that these techniques are prohibitively expensive has brought to the fore difficult and extremely uncomfortable problems in medical ethics, especially with regard to who should have and who should not have high technology medical treatment. ⋯ Normally it is imperative that individuals make their own autonomous decisions in respect of medical treatment but there are times when consent is of secondary importance and when autonomy must of necessity be limited. However, information concerning medical decisions in intensive care should always be freely available to patients and their surrogates.
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Forensic medical services in South Africa are rendered by state-employed district surgeons and forensic pathologists, who are obliged to utilize the physical infrastructure and personnel of the South African Police in their examinations. Recent highly publicized incidents have (again) highlighted the alleged involvement of the South African Police and/or state security forces in political killings and deaths in custody. The perception has arisen that the South African Police is often a party to a dispute and yet may have virtually unlimited access to evidence and findings, thereby gaining unfair advantage and opportunity for prejudicing the eventual outcome of the investigation. ⋯ It is imperative that the public and the courts perceive the rendering of medicolegal services to be independent and scientifically objective. A model is proposed for the restructuring of medicolegal services in South Africa so as to be autonomous and without the integral involvement of the South African Police. Regard should be had to the opportunity for change now presenting itself in South Africa.
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Five cases of lethal injuries caused by gas or warning firearms are discussed. In one suicide case a modified weapon (elongated barrel) and steel bullets were used to fire a shot into the head, the bullets lodged in the skull and lethal bleeding resulted. ⋯ Two of these cases were suicides (temporal contact shot and back of the neck contact shot), one was an accident (inguinal contact shot with lethal bleeding), and one was an attack by another person with a contact shot against the neck with bilateral tears of the hypopharynx. After successful surgery, a delayed death occurred 12 days later caused by bleeding into the airways from the ruptured external carotid artery.