What do forensic medicine specialists think about the death?

Forensic autopsies are performed by the forensic medicine department and the microscopic examination processes by pathology specialists within the forensic medicine practice in Turkey. This disconnection in the process raises problems in the training of both branches. The aim of this study was to determine the awareness of pathology staff on forensic medicine practices and responsibilities and their opinion on the pathology training model in the forensic medicine specialty and to discuss the matter within the framework of the present situation and global applications. A 15-item questionnaire form distributed to the participant physicians during registration at the 21st National Pathology Congress held in 2011 was evaluated. 94 participants responded. A negative opinion was expressed by 72% about the interest in the general post-mortem process. The view that pathology specialists should undergo a separate training to perform autopsies was predominant and there was a general lack of interest in all kinds of autopsy processes. The percentage who said they knew the legal responsibility of a pathology specialist regarding forensic autopsies correctly was 37%. The questions "what are the necessary factors to contribute to the pathology training in forensic medicine" and "if anything is required, which of them would take priority" were respectively answered as "for me to be interested (46%)" and "a system guaranteeing that training will always be given by pathology specialists (67%)". Despite the possibility of becoming a forensic medicine specialist in two years, the mean answer score of the participants to the phrase "I do not consider becoming a forensic medicine specialist" was 4.1 (out of 5). A reluctance among the pathologists in our country was seen regarding forensic medicine specialists being able to perform post-mortem microscopic examination. However, despite their legal responsibilities, their interest in forensic pathology practice was low. There seems to be rational factor that would increase this interest in the near future. Cooperation is necessary to enable forensic medicine specialists to perform post-mortem pathology procedures. This cooperation should be based on improving the training of pathology research assistants.

BackgroundThe rise of artificial intelligence in the field of medicine has had a wide-ranging impact, from clinical applications to research. Artificial intelligence-based language models such as Chat Generative Pre-Trained Transformer have the potential to expedite the process of forensic reporting, particularly in forensic medicine. This study aims to evaluate the forensic reporting capabilities of Chat Generative Pre-Trained Transformer-4 in comparison with forensic medicine assistants. The Turkish Penal Code-related forensic medicine guide and 20 case examples were used to train Chat Generative Pre-Trained Transformer-4 in this study. Chat Generative Pre-Trained Transformer-4 was asked to write reports like forensic medicine specialists. In the retrospective phase, 100 forensic cases were assessed by Chat Generative Pre-Trained Transformer-4, while in the prospective phase, 266 new cases were assessed by both Chat Generative Pre-Trained Transformer-4 and forensic medicine assistants. Two forensic medicine specialists assessed the accuracy of these reports in terms of adherence to the forensic medicine guide.ResultsChat Generative Pre-Trained Transformer-4 achieved an accuracy rate of 96.6% in the retrospective phase and 96.2% in the prospective phase for the combined categories of “Life-threatening” and “Simple Medical Intervention”. Forensic medicine assistants, however, demonstrated a higher accuracy rate of 99.1% in these categories compared to Chat Generative Pre-Trained Transformer-4.ConclusionsThe success of Chat Generative Pre-Trained Transformer-4 indicates that the combination of technology and human expertise could establish new standards in forensic reporting. However, it is emphasized that supervision by forensic medicine specialists remains crucial in this process.

Forensic pathology is currently one of the basic touchstones of forensic science in criminal investigations. Together with developing technology and science, the importance of forensic pathology in resolving judicial events is increasing. The aim of this paper was to review the historical development of forensic pathology and the current status. Since ancient times, determining the cause of death has been of the greatest importance for the determination of the punishment to be given for crimes committed. There is known to have been an autopsy to determine the cause of death following the assassination of Roman Emperor Julius Caesar (44 BC). Developments over time in medicine also led to developments in autopsies. Pathology became a separate science with developments in the knowledge of anatomy starting in the 16th century and the invention of the microscope in the 17th century, and thus the normal anatomy, histology and pathology of human tissue came to be better understood. The first pathological anatomy autopsy is known to have been performed in 1286. The importance of forensic medicine and pathology in the process of explaining the cause of death and resolving judicial events has been well understood for hundred of years and has rendered the existence of forensic pathology imperative. Thus, in current international autopsy protocols, pathological examinations have become an indispensable part of autopsies. Despite the different nomenclature in different countries, such as forensic medicine specialist or forensic pathologist, a multidisciplinary approach is necessary in all forensic autopsies. Autopsy procedures are performed by forensic medicine specialists in Europe, by forensic pathologists in the USA and some other countries, and by forensic medicine specialists and forensic pathologists together in Turkey.

Compassion fatigue explains the reduced caregiving capacity of healthcare workers as a consequence of repeated exposure to patients' suffering. It is aimed to evaluate compassion fatigue and factors affecting this situation in forensic medicine specialists who evaluate cases that are victims of permanent trauma due to their profession. Data collection forms including demographic data and a short compassion fatigue scale (SCFS) in healthcare workers were filled out online by volunteer forensic experts. 113 forensic experts participated. It was determined that participants' total SCFS score average was 36.86±21.01, secondary trauma sub-dimension average was 12.39±7.74, occupational burnout sub-dimension average was 24.47±14.52. The total mean score of SCFS of the participants who evaluated less sexual assault was statistically significantly higher. The total mean score of SCFS and the mean of occupational burnout sub-dimension of the participants who did autopsy were found to be statistically significantly lower. The occupational burnout sub-dimension average of those who performed autopsy above the monthly autopsy median value was found to be statistically significantly lower. Sub-dimension average of burnout of participants in the first five years of their professional life was found to be statistically significantly higher. It is noteworthy that total and sub-dimension average scores of forensic medicine specialists in Turkey are significantly lower than those of different professions, especially health workers, in different countries. While this may be an indication that occupational depersonalization has developed over the years among forensic medicine specialists in Turkey, especially those who evaluate autopsy and sexual assault cases, from a different perspective, it can be said that increasing professional experience and working in harmony with the education received have a positive effect on compassion fatigue and burnout.

This study aimed to examine the relationships among meaning and purpose in life, life satisfaction, and occupational burnout among forensic medicine specialists and autopsy technicians. Additionally, the impact of individual and professional variables, including autopsy frequency, on these psychosocial outcomes was investigated. The sample consisted of 298 participants, comprising forensic specialists and autopsy technicians. Data were collected using standardized instruments: the Meaning and Purpose in Life Scale (MPLS), the Satisfaction with Life Scale (SWLS), and the Maslach Burnout Inventory (MBI). Statistical analyses included descriptive statistics, reliability testing, correlation and regression analyses, as well as t-tests and ANOVA. The results indicated that MPLS and SWLS had moderate reliability, while the MBI showed moderate internal consistency. A strong positive correlation was observed between meaning in life and life satisfaction. Conversely, both were significantly negatively correlated with burnout. Regression analyses revealed that higher MPLS and SWLS scores significantly predicted lower levels of burnout. Moreover, significant differences in MPLS, SWLS, and MBI scores were found based on education level, income, institution, professional role, years of experience, and autopsy workload. The findings suggest that meaning and purpose in life, along with life satisfaction, serve as protective factors against occupational burnout in forensic medicine professionals. High autopsy workload and recent involvement in autopsy procedures were associated with reduced psychological well-being. These results underscore the importance of institutional strategies to support the mental health and long-term sustainability of this vital workforce.

This study aimed to identify the most common errors made by physicians who are not forensic medicine specialists while preparing forensic reports. The forensic investigation files of 2.321 cases for which a final report was requested between 2018 and 2022 at the Tokat Branch of the Council of Forensic Medicine were reviewed for this study. Among the examined cases, 178 (7.7 %) were aged < 18 years, while among adult cases, 782 (33.6%) were female and 1361 (58.6%) were male. Among all reports, 564 (24.2%) showed discrepancies in determining whether the injury could be classified as minor and treatable with a simple medical intervention. Additionally, 214 reports (9.2%) contained different conclusions regarding whether the injury could result in a life-threatening condition. The study concluded that physicians who are not forensic medicine specialists need to acquire more knowledge of forensic report preparation to ensure accuracy in forensic documentation and prevent disruptions in the judicial process.

Çalışanlar, iş ortamındaki birçok faktör nedeniyle strese maruz kalır ve bu stres nedeniyle de fiziksel, ruhsal ve sosyal değişiklikler yaşar. Bu çalışmada; adli tıp uzman ve asistanlarının örgütsel stres düzeyinin ve stres düzeyini etkileyebilecek sosyo-demografik değişkenlerin ortaya konulması amaçlanmıştır. Örgütsel stres faktörlerinin düzeyini belirlemede Örgütsel Stres Anketi-D (VOS-D) kullanılmıştır. Anketin Türkçe versiyonu 27 ilden 120 adli tıp uzman/asistanına e-mail ya da posta ile gönderilmiş, 113’ü anketi doldurarak geri göndermiştir. Elde edilen veriler paket istatistik programı kullanılarak analiz edilmiştir. Çalışmaya katılanların 78’i (%69) üniversitelerin adli tıp anabilim dallarında, 28’i (%24.8) Adli Tıp Kurumu ve buna bağlı birimlerde, 7’si de (%6.2) Sağlık Bakanlığı’na bağlı hastanelerde görev yapmaktadır. Katılımcıların 70’i (%61.9) adli tıp uzmanı, 43’ü (%38.1) adli tıp asistanıdır. Adli tıp uzman ve asistanlarının 87’si (%77) erkek, 26’sı (%23) kadındır ve yaş ortalaması 35.9 + 7.3 (25-62) yıldır. Yanıtlanan ölçeklerin persantil dağılımına ve ortalama skorlara bakıldığında; katılımcıların ilk sırada sorumluluk, ikinci sırada aşırı iş yükünden etkilendiği görülmektedir. Stres faktörlerinden etkilenme açısından cinsiyetler arasmda istatistiksel olarak anlamlı fark bulunmamaktadır. Rol belirsizliği ve gelecek belirsizliği en çok adli tıp asistanlarını etkilerken, sorumluluk adli tıp uzmanlarında daha fazla stres yaratmaktadır. Sonuç olarak; adli tıp uzman ve asistanlarının, çalışma ortamında karşılaştığı stres faktörlerinin en aza indirgenebilmesi için, sorumluluğun paylaşılması, iş yükünün dengelenerek azaltılması gibi birtakım önlemler alınması gerekmektedir.Anahtar kelimeler: Adli tıp, örgütsel stres

In addition to poor infrastructure, and human resource constraints, forensic medicine specialists in developing countries face many external challenges. We aimed to investigate the prevalence, type, and source of external challenges confronting them including sex, age, religion, deceased's place of residence and the number of accompanying relatives. This cross-sectional, observational study was conducted between August 2020 and July 2022 at the Mortuary of AIIMS, Bhubaneswar with the approval of the ethical committee. Of note, forensic medicine specialists faced external challenges in about one in five cases (20.5%). Most demands were to either minimise the autopsy procedure (n = 65) or to conduct the autopsy at inappropriate times (n = 58). The demands to minimise the autopsy procedure were significantly associated with the deceased's age (p = 0.046), religion (p = 0.010), socioeconomic class (p = 0.020) and manner of death (p = 0.019). Our study found that forensic medicine specialists in India face significant external challenges. Avoiding unnecessary complete autopsies, implementing night autopsies, and embracing minimally invasive autopsies are recommended to mitigate these challenges.

Çocuk ve ergen ruh sağlığı çalışanları istismar olgularının tedavilerine yönelirken bir taraftan da adli sürece katkıda bulunurlar. Hastanın gizlilik hakkı ve hekimin yasal sorumlulukları bu konuda en sık yaşanan etik ikilemdir. Bu çalışmada bir olgu üzerinden giderek, adli tıp ve çocuk ve ergen ruh sağlığı uzmanlarının olaya bakışlarının belirlenmesi ve konunun tartışılması amaçlanmıştır. Adli sürecin başlatıldığı asılsız cinsel istismar iddiası olan bir olgu hakkında bilgiyi içeren bir anket hazırlandı. Ankette katılımcılara; “bu durumda suç duyurusunda bulunur muydunuz?” şeklinde sorular yöneltildi. Anket gönüllü Adli Tıp ve Çocuk Ruh Sağlığı çalışanları tarafından dolduruldu. Çalışmaya 72 adli tıp, 34 çocuk psikiyatrisi çalışanı toplam 106 kişi katıldı. Katılımcıların 94 (%88.7)’ü yasal bildirimde bulunacağını; 12 (%11.3)’si ise bildirimde bulunmayacağını belirtmişti. Adli tıp çalışanlarının %13.9’u, çocuk psikiyatrisi çalışanlarının ise %5.9’u bildirimde bulunmayacaklarını belirtmişlerdir. Her iki grup arasında bildirim oranlarıyla ilgili istatistiksel olarak anlamlı bir fark bulunmamıştır. Hekimlerin etik ve adli sorumlulukları bu olgu üzerinden tartışıldı.Anahtar kelimeler: Cinsel istismar, asılsız bildirim, hekim sorumluluğu, etik ikilem

Introduction: Ideally, the medico-legal autopsies have to be conducted by doctors specialized in the branch of Forensic Medicine. However, there is limited availability of forensic medicine specialists in India as compared to the number required. The bulk of the medico-legal autopsies are usually carried out by graduate doctors and not by forensic medicine specialists. This study was contemplated to know the attitude of the undergraduate medical students, about the medico-legal autopsy and to ascertain the change in their perception and attitude for autopsy, if any, after passing the Forensic Medicine subject as per their medical curriculum. Materials and Methods: Study was carried out on first, second and third-year undergraduate medical students. Questionnaires to be answered were administered to the participating medical students in physical form. SPSS statistical software was used for comparing the mean among three groups using ANOVA test. Chi-square and Fischer exact test was also used. Results: 249 undergraduate medical students took part in the study. Significant increase in knowledge for medico-legal autopsy was observed among 3rd-year medical students. On comparing mean among all the three groups regarding the knowledge, perception, experience and change in attitude for medico-legal autopsy, it was found to be statistically highly significant (p-value Conclusion: The undergraduate medical students should be encouraged to observe more autopsies during their study course. Problem-based learning during practical training of autopsy must be incorporated, as a part of the medical curriculum and instead of elective, compulsory rotatory internship training should be there for Forensic Medicine. Keywords: Autopsy, Postmortem examination, Students, Attitude.

Healthcare professionals often face immense pressure and work-related stress, particularly in life-saving situations and when working with their clients. Since the COVID-19 pandemic, there has been a noticeable rise in burnout, exacerbated by increasing instances of violence against doctors. Forensic medicine, a demanding field that works closely with law enforcement, prosecution, and the judiciary, has received less attention in burnout studies. The present study aims to assess the prevalence of burnout among qualified forensic medicine practitioners working at a tertiary care facility in South India. Additionally, it explores the common coping mechanisms these doctors use to manage stress.An adapted version of the Maslach Burnout Inventory (MBI) and a semi-structured questionnaire were administered via Google Forms to assess burnout prevalence and coping mechanisms. Informed consent was obtained from all participants prior to data collection.The study included ten forensic medicine practitioners registered with the Andhra Pradesh Medical Council, comprising eight males and two females, with an average age of 46.7 years and an average work experience of 9.3 years. The mean scores for the MBI domains in our study were as follows: Emotional Exhaustion (6.6 ± 2.9), Depersonalization (7.5 ± 4.45), and Personal Accomplishment (33.8 ± 8.6), indicating low, moderate, and moderate levels of burnout, respectively. However, when considered overall, there is no burnout among the participants.The study finds that forensic medicine specialists exhibit low burnout scores, likely due to their engagement in extracurricular activities and strong support networks, including discussions with colleagues and family. These findings support the view that forensic doctors are mentally tough and emotionally resilient.

Background: Forensic medicine finds more and more resonance due to requests and queries from clinicians and acts as a mediator between the individual medical disciplines, in particular with regard to legal issues, and as an interface between the fields of medicine, police and judiciary. The aim of this short narrative overview is to make surgeons aware of the forensic aspects of their work, which is usually focused on clinical and curative aspects. Crucial points: Traditionally, the basic work in forensic medicine comprises sudden and unexpected deaths, for which it is important to definitely clarify the mode of death based on the detected cause of death. In addition to violent and unnatural deaths, there are sudden natural deaths, which are natural, but also unsolved. Clinical forensic medicine basically concentrates on the examination of victims of violence, which may comprise various types of bodily harm including sexual crime, child maltreatment and traffic accidents. The investigational results (autopsy findings, injury patterns, results from the investigation of traces) need to be presented and interpreted in public procedures at court by forensic medicine specialists, who act as experts answering questions while retaining a neutral position. Conclusion: Specialists in forensic medicine should not only be consulted for issues related to the inspection of corpses and to issue a death certification. Much rather, they should also be consulted as specialised partners of surgeons and other clinicians, e.g. for the documentation of specific findings and the description of injury patterns in injured persons who are still alive.

Personal loan-linked life insurance is widely used in our country. The insurance company is required to provide information, whereas the insured must reveal any pre-existing health conditions. After his death, disagreements may emerge regarding undisclosed medical conditions. In such cases, courts frequently request expert opinions from forensic medicine specialists regarding the causal relationship between the undisclosed condition and the cause of death. This study analyses essential factors to evaluate causality in the lack of an autopsy. Four male subjects aged 47 to 69 deceased in the study. A causal link was established between the undisclosed disease and death in two cases; in one case, causality could not be determined. In another, the undisclosed illness was deemed a complication of a declared disease, thus not requiring separate disclosure. Forensic medicine specialists must evaluate the causality utilizing medical records, clinical findings, and the death certificate, while considering the certainty of the diagnosis.

<p><strong>Abstract</strong></p><p>Dr. Bahaeddin Şakir Bey (1874-1922) was a forensic medicine specialist in addition to being an important political figure who worked in critical positions in breaking points of the whole world history. He later had to go to Paris because of the political activities he attended since the days he studied in The Faculty of Military Medicine. As he completed his forensic medicine specialization in Paris Faculty of Medicine, the Young Turks movement abroad gained a certain momentum with his arrival.</p><p>He returned to Istanbul after the proclamation of constitutional monarchy and while he was teaching forensic medicine and working as associate dean in the faculty of medicine, he wrote Textbook of Forensic Medicine which is the first copyrighted work in forensic medicine field in our country. He was assigned as the first director of Legal Medicine Directorate. He also worked as the head physician in Red Crescent Hospital in Edirne during the Balkan War.</p><p>He worked in top-level tasks in Party of Union and Progress which was a remarkable party in its period and the political intelligence organization of the period The Special Organization. He also played an active role in the independence of provinces while working in the Caucasian Front in World War I. In addition to being the originator of "Armenian Deportation", he played a role in; its planning during his visits to the eastern cities.</p><p>After World War I, he had to go abroad and was sentenced to death in his absence. His activities attracted attention and he was invited to the Congress of the Peoples of the East of the Soviet Union. After he was killed by an Armenian assassin in Berlin in 1922, Atatürk protected his wife and children in personally and didn't refrain his support and help.</p><p><strong>Öz</strong></p><p>Dr. Bahaeddin Şakir Bey (1874-1922); sadece ülkemiz değil, dünya tarihi açısından da kırılma noktası olan dönemlerde, kritik görevlerde bulunmuş önemli bir siyasi figür olması yanında adli tıp uzmanı bir hekimdir. Mekteb-i Tıbbiye-i Askeriye’deki öğrencilik yıllarından itibaren içinde bulunduğu siyasal faaliyetleri nedeniyle, sonradan Paris’e gitmek zorunda kalmıştır. Bir yandan Paris Tıp Fakültesi’nde adli tıp ihtisasını tamamlarken, yurtdışındaki Jön Türk hareketi de onun gelişiyle birlikte belirgin ivme kazanmıştır.</p><p>Meşrutiyetin ilanından sonra İstanbul’a dönmüş, tıp fakültesindeki adli tıp hocalığı ile dekan yardımcılığı görevleri sırasında ülkemizdeki adli tıp alanında ilk telif eser olan “Tıbb-i Kanuni Dersleri” kitabını yazmıştır. Kendisinin ayrıca, taşraya atanan hekimlere yönelik rehber niteliğinde yazmış olduğu bir kitap ile ölüm olgusunu işlediği bir başka adli tıp kitabı da mevcuttur. Günümüzdeki Adli Tıp Kurumu’nun ilk nüvesi olarak kurulan “Tababet-i Adliye Şubesi”nin ilk müdürü olarak atanmıştır. Hilal-i Ahmer Cemiyeti’nin yeniden organizasyonunda ve Balkan Savaşı sırasında Edirne’deki Hilal-i Ahmer Hastanesi başhekimliği görevinde bulunarak, tıp alanındaki katkılarını akademi ile sınırlı tutmamıştır.</p><p>Bir döneme damgasını vuran “İttihat ve Terakki Cemiyeti”nde ve dönemin siyasal istihbarat örgütü “Teşkilat-ı Mahsusa”da üst düzey görevlerde bulunmuş, 1. Dünya Savaşı’nda Kafkas Cephesi’nde görev alarak; Artvin, Ardanuş ile Ardahan’ın kurtuluşunda bizzat rol oynamıştır. “Ermeni Tehciri”nin fikri ideoloğu olması yanında, doğu vilayetlerine giderek bizzat planlanmasında rol almıştır.</p><p>1. Dünya Savaşı’nın ardından yurtdışına çıkmak zorunda kalmış, gıyabında idama mahkum edilmiştir. Yurtdışındayken sürdürdüğü, Müslüman milletlerin mücadelesine dair faaliyetleri ilgi çekmiş ve Sovyetler Birliği’nin Doğu Halkları Kurultayı’na davet edilmiştir. 1922 yılında Berlin’de Ermeni bir suikastçı tarafından öldürülmesi sonrasında, Atatürk; eşi ve çocuklarına bizzat sahip çıkmış, desteğini ve yardımlarını esirgememiştir.</p>

Adli ölüm olaylarında erken dönemde ve ayrıntılı bir şekilde yapılacak otopsi, ölümden sonra ortaya çıkabilecek birçok iddia ve varsayımı ortadan kaldırır. Otopsi yapılmadan veya eksik otopsi sonrası cesedin gömülmesi sonucu ortaya çıkabilecek problemlerin çözümü için cesedin mezardan çıkartılması (feth-i kabir) gerekebilir. Çalışmada Adli Tıp Kurumu Konya Adli Tıp Şube Müdürlüğü’nce Konya il merkezinde ve adli tıp uzmanı tarafından Konya’nın ilçelerinde otopsileri yapılan feth-i kabir olgularının özelliklerinin ortaya konması amaçlandı. Bu amaçla 2001-2007 yılları arasında feth-i kabir yapılan 42 olgunun tutanakları incelendi. Olguların yaşları 15 gün ile 92 yaş arasında değişmekte olup, ortalama yaş 39.8 + 21.8 bulundu. Olguların 29’u (%69) erkek, 13’ü (%31) kadın idi. Feth-i kabir, 16 (%38.1) olguda defnedildikten sonraki 1-10 gün içinde yapılmıştı. İl merkezinde 7 (%35), ilçelerde ise 5 (%22.7) olgu olmak üzere toplam 12 (%28.6) olguda, belediye hekimi ya da hastane yetkilileri tarafından adli olgu ihbar edilmeden defin ruhsatı düzenlenmesi nedeniyle feth-i kabir gerçekleştirilmişti. İlçelerdeki feth-i kabirlerin en sık nedeni 7 (%31.8) olgu ile adli olguya yalnızca ölü muayenesi yapılarak defin ruhsatı verilmesiydi. Feth-i kabir sayılarını azaltmak için defin ruhsatı düzenleyen birimlere adli olgu ve adli olgunun ihbarı konusunda, halka ise cesetlerini defin ruhsatsız defnetmeme konusunda eğitim verilmesi uygun olacaktır. Ayrıca adli ölüm olgularında tam ve eksiksiz bir otopsi işlemi için tüm otopsilerin belirli merkezlerde adli tıp uzmanlarınca yapılmasının gerekli olduğunu düşünüyoruz.Anahtar kelimeler: Feth-i kabir, defin ruhsatı, ölüm, adli tıp