Abstract: Reliance on recent evidence to answer a clinical question is the key element in Evidence Based Medicine (EBM). The practice of EBM involves identifying the best evidence pertaining to a given situation and integrating it with clinical expertise and patient values in making the best decision with regard to the situation1. Finding the best evidence can be a difficult task given the proliferation of information generated by individual studies, which may be of different quality in methodology and context2. In such a situation, conducting Systematic Reviews is considered the least biased, most logical and scientific approach to find the best evidence for a given scenario. Credibility of the conclusions of a SR depends on the reliability of its methodology and the quality of reporting the systematic review. Authors of SRs are expected to report a complete, accurate and transparent account of the procedure and results. This article focuses on the issues observed in reporting of SRs in medical journals and aims to provide an account on some aspects to consider when reviewing SR articles. A brief account on the methodology, standards and guidelines of the SR process is presented along with the significance of the technicalities of some important steps that need to be followed. SRs generate new knowledge based on already existing findings, aiming at different types of potential users such as policy makers, healthcare providers, patients and researchers1. It is important that reviewers strictly adhere to the guidelines and standards in conducting the review and in reporting their work to produce high quality and reliable SRs. Published on 2022-12-16 00:00:00
Abstract: Present study was undertaken to observe the change in pattern of unnatural deaths, particularly suicidal deaths between regular periods, i.e., Pre-COVID and a pandemic period, i.e., COVID period at a tertiary care hospital of New Delhi, India. The data was collected from the records of post-mortem reports of autopsies done at Dr. R.M.L. Hospital, New Delhi, between 1st April 2019 to 30th September 2019 (Pre-COVID period) and 1st April 2020 to 30th September 2020 (COVID period). The data collected was subjected to statistical analysis concerning incidence rate, Odds ratio (OR), numbers, percentage, age, gender, and suicide methods.Findings suggests a notable change in the pattern of unnatural deaths, particularly suicidal deaths in the population of Delhi, India, due to the impact of COVID and nationwide lockdown following the first wave of the COVID pandemic, apart from an increase in natural deaths. There was a significant decrease in accidental and homicidal deaths, whereas a 61% increase was observed in suicidal deaths during the COVID period compared to the Pre-COVID period. The difference in the number of suicidal deaths out of total unnatural deaths during the Pre-COVID and COVID period was found to be significant (P-value
Abstract: Introduction Medical ethics is a key element in the practice of medicine. This study highlights the application and conceptualization of those principles in the process of death investigation during the COVID-19 pandemic.ObjectiveTo identify different ethical principles and their application in deaths during the COVID-19 pandemic.MethodologyAutopsy information of 41 deaths from 2020-2021, which came for inquests with positive Polymerase Chain Reaction (PCR) test for COVID-19 or positive rapid antigen test was analysed. The death investigation process was conceptualized against the ethical principles; justice, autonomy, beneficence, and non-maleficence. ResultsThe majority of deaths (36.59%) were aged between 71-80 years, with less gender disproportion (M:F- 51:48). Home deaths (63.41%) were commoner, while deaths of non-vaccinated people (80.49%) were predominant. PCR was done in 30 group was 17.07% with COVID-19 infection being a contributory cause of death in 57.14%, while all had a duration of illness of
Abstract: One of the emerging scientific ventures in the world is the development of artificial gestation of human beings and the Artificial Womb Technology (AWT). This technology supports women who are unable to bear natural pregnancy to procreate. This process has been praised by scientists in view of its contribution to the reproductive process and its purview to act as an alternative to medical termination of pregnancy. The emerging technology has its own pros and cons. The first argument against the Artificial Womb is the fact that, it collides with the reproductive autonomy of women. The positivity of such a venture is signified only in the instances where it is used as a choice but not as a compulsory alternative to a reproductive health right of termination of pregnancy. The substitution of Artificial Womb as a substitute for the termination of pregnancy causes serious predicaments to women in countries with highly restrictive abortion laws where they are compelled to end up with a forced pregnancy. The Author has discussed international and domestic legal frameworks. As the concluding perspective, the author has recognized the fact that, women are entitled to the right of physical integrity, autonomous decision making and unique rights relating to pregnancy namely right not to procreate with the right to genetic privacy. If a technology compels a woman to continue a physical condition which she does not want to continue, that amounts to ‘involuntary servitude’ and a derogation of international human rights law. Published on 2022-12-16 00:00:00
Abstract: Introduction: Killing of people practicing or suspected of practicing black magic which is also known as “witch- hunting” is not uncommon in India. People believe that any tragedy or misfortune that may befall them like, damaged crops, epidemics, sudden and unexplained deaths of children is the work of evil ‘witches’. We report a case where a person was murdered due to the belief that he was practicing black magic or witchcraft. Case report: A dead body of a 60-year-old male was brought by the police for autopsy to a tertiary care center. It was alleged that he was assaulted by a sharp weapon. The alleged assailant was the neighbor of the deceased who believed that the deceased used black magic to cause the death of his four year old child a few months before. Autopsy revealed multiple incised wounds mainly on the back of the head, with compound fracture of occipital bone leading to intracranial and intracerebral bleeding. Conclusion: This case illustrates a homicide caused by superstition as a motive. Multiple sharp blows to the head, proves adequate intention and knowledge by the accused to kill. As this kind of belief or superstition about black magic is more prevalent in less educated persons, the need arises to raise awareness about witchcraft and other superstitious activities. We propose that it can be included as a subject in schools to change the beliefs of society on superstition and related activities. Published on 2022-12-16 00:00:00
Abstract: The 21st century marked increased emphasis on fetal rights which has resulted in the development of advanced medical procedures such as fetal surgery. Fetal surgery has been considered as a starting point of the maternal – fetal conflict owing to the fact that it involves two patients; the fetus and mother. Recognition of fetal patients has caused controversies in the field of law when determining issues pertaining to medical negligence and pre- birth injury. Legal scholars argue on the fact of imposing medical malpractice liability on physicians when fetal patients are injured during surgery. In addition, the “glorification” of the fetus while considering the termination of pregnancy as a secondary option is disputed by feminists. The reason is that, the termination of pregnancy signifies bodily independence of women and autonomy. The author, in this article has adapted a qualitative approach of methodology with a normative and content analysis. The author has discussed primary and secondary sources of law including foreign domestic legislations namely the Abortion Act 1967 (amended by the Human Fertilization and Embryology Act 1990) in the United Kingdom, The Offences against Persons Act 1861 and The Infant Life Preservation Act 1929. The central focus of the article is on the United Kingdom as an illustrative jurisdiction. The basic focus of this article is directed to study whether there is a conflict of rights between fetal patients and pregnant women in the face of the law of tort, medical law and ethics and to suggest the incorporation of the ‘Two-Patient Model’ to balance conflicting interests while discussing the Chervenak and McCullough’s ethical framework. Published on 2022-12-16 00:00:00
Abstract: Investigation of death differs between countries and whether deaths are natural or unnatural. This article aims to describe the investigation of both natural and unnatural deaths in Brazil, a federation formed by 26 States plus the Federal District. Although the Brazilian States are self-governing, death investigation follows some standardised processes throughout the country. Some deaths require little to no investigation, such as natural deaths that occur under the supervision of a medical doctor; in these cases, the body can be released directly to the funeral services. Other deaths are investigated more thoroughly, such as suspicious deaths with non-identified body. Such cases usually involve more parties, such as the Military Police, the Judicial Police, Forensic Experts, Prosecutors, and a Judge. Reports from Forensic Experts, such as Forensic Pathologists, Forensic Toxicologists, and Crime Scene Investigators, are compiled together with other documents within the inquiry process and are critical to the success of the investigation. The Forensic Experts normally work in the Medico-Legal Institutes or in the Criminalistics Institutes and they may or may not be part of the Judicial Police force, depending on the State; in some States, they are part of another institution called Scientific Police. A crucial step in the process of death investigation is the chain of custody, which has evolved greatly in Brazil in the past few years. However, the investigation process may still take years to be completed due to the lack of resources and investment in the involved parties, especially the Polices forces. Published on 2022-09-30 00:00:00
Abstract: Death investigations within Canada are conducted at a provincial or territorial level, with medico-legal systems being either Coroner or Medical Examiner based. Each province or territory has defined legislation which guides the death investigation process. Despite similar frameworks, great variation exists in the implementation of the legislation. This paper will outline death investigation systems within Canada, including the legislative framework for each system. An overview of forensic pathology facilities as well as educational programs in forensic pathology training will also be provided. Published on 2022-09-30 00:00:00
Abstract: Suspicious unexpected death is one of the worst events that a family will experience. To allow closure there is the need to identify any underlying medical causes of death. This requires thorough investigation to exclude unnatural causes of death. Death investigations within England and Wales are conducted at local authority level, with the medico-legal systems being a combination of Coroner and Medical Examiner. Post-mortem examinations were carried out on 39% of all deaths reported to the coroner in 2020, with the medico-legal dissection rate for England and Wales being around 13%. Death investigation in England and Wales remained relatively unchanged for decades, but the system has experienced comprehensive revisions allowing a system that is less fragmented with clear supervisory and leadership responsibilities. This paper will outline the death investigation systems, including the legislative framework, key players and their symbiosis. Published on 2022-09-30 00:00:00
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