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Teijeira R.,Instituto Navarro Of Medicina Legal | Teijeira R.,University of Navarra | Banon R.,Institute Medicina Legal Of Murcia | Barberia E.,Institute Medicina Legal Of Catalonia | Barberia E.,Rovira i Virgili University
Revista Espanola de Medicina Legal

Spain occupies a privileged position in the world with highest deceased donation rates. The Spanish Model of organ donation and transplantation has a great prestige at the world and has been studied and imitated. This paper discusses legislative developments in Spain until the recent enactment of Royal Decree 1723/2012 and the newest medico-legal aspects. In the case of living donors emphasizes the provision of consent in front of civil court resulting from the change of Civil Registry Office status. In cadaveric organ donation expands diagnostic of circulatory and respiratory death criteria. Judicial intervention and the forensic pathologist rol are analyzed in the process of organ donation, emphasizing the need for improving practical guides including exploration of the body. © 2013 AsociaciÓn Nacional de Médicos Forenses. Published by Elsevier España, S.L. All rights reserved. Source

Jimenez Nuno J.,Institute Medicina Legal Of Catalonia | Arrufat Nebot F.X.,Servicio de Salud Mental | Carrera Goula R.,Consorcio Hospitalario de Vic | Gay Pastor M.,Grupo de Mortalidad
Revista Espanola de Medicina Legal

Introduction: This work is a collaboration between the Hospital Consortium of Vic (CHV) and the Legal Medicine Institute of Catalonia (LMIC), through Forensic Clinical Services (FCS) of Vic, for the analysis and assessment of deaths by suicide. Material and methods: Prior to the study, we negotiated an agreement establishing the terms of the collaboration between both institutions. We analyzed all deaths by suicide in the judicial district of Vic since 2006. Variables studied were: age, sex, country of origin, marital status, physical constitution, used method, population, time of year, medical and psychiatric history, suicide scene, previous suicide attempts and suicide notes. We calculated the rate of incidence and distribution of suicides according to these variables, and put into practice actions to reduce suicide incidence. Results: Suicide is more common in men than women. It prevails both in middle age and old age of life. Violent methods (hanging, jumping from heights, train impact) are the most frequent. A high percentage of people who committed suicide had a psychiatric history. Discussion: Suicide rate in Osona is higher than in Catalonia. The rate has decreased from the baseline, except for the last year. A large percentage of suicidal patients with a psychiatric history were untreated. This suggests the need to develop programs to increase detection and treatment of people at risk, by means of raising awareness and training of groups in contact with them (gatekeepers). In the future, we will use psychological autopsy to study suicides in order to obtain complete and relevant information. © 2012 Asociacion Nacional de Medicos Forenses. Publicado por Elsevier Espana, S.L. Todos los derechos reservados. Source

Barberia E.,Institute Medicina Legal Of Catalonia | Barberia E.,Rovira i Virgili University | Xifro A.,University of Barcelona | Arimany-Manso J.,University of Barcelona
Medicina Clinica

The main mission of Spanish Institutes of Legal Medicine (ILMs) is to serve the justice system. We review the potential broader role of the work done by ILMs, with an emphasis on forensic pathology. The relevance of forensic information to increase the quality of mortality statistics is highlighted, taking into account the persistence of the low validity of the external causes of death in the Mortality Register that was already detected more than a decade ago. The new statistical form and reporting system for the deaths under ILMs jurisdiction, as introduced by the Spanish Instituto Nacional de Estadística in 2009, are also described. The IMLs role in the investigation of the following mortality causes and of their determinants is reviewed in detail: traffic accidents, suicide, drugs of abuse, child deaths and sudden deaths. We conclude that an important public role of IMLs is emerging beyond their valuable service to the justice system, mainly through the gathering of data critical to assess and prevent several medical and public health and safety issues of great social impact and through their participation in epidemiologic research and surveillance. © 2014 Elsevier España, S.L. All rights reserved. Source

Robinat A.P.,Institute Medicina Legal Of Catalonia | Robinat A.P.,International University of Catalonia | Justes S.M.,CASM Benito Menni | Gomez-Duran E.L.,International University of Catalonia
Medicina Clinica

Over the last 20 years there have been steps forward in the field of scientific research on prediction and handling different violent behaviors. In this work we go over the classic concept of "criminal dangerousness" and the more current of "violence risk assessment". We analyze the evolution of such assessment from the practice of non-structured clinical expert opinion to current actuarial methods and structured clinical expert opinion. Next we approach the problem of assessing physical violence risk analyzing the HCR-20 (Assessing Risk for Violence) and we also review the classic and complex subject of the relation between mental disease and violence. One of the most problematic types of violence, difficult to assess and predict, is sexual violence. We study the different actuarial and sexual violence risk prediction instruments and in the end we advise an integral approach to the problem. We also go through partner violence risk assessment, describing the most frequently used scales, especially SARA (Spouse Assault Risk Assessment) and EPV-R. Finally we give practical advice on risk assessment, emphasizing the importance of having maximum information about the case, carrying out a clinical examination, psychopathologic exploration and the application of one of the described risk assessment scales. We'll have to express an opinion about the dangerousness/risk of future violence from the subject and some recommendations on the conduct to follow and the most advisable treatment. © 2014 Elsevier España, S.L. All rights reserved. Source

Medallo Muniz J.,Institute Medicina Legal Of Catalonia | Martin-Fumado C.,Institute Medicina Legal Of Catalonia | Nuno Vieira D.,Instituto Nacional Of Medicina Legal | Nuno Vieira D.,University of Coimbra
Medicina Clinica

The problems involved in caring for individuals in custody, as well as deaths that occur during custody, are relevant aspects of legal and forensic medicine in terms of the possible criminal, civil and administrative responsibility of health professionals and/or public or private institutions that might hold individuals in custody and deprived of freedom. The rule of law should ensure that these cases comply with state law and international agreements and treaties related to human rights and the special treatment of individuals deprived of freedom in hospitals or detention centers. Of particular mention is the medical-forensic activity regarding deaths associated with the use of control holds and/or restraint during the detention of individuals by members of the armed forces or law enforcement or in healthcare centers by safety and healthcare personnel. In these cases, both the immediate healthcare treatment subsequent to the events and the medical-forensic study should be particularly careful. These situations, which are often high profile, cause social alarm and involve judicial actions that can result in especially severe liabilities. © 2014 Elsevier España, S.L. All rights reserved. Source

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