Medicine,Science and the Law

This article concerns the law and procedure governing the production and disclosure to an accused of medical and therapeutic records in the hands of third parties, not part of the Crown's case against the accused. Following a brief analysis of the medicolegal issues involved, this article examines recent statutory changes regarding involuntary disclosure to an accused by third parties of private records in their possession.

Sixteen patients were returned to Ashworth in a one-year period (five second admissions, 10 failed leave of absence and one warrant of recall) making up 31% of admissions for the year. Demographic details and reasons for return were collected. Fifty per cent of patients had a clinical diagnosis of personality disorder. Reasons for return included relapse of psychosis, persistent transgression of boundaries, aggression or threatened aggression, unsuitable placements and failure to progress towards discharge.

The final judgment from a recent criminal trial in the British Columbia (Canada) Supreme Court is summarized and discussed. The trial involved sexual misconduct with a child, excessive alcohol use, and a successful ‘sleepwalking (SW) defence’ (non-insane automatism). Our comments on this trial provide an opportunity to present our arguments buttressing two newly proposed forensic categories: (i) parasomnia with continuing danger as a non-insane automatism, which originally was proposed for cases involving recurrent, sleep-related violence, but which can also be applied to SW cases involving sleep-related sexual misconduct and alcohol abuse (and other high-risk self-abusive behaviours); (ii) (intermittent) state-dependent continuing danger, an intermediate category within the ‘continuing danger’ concept, with the core feature being that a person acquitted of a criminal charge on the basis of the ‘SW defence’ (or some other parasomnia defence), in which the SW episode was provoked by a high-risk behaviour (e.g. alcohol intoxication) should bear full legal culpability for any future episode that was provoked by a recurrence of the high-risk behaviour — provided that the individual had wilfully engaged in that behaviour.

The giving of dowry on marriage is a widespread custom in India, but the attitude of society towards this practice is neither uniform nor consistent. ‘Dowry death’ is the result of a unique form of violence suffered by Indian women. The existing legal provisions relating to dowry and dowry deaths are summarized, and the role of the Indian Penal Code is discussed. Case reports are presented.

Random samples from normal distributions are an important assumption for many statistical methods. The present study evaluates this assumption with regard to quantitative breath alcohol analyses. Eight individuals (six male and two female) consumed alcoholic beverages and subsequently provided replicate (n ranging from 22 to 69) breath samples to an infrared breath alcohol instrument within short time intervals. The serially collected data were treated with several descriptive and inferential methods. Descriptive results among the eight individuals included: mean 0.0420–0.1175 g/210L, SD 0.0008–0.0045 g/210L and CV: 1.9%–4.7%. Statistical tests for normality showed seven of the distributions to be reasonably normal (p ≥ 0.25) and the other marginal (p = 0.051). A test for runs about the median showed random results (p ≥ 0.10) for four individuals and non-random (p ≤ 0.01) for the other four. The results suggest an individual's breath alcohol measurement, when appropriately collected and analysed, should be considered a random sample from a normal within-subject distribution. The existing variability in breath alcohol analysis, due largely to biological and sampling considerations, is acceptably minimized to warrant forensic application.

Claims that breath alcohol values measured on the Lion Intoximeter 3000 are invalid if the machine clock is incorrect by more than four minutes have been shown to be technically incorrect. A study involving measurement of simulated breath alcohol levels with various Intoximeter 3000 clock times shows no variation within normal tolerances for breath alcohol values.

This study reports the demographic and social characteristics and level of psychological dysfunction in regular khat users compared with matched non-users. The results indicate that khat users resemble non-users on a number of psychosocial variables and GHQ scores, with no evidence to suggest higher morbidity amongst users.

The two groups appear to differ only in the level of their use of nicotine and also in their perception of the harmful effects associated with khat use.

A time-series study of suicide and homicide rates in Australia and New Zealand from 1950–85 provided limited support for Durkheim's theory of suicide and no support for Henry and Short's theory of the relationship between suicide and homicide. The need for rival theories is discussed.

A case of non-accidental injury to an infant caused by the discharge of an air pistol is presented, the first such case to be reported. A two-month-old baby was shot at close range by his father with a ***.177 air pistol. A false account of the cause of the injury was given by the father and initially supported by the mother. The pellet penetrated the skin in the centre of the child's forehead and lodged in the anterior wall of the sagittal sinus. It was removed under general anaesthetic and the child made an uncomplicated recovery. The father was subsequently convicted and jailed for the assault. The relevant literature on air weapon injuries and bizarre forms of child abuse is discussed.

A case of unexpected death in a six-year-old child, who died after a period of non-specific symptoms and clinical signs, is described. The cause of death was a pilocytic astrocytoma of the pontocerebellar angle, rare with regard to location and histology. The authors have reviewed the literature, which was scanty.

A case of self-inflicted bite injuries of the fingers with an episode of small intracerebral haemorrhages is presented. There were many injuries on the right fingers. The tip of the right forefinger was bitten off, and some small pieces of the finger had been aspirated and swallowed. This unusual case seemed to be an emotional response to pain from cerebral episode.