Objective: Article 280 of the Turkish Penal Code (TPC) concerns healthcare professionals reporting crimes. Psychiatrists and emergency physicians who frequently encounter patients who have been exposed to violence against women (VAW) are faced with a dilemma when the patient does not want judicial notification. Methods: One hundred and thirty-eight psychiatrists and 70 emergency medicine physicians participated in the research. In the online survey, participants were asked about their level of knowledge regarding Article 280 of the TPC, their attitudes towards VAW, and their experiences with VAW cases. Trends in making judicial notifications and keeping medical records were examined based on physical violence (PV) and sexual violence case reports. Results: Regarding the case examples, physicians’ tendencies to keep medical records and make judicial notifications differ for PV and sexual violence. Emergency medicine physicians are more likely to make judicial notifications in VAW cases than psychiatrists (each p<0.001). The tendency to make a judicial report and to make a medical record) was higher in the PV case than in the sexual violence case. Being a specialist physician increased the probability of reporting PV by 2.1 times (p=0.009). All psychiatrists and 91% of emergency physicians are concerned about the physical safety of their patients in case reports. Conclusion: In its current state, the crime of a healthcare professional not reporting the crime leaves physicians in a dilemma between doing what is suitable for the patient’s well-being and doing what is legal. The relevant law needs to be reviewed, and physicians should be trained on the forensic aspects of VAW cases.
Objective: It involves the evaluation of the effects of different biological materials deposited on cartridge cases on the amount of DNA recovered post-firing, considering the influence of time and different types of swabs Methods: MKE 9x19 mm brass cartridges were contaminated with blood and epithelial cells, fired, and swabbed at different intervals (1 day, 1 week, 2 weeks, 3 weeks, 4 weeks, 2 months, 3 months) to assess DNA quantity. The study compared microfiber and cotton swabs, utilizing the phenol-chloroform method for DNA extraction and the Quantifiler Trio kit with the 7500 real-time polymerase chain reactionsystem for quantification. Results: According to the AmpFlSTR™ Identifiler™kit, eight cartridge cases fell within the high-quality DNA profile range (0.05-0.125 ng/µL). One of these is an epithelium- contaminated cartridge, while the others are blood-contaminated cartridges. For cotton swabs, the highest degradation rate was obtained in the 4th week for blood contaminated cases, 2nd weeks for epithelial cell-contaminated cases. For microfiber swabs, the highest degradation rate was obtained in the 3rd month for blood contaminated cases, 1st day for epithelial cell-contaminated cases. In a study using cotton and microfiber swabs to collect samples from different biological materials on cartridge cases, no significant difference was found in DNA quantity between the swab types on day 1 and month 3. Conclusion: The microfiber swab, considered an alternative to the routinely used cotton swab, did not demonstrate superiority. DNA sufficient for successful profiling was obtained even from cartridges swabbed three months after firing. Additionally, blood-contaminated cartridges had significantly higher DNA levels than those contaminated with epithelial cells.
Objective: The aim of this study is to examine the relationship between the psychological resilience levels and secondary trauma levels of mental health professionals who were involved in the Kahramanmaraş-centered earthquake on February 6. Additionally, the study investigates whether psychological resilience and secondary trauma levels vary based on demographic factors. Methods: Psychological resilience has been shown to negatively predict secondary traumatic stress (β=-0.412; t=-5.034; p<0.001). It was found that having experience in similar roles and exposure to short-term traumatic events may increase psychological resilience, while working with trauma victims for extended periods may increase the risk of secondary traumatic stress. Results: The findings revealed that psychological resilience negatively predicted secondary traumatic stress. Moreover, significant differences were found in the levels of psychological resilience and secondary traumatic stress according to various demographic variables. It was found that having prior experience in similar roles and being exposed to short-term traumatic events could enhance psychological resilience, while prolonged work with trauma victims could increase the risk of secondary traumatic stress. Conclusion: In conclusion, it is recommended to develop training programs and intervention strategies to enhance the psychological resilience of professionals working in disaster and trauma fields, as well as to establish institutional policies and support systems to prevent and manage secondary traumatic stress.
Objective: The violence in healthcare is any verbal, behavioral threat or physical attack that endangers the healthcare worker by patients, their relatives or another person. In this study, we aim to assess how the attitudes of the medical students are shaped towards violence against physicians and how the violence in healthcare affects their area of expertise, working environment and future and we want to show the effect of the violence in healthcare on the medical students’ career plans and discuss the measures against the healthcare violence. Methods: A questionnaire was prepared for 983 students studying at Manisa Celal Bayar University Faculty of Medicine between 01.07.2019-08.10.2019 in the 2019-2020 academic year. Data were analyzed using the Statistical Package for Social Sciences 21.0. Results: We determined that 54.9% of the medical students who cooperated in our study were female, with an average age of 20.83±2.05, 59.9% preferred medical school to be a physician. Our results showed that 15.9% of the participants experienced violence against physicians. They experienced violence particularly in the emergency service; verbal violence was the most common. 93% of them found the measures taken were inadequate. Besides, with the increase of term, students started to prefer internal branches over surgical branches. Conclusion: We show that violence against physicians significantly influences the preferences of medical students. The best option for our country will be the correct implementation of the measures and rearrangement and execution of systematic and legal infrastructure against the violence.
Objective: Prejudice, which disregards basic human rights and threatens the culture of living together, is a widespread social problem encountered all over the world and is the source of discrimination and hate crimes. In order to struggle the social problems created by prejudice toward immigrants, which has reached serious levels worldwide, it is important to understand the conditions that lead to the development and maintenance of prejudice. So, the current study aims to reveal the factors that predict the prejudice of citizens of the Republic of Turkey toward Syrian immigrants. Methods: The sample consists of 461 people aged 18/over from different social segments of Istanbul and Hatay provinces. The level of predictive power of the social dominance orientation, the group identification, the integrated threat theory and the intergroup contact scales on prejudice toward immigrants was determined by using hierarchical regression analysis. Results: Upon evaluating the statistical data from the scales, it was found that the mean perception of realistic threat in the Istanbul sample (x̅=41.28) was significantly lower than in the Hatay sample (x̅=45.06), with a statistically significant difference [t(458)=4.713, p<0.001]. Similarly, the symbolic threat perception in the Istanbul sample (x̅=41.22) was also significantly lower than in the Hatay sample (x̅=43.42) [t(457)=2.819, p<0.01]. The strongest predictors of prejudice against immigrants were identified as intergroup anxiety and the positivity of intergroup contact. Across all threat perception scales, Hatay, a border province, exhibited higher scores. This suggests that the predictors of prejudice are more closely linked to social factors than to individual traits. Conclusion: Considering that unavoidable prejudices can lead to discrimination and hate crimes toward immigrants, which can turn into legal cases and cause widespread negative social consequences, it is underlined that a large-scale struggle that can function at the societal level to reduce prejudice is necessary.
Every year, many people in our country lose their health due to traffic accidents, work accidents, and occupational diseases, and they continue the rest of their lives with varying degrees of damage. In terms of compensation law, various tables included in legal regulations are used to determine the extent of the damage. Which regulation will be applied when determining the disability rate also causes confusion in judicial decisions due to frequently changing legislation in recent years. Our forensic medicine polyclinic has been responding to a large number of disability rate requests for many years. The aim of this text is to discuss the some problems encountered in practice within the framework of the current disability legislation and to make suggestions about some situations that are not included in the legislation or are inadequate. Having legal regulations that are clear, understandable and do not require much interpretation when calculating disability rates is an important factor that facilitates the work of experts who prepare reports on disability. At the same time, the table of sequelae included in the legislation should be update by discussing them at regular intervals with experts in the field, in line with changing and developing medical information.
Objective: Child sexual abuse is defined as “involving a child in sexual activities that they do not fully comprehend, cannot give informed consent to, or are not developmentally prepared for, or that violate the laws or social taboos of society.” This issue is a global problem that is difficult to detect and creates lifelong negative effects on the physical and mental health of victims. In this study, it is aimed to evaluate the children who have been victims of sexual abuse and have applied to the Aydın Child Advocacy Center, and to contribute to solving the problem through the data obtained. Methods: This study, designed as a retrospective and descriptive study, included cases referred to the Child Advocacy Center with allegations of sexual abuse between 01.08.2018 and 01.08.2022, whose interviews and examinations were completed. Cases that did not report abuse in their medical history or had incomplete histories were excluded from the study. Results: In the evaluation of 762 children who reported abuse and were assessed, it was found that 84% (n=640) were girls and 16% (n=122) were boys, with an average age of 12.5±3.4 years. It was determined that most of the victims came from nuclear families (51%) and that the most common location of the incident was district centers (51.8%). Almost all of the alleged perpetrators were male (98.4%) and acted alone (89.9%), with an average age of 27.1 years. It was observed that girls were most frequently abused by boyfriends (13%), while boys were most commonly abused by peers and friends (35.2%). Girls were found to be significantly more likely to experience intrafamilial abuse compared to boys. The incidents of abuse were most commonly shared with parents (43.6%), and it was found that intrafamilial abuse (50.7%) tended to recur more often than extrafamilial abuse (34.1%), with the number of reported cases increasing over the years. Intrafamilial abuse cases were reported later than extrafamilial ones. It was noted that 43.2% of the victims described interfemoral contact or rubbing, 37% of the cases were examined, and in 4.2%, no examination was necessary due to pregnancy. Vaginal examination revealed that the most common finding was a tear older than 10 days (60%), while anal examination showed no findings in the majority of cases (75.2%). Conclusion: In our study, it was observed that the majority of the suspects were familiar individuals. It was particularly noted that intrafamilial abuse incidents tended to recur multiple times and that the time between the incident and the report was longer compared to cases involving other suspects.
Objective: This study aims to contribute to the literature by presenting our department’s experience in retrospective assessment of legal capacity, occasionally encountered in clinical forensic medicine. Methods: Forensic psychiatry reports prepared at Hacettepe University Faculty of Medicine, Department of Forensic Medicine between 01.01.2021 and 31.03.2024 were examined retrospectively. Cases who underwent retrospective legal capacity evaluation after death were included in the study. The demographic characteristics such as age and gender of the cases, their medical and psychiatric histories, causes of death, witness statements and visual records available in the forensic investigation files, as well as health reports pertaining to legal capacity dated prior to the incidents, were evaluated. Results: Five cases were male, one was female. Ages ranged from 81 to 96, with a mean of 88.2. All had at least one chronic illness; four had dementia. Two did not have health reports at the contract date; in four cases with health reports, legal capacity was noted. Forensic psychiatry reports prepared by our department indicated indicated legal capacity in three cases, absence in two, and inconclusiveness in one. Conclusion: In the majority of cases where retrospective legal capacity assessment following death is requested, a diagnosis of dementia is prevalent. The inability to examine the cases necessitates a meticulous and standardized evaluation. Firstly, the scientific adequacy of the medical report prepared at the time of the incident should be scrutinized. Following examination of medical and legal documents, a forensic psychiatry report should be prepared meticulously and in accordance with reasoned and scientific criteria.
Sharp force injuries to the anterior aspect of the neck are called “cut-throating”. Cut-throating is most commonly homicidal, but can also occur as a result of suicide or accident. We present two cases of cut-throating consist of one homicide and one suicide handled by the husband in the same scene. Causes of death for both are reported as “as a result of bleeding due to major vascular damages caused by sharp force injury”. According to judicial investigation; the couple had been in process of divorcing and that night the man firstly killed his wife and then himself by cut-throating with a knife while their kids present. We present this case because it involves both homicide and suicide (dyadic death) handled by the same hands with the same method in an event. We aimed to emphasize the importance of the differences in the findings obtained from the crime scene and the corpse in determining the origin in deaths by cut-throating.
Determining the rate of loss of earning capacity (disability rate) in the profession is important all over the world. Because the proportional determination of the limitation in a person’s body creates certain rights for the person. Relevant legislation has been regulated in this regard, although it varies in each country. The regulation in force in our country on this subject is the Regulation on Determination of the Ratio of Loss of Working Power and Earning Power in the Profession, issued in 2008. In evaluating loss of earning capacity in the respiratory profession, the pertinent regulation is also considered. Respiratory diseases are classified as mild-medium-severe under this regulation. We presented a case in which pneumomediastinum and hemopneumothorax developed as a result of a tractor trailer passing over the rib cage and stenosis in the left main bronchus was detected during follow-up, discussing disability within the scope of the relevant regulation.
Objective: Torture is a violation of human rights which still preserves its importance in today’s world. Istanbul Protocol (IP), is a formative document prepared by many experts working in related fields on the medical reporting of torture and is accepted by United Nations. Our objective in this study was to evaluate the effectiveness of the provision of IP training to students who will probably work as the wardens of the future. Methods: A survey covering twelve statements structured according to IP was administered to 29 volunteers (17 males, 12 females) who second-year students of Criminal Execution and Security Services Program. Students were asked to respond to the statements in the survey as agree, disagree, or have no idea. The changes in the answers given before and after the training were examined. Results: A higher rate of correct answers in all statements of the survey was observed after the training and the change acquired in all statements except one was detected to be statistically significant. For instance the rate of those who thought that it would be appropriate for security forces to accompany the examination was 68.9%, and the rate of those who thought that a biological sample could be taken by force was 65.5%. After training, these rates decreased dramatically. Conclusion: In the struggle against human rights violations and torture, the acquisition of information and sensitivity on these subjects by all addressees of the subject is very important and IP training would constitute good means for this aim.
Objective: In this study, it is aimed to evaluate forensic medicine and genetics specialists and residents, medical students and genetics PhD students’ opinions on purpose, management and use of data of the forensic DNA database and their perspectives on the bank. Methods: In this study, an online survey application was preferred. Five hundred sixty-eight questionnaires were evaluated, including 354 medical students, 73 forensic medicine specialists, 98 forensic medicine residents, 14 genetics specialists, 24 genetics residents, and 5 genetics PhD students. In the survey; sociodemographic characteristics, professional characteristics, opinions about which institution should manage if a forensic DNA bank is established in our country, whose information will be stored, and positive aspects and concerns about the database were asked. Results: 46.7% of the participants were female and 53.3% were male. The mean age was 25.88±8.20 years. Approximately 50% of the participants stated that the DNA information of convicts, suspects, and volunteers should be kept. It was determined that positive opinions were at a higher level than concerns. It was observed that the anxiety levels of the medical faculty students were higher than the other participants. It was found that the level of anxiety decreased as the age increased. Conclusion: It is necessary to support the questions in our study, which sheds light on the general attitude about DNA bank for forensic purposes, with samples reflecting the society.
Child abuse and neglect (CAN) is the exposure of a child in the 0-18 age group to a harmful, non-accidental and preventable behavior by the person or persons responsible for caring for him/her at home or in an institution with which he or she interacts. The fact that countries adhere to their own cultural norms and have differences in legislation regarding the adoption of internationally accepted common definitions has made epidemiological studies difficult and has brought about many deficiencies in the prevention and intervention phase of the CAN problem. World Health Organization, UNICEF, UNESCO, the United Nations Secretary-General’s Special Representative on Violence Against Children and the Global Partnership to End Violence Against Children have compiled seven principles called INSPIRE, which will include a forward 10-year period with national development targets, titled “Global Status Report on Preventing Violence Against Children 2020”. A based strategic plan has been developed. According to preliminary data collected from countries, most countries have taken some steps, but the efforts of government officials are reported to be insufficient to achieve sustainable development goals. To bring a universal regulation to combat and intervention methods against CAN; INSPIRE, which draws attention to the importance of health, law, education and social policies, is both hopeful and valuable with its ten-year action plan between 2020-2030 and its recommendations for the need for urgent action.
Objective: Eye injuries have a significant effect, causing vision loss and an increase in the prevalence of visual impairment on a global scale. Traffic accidents are increasingly responsible for eye injuries, especially in developing countries. Traffic accidents cause people to suffer physical and/or psychological damage every year in our country and around the world. Through the analysis of impairment rates, this research aims to identify the strengths and weaknesses of the impairment assessment criteria. Methods: Patients who applied to Mersin University Faculty of Medicine Forensic Medicine Department Impariment Polyclinic between January 1, 2015, and January 1, 2022 with eye injuries connected to traffic accidents had their sociodemographic and accident-related data scanned. Impairment rates were calculated individually for each case in accordance with the American Medical Association Guides to the Evaluation of Permanent Impairment (AMA guideline), the Regulation on Disability Assessment for Adults (Disability regulation), and The Regulation on Determination of Working Power and Loss of Profitability in Occupations [Social Security Institution (SSI) regulation]. Results: In our study, 67.1% of the 82 cases were male, with a mean age of 36.01. The cases exhibited the most common occurrences of corneal and nerve injuries. We observed a statistically significant difference in the medians of impairment rates calculated according to the AMA guidelines and the Disability and SSI regulations. Conclusion: The calculation of impairment rates based on the SSI regulation for eye injuries revealed a constrained methodology, resulting in higher impairment rates compared to those determined by the AMA guideline and the Disability regulation. The Disability regulation and AMA guidelines were found to follow similar and detailed calculation methodologies. Within our country, we advocate for the adoption of a comprehensive guideline devoid of subjective interpretation for the determination of impairment rates in eye injuries resulting from traffic accidents, encompassing all conceivable eye-related diagnoses.
Objective: Worker fatalities is a concept that encompasses all deaths occurring during the execution of a profession, which is undertaken to sustain a person’s livelihood, due to the physical and psychological effects of the work. The aim of this study is to examine various parameters in cases aged 65 and over, aiming to reveal the level, form, and causes of occupational accidents and fatalities in the geriatric population. Through this, the study aims to contribute to the literature by shedding light on the exposure level, form, and causes of occupational accidents and fatalities among the geriatric population. Methods: In this cross-sectional, descriptive study, a retrospective analysis was conducted on 86 cases of work-related deaths among the population aged 65 and over in Turkey in 2020, which were reported in the national print and visual media. Results: Of the examined 86 worker fatalities, it was found that 77.9% (n=67) were in the age range of 65-74 years, 88.4% (n=76) of the cases were male, and accidents were the leading cause of death in 72.1% (n=62) of cases. When examined in terms of location distribution, it was found that 43.0% (n=37) occurred in rural areas. Conclusion: In our country, the number of individuals in the geriatric population participating in the workforce is higher compared to developed countries. Consequently, occupational fatalities among the geriatric workforce are also higher. Policies implemented in Europe and America for the aging workforce should be observed, and regular health check-ups should be ensured.
Objective: To analyze whether psychopathological symptoms have a mediating effect on the relationship between childhood traumas and criminal attitudes. Methods: In order to achieve the purpose, the correlational survey model was used, and a total of 391 people over the age of 18 participated online in this study covering the dates January 2023-January 2024 with the convenience sampling technique. Psychopathological symptoms in the relationship between childhood traumas and attitudes towards crime were examined with parallel multiple mediating variable analysis. Results: It was observed that childhood traumas did not have a direct effect on attitudes towards crime. Similarly, when childhood traumas were controlled and the effects of psychopathological symptoms on attitudes towards crime were examined, it was determined that no psychopathological symptom had a direct effect on attitudes towards violence, but interpersonal sensitivity and hostility symptoms had the possibility of indirectly strengthening the relationship. Conclusion: It was concluded that attitudes towards crime emerged as a result of the effects of the family, neighborhood and society on the individual rather than a mechanism triggered by individual characteristics or experienced traumas, and that psychopathological characteristics or past traumas trigger the tendency towards crime only if social conditions are appropriate.
Objective: Forensic medical interviews of victims of violence against women constitute an important step in the reporting processes. It is aimed to develop standardize interview for violence against women and to create an interview model. Methods: A prospective study was planned with 80 women between the ages of 18-65 who applied to the Muğla Training and Research Hospital Forensic Medicine Polyclinic between 2020-2021 after being exposed to physical violence by intimate partners. One-on-one clinical interviews were conducted with the cases and information on sociodemographic characteristics and physical violence were obtained including three generations. In addition to the descriptive characteristics of the cases, Pearson chi-square test, Fisher Exact test and Spearman Correlation Coefficient were used to model the relationship between the dependent variable and independent variables. Results: The mean age was 35.3 years, the mean age of intimate partners was 39 years. In 66.3% of the cases, the duration of exposure to violence is less than 5 years. 95% reported that there was emotional and economic violence with it. 53.8% of the cases were exposed to violence in their childhood, 41.3% of them witnessed violence between their parents. 63.7% of the women inflict violence on their children. Psychiatric referral was made in 40%, 71.9% of those who received psychiatric support stated that this support was good for them. Conclusion: Violence against women is a serious public health problem faced by all healthcare professionals, especially forensic medicine specialists. A standardized clinical interview with the surviwors of violence; will be able to evaluation processes such as a checklist. With the results of this study, a standardized interview model has been developed.
Objective: In this study, it was aimed to determine current study topics and changing dynamics in the field of Disaster Victim Identification by conducting a bibliometric analysis of articles in the international literature. Methods: In the Web of Science database, the words “disaster victim identification”, “DVI” and “mass disaster” were searched in the titles and keywords of the publications and the articles in the literature were evaluated. The study contained 190 articles which fulfilled the criteria of being indexed in SCI-E, SSCI, or ESCI, having the research area “medicine legal”, being of document type “article”, and being in English language were included in the study. The VOSviewer 1.6.19 software was used to analyze and visualize networks. Results: The first paper was published in 1971, and the peak year for publications was 2011. Australia was the most productive country in this field with 42 publications. The articles received a total of 2,664 citations over the years, with the highest number of citations occurring in 2021. These articles were published in 15 journals, and Forensic Science International was the leading journal in this field with 55 articles. When the top 10 most cited articles were examined, it was observed that the studies covered various fields such as genetics, anthropology, radiology and odontology. Conclusion: This study is the pioneering bibliometric analysis of disaster victim identification articles. By assessing publication characteristics, international collaboration, and co-citation analysis, we’ve shed light on the latest research trends in this field. Consequently, we believe our work offers valuable insights to researchers in forensic medicine and forensic sciences.
Abusive head trauma is a serious type of child abuse that causes skull and brain damage as a result of the child being violently shaken and/or exposed to blunt trauma. It is seen in children under 5 years, most commonly under 2 years. Its classic triad is the simultaneous occurrence of subdural hematoma, retinal hemorrhage, and encephalopathy. Histopathological and immunohistochemical examinations at autopsy are crucial in determining the cause of death and the age of the lesions in cases resulting in death. While these examinations confirm the macroscopic diagnosis, they also enable the determination of macroscopically undetectable findings and the age of the trauma. Determining a protocol specifically for central nervous system examinations in cases of suspected child abuse and sampling by this standard approach will make significant contributions to the proper functioning of justice.
Objective: This study examines cases of violence victims who applied to the newly established Forensic Medicine Polyclinic in the first nine months. It aims to discuss the sociodemographic, medical, and judicial characteristics and explore what experts can do to prevent violence, a serious public health issue, and establish justice more effectively. Methods: The forensic reports of violence victims who sought treatment at the Forensic Medicine unit, where the study was conducted, between September 22, 2022, the day of its establishment, and June 22, 2023, as outpatients under law enforcement supervision, were retrospectively examined. Statistical analysis was conducted by evaluating the type of violence, age, gender, application time, findings, consultations, and outcomes. Results: Out of 172 victims, 58.7% were male, 41.3% were female, and 89% were aged 18-65. 63% were brought for examination by law enforcement, with physical violence detected in 97.6%. Sixty-four percent of cases were examined within the first 3 hours, 74.4% had treatable wounds, and women were often attacked at home by their spouses and lovers. Men faced violence from acquaintances in open spaces and workplaces, with cases frequently referred to the psychiatric clinic. Conclusion: Factors such as demographic characteristics (e.g., gender, age), type and duration of violence, and hospitalization are very important in assessing violent incidents. This data helps prevent violence and provide appropriate support and treatment to victims. Collaboration with forensic medicine experts and other branches is useful in forensic case management, especially in emergency departments.
