A witness or party's fitness to attend court or give evidence is an everyday issue for courts. A number of judgments are used to illustrate how some healthcare professionals fail to provide evidence that assists the courts when this is an issue. The court needs to understand the functional impact of the condition having regard to the physical and mental demands of attendance and the specific legal tasks that participation will entail. From these judgments, the information is identified which healthcare professionals need in order to provide optimal assistance to the courts. Recommendations are made as to the contents of a healthcare professional's report addressing the issue and as to guidance which should be drawn up for the courts, the legal and healthcare professions and the charities or organisations that provide practical assistance to litigants in person.
Determining the postmortem interval (PMI) and cause of death (COD) in decomposed remains a major challenge in forensic pathology because morphological and biochemical indicators progressively deteriorate during decomposition. Microbial communities are highly responsive to environmental and physiological changes and may therefore provide complementary forensic information. In this study, we used a murine model to investigate postmortem microbial succession associated with three death-related conditions—ligature strangulation (LS), hemorrhagic shock (HS), and organophosphate poisoning (OP)—across postmortem time points from 2 to 20 days. Swab samples from three skin sites (face, chest, and abdomen) were collected and subjected to 16S rDNA sequencing, and microbial community dynamics were evaluated using bioinformatics and random forest (RF) machine-learning models. Our results revealed distinct COD-associated microbial trajectories. LS carcasses exhibited accelerated morphological decomposition and earlier Proteobacteria dominance, whereas HS showed delayed decomposition-related changes. OP exhibited distinct microbial diversity and succession patterns, particularly during early PMI. Alpha- and beta-diversity analyses indicated that both COD and PMI significantly influenced microbial community structure. RF models showed strong discriminatory performance for COD classification (AUC > 0.95) and PMI classification (AUC 0.88–0.98), with distinct microbial features contributing to the two classification tasks. These findings suggest that physiological conditions associated with different causes of death may contribute to distinct postmortem microbial trajectories, while temporal microbial succession provides informative markers for categorical PMI classification. Collectively, microbiome-based approaches may serve as complementary forensic tools for simultaneous PMI classification and discrimination of death-related conditions.
Comparative data on the clinical and criminological profiles of female homicide offenders from non-Western jurisdictions remain scarce. This retrospective observational study characterised 112 consecutive female offenders referred between June 2018 and June 2023 to the Council of Forensic Medicine (Adli Tip Kurumu, ATK) of Türkiye the national-level referee body that provides binding forensic psychiatric opinions to all criminal courts, for intentional or attempted homicide, identifying independent predictors of full exemption from criminal responsibility under Article 32 of the Turkish Penal Code. The cohort (mean age 33.1 years) was predominantly of low educational attainment (71.5%) and unemployed (67.0%). Most offences occurred domestically (69.7%). Victims were primarily intra-familial, including the offenders’ own children (42.0%, with neonates comprising a third of child victims), intimate partners (21.4%), and other relatives or non-relatives (36.6%). Nearly half (49.1%) had a documented pre-offence psychiatric diagnosis. Ultimately, 16.1% were adjudicated non-responsible; all of these cases involved psychotic-spectrum diagnoses or excitative/peripartum states, namely acute manic and postpartum psychotic episodes. Multivariable logistic regression demonstrated that active delusions at the time of the offence (aOR 48.0) and a pre-existing psychiatric diagnosis (aOR 8.7) strongly predicted legal exemption, whereas filicide paradoxically served as a negative predictor (aOR 0.14). Exploratory k-means cluster analysis suggested two tentative, hypothesis-generating typologies, a “filicide-reactive” group and a “psychotic/non-domestic” group, with the latter exhibiting a 4.5-fold higher rate of criminal exemption. These findings indicate that active psychotic symptomatology, rather than the specific victim-offender relationship, dictates criminal non-responsibility. The data underscore the clinical necessity for systematic screening protocols targeting perinatal mental disorders, acute psychosis, and intimate-partner violence upon initial contact with the criminal justice system to improve both forensic accuracy and preventative interventions.
Background Hyoid bone findings are frequently discussed in court judgments involving alleged strangulation/neck compression, yet their documentation and judicial interpretation vary. We examined whether hyoid fracture status is associated with judgment outcome and how hyoid-related arguments are used in judicial reasoning. Methods A mixed-methods study was conducted using Indian High Court/Supreme Court (HC/SC) judgments (2024–2025) retrieved from Indiankanoon.org . Quantitative analyses were performed on strangulation/neck compression judgments ( n = 370). Judgment outcomes were categorised and collapsed into accused-favourable versus prosecution/anti-accused-favourable outcomes. Victim-level analysis included 376 victims. Associations were examined using chi-square/Fisher's exact tests with odds ratios. A qualitative thematic synthesis was undertaken on the broader HC/SC hyoid corpus ( n = 500) to contextualise quantitative findings; key themes were summarised. Results Accused-favourable outcomes were less frequent in cases with documented hyoid fracture than in intact/not-mentioned cases (47.2% vs. 62.7%; OR = 0.53, 95% CI: 0.35–0.81; p = 0.003). In accused-side applications, high weightage to literature-linked hyoid arguments was associated with lower accused success in fracture cases (OR = 0.40) but higher success in intact/not-mentioned cases (OR = 2.39), suggesting effect modification by fracture status. Victim-level analyses showed fracture was more frequent when manual/throttling was alleged compared to ligature strangulation (OR = 2.17, 95% CI: 1.34–3.52; Fisher's exact p = 0.0022). Qualitative synthesis identified recurrent judicial reliance on hyoid fracture as a decisive sign, variable use of literature, and documentation gaps influencing interpretation. Conclusions Hyoid fracture documentation is associated with judicial outcomes and shapes argumentation strategies. Standardised forensic documentation and cautious interpretation of isolated hyoid findings are warranted.
Individuals with intersex traits continue to experience a significant lack of protection within the Italian legal and healthcare system. The absence of specific legislation and standardized clinical guidelines contributes to practices that vary across regions and institutions, generating uncertainty in the medico-legal sphere and raising bioethical concerns about autonomy, non-maleficence, and justice. In particular, the persistence of early surgical interventions without the individual's consent remains controversial, especially when contrasted with the consent-based frameworks emerging in other European states. This article provides an in-depth analysis of the Italian normative vacuum, highlighting its consequences for clinical practice and the medico-legal landscape, with reference to the risk of future claims of biological damage resulting from physical and psychological harm. By situating the Italian scenario within a broader European context, including reforms in Malta, Germany, Portugal, Greece, Iceland, and Spain, the article demonstrates how Italy lags behind in recognizing and protecting the rights of individuals with intersex traits. The conclusion calls for urgent legislative and clinical reform that integrates international human rights principles and ensures the consistent application of bioethical standards in intersex healthcare.
