IALM - XXI Congress of the International Academy of Legal

XXI Congress of the International Academy of Legal Medicine
(IALM)
SESSION F
ORAL PRESENTATIONS
MAY, 29th – FRIDAY – Room 2

XXI Congress of the International Academy of Legal Medicine
(IALM)
ORAL PRESENTATIONS INDEX
O.F1 - HIPPOCRATIC OATH AND EVIDENCED-BASED-MEDICINE IN THE PRACTICE OF MODERN MEDICINE.
B. Meel, R. Kaswa
O.F2 - RESPECT OF THE DEAD HUMAN BODY AND LEGAL PROVISIONS IN AUTOPSY PRACTICE IN GREECE.
G. Leon, A. Papetta, D. Mytilinaios, C. Spiliopoulou
O.F3 - THE FACULTY OF FORENSIC AND LEGAL MEDICINE - THREE YEARS ON.
I. Wall
O.F4 - ANALYSIS ON LEGAL PROCEEDINGS AGAINST FORENSIC EXPERTS IN CHINA.
X. Liu
O.F5 - ANÁLISIS DE LAS RECLAMACIONES DE RESPONSABILIDAD PROFESIONAL MÉDICA, NOTIFICADAS EN EL
SERVICIO DE RESPONSABILIDAD PROFESIONAL DEL COLEGIO OFICIAL DE MÉDICOS DE BARCELONA (COMB),
EN EL PERÍODO 2003-2008.
J. Arimany-Manso, J. Benet, C. Sauca, J. Klamburg, J. Bruguera, G. Marti-Amengual
O.F6 - TEN-YEAR EXPERIENCE OF POST-GRADUATE LAW STUDIES FOR MEDICAL DOCTORS AND PHARMACISTS AT
THE POST-GRADUATE LAW SCHOOL OF THE EÖTVÖS LÓRÁND UNIVERSITY, BUDAPEST.
E. Kereszty

XXI Congress of the International Academy of Legal Medicine
(IALM)
O.F1
HIPPOCRATIC OATH AND EVIDENCED-BASED-MEDICINE IN THE
PRACTICE OF MODERN MEDICINE
Authors: B. Meel, R. Kaswa
Institution: Walter Sisulu University, Mthatha - South Africa
Abstract: During the past few years, there has been a burgeoning interest in evidence-based medicine. Doctors
practising evidence-based medicine will identify and apply the most efficacious interventions to maximize the
quality and durartion of life for the individual patient, and this should raise rather than lower the cost of their
care.
The unlimited needs of human beings would not have been a problem if we had unlimited necessary and
sufficient resources. The fact is, however, that our resources are finite. The Hippdegrees Cratic Oath teaches
us to care for individual patients and to enhance their welfare, irrespective of resource constraints. By
focussing on the needs of the individual patient, adV O Cates of evidence-based medicine refuse to
acknowledge the benefits in terms of future treatment of other patients. The present writer will discuss, with
various examples, the need to redefine the centuries-old ethical issues based on the lines of the Hippdegrees
Cratic Oath in relation to the care of today’s patient.

XXI Congress of the International Academy of Legal Medicine
(IALM)
O.F2
RESPECT OF THE DEAD HUMAN BODY AND LEGAL PROVISIONS IN
AUTOPSY PRACTICE IN GREECE
Authors: G. Leon, A. Papetta, D. Mytilinaios, C. Spiliopoulou
Institution: University of Athens, Medical School, Department of Forensic Medicine and Toxicology - Greece
Abstract: Introduction: Human response to the death of a loved one varies among the different societies, religions,
cultures and races through a series of ceremonies and observances. Since postmortem examination may be
offensive to some of these groups, the determination of the need for an autopsy should be based on ethical
and legal principles.
Aim and Material: We studied if the autopsy examination in Greece respects the dignity of the dead human
body. For the purpose of our study we have reviewed the legislation of the country, the national and the
international bibliography.
Results: The relevant provisions of the Greek Penal Code (such as art. 201, 335, 426, 443 and others) are
contrary to any notion of property over the dead human body that is still regarded as “res religiosa”.
Therefore, these provisions evince the reference of the legislator towards the dead body. Thus, the corpse is
elevated above the notion of property.
Conclusion: Respect of the dignity of the corpse is fully expressed in the Greek legislation. Autopsy permission
is required in medicolegal cases where permission is granted by law. The postmortem examination limited in
these special cases seems to comply with the overall respect shown to the dead body by the Greek Penal
legislation.

XXI Congress of the International Academy of Legal Medicine
(IALM)
O.F3
THE FACULTY OF FORENSIC AND LEGAL MEDICINE - THREE YEARS
ON
Authors: I. Wall
Institution: Faculty of Forensic and Legal Medicine - England
Abstract: The Faculty of Forensic and Legal Medicine was formed in April 2006 by the Royal College of Physicians of
London and has been founded to achieve the following objectives:
- To promote for the public benefit the advancement of education and knowledge in the field of forensic and
legal medicine.
- To develop and maintain for the public benefit the good practice of forensic and legal medicine by ensuring
the highest professional standards of competence and ethical integrity.
The Faculty includes three different professional groups:
- Forensic physicians
- Medically qualified coroners
- Medico-legal advisers to the medical defence organisations.
This presentation will charter the progress made by the Faculty in its first three years and follows on from the
presentation I made at IALM in August 2006 about recent developments in clinical forensic medicine in the UK.

XXI Congress of the International Academy of Legal Medicine
(IALM)
O.F4
ANALYSIS ON LEGAL PROCEEDINGS AGAINST FORENSIC EXPERTS
IN CHINA
Authors: X. Liu
Institution: Institute of Evidence Law and Forensic Science, CUPL - China
Abstract: As an important lever used in a lawsuit to provide evidences to the court, forensic medical examination is
clearly stipulated and provided in all three procedure laws in China, i.e. Criminal Procedure Law of the
People’s Republic of China, Civil Procedure Law of the People’s Republic of China and Administrative
Procedure Law of the People’s Republic of China.
Thanks to the large population and vast territory in our country, the disputes and cases also encounter with a
challenging amount. In order to address specific forensic medical issues involved in the cases, forensic
organizations are often commissioned by the investigation and judicial organs to provide forensic service.
Driven by the huge needs, a large forensic community was formed with various entities and diversified
practitioners. But due to under-regulation, different levels of proficiency, and totally profit-oriented mind,
many problems still existed in the community.
This paper collects and presents xxx cases suited against forensic experts for unsatisfied forensic results or
services. These cases shed light on the following questions: irregular service, illegal and infringing operation,
missing information, improper result description and even wrong result. After careful analysis and study, the
author thinks that the task to improve the proficiency and competence for the forensic community is
impending and finally gives some suggestions on standardization of forensic system of China.

XXI Congress of the International Academy of Legal Medicine
(IALM)
O.F5
ANÁLISIS DE LAS RECLAMACIONES DE RESPONSABILIDAD PROFESIONAL
MÉDICA, NOTIFICADAS EN EL SERVICIO DE RESPONSABILIDAD
PROFESIONAL DEL COLEGIO OFICIAL DE MÉDICOS DE BARCELONA
(COMB), EN EL PERÍODO 2003-2008
Authors: J. Arimany-Manso, J. Benet, C. Sauca, J. Klamburg, J. Bruguera, G. Marti-Amengual
Institution: Colegio Oficial de Medicos de Barcelona (Comb) - Spain
Abstract: Introducción. El Servicio de Responsabilidad Profesional (SRP) del Colegio Oficial de Médicos de Barcelona (COMB), que
gestiona la póliza colectiva de responsabilidad civil (RC) de los cuatro colegios catalanes desde 1992, asegura a más de
26.000 médicos.
Objetivo. El objetivo de este estudio es el de analizar las reclamaciones contra los médicos notificadas en el SRP en el
período comprendido desde el año 2003 al 2008, en el área de la Comunidad Autónoma de Cataluña, determinando su
tipología, frecuencia e incidencia. Se ha pretendido condegrees Cer la vía de inicio de las reclamaciones (judicial civil,
penal o extrajudicial), su evolución temporal, su incidencia entre las distintas especialidades y, finalmente, su resolución.
Resultados. En el período mencionado, se han notificado un total de 2.017 reclamaciones que suponen una media de 336
reclamaciones/año (con un mínimo 298 reclamaciones en el año 2006 y un máximo de 387, en el 2003). Se ha observado
una tendencia creciente en la vía de inicio de la reclamación extrajudicial, mientras que en el año 2003, el inicio por esta
vía fue de un 26,1%, en el año 2008, este porcentaje ascendió al 59%. Éste porcentaje difiere entre las distintas
especialidades. Los principales motivos de las reclamaciones contra los médicos han sido: por defecto de práctica
quirúrgica (27,9 %), por error diagnóstico (13,9 %), por secuelas (11,6 %) y por defecto de seguimiento en el proceso
asistencial (4,2 %).
La distribución de la responsabilidad de las reclamaciones entre las especialidades difiere según la vía de inicio de la
misma. Este estudio presenta las reclamaciones en las distintas especialidades médicas, valorando la vía de reclamación
inicial, determinando los porcentajes y las características de las sentencias condenatorias y los acuerdos extrajudiciales.
Existen especialidades como la Anestesia, Estomatología, Cirugía Plástica, Obstetricia y Ginecología, Cirugía Ortopédica y
Traumatología, Cirugía General y Oftalmología, que concentran el mayor número de reclamaciones.
Conclusiones:
•El estudio objetiva una tendencia a la estabilización del número de reclamaciones de RC médica.
•Ha aumentando la vía extrajudicial como inicio de presentación de una reclamación, en los últimos dos años.
•La mayor parte de reclamaciones se concentran en determinadas especialidades que, por otra parte, coinciden en
concentrar un mayor número de actos asistenciales y, al mismo tiempo, aquellos prdegrees Cedimientos quirúrgicos de
mayor riesgo de complicaciones.
•La responsabilidad del facultativo se dio en 1 de cada 6-7 reclamaciones, siendo mayor en el caso de las reclamaciones
judiciales (y dentro de éstas, sobretodo, en las del ámbito civil) que en las extrajudiciales.
•Algunas especialidades presentaron mayor responsabilidad cuando se iniciaron por la vía extrajudicial (Anestesia,
Estomatología y Cirugía Ortopédica y traumatología). En cambio, en otras especialidades mostraron mayor porcentaje de
responsabilidad en el ámbito judicial (Oftalmología, Cirugía Plástica y Cirugía general.
•Se ha constatado un aumento de casos de reclamaciones de la denominada Medicina Satisfactiva (Voluntaria),
especialmente, de cirugía estética y cosmética, y cirugía ortognática (implantes).

XXI Congress of the International Academy of Legal Medicine
(IALM)
O.F6
TEN-YEAR EXPERIENCE OF POST-GRADUATE LAW STUDIES FOR MEDICAL
DOCTORS AND PHARMACISTS AT THE POST-GRADUATE LAW SCHOOL OF
THE EÖTVÖS LÓRÁND UNIVERSITY, BUDAPEST
Authors: E. Kereszty
Institution: Inst. of Forensic Medicine, Faculty of Medicine, Szeged University of Sciences - Hungary
Abstract: Since 1998 the Post-graduate Law School of the Eötvös Lóránd University have undertook a special program
for medical ddegrees Ctors, dentists and pharmacists called „medico-lawyer certification”.
The 2-year program is similar to the Msc. programs, and the certification ensures special knowledge in health
law and health administration. During the medical studies the students have only a few lessons focussing only
the very basics of health and medical law, but in the daily work they face challenges when managing patient’
rights issues, malpractice suits, contracting with the insurance company or working at a health agency, or
professional councils preparing drafts of the health legislation or controlling the providers. Most of the
certified students are working now in a position, where they use these attainments as a part of their job (e.g.
MP-s, the Chief Medical Officer, the Deputy Chief Pharmaceutical Officer, patient’ rights advocates).
The degree-work of the students frequently based on their work experiences, and they tried to personalise the
fresh knowledge in law into the medical speciality they were practising. As a result they are deeply involved in
the practical implementation of the general health rules in the different levels and different providers.
On the ten-year experience the program was renewed in 2008, and continuous education unit courses were
organised for the certified students.