The multi-factorial determinism of forensic expertise regarding sentence interruption on medical grounds and decision

Journal <strong>of</strong> Forensic and Legal Medicine 61 (2019) 45–55
ContentslistsavailableatScienceDirect
Journal<strong>of</strong>ForensicandLegalMedicine
journal homepage: www.elsevier.com/locate/yjflm
ResearchPaper
<strong>The</strong><strong>multi</strong>-<strong>factorial</strong><strong>determinism</strong><strong>of</strong><strong>forensic</strong><strong>expertise</strong><strong>regarding</strong><strong>sentence</strong>
<strong>interruption</strong>onmedicalgroundsanddecision ☆
T
CristianGherman,AlexandraEnache,CristianDelcea ∗
"VictorBabes"University<strong>of</strong>MedicineandPharmacy,Timisoara,Romania
ARTICLEINFO
Keywords:
Forensicmedicine
Forensic<strong>expertise</strong>
Decision
ABSTRACT
<strong>The</strong>topicproposedbythisresearchisthecomplex<strong>determinism</strong>orrequesting<strong>forensic</strong><strong>expertise</strong>forthepurpose
<strong>of</strong> postponing or interrupting a <strong>sentence</strong> in medical ground. Within the topic, it was necessary to perform a
complexanalysisonseveralaspects<strong>of</strong>inmatelife,fromthepoint<strong>of</strong>view<strong>of</strong>theirrightsandespeciallytheright
to medical assistance. We have included aspects related to the evolution <strong>of</strong> the legal framework and current
regulations,tothestatus<strong>of</strong>medicalassistanceinthepenitentiaryenvironment(illustratingrealitiesrelatedto
morbidity and mortality) and to the doctor-patient relationship during a <strong>forensic</strong> <strong>expertise</strong>. To this end, this
paperaimstorevealtherealities<strong>of</strong>howinmatesareinformedabouttheframeworkinwhichtheinstitution<strong>of</strong>
<strong>forensic</strong><strong>expertise</strong>operates,aswellastoanalysetheinmates’perceptionontheaccessibilityandusability<strong>of</strong>this
type <strong>of</strong> <strong>expertise</strong>. At the same time, we aimed to identify cases which abusively exceed the boundaries <strong>of</strong> requesting
<strong>sentence</strong> <strong>interruption</strong> on medical grounds and the causes <strong>of</strong> these situations. In the first part, a retrospectivestatisticalstudywasperformedinmortalitywithinthepenitentiarypopulationintheareaincludedin
thestudy.<strong>The</strong>characteristicsparticulartothedoctor-inmatepatientrelationshipwerealsoexplored.
1. Introduction
<strong>The</strong> status <strong>of</strong> inmates is a permanent topic <strong>of</strong> interest and preoccupation,bothinEuropeandworldwide.Thismustalsobeseenfrom
the point <strong>of</strong> view <strong>of</strong> aligning to specific provisions related to human
rights and implicitly the right to medical assistance, to which our
countryhascommitted.<strong>The</strong>reare<strong>multi</strong>plewaystoreflectthecondition
<strong>of</strong> individuals in detention. Objective information, specific to the penitentiaryenvironment,issourcedfromrelevantdatafrominstitutions
directly involved in the penitentiary environment. Specific skills for
carrying out <strong>forensic</strong> <strong>expertise</strong> upon the request <strong>of</strong> criminal investigationauthoritiesandcourts<strong>of</strong>lawareincludedinthepreoccupations<strong>of</strong>
<strong>forensic</strong>institutions.Forensicmedical<strong>expertise</strong>isanimportanttoolfor
assessinglifeindetention,byapproachingvarioussituationsincluding
trauma,psychiatryandevengroundingacertaindeathdiagnosisinthe
cases<strong>of</strong>penitentiarydeath. 1 (seeTables1–6,Figs.1–4)
Identifyingcauses<strong>of</strong>deathinthepenitentiarypopulation,assessing
violence phenomena, are key to identifying the required measures for
adaptingmedicalassistanceandpsycho-socialorpsychiatricassistance,
inordertopreventandreducetheoccurrence<strong>of</strong>suchphenomena.Last
butnotleast,<strong>expertise</strong>forthepurpose<strong>of</strong>postponingorinterruptinga
<strong>sentence</strong> on medical grounds is called upon to establish the inmatepatient's
state <strong>of</strong> health and to assess vital risk, by corroborating the
inmate'sentiremedicaldocumentation. 2
2. Approaches
AccordingtoAlvaradoV.E., 3 <strong>forensic</strong>medical<strong>expertise</strong>committees
for <strong>sentence</strong> <strong>interruption</strong>/postponement on medical grounds must answertoallrequestsbycarryingouttheir<strong>expertise</strong>withinareasonable
deadline. <strong>The</strong> human and material resources mobilised in order to
completethe<strong>expertise</strong>dependuponthenumber<strong>of</strong>medicalstaffinthe
☆ Citation:GhermanC.EnacheA.StanciuC.DelceaC.(2017)Determinismul<strong>multi</strong><strong>factorial</strong>alsolicităriiexpertizeimedico-legaleprivindîntrerupereaexecutăriipedepsei
pemotivedeboalășidecizia.
∗ Correspondingauthor.
E-mailaddresses:gcpnad2002@yahoo.com(C.Gherman),esanda2000@yahoo.com(A.Enache),cristian.delcea.cj@gmail.com(C.Delcea).
https://doi.org/10.1016/j.jflm.2018.10.005
Received9March2018;Receivedinrevisedform25September2018;Accepted19October2018
Available online 10 November 2018
1752-928X/ © 2018 Elsevier Ltd and Faculty <strong>of</strong> Forensic and Legal Medicine. All rights reserved.

C.Ghermanetal. Journal <strong>of</strong> Forensic and Legal Medicine 61 (2019) 45–55
Table1
DescriptiveStatistics
N Range Minimum Maximum Mean Std.Deviation Variance
Statistic Statistic Statistic Statistic Statistic Std.Error Statistic Statistic
Age 369 3 1 4 2,16 ,044 ,839 ,703
Highbrow 369 1 1 2 1,43 ,026 ,495 ,246
Educational 369 4 1 5 2,79 ,054 1045 1091
APR 369 30 1 31 9,68 ,376 7230 52,279
Disorder 369 2 1 3 1,85 ,046 ,890 ,792
Punishment 369 3 1 4 1,66 ,038 ,735 ,540
knowledge 369 1 1 2 1,12 ,017 ,328 ,107
Firstrequest 369 4 1 5 2,17 ,064 1239 1535
Reasons 369 2 1 3 1,42 ,033 ,625 ,391
knowstheprisoner 369 1 1 2 1,07 ,014 ,261 ,068
itwasnot 369 1 1 2 1,30 ,024 ,460 ,212
howmanyrequests 369 3 1 4 1,72 ,041 ,784 ,615
<strong>interruption</strong> 369 1 1 2 1,07 ,013 ,252 ,063
hasnoquitting 369 2 1 3 1,23 ,024 ,460 ,212
Reasonsforrenunciation 369 4 1 5 1,35 ,038 ,730 ,533
ValidN(listwise) 369
Fromtheresults(table1)onecannotethatastatisticaldescription<strong>of</strong>averages,standarddeviations,devianceandvariancewasobtained<strong>regarding</strong>thevariables
invokedintheresearch.
<strong>forensic</strong>medicinenetworkandinthepenitentiaryenvironment.Byard
R.&Payne-JamesJ. 4 refertoandclaimthattransportforexamination
by the committee, for carrying out the required specialised examinations,
ensuring security personnel as per specific security regulations,
alsoincurfinancialcostswhichmustbesupportedbythepenitentiary
system.Costimplicationsreferbothtothesystem<strong>of</strong>medicalassistance
within the penitentiary environment and to specialised health units
withinthehealthcarenetwork.
BarskyE.A. 5 alsoclaimedthateach<strong>expertise</strong>ischaracterisedbya
high degree <strong>of</strong> specificity, representing a complex and complete analysis
<strong>of</strong> each case under examination. <strong>The</strong> goals <strong>of</strong> interdisciplinary
<strong>expertise</strong> are to establish a certain diagnostic which also includes an
assessment <strong>of</strong> the stage <strong>of</strong> the medical conditions, as well as the recommended
treatment, but also establishing the possibility for treatment
to be performed within the penitentiary medical network. <strong>The</strong>
conclusions <strong>of</strong> the <strong>expertise</strong> must be completed with mentioning any
recommendation<strong>regarding</strong>interruptinga<strong>sentence</strong>inordertograntthe
necessaryspecialisedtreatment.
Yao J. Y. 6 claimed that, under the conditions <strong>of</strong> taking a decision
<strong>regarding</strong> access to medical assistance as being restrictive and limited
(through the fact that a penitentiary treats inmates within its own
healthnetwork),itbecomesevidentthat<strong>forensic</strong>medical<strong>expertise</strong>for
<strong>sentence</strong><strong>interruption</strong>onmedicalgroundsisrequiredasacompletionin
ordertoensuretheaccess<strong>of</strong>inmatestocompletemedicalassistance.
3. Methodandprocedure
3.1. Instruments
<strong>The</strong> research instrument used in this study was a screeningquestionnairewithtwosub-scales.<strong>The</strong>firstscalereferstogeneraldata
(age, sex, background, education, medical history and current condition)
and the second scale takes into account data <strong>regarding</strong> <strong>forensic</strong>
medical <strong>expertise</strong> (<strong>sentence</strong>, knowing the conditions for requesting a
<strong>forensic</strong> medical <strong>expertise</strong>, detention period served up to the moment
<strong>expertise</strong> was requested, real reasons for requesting the <strong>expertise</strong>,
whether the inmate who requests the <strong>expertise</strong> is informed, whether
he/she thinks he/she has been influenced/guided by colleagues, how
many <strong>expertise</strong> requests the inmate has already filed, whether the inmate
has had a <strong>sentence</strong> <strong>interruption</strong> on medical ground before, how
many <strong>expertise</strong> requests he inmate has withdrawn and reasons for
withdrawal).
3.2. Participants
Respondents (N=369) to the research are from din Dej
Penitentiary Hospital, under the administration <strong>of</strong> the National
Penitentiary Agency <strong>of</strong> Romania (ANP). <strong>The</strong> participants are male
(N100%), with an average educational level <strong>of</strong> 11 grades (m=2.79,
=0.054), with an average age <strong>of</strong> 33 (m=2.16, =0.044), with a
predominantlyurbanbackground(m=1.43, =0.026),with<strong>multi</strong>ple
medical causes (cardiovascular, respiratory, digestive, neuropsychological,tumoralandotherdisorders,m=1.85,
=0.026),andtheyare
serving<strong>sentence</strong>sbetween5and15years(m=1.66, =0.038).
3.3. Procedure
Participants (N369) were questioned, and following the screening
and the collection <strong>of</strong> personal history (medical, social, psychological)
data,amedical-legalpr<strong>of</strong>ilewasdraftedforthesubjectsinvolvedinthe
46

C.Ghermanetal. Journal <strong>of</strong> Forensic and Legal Medicine 61 (2019) 45–55
Table2
Correlations Age Highbrow Educational APP Disorder Punishment
Kendall's
tau_b
Spearman's
rho
Age
Highbrow
Educational
APP
Disorder
Punishment
knowledge
Firstrequest
Reasons
knows
theprisoner
itwasnot
<strong>interruption</strong>
hasnoquitting
howmanyrequests
Reasonsforrenunciation
Age
Highbrow
Educational
APP
Correlation 1000 -.109 231 020 360 095
Coefficient
Sig.(2-tailed) 025 000 625 000 043
N 369 369 369 369 369 369
Correlation -.109 1000 -.458 014 -.039 111
Coefficient
Sig.(2-tailed) 025 000 748 429 028
N 369 369 369 369 369 369
Correlation 231 -.458 1000 011 120 -.041
Coefficient
Sig.(2-tailed) 000 000 777 008 372
N 369 369 369 369 369 369
Correlation 020 014 011 1000 062 020
Coefficient
Sig.(2-tailed) 625 718 777 136 633
N 369 369 369 369 369 369
Correlation 360 -.039 .120 .862 1000 -.094
Coefficient
Sig.(2-tailed) 000 429 008 136 049
N 369 369 369 369 369 369
Correlation 095 111 -.041 020 -.094 1000
Coefficient
Sig.(2-tailed) 043 028 372 633 049
N 369 369 369 369 369 369
Correlation -141 113 -084 131 -133 -101
Coefficient
Sig.(2-tailed) 004 031 076 003 007 044
N 369 369 369 369 369 369
Correlation 239 014 -030 -071 186 275
Coefficient
Sig.(2-tailed) 000 775 492 081 000 000
N 369 369 369 369 369 369
Correlation 346 -.062 117 -.010 227 .179
Coefficient
Sig.(2-tailed) 000 225 011 820 000 000
N 369 369 369 369 369 369
Correlation -.103 -.012 001 157 -.107 -.043
Coefficient
Sig.(2-tailed) 034 821 981 000 031 397
N 369 369 369 369 369 369
Correlation -.025 048 -.097 -.134 -.028 083
Coefficient
Sig.(2-tailed) 602 356 042 002 578 097
N 369 369 369 369 369 369
Correlation 227 -.027 013 -094 207 184
Coefficient
Sig.(2-tailed) 000 579 772 024 000 000
N 369 369 369 369 369 369
Correlation 248 -.015 079 045 139 141
Coefficient
Sig.(2-tailed) 000 768 098 301 005 005
N 369 369 369 369 369 369
Correlation 105 -.002 006 -.070 130 017
Coefficient
Sig.(2-tailed) 030 960 893 108 008 733
N 369 369 369 369 369 369
Correlation 094 017 008 -.073 122 028
Coefficient
Sig.(2-tailed) 048 736 863 089 012 571
N 369 369 369 369 369 369
Correlation 1000 -.117 268 022 414 106
Coefficient
Sig.(2-tailed) 024 000 672 000 042
N 369 369 369 369 369 369
Correlation -117 1000 -502 017 -041 115
Coefficient
Sig.(2-tailed) 024 000 749 430 027
N 369 369 369 369 369 369
Correlation 268 -502 1000 012 138 -047
Coefficient
Sig.(2-tailed) 000 000 811 008 369
N 369 369 369 369 369 369
Correlation 022 017 012 1000 074 025
Coefficient
Sig.(2-tailed) 672 749 811 156 626
47
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C.Ghermanetal. Journal <strong>of</strong> Forensic and Legal Medicine 61 (2019) 45–55
Table2(continued)
Correlations Age Highbrow Educational APP Disorder Punishment
Disorder
Punishment
knowledge
Firstrequest
Reasons
knows
theprisoner
itwasnot
<strong>interruption</strong>
hasnoquitting
howmanyrequests
Reasonsforrenunciation
N 369 369 369 369 369 369
Correlation 414 -.041 138 074 1000 -.103
Coefficient
Sig.(2-tailed) 000 430 008 156 048
N 369 369 369 369 369 369
Correlation 106 115 -047 025 -103 1000
Coefficient
Sig.(2-tailed) 042 027 369 626 048
N 369 369 369 369 369 369
Correlation -151 113 -092 156 -.140 -105
Coefficient
Sig.(2-tailed) 004 030 076 003 007 044
N 369 369 369 369 369 369
Correlation 273 015 -.037 -.094 213 302
Coefficient
Sig.(2-tailed) 000 776 483 072 000 000
N 369 369 369 369 369 369
Correlation 377 -063 132 -.011 246 191
Coefficient
Sig.(2-tailed) 000 226 011 831 000 000
N 369 369 369 369 369 369
Correlation -111 -012 001 186 -112 -044
Coefficient
Sig.(2-tailed) 033 821 981 000 031 398
N 369 369 369 369 369 369
Correlation -027 .048 -.106 -.159 -029 087
Coefficient
Sig.(2-tailed) 603 356 042 002 579 097
N 369 369 369 369 369 369
Correlation 257 -.029 017 -.122 230 200
Coefficient
Sig.(2-tailed) 000 580 750 019 000 000
N 369 369 369 369 369 369
Correlation 265 -.015 086 054 146 146
Coefficient
Sig.(2-tailed) 000 .769 098 302 005 005
N 369 369 369 369 369 369
Correlation 114 -002 007 -084 138 018
Coefficient
Sig.(2-tailed) 029 968 894 108 008 733
N 369 369 369 369 369 369
Correlation 105 .018 009 -.087 132 029
Coefficient
Sig.(2-tailed) 045 737 868 096 011 575
N 369 369 369 369 369 369
knowledge Firstrequest Reasons Knowsthe
prisoner
itwasnot
Howmany
requests
<strong>interruption</strong> hasnoquitting Reasensforre
nunciation
Kendall's
tau_b
-.141 239 346 -.103 -025 227 248 105 094
004 000 000 034 602 000 .880 030 048
369 369 369 369 369 369 369 369 369
113 014 -.062 -.012 048 -.027 -.015 -.002 017
031 775 225 821 356 579 768 968 736
369 369 369 369 369 369 369 369 369
-.084 -.030 117 001 -.097 013 079 006 008
076 492 011 .981 042 772 .098 .893 863
369 369 369 369 369 369 369 369 369
131 -071 -010 157 -134 -094 045 -070 -073
003 081 820 800 002 024 301 108 089
369 369 369 369 369 369 369 369 369
-133 186 227 -.107 -.028 .207 139 130 122
007 000 000 031 578 000 005 008 012
369 369 369 369 369 369 369 369 369
-101 276 179 -.043 083 184 141 817 028
044 000 000 397 097 000 005 733 571
369 369 369 369 369 369 369 369 369
1000 -326 -.260 468 -.210 -339 -100 -175 -170
000 000 900 000 000 054 001 001
369 369 369 369 369 369 369 369 369
-326 1000 602 -239 399 803 278 398 394
000 000 000 000 000 000 000 000
369 369 369 369 369 369 369 369 369
-.260 602 1000 -177 -.034 .572 378 210 210
000 000 .800 509 000 .800 000 000
48
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C.Ghermanetal. Journal <strong>of</strong> Forensic and Legal Medicine 61 (2019) 45–55
Table2(continued)
knowledge Firstrequest Reasons Knowsthe
prisoner
itwasnot
Howmany
requests
<strong>interruption</strong> hasnoquitting Reasensforre
nunciation
369 369 369 369 369 369 369 369 369
468 -.239 -.177 1.880 -.185 -.258 -.076 -.122 -117
000 000 000 000 000 146 019 021
369 369 369 369 369 369 369 369 369
-210 399 -.034 -185 1000 486 033 357 355
000 000 509 000 000 525 000 000
369 369 369 369 369 369 369 369 369
-339 803 572 -250 486 1000 303 544 530
000 000 000 000 000 000 000 000
369 369 369 369 369 369 369 369 369
-.100 278 378 -.076 033 .303 1000 .064 067
054 000 000 146 525 000 220 189
369 369 369 369 369 369 369 369 369
-.175 398 210 -.122 357 544 064 1000 942
001 000 000 019 000 000 220 000
369 369 369 369 369 369 369 369 369
-170 394 210 -.117 355 538 067 942 1000
001 000 000 021 000 000 189 000
369 369 369 369 369 369 369 369 369
Spearman's
rho
-151 273 377 -.111 -027 257 265 114 105
004 000 000 033 603 000 000 029 045
369 369 369 369 369 369 369 369 369
113 015 -963 -012 048 -029 -.015 -.002 018
030 776 226 821 356 580 769 .968 737
369 369 369 369 369 369 369 369 369
-092 -037 132 001 -106 017 086 007 009
076 483 011 981 042 750 098 894 868
369 369 369 369 369 369 369 369 369
156 -.094 -.011 186 -.159 -122 054 -.084 -.087
003 072 831 000 002 019 302 108 096
369 369 369 369 369 369 369 369 369
-140 213 246 -.112 -.029 230 146 138 132
007 000 000 .031 579 000 005 .008 011
369 369 369 369 369 369 369 369 369
-105 302 191 -044 087 200 146 018 029
044 000 000 398 097 000 005 733 575
369 369 369 369 369 369 369 369 369
1000 -352 -268 468 -.210 -.358 -.100 -176 -174
000 000 000 000 000 054 001 001
369 369 369 369 369 369 369 369 369
-352 1000 662 -.258 432 892 300 435 437
000 000 000 000 000 000 000 000
369 369 369 369 369 369 369 369 369
-.268 662 1000 -182 -.034 614 388 217 221
000 000 .000 510 000 .000 000 000
369 369 369 369 369 369 369 369 369
468 -258 -182 1000 -185 -263 -076 -.123 -121
000 000 000 000 000 146 018 020
369 369 369 369 369 369 369 369 369
-.210 432 -.934 -185 1000 .512 .033 360 365
000 000 510 .000 000 526 000 000
369 369 369 369 369 369 369 369 369
-.358 892 614 -263 512 1000 319 573 574
000 000 000 000 000 000 000 000
369 369 369 369 369 369 369 369 369
-.100 300 388 -.076 033 319 1000 064 068
054 000 000 146 526 000 220 190
369 369 369 369 369 369 369 369 369
-176 435 217 -.123 360 573 064 1000 960
001 000 000 018 000 000 220 000
369 369 369 369 369 369 369 369 369
-174 437 221 -.121 .365 574 .068 980 1000
001 000 000 020 000 000 190 000
369 369 369 369 369 369 369 369 369
Table 2illustrates significantcorrelations inother itemscongruent withthe <strong>multi</strong><strong>factorial</strong> <strong>determinism</strong> <strong>of</strong>requesting a<strong>forensic</strong> legal<strong>expertise</strong> for <strong>sentence</strong><strong>interruption</strong>onmedicalgrounds.PearsonandSpearmancorrelationcoefficientshavebeenusedforanumericindexshowingthestrengthanddirection<strong>of</strong>therelationship
between several research variables, and the results (sig=0.05 and=sig. 0.01) above confirm a good correlation with several groups/variables invoked in the
research.
Correlationissignificantatthe0.05level(2-tailed).
Correlationissignificantatthe0.01level(2-tailed).
49

C.Ghermanetal. Journal <strong>of</strong> Forensic and Legal Medicine 61 (2019) 45–55
Table3
ANOVA
Sum<strong>of</strong>Squares df MeanSquare F Sig.
Age BelweenGroups 43,041 2 21,520 36,491 ,000
WithinGroups 215,843 366 ,590
Total 258,883 368
Highbrow BetweenGroups ,634 2 ,317 1293 ,276
WithinGroups 89,713 366 ,245
Total 90,347 368
Educational BetweenGroups 15,651 2 7825 7422 ,001
WithinGroups 385,862 366 1054
Total 401,512 368
APP BetweenGroups 147,206 2 73,603 1411 ,245
WithinGroups 19091,417 366 52,162
Total 19238,623 368
Punishment BetweenGroups 2622 2 1311 2448 ,088
WithinGroups 196,034 366 ,536
Total 198,656 368
knowledge BetweenGroups ,812 2 ,406 3842 ,022
WithinGroups 38,700 366 ,106
Total 39,512 368
Firstrequest BetweenGroups 34,234 2 17,117 11,805 ,000
WithinGroups 530,682 366 1450
Total 564,916 368
Reasons BetweenGroups 9191 2 4595 12,486 ,000
WithinGroups 134,701 366 ,368
Total 143,892 368
knowstheprisoner BetweenGroups ,432 2 ,216 3214 ,041
WithinGroups 24,592 366 ,067
Total 25,024 368
itwasnot BetweenGroups 2138 2 1069 5157 ,006
WithinGroups 75,868 366 ,207
Total 78,005 368
howmanyrequests BelweenGroups 16,852 2 8426 14,727 ,000
WithinGroups 209,398 366 ,572
Total 226,249 368
<strong>interruption</strong> BetweenGroups ,542 2 ,271 4358 ,013
WithinGroups 22,764 366 ,062
Total 23,306 368
hasnoquitting BetweenGroups 1940 2 ,970 4671 ,010
WithinGroups 76,016 366 ,208
Total 77,957 368
Reasonsforrenunciation BetweenGroups 2111 2 1055 1990 ,138
WithinGroups 194,090 366 ,530
Total 196,201 368
Table3showssignificantintra-groupandinter-groupresults.Forinstance,ageresultsarehomogeneousandasignificantscorewasobtained(F36.4991Sig.000),
sameasinthecase<strong>of</strong>educationlevel(F7.422,Sig.001),firstrequestitem(F11.805,Sig.000),requestreason(F12.486,Sig.000),andhowmanyrequestswere
filed(F14.727,Sig.000).
50

C.Ghermanetal. Journal <strong>of</strong> Forensic and Legal Medicine 61 (2019) 45–55
Table4
Test<strong>of</strong>Homogeneity<strong>of</strong>Variances
Table5
RobustTests<strong>of</strong>Equality<strong>of</strong>Means
research and a database was created in order to identify the causes <strong>of</strong>
<strong>sentence</strong>postponementrequestsorotherassociatedrequests.
3.4. Dataprocessing
Data collection was followed by its introductioninto the database.
Statistical data processing was performed with the SPSS s<strong>of</strong>tware
(Statistical Package forthe Social Sciences)version20.0. Apart from descriptivestatistics,datagroupswerecomparedusingthet-test,ANOVA
andANCOVA.<strong>The</strong>level<strong>of</strong>significanceisestablishedatp≤0,05.
3.5. Hypothesis
Weassumethatage,educationandyears<strong>of</strong>detentionarepredictors
<strong>of</strong><strong>multi</strong><strong>factorial</strong><strong>determinism</strong>torequest<strong>forensic</strong><strong>expertise</strong>.
4. Conclusions
LeveneStatistic df1 df2 Sig.
Age 15,039 2 366 ,000
Highbrow 7279 2 366 ,001
Educational ,321 2 366 ,725
APR 0,075 2 366 ,000
Punishment 1456 2 366 ,235
knowledge 17,743 2 366 ,000
Firstrequest ,320 2 366 ,720
Reasons 24,661 2 366 ,000
knowstheprisoner 14,504 2 366 ,000
itwasnot 37,005 2 366 ,000
howmanyrequests ,025 2 366 .975
<strong>interruption</strong> 19,221 2 366 ,000
hasnoquitting 14,154 2 366 ,000
Reasonsforrenunciation 3130 2 366 ,045
Table 4 calculates scores obtained in the variance analysis <strong>of</strong> absolute differences,
in order to determine whether the variance <strong>of</strong> two or more non-correlated
groups differ significantly. <strong>The</strong> table above shows significant results
(sig.=000*)inage,highbrow,app,knowledge,Reason,Knowstheprisoner,it
wasnot,and<strong>interruption</strong>,hasnoquittinggroups.
Ourpreviousresearch 7 , 8 completedbysignificantstatisticalresults
obtained in this study with ANOVA, correlation coefficients, <strong>factorial</strong>
analysis,falsepositiveresultsverificationtests,TukeyHSD,WSD,lead
Statistic 3 df1 df2 Sig.
Age Welch 41,255 2 159,089 ,000
Brown-Forsythe 30,066 2 178,607 ,000
Highbrow Welch 1339 2 180,961 ,265
Brown-Forsythe 1317 2 277,796 ,270
Educational Welch 7632 2 179,150 ,001
Brown-Forsythe 7458 2 273,971 ,001
APP Welch 1284 2 177,634 ,279
Brown-Forsythe 1411 2 248,601 ,246
Punishment Welch 2654 2 173,397 ,073
Brown-Forsythe 2357 2 221,581 ,097
knowledge Welch 4858 2 176,015 ,009
Brown-Forsythe 4041 2 240,292 ,019
Firstrequest Welch 11,417 2 174,857 ,000
Brown-Forsythe 11,487 2 257,421 ,000
Reasons Welch 12,434 2 157,323 ,000
Brown-Forsythe 10,845 2 218,687 ,000
knowstheprisoner Welch 4718 2 164,881 ,010
Brown-Forsythe 3167 2 192,165 ,044
itwasnot Welch 7369 2 198,244 ,001
Brown-Forsythe 5777 2 327,030 ,003
howmanyrequests Welch 13,320 2 175,523 ,000
Brown-Forsythe 14,485 2 269,926 ,000
<strong>interruption</strong> Welch 4496 2 143,880 ,013
Brown-Forsythe 3528 2 199,392 ,031
hasnoquitting Welch 4006 2 176,984 ,020
Brown-Forsythe 4658 2 278,232 ,010
Reasnnsforenunciation Welch 2055 2 166,558 ,131
Brown-Forsythe 1792 2 216,524 ,169
<strong>The</strong>tableshowstheresultsobtainedfromtheBrown-ForsytheandWelchtests
tocheckmeanequalitywhengroupsdonothaveequalsizes.<strong>The</strong>setestsdonot
startfromthepremisethatthereisvariancehomogeneity,butratherrobustness
(sig. = 000*) <strong>of</strong> means in the abovementioned groups (age, educational, first
request,reasons,itwasnotandhowmanyrequests).<strong>The</strong>resultsaboveconfirm
meanequalityinthegroups.
a.AsymptoticallyFdistributed.
51

C.Ghermanetal. Journal <strong>of</strong> Forensic and Legal Medicine 61 (2019) 45–55
Table6
TukeyHSD
DependentVariable fhDisorder CJ1Disorder Mean
Difference(IJ)
Std.Error Sig. 95%ConfidenceInterval
LowerBound
UpperBound
Age 1 2 -.504″ ,109 ,000 -.76 -.25
3 -.751” .090 ,000 -.96 -.54
2 1 .504″ ,109 ,000 .25 .76
3 -.247 .116 ,085 -.52 .03
3 1 .751″ .090 ,000 .54 .96
2 .247 .116 ,085 -.03 .52
Highbrow 1 2 .113 .070 ,244 -.05 .28
3 ,034 ,058 ,825 -.1° .17
2 1 -.113 .070 .244 -.28 .05
3 -.078 ,075 .545 -.25 .1°
3 1 -.034 .058 ,825 -.17 .10
2 ,078 ,075 ,545 -.1° .25
Educational 1 2 -.544″ .146 ,001 -.89 -.20
3 -.260 .121 ,081 -.54 ,02
2 1 .544 .146 ,001 .20 .89
3 .284 .155 .159 -.08 .65
3 1 .260 .121 ,081 -.02 .54
2 -.284 .155 .159 -.65 .08
APP 1 2 −1,677 1.024 .231 −4,09 .73
3 -.166 .849 ,979 −2,16 1,83
2 1 1,677 1.024 .231 -.73 4,09
3 1,510 1.088 ,348 −1,05 4,07
3 1 ,166 .849 ,979 −1,83 2.16
2 −1510 1.088 ,348 −4,07 1,05
Punishment 1 2 .138 ,104 .377 -.11 .38
3 ,182 .086 ,089 -.02 .38
2 1 -.138 ,104 .377 -.38 .11
3 .043 ,110 ,919 -.22 ,30
3 1 -.182 ,086 .089 -.38 ,02
2 -.043 .110 ,919 -.30 .22
knowledge 1 2 .032 .046 .761 -.08 .14
3 ,106” ,038 .017 .02 .20
2 1 -.032 .046 .761 -.14 .08
3 ,073 .049 .296 -.04 .19
3 1 -.106″ .038 .017 -.20 ,02
2 -.073 .049 .296 -.19 .04
Firstrequest 1 2 .033 .171 ,979 -.37 .43
3 -.638″ .142 ,000 -.97 -.30
2 1 -.033 .171 ,979 -.43 .37
3 -.671“ ,181 ,001 −1,10 -.24
3 1 .638 .142 ,000 .30 .97
2 ,671“ ,181 ,001 .24 1.10
Reasons 1 2 -.214 ,086 ,035 -.42 -.01
3 -.351″ .071 ,000 -.52 -.18
2 1 .214 ,086 ,035 .01 .42
3 -.136 .091 .295 -.35 .08
3 1 .351″ .071 ,000 .18 .52
2 .136 .091 .295 -.08 .35
knowstheprisoner 1 2 -.006 ,037 ,986 -.09 .08
3 .071 .030 ,053 .00 .14
2 1 ,006 ,037 ,986 -.08 .09
3 ,077 ,039 ,122 -.02 .17
3 1 -.071 ,030 ,053 -.14 .00
2 -.077 ,039 ,122 -.17 .02
itwasnot 1 2 .198″ .065 ,007 .05 .35
3 ,007 ,054 ,992 -.12 .13
2 1 -.198″ .065 ,007 -.35 -.05
3 -.191“ ,069 ,015 -.35 -.03
3 1 -.007 .054 ,992 .13 .12
2 ,191″ .069 ,015 ,03 .35
howmanyrequests 1 2 .028 .107 ,963 -.22 .28
52

C.Ghermanetal. Journal <strong>of</strong> Forensic and Legal Medicine 61 (2019) 45–55
Table6(continued)
TukeyHSD
DependentVariable fhDisorder CJ1Disorder Mean
Difference(IJ)
Std.Error Sig. 95%ConfidenceInterval
LowerBound
UpperBound
3 -.446″ .089 ,000 -.66 -.24
2 1 -.028 .107 ,963 -.28 ,22
3 -.474″ ,114 ,000 -.74 -.21
3 1 .446 ,089 ,000 .24 .66
2 .474″ ,114 ,000 .21 .74
<strong>interruption</strong> 1 2 -.073 ,035 ,097 -.16 .01
3 -.078” .029 ,021 -.15 -.01
2 1 ,073 ,035 ,097 -.01 .16
3 -.005 ,038 ,990 -.09 .08
3 1 ,078″ .029 ,021 .01 .15
2 .005 ,038 ,990 -.08 ,09
hasnoquitting 1 2 ,011 ,065 ,983 -.14 .16
3 -.151“ ,054 ,014 -.28 ,02
2 1 -.011 ,065 ,983 -.16 .14
3 -.162″ ,069 ,049 -.32 .00
3 1 .151″ ,054 ,014 ,02 .28
2 ,162″ ,069 ,049 .00 .32
Reasonsforrenunciation 1 2 -.027 ,103 ,964 -.27 ,22
3 -.167 ,086 ,126 -.37 .03
2 1 .027 ,103 ,964 -.22 .27
3 -.140 .110 ,409 -.40 .12
3 1 .167 ,086 ,126 -.03 .37
2 .140 ,110 ,409 -.12 .40
<strong>The</strong>tableshowsresultsobtainedfromtheTukey'sHSDtest,alsoknownasTukeyHSD,WSD,orTukeytest(a),whichcontrolsfalsepositiverateingrouppairs.By
performingpaircomparisons,thelikelihood<strong>of</strong>obtainingoneormoresignificantfalsepositiveanswerswasidentified.
<strong>The</strong>meandifferenceissignificantatthe0.05level.
to the conclusion that age, education and years <strong>of</strong> detention are a
predictor<strong>of</strong><strong>multi</strong><strong>factorial</strong><strong>determinism</strong>forrequesting<strong>forensic</strong>medical
<strong>expertise</strong>forthepurpose<strong>of</strong>interruptinga<strong>sentence</strong>onmedicalgrounds.
<strong>The</strong> analysis <strong>of</strong> the obtained data shows a number <strong>of</strong> interesting
results:
• Upon entry into thepenitentiary,the incidence <strong>of</strong>new diseasesincreases;
•
<strong>The</strong> age-old comparison shows that the highest rate <strong>of</strong> disease occursinthe36–50agegroup
• Comparison<strong>of</strong>thenumber<strong>of</strong>yearsspentindetentionindicatesthat
most detentions are imposed on persons aged 5–10 years in the
penitentiarysystem
Fig.1.Fromthedata(Fig.1)onecannoteanaverage<strong>of</strong>1.85,withastandard
deviation<strong>of</strong>0.05andafrequency<strong>of</strong>F178higherinoccurrence<strong>of</strong>newdiseases
since beginning <strong>of</strong> detention, compared tothose in column 3, where older organiccausesinvokedbytheinmatesareillustrated.
<strong>The</strong>se results are a prerequisite for future research on the incarceratedpopulation.
Our hypothesis is confirmed and we can conclude that <strong>sentence</strong>
postponementrequestsmustbeanalysedfromthepoint<strong>of</strong>view<strong>of</strong>the
rationalisation <strong>of</strong> excessive behaviours, which put <strong>forensic</strong> medical
<strong>expertise</strong> into difficulty and hinder it, thus incurring costs for the
Romanianstate.
53

C.Ghermanetal. Journal <strong>of</strong> Forensic and Legal Medicine 61 (2019) 45–55
Fig.2.Figure2showsageresults(m=2.16, =0.044)highercomparedtootherageintervals.Anassociationwasfoundbetweendisorderandageinthosewho
request<strong>forensic</strong>medicalexaminationforvariousreasons.
Fig.3.Figure3showshighcorrelations/associationsbetweenthelevel<strong>of</strong>educationandtheenvironment<strong>of</strong>origin,thoseintheurbanareahavinghighereducational
levelscomparedtotheruralones.
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C.Ghermanetal. Journal <strong>of</strong> Forensic and Legal Medicine 61 (2019) 45–55
Fig.4.Figure4showsthatsubjectswith<strong>sentence</strong>sbetween
5 and 10 years, with m=1.66, =0.038, request more
<strong>sentence</strong> postponement and request a <strong>forensic</strong> medical examinationmore<strong>of</strong>tencomparedtosubjectswith<strong>sentence</strong>s<strong>of</strong>
under5orover15years.
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