ABSTRACT
The objective of our study was to assess the reliability of the estimation of posttraumatic survival time (PTST) in forensic cases based on microCT and histology of putrefied/dry bone samples with comparison of initial macroscopic fracture classification performed during autopsy. Macroscopic morphological patterns of bone fracture are routinely used in forensic pathology and anthropology to distinguish between antemortem, perimortem and postmortem injuries. Based on macroscopic and microscopic analysis of six craniofacial fractures, our study results illustrate the need to complete macroscopical findings and initial fracture classification with microscopic analysis to avoid any inaccuracy. MicroCT has become a powerful technique to identify early bone healing signs but histology remains the gold standard to estimate the PTST and determine vital fracture based on hemorrhage marker. Raman microspectroscopy can identify a blood clot in the fracture line.
Subject(s)
Body Remains/diagnostic imaging , Forensic Anthropology/methods , Skull Fractures/diagnosis , Skull/diagnostic imaging , Body Remains/pathology , Bone Remodeling , Humans , Male , Middle Aged , Postmortem Changes , Reproducibility of Results , Skull/pathology , Skull Fractures/mortality , Skull Fractures/pathology , Spectrum Analysis, Raman , Time Factors , X-Ray Microtomography , Young AdultABSTRACT
From a juridical point of view, in France, we become a "person" only when we are born "living" and "viable". These two criteria are necessary, but the threshold of viability is not defined by the law. The general education of registry office leaned on a circular fixing a << threshold of viability >> itself based on a recommendation of the Worldwide Organization of Health (WHO). The fetus was considered as viable after a term of twenty-two weeks of amenorrhea or if it had a weight over or equal to 500 grammes. The inscription to Registry office differs, as well as the taking care of the body of the child, depending on whether he was born living, viable and living and not viable, dead and viable, or dead and not viable. In France, the civil officer established an act of child declared lifeless when the child was born living but not viable or when the child is death - born but viable. However, parents of not viable and born dead children, often close to the threshold of viability, also liked to acquire an act of lifeless child, to be able to organize funeral has child lifeless and to inscribe it in their family record book. The act of child declared lifeless allows to inscribe the child on the family record book if the parents wish and give to the families the delay of ten days to claim the body. By judgment of February 6th, 2008, the Supreme Court of appeal cancelled rulings where the threshold had been kept to refuse the deliverance of an act of lifeless child. Her Supreme court of appeal considers that law does not impose de threshold from which the recognition of the status of lifeless child would be possible. Since the decrees of August, 2008, there is no border anymore of minimum of term or weight. Consequently, the lifeless born children after an unprompted delivery or a medical break, the pregnancy can be inscribed on the civil record. On the other hand, it is not possible for the precocious wrong coat and the termination of pregnancy.
Subject(s)
Fetal Death/epidemiology , Registries/statistics & numerical data , Body Weight , Delivery, Obstetric/methods , Female , France , Humans , Medical Records , Pregnancy , World Health OrganizationSubject(s)
Health Policy/legislation & jurisprudence , Palliative Care/legislation & jurisprudence , Physician-Patient Relations/ethics , Right to Die/legislation & jurisprudence , Terminal Care/legislation & jurisprudence , Attitude to Death , Decision Making , France , Humans , Palliative Care/ethics , Right to Die/ethics , Terminal Care/ethicsABSTRACT
The death certificate must be established within 24 hours following the death and handed to the mayor. The obligation to place in the coffin immediately is planned by a defined list of contagious diseases. Medicolegal obstacle must be ticked if there is a doubt on the cause of death. In order to look into the causes of the death, swabs can be asked by the physician. It is a medical or scientific autopsy to look into the causes of the death apart from a juridical procedure. The presence of a battery prosthesis (pacemaker) must be specified, so that it can be removed by a physician or a thanatopractionner before the placing in the coffin. Death certificate is passed on by the city hall to Insee, which updates the identification national register of physical people. Inserm receives anonymous data of the causes of death allowing to establish the mortality national statistics. In the absence of medicolegal obstacle or obligation to place in the coffin immediately, funeral operations can begin: preservation care, body transport, placing in the coffin and finally burial or cremation.