[Forensic analysis of the socio-economic profile of women victims of domestic violence in the region of Liège according to the seriousness of the injuries suffered]. / Analyse médico-légale du profil socio-économique de femmes victimes de violences conjugales en région liégeoise selon la gravité des blessures subies.

The aim of this study was to analyse retrospectively the profile of female victims of intimate partner violence (IPV) within the population of victims of assault and battery seen in expertise at the Forensic Institute of Liège. Overall, 678 files were analysed. The proportion, nature and type of IPV were determined, as well as the profile of the victims. The link between the socio-economic profile and the seriousness of the sequelae was analysed on the basis of the Chi-square test. 8,4 % of the files concerned IPV, of which 93,0 % were female victims. All the victims had suffered physical domestic violence and 55,5 % of the victims cumulated at least two forms of violence. According to Johnson's typology, 56,6 % of IPV cases may be considered as «Situational Couple Violence¼ and 43,4 % as «Intimate Terrorism¼. There are differences between the profile of victims of IPV according to the literature and the profile of victims seen at the IML. Subject to these differences, we have not found a link between the socio-economic status and the severity of the sequelae of IPV victims.

Cette étude avait pour but d'analyser rétrospectivement le profil des victimes féminines de violences conjugales (VC) au sein de la population des victimes de coups et blessures vues en expertise à l'Institut Médico-Légal (IML) de Liège. Un total de 678 dossiers ont été analysés. La proportion, la nature et le type de VC ont été déterminés, ainsi que le profil des victimes. La gravité des séquelles a été appréciée selon les définitions des articles 399 et 400 du code pénal belge. Le lien entre le profil socio-économique et la gravité des séquelles a été analysé sur base du test du Chi carré. 8,4 % des dossiers concernaient des VC, dont 93,0 % de victimes féminines. Toutes les victimes avaient subi des violences physiques et 55,5 % des victimes cumulaient au moins deux formes de violences. 56,6 % des cas de VC relevaient de «Situational Couple Violence¼ et 43,4 % d'«Intimate Terrorism¼ (typologie de Johnson). Il y a des différences entre les profils des victimes de VC identifiés par la littérature et ceux rencontrés à l'IML. Nous n'avons pas mis en évidence de lien entre le statut socio-économique et la gravité des séquelles des victimes de VC vues en médecine légale.

[Virginity testing and hymen examination]. / Les tests de virginité et l'examen hymeneal.

In October 2018, the World Health Organization (WHO) has published a report condemning the practice of virginity testing, which are scientifically unfounded and turn out to be harmful for the women who are victims of these. In February 2019, the Belgian National Council of Physicians Order follows the WHO and has recalled that virginity testing is not justified, neither scientifically nor ethically. To complete these reports, the present article intends to provide to the clinician, whatever its speciality field, an up-to-date and practical guide explaining the nature of hymen, its clinical examination, the mechanism leading to the onset of the lesions, their description and their forensic interpretation. According to the legal and social aspects of forensic medicine, we also would like to recall the nature and the inherent dangers of virginity testing, as well as the legal framework of which the clinician must be aware of, in response to such a request from a patient.

En octobre 2018, l'Organisation Mondiale de la Santé (OMS) a publié un rapport condamnant la pratique des tests de virginité, qui n'ont pas de base scientifique et sont nuisibles pour les patientes qui en sont victimes. En février 2019, le Conseil national de l'Ordre des Médecins a suivi l'OMS en rappelant que la rédaction d'un certificat de virginité n'était justifiée ni sur le plan scientifique, ni sur le plan déontologique, ni sur le plan éthique. Afin de compléter ces rapports, le présent article a pour but de fournir au clinicien, quelle que soit sa spécialité, un guide pratique actualisé concernant la nature de l'hymen, son examen clinique, le mécanisme de survenue et la description de ses lésions et, enfin, leur interprétation médico-légale. Conformément aux aspects juridique et social de la médecine légale, nous rappellerons également la nature et les dangers inhérents à la pratique des tests de virginité, ainsi que le contexte légal dont le clinicien doit être conscient lorsqu'il est confronté à une telle demande de la part d'une patiente.

Forensic entomology investigations from Doctor Marcel Leclercq (1924-2008): a review of cases from 1969 to 2005.

Dr. Marcel Leclercq was a pioneer in the field of forensic entomology. He has provided his knowledge of insect biology to many forensic cases, and most of them have found the way to publication. Most of the articles he has written were focused on individual cases, and despite the abundance of entomoforensic investigations he conducted, no synthesis has been published. This article summarizes 36 yr of forensic entomological investigations in temperate Europe, mainly in Belgium. Dr. Leclercq's work includes 132 entomological cases involving 141 human corpses found in various death scenes. Under certain conditions, insect specimens found at death scene can provide information on when (postmortem interval estimation), where and how a person died. More or less 100 insect species associated with a dead body have been identified by Dr. Leclercq.

[Anti-vitamins K and oral surgery: the end of their prohibition?]. / Les AVK en chirurgie bucco-dentaire: la fin des vieux tabous?

In patients under oral anticoagulation therapy, the risk of haemorrhage following surgery must be balanced with the risk of thrombo-embolism induced by its discontinuation. Dental surgery is usually safe. Indirect anticoagulation may be continued provided rigorous surgical techniques and careful local hemostasis are applied.

[Medical responsibility and legal malpractice]. / Responsabilité médicale et faute pénale.

The principle that obliges anyone to answer for his acts, is one of the foundations of our law and ethic systems; so the fault committed by a doctor is punished, penally speaking, by the articles 418 and next of the penal code. These articles specify that a doctor's charge of unintentional blows and wounds or of unintentional homicide rests on the conjunction of three elements: a fault which can be defined as any act which wouldn't have been carried out by any other doctor of the same spéciality who is normally cautious, competent and diligent and placed in identical circumstances, a harm: either the patient's death (homicide) or blows and wounds which can be caused by simple omission, an obvious relationship of cause and effect between the fault and the harm. The absence of a practioner's recording of his free and conscious patient's consent is considered similar to a fault by the doctrine. The same doctrine asserts that going beyond the patient's refusal to receive the suggested cares is considered as the same harm as intentional blows and wounds?

[Abuse of prescribed sleeping, narcotic or psychotropic agents]. / L'abus de prescription de substances soporifiques, stupéfiantes ou psychotropes.

Treating a drug addict in a state of lack or of weaning is no easy task, either on a strictly medical or judicial point of view. As far as the only judicial aspect is concerned, sleeping, narcotic or psychotropic drugs cannot be used without taking into account the legal provisions which regulate them: the December 24, 1921 law and the different complements and modifications it has been subjected to since then. According to that law, are considered as offences: the use of substances (described in the December 31, 1993 (royal) decree as sleeping or narcotic drugs, and in the December 2, 1998 decree as psychotropic drugs) likely to create, maintain or increase dependence, no result being required; the existence of excess, defined as antithetic notion of what is considered as normal and in accordance with the rules and the ordinary or permitted measure in the practice of the art of healing; the author's intention does not matter: it is not necessary for the author to have aimed at the effect which has been produced or is likely to be.

Fourteen shots for a suicide.

A 56-year-old man is discovered unconscious in a pool of blood in the kitchen of his house. According to findings, the man used a 22 long Rifle to fire 14 shots at his thorax with trajectories going from front to back, from right to left and on a nearly horizontal level. All the projectiles got into the left front side of his thorax and came out just under the back of his left armpit. One of them then got through his left arm and fractured his left humerus. According to the findings made on the premises and the position of the bloodstains, we think that man put his rifle against the wall, resting on a pipe. He fired, unloading two clips into his thorax. He had to handle the bolt of the rifle before each shot. To reload, he took the bullets which were on the nearby table on which blood marks can be seen. When reloading at a certain moment, he sat down in his armchair and when he wanted to stand up, he leaned on the armrests, on which blood marks can be seen. The last bullet was probably the one which went through his left arm, preventing him from keeping on shooting. His death, caused by a hypovolemical shock, was obviously very slow.