Интересное сообщение из Ланцета по плачевному состоянию судебной медицины в Великобритании.
The Lancet
Special Issue: Medicine, Crime and Punishment
Vol 364 p8-9 (2004)
Forensic medicine: past, present, and future
Peter Vanezis
Department of Forensic Medical
Sciences, Forensic Science
Service, 109 Lambeth Road,
London SEl ]LP, UK
Correspondence to.
Prof Peter Vanezis
[email protected].
police.uk
Until a few years ago forensic pathology was not regarded as one of the usual branches of medicine a doctor would consider as a career. Indeed, it would be safe to say that anyone so inclined might be thought a bit odd for preferring the mortuary slab to the bedside or couch. Not so today. The media have highlighted the work of forensic practitioners and so created unprecedented interest in and fascination with the specialty. There are many television series portraying the forensic pathologist as someone who always solves the murder and in addition to doing an autopsy and being an expert witness is an investigator who interrogates witnesses, a social worker, and any other role that might conceivably help improve ratings. Thus the perception of the forensic doctor as a superhero in
programmes such as CSI, Callum, Silent Witness, and Quincy has bestowed a status at least on a par with clinical colleagues who are portrayed so compellingly in dramas such as Holby City and ER. The downside to these developments is a tendency to raise the general public's expectations of the forensic specialist to unrealistic levels.
Despite recent global interest in forensic medicine, the specialty has gone through many ups and downs in its development. The UK has undoubtedly lagged behind Italy, France, and Germany, among other countries, in recognising the role and importance of medical witnesses in the courts. More extensive development in these countries is probably a result of differences in legal systems and practice. The approach of Roman canon law to legal decision making, in contrast to English common law, encouraged the development of forensic medicine. Because all decisions in Roman canon proceedings were made by judges, technical evidence could be incorporated more fully into the process of adjudication than was possible in commonlaw trials, where the use of juries tended to discourage testimony that could not be readily understood by lay people.
In Great Britain, the principle of seeking expert evidence to assist the court has been in place since the Middle Ages, although such assistance appears to have been used on an ad hoc basis, with its importance going largely unappreciated. Before the 18th century, forensic autopsies were the exception rather than the rule, and until the early 19th century many homicide trials were conducted without the benefit of an autopsy report or the expert testimony of a medical witness. Further, English-language texts on the subject were virtually nonexistent; organised teaching was not in place until the late 18th century, with the establishment of chairs in Edinburgh, and Glasgow, and later, elsewhere. A steady increase in the proportion of homicide trials after 1778
(in which autopsy findings were described) reflected the influence of surgeon-pathologists like William Hunter and Astley Cooper as well as the appearance of textbooks, initiation of university courses, and increasing recognition of the important role of the medical witness.
By 1834, 37 medical schools in Great Britain provided courses of instruction in forensic medicine, the subject having been made obligatory the year before in the medical curriculum of every medical school. Medicolegal knowledge and practice thus came to be viewed as an important priority for doctors as part of a drive to reform the medical profession and enhance its public image. However, despite such encouraging developments, forensic medicine went into decline and by the early part of the 20th century few thought of forensic medicine as academic. Virtually no research came from those who specialised in the subject. And too many untrained "specialists" carried out a vast number of autopsies badly. There were, of course, notable exceptions, such as Bernard Spilsbury, Roche Lynche, and Sydney Smith.