Sars-CoV-2 Infection After Lung Transplantation: Is There Professional Liability?

For the first time in the literature, a case of Sars-Cov-2 infection after lung Transplantation has been described. This case, particularly rare, brought attention on the in-depth screening for Sars-CoV-2 on lung donor. In addition to infectious problems, it is important to focus attention on medico-legal issues related to this case. In fact, from the point of view of professional responsibility, in theory, there could be criteria for identifying professional responsibility. The author analyzes the possible presence of medical liability in this specific case.

A full Bayesian calibration model for assessing age in adults by means of pulp/tooth area ratio in periapical radiography

The Bayesian approach is being a fundamental tool in forensic and legal field where inferences and decisions are made. In this study, a full Bayesian calibration model was developed to make probabilistic inferences about age estimation in a reference sample of 891 periapical X-rays of upper and lower canines. These teeth belonged to both deceased and living adult subjects, aged between 20 and 86 years, coming from five different countries (Turkey, Italy, Portugal, Japan and Mexico). For this purpose, the narrowing of pulp chamber due to the apposition of secondary dentine was analysed by means of the pulp/tooth area ratio. To determine the agreement of the method, intra- and inter-observer differences for measuring process were calculated by means of the intraclass correlation coefficient (ICC) analysis. Observer error tests showed excellent agreement between observers and between repeated assessments. According to the results of the ANCOVA, neither nationality nor sex was associated to the secondary dentine apposition while it is associated with individual's age. The results of the present study indicated that the concept of probability is intrinsically linked to the assessment of age in a forensic context, and the Bayesian approach could be considered a robust tool to overtake the bias generated by traditional regression models, thus helping the decision-making process in a legal framework.

The decline of COVID-19-related deaths and the risk of underestimating the pandemic

COVID-19 pandemic has put a strain on the stability of National Health Systems and society itself. The decline in COVID-19-related mortality is positive. However, we do not know the reason for this decline associated with a rise in infection in many countries of the world. For these reasons, this is not the time to lower our guard and excessively reduce preventive strategies against COVID-19.

Apps for COVID-19 contact-tracing: Too many questions and few answers

Recently, for the second phase of prevention of the COVID-19 Pandemic, it is being assumed the use of an app for the prevention of infections COVID-19. The utility of these apps is not yet proven and the apps for COVID-19 contact-tracing probably cannot be used as a preventive tool until the bioethics and legal issues related to their use are resolved.

Legal Considerations of COVID-19 Patients' Disposition in Emergency Department; Report of 10 Cases

COVID-19 pandemic is a challenge in the current era. The spread of this viral infection began in Wuhan City in China, and Iran was also one of the countries struggling with it. Considering the nature of this virus and the current pandemic, it is essential that the healthcare system authorities issue a clear and firm law on treating people infected with COVID-19 to prevent the consequences affecting the professional life of physicians and healthcare staff. The current study aimed at evaluating the legal consequences of COVID-19 cases in emergency department (ED). This case series reported 10 patients that filed complaints against medical staff for problems that occurred on arrival, during the hospital stay or discharge in Shohada-ye-Tajrish and Shahid Modarres educational Hospitals, Tehran, Iran. Consultation with forensic medicine department was requested for all patients and the final decision for each case was reported under the title legal considerations.

Response to letter to the Editor regarding physical restraint in psychiatric setting

The following letter addresses the issues of the applicability of physical restriction, with particular attention to the therapeutic regime and its meaning as a therapeutic or restrictive provision, while considering possible alternative measures in the context of Italian jurisprudence. The letter, in response to the questions posed by Cioffi and Tomassini, examines the possible legal implications for doctors and suggests that the integration of jurisprudence and psychiatry seems to be mandatory to define the operational protocols for the management of physical restraint. La seguente lettera affronta il problema relativo all'applicabilità della contenzione fisica, con particolare riferimento al regime terapeutico, nonché la sua valenza giuridica quale misura terapeutica o restrittiva, considerando eventuali approcci alternativi. La lettera, in risposta alle domande poste da Cioffi e Tomassini, esamina le possibili implicazioni legali cui possono incorrere i medici nell'applicare la contenzione fisica, suggerendo la necessità di un'integrazione tra le norme giurisprudenziale e la scienza psichiatrica, al fine di definire i protocolli operativi di gestione della contenzione fisica.

Is it time for international guidelines on physical restraint in psychiatric patients?

The freedom-restraining measures used during Involuntary Health Treatment (IHT) are highly criticized in the medical community. Physical restraint techniques are currently largely used worldwide in Psychiatry. The use of restraints against the patient's will can be considered a serious intrusion of basic human rights and even an act of violence against the patient. In all cases, the restraint should not lead to injuries or damage to the patient's health and should be implemented with a respect of the human rights and dignity. Generally, the use of restraint should be considered as a last resource, when all the other methods have failed. Since it represents the principal freedom-limitation measure, it should be constantly monitored by physicians who apply these methods. The case of a 58 years-old white male, affected by chronic schizoaffective disorder and cannabinoid dependence, was under involuntary medical treatment as a consequence of antisocial behavior. During the IHT he suffered firstly a pharmacological restraint and then a physical restraint in order to suppress a slight state of agitation. The patient was completely blocked to the bed for more than 80 hours and died after three days of hospitalization. The aim of this study is to evaluate the suitability of restrictive methods for psychiatric patients in order to establish specific rules to prevent abuse of restraint techniques and even to help physicians to treat psychiatric patients.

Letter to the editor in response to "Is it time for international guidelines on physical restraint in psychiatric patients?"

The Mastrogiovanni case was a revolutionary case in the field of Italian forensic psychiatry. A recent judgment of the Court of Cassation has defined what the legal limits of mechanical restraint should be. On the other hand, even today, there is a gap in the scientific community about the presence of guidelines governing mechanical restraint. It is probably time to create specific guidelines to protect the psychiatric patient and the mental health worker.

Sexual homicide attempt: A case report and a short review of the literature

Sexuální násilí je předmětem nepřetržitého výzkumu v oblasti forenzních i právních věd při určování profilů pachatelů a obětí a rozpoznávání okolností, které v daném okamžiku částečně odpovídají za vyjádření základních pobídek a podnětů. Široká škála sexuálních zločinů a násilí se týká například sexuálního útoku, znásilnění a sexuálního zabití, které sice sdílejí některé podobné rysy, ale z právních důvodů jsou považovány za samostatné trestné činy. Znásilnění a sexuální zabití jsou některými odborníky vnímány jako různé úrovně sexuálního násilí. Příspěvek popisuje případ sexuálního napadení a pokusu o vraždu mužského pachatele spáchaný na  dospělé ženě. Ačkoliv psychiatrická anamnéza pachatele byla zčásti známa, psychiatrická diagnostika byla komplikovaná, protože existovalo mnoho náznaků přítomnosti různé psychopatologie (schizofreniformní porucha, porucha osobnosti, alkoholismus), v osobní anamnéze figurovala hospitalizace s paranoidními bludy následovaná dlouhými obdobími relativně vysoké funkčnosti bez medikace, koordinovaného jednání navzdory konzumaci alkoholu i zhoršeného sebeovládání, ale s náznaky částečné promyšlenosti. Tento příspěvek by měl pomoci k lepšímu pochopení sexuálních zločinů a pachatelů.

Forensic psychiatry in iran

In Iran, department of forensic psychiatry is one of the special units of Legal Medicine Organization concerned with individuals who demonstrate psychological and psychiatric problems. The duties of forensic psychiatrists in the department are, performing psychiatric examinations and determining mental competence of two major groups of referrals: Individuals who are involved in a legal problem related to civil law and individuals who are involved in criminal responsibility and/or forbearance of punishment such as offenders and prisoners. One of the worries of the Iran jurisdiction system is the absence of a secure mental hospital devoted to the irresponsible mentally ill criminals. In fact, there is no forensic inpatient unit available in the country.