Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Analysis of medicolegal examination in alleged sexual abuse presented to a tertiary care hospital in Sri Lanka(Wolters Kluwer - Medknow, 2023) Kitulwatte, I.D.G.; Wijewardena, H.P.; Edirisinghe, P.A.S.; Senarathne, U.D.Forensic experts are often expected to provide an opinion on alleged physical or sexual contact between individuals following medicolegal examination of a case of sexual abuse (SA). There are many factors influencing the opinion. A retrospective descriptive study was performed to study the factors influencing the medicolegal opinion in SA forensic examination using medical and medicolegal records of alleged SA victims to extract data. Records of 441 victims were studied. A majority, 180 (40%), presented due to the guardian’s concerns – 302 (68%) presented for medicolegal examination 72 h after the incident. Recent injuries were observed in only 15% of the victims. Genital injuries were observed in 74% of the victims brought due to concerns of the guardians, with 12 victims having recent injuries. Of the 172 victims who complained of vaginal intercourse, 21% had recent injuries. A firm positive medicolegal opinion could be given in 63% of all cases. In 124 individuals, a firm positive or negative opinion could not be given. A majority (n = 90, 73%) of these individuals did not have any injuries, while 23% had healed injuries. According to the nature of the complaint, in a significant number of victims (53%), no scientific evidence was present to make a firm opinion. The nature of the sexual act and the absence of injuries influence the medicolegal opinion on SA, making it a challenging task for forensic experts.Item Ethical dilemmas in forensic medical practice(Department of Forensic Medicine, Faculty of Medicine, University of Peradeniya, 2019) Kitulwatte, I.D.G.; Edirisinghe, P.A.S.ABSTRACT: Forensic practitioners need to ensure that basic medical obligations towards individual patients, judiciary and the public are met while balancing their responsibilities to these parties. Unlike in clinical practice the patient does not present for treatment but for forensic evaluation. Even so, medical practitioners are expected to ensure that ethical standards like for any other medical discipline are maintained in medicolegal practice. At a forensic medical examination, there is an obligation to act in the best interest of the patient and to attend to his/her critical needs. However, attending to the needs of the patient may be viewed as taking undue interest or being fractional by the judiciary. On the other hand, in medical practice, responsibility to patients should overide the interests of third parties. In examination of the dead for medico-legal purposes, the question that can arise is whether there is actually a doctor patient relationship since the examinee is already dead. While there is a duty towards the judiciary to find out the truth about the cause and manner of death there is a duty towards the relatives of the deceased to reveal the true findings especially after having contact with them at the preliminary inquiry. Many of the conclusions made in forensic practice are matters of opinion, and therefore, disagreement is expected which can lead to personal friction specially in handling cases of medical negligence. If forensic practitioners follow the basic principles of medical ethics, while maintaining the highest standards based on scientific evidence they can overcome the majority of the conflicting issues and can perform their duty in the administration of justice. KEYWORDS: Ethics, Forensic medicine and pathology, Best interest, Doctor patient relationship, Judiciary