Morphologische untersuchungen in der rechtspflege — Anspruch und wirklichkeit

Summary

A critical analysis is given of the investigation and examination of fatalities for the public prosecution office and for the courts. Rationalistic simplifications in legal quarters, changes in legal procedures and bureaucracy have had negative effects on the field of forensic medicine. It is questionable whether forensic science today can fulfil the scientific demands with regard to a complete and thorough explanation of the cause of death. The reduced interest in expert opinions concerning the pattern of injuries that can help in the reconstruction of the act or in judging the intention and guilt of the perpetrator is a striking and alarming development in criminal justice. Medical examinations in the somatic field are no longer used enough in forensic cases; with regard to the administration of justice, the role of the forensic expert is limited to the postmortem findings and the cause of death. On the other hand, there is increased interest in the expert opinion of psychologists, psychiatrists and specialists in the field of drugs and alcohol. The fact that the number of autopsies and histological as well as toxicological examinations ordered by the public prosecutor is rather small has serious and negative implications for establishing the truth. Such orders are merely dependent on the circumstance of death and the situation in which the body was found. However, the external circumstances can be misleading or they can be manipulated. That is why some crimes are not revealed.

In the Federal Republic of Germany, if there is no suspicion of external violence permission is granted for corpses to be buried without the cause of death being clarified by autopsy. However, the fact that the opinions of forensic specialists differ regarding this development in the administration of justice must also be criticized. There is an increasing tendency for investigations to be carried out only if they are ordered by the prosecutor and for questions to be answered only if they are asked offically. Even our colleagues are influenced too much by external circumstances and consider an autopsy unnecessary if the cause of death seems to be clear (for instance in cases of hanging, drowning or bleeding to death).

Second autopsies have shown that the thoroughness and the quality of the first autopsy often leave much to be desired. It is, for instance, unforgivable if organs are described without being examined. Special interest is afforded to the necessity for and significance of histological examinations. Unfortunately, specialists in forensic medicine very often neglect these examinations themselves, not only because of the influence exercised by the authorities regarding money-saving. If the evidence changes in subsequent preliminary proceedings, the failure to perform histological examinations can lead to gaps in the argumentation, which then cannot be disproved. Furthermore, changes in the facts found during the preliminary proceedings cannot be foreseen. That is why it is one of the principal tasks of the forensic pathologist to indicate the necessity for histological examinations at the end of his preliminary postmortem report. The questions to be answered are not only of special forensic histological character. The examination has to include every pathological alteration in the organs that cannot be seen macroscopically. This can be of a major legal importance if natural and unnatural lesions of importance for the cause of death are to be sharply contrasted against each other. Therefore, no autopsy should be performed without histological examination of the parenchymatous organs.

The second section emphasizes the necessity for care to be taken in morphological examinations to clarify cases of death. There are no clear directions as to what is expected of medical experts or criminal justice. However, it has to be emphasized that a forensic pathologist can be held responsible for mistakes (leading to false accusations) which he has caused by failing to perform necessary morphological examinations. The care that is required is defined legally as the observance of professional ethics, the opposite being gross negligence. The extent and nature of the careful and thorough examination required are dependent on the respective level of medical science. Specialized knowledge should be determined and proved by the medical experts themselves. Similar demands on the opinions of morphological experts have also be made in the English literature.

The third section deals with proposals on how to increase the number of autopsies and histological examinations ordered by the public prosecutor. A specialist in forensic medicine should work closely together with the police and the prosecutor to decide whether it is necessary to perform an autopsy or not. Judicial inquiries should only be completed when the cause of death is clear. It is suggested that requirements for morphological examinations should be worked out to obtain an expert opinion about the cause of death. This should be carried out by a commission of the German Society for Legal Medicine. The commission would put forward the basic conditions for a quality control. The completeness and the quality of autopsies and histological examinations must be based on modern scientific methods (including, for example, immunohistology and in situ hybridization in special cases). Obligatory standards must be arrived at that are acceptable both to those involved in forensic medicine and in the administration of justice.

Zusammenfassung

Vorgelegt wird eine Analyse der Untersuchung und Begutachtung von Todesfällen für die Staatsanwaltschaft und Gerichte. Veranlassung zur Kritik geben Veränderungen und rationalistische Vereinfachungen auf seiten der Justiz. Auffallend ist die geringer gewordene Inanspruchnahme morphologischer Erkenntnismöglichkeiten. Bedenklich ist der viel zu geringe Einsatz von gerichtlichen Sektionen. Es wird Stellung genommen gegen die Bedeutung der „äußeren Umstände“ als Entscheidungsgrundlage im Todesermittlungsverfahren, indem die Kenntnis der tatsächlichen Todesursache vernachlässigt wird. — Auf seiten der Rechtsmedizin ist kritisch anzumerken, daß dieser Entwicklung in der Rechtspflege nicht mit fachlicher Geschlossenheit begegnet wird. Im wesentlichen wird nur das untersucht, was in Auftrag gegeben wurde. Die Erfahrungen an Nachsektionen zeigen, daß Vollständigkeit und Qualität von Autopsien manchmal zu wünschen übrig lassen. Hervorgehoben wird die Notwendigkeit histologischer Untersuchungen, die auch ohne Maßgabe kostensparender Ermittlungsbehörden unterlassen werden. Das Fehlen der Histologie kann bei Änderung der Beweislage zu unwiderlegbaren Behauptungen führen. Gefordert wird ein histologischer Grundstatus für jede Sektion. — Besonders besprochen wird die notwendige Sorgfalt bei der Anwendung von morphologischen Untersuchungen zur Klärung von Todesfällen. Es fehlt an verbindlichen Richtlinien, deren Einhaltung sowohl von den medizinischen Gutachtern als auch von der Rechtspflege gefordert werden muß. Rechtsmedizinische Gutachter können haftbar gemacht werden, wenn sie nicht sorgfältig sind. Die „erforderliche Sorgfalt“ wird rechtlich als Einhaltung der „berufsspezifischen Sorgfalt“ definiert. Ihre Nichteinhaltung bedeutet Fahrlässigkeit. — Zur Verbesserung des Zugangs zu gerichtlichen Sektionen wird die Mitwirkung forensisch geschulter Ärzte bei der Entscheidung über Sektion oder Freigabe der Leichen vorgeschlagen. Empfohlen wird die Erarbeitung von Mindestanforderungen an morphologische Untersuchungen zur Begutachtung von Todesfällen. Dazu werden Rahmenbedingungen vorgestellt. Es soll erreicht werden, daß verbindliche Qualitäts-Standards vorliegen, die von der Rechtsmedizin und von der Rechtspflege akzeptiert werden.