chapter
8 Pages

Introduction

Every politically organized society is regulated by laws which its government must enforce, and it is in this context that forensic medicine is to be understood, as the application of medical knowledge and practice to the clarification of uncertain issues that come before the law courts. The importance of forensic medicine thus rests on its ability to contribute to the fact-finding processes typical of both the pursuit of legal solutions to disputes between individuals, and of the state’s duty to promote public security by preventing crime. The relationship between medicine and law is therefore one of shared responsibility in the areas of legal enquiry in which they meet, including criminal trials for a variety of forms of interpersonal violence and civil examinations into personal characteristics such as sanity and sexual potency. However, the relationship has not been equally developed at all times or in all places, for reasons largely to do with the organization of Western legal systems; although the history of forensic medicine is centuries old and its sphere of activity wide, its practice has been inconsistent. Medical practitioners have been asked to provide specialist opinions to help the courts reach just decisions, but the degree to which they could truly be considered expert has changed over time, as have their interests, methods and techniques. This book is concerned with the practice of forensic medicine in the West, with the main areas of the law to which it contributed, the development of notions of expertise, and medical attitudes towards the victims and perpetrators of crime and the wider influences such attitudes had. By the end of the book the reader will understand how medicine has played an active part in shaping legal, political and social change. The origins of Western forensic medicine lie on the European continent;

although the forensic activities and writings of the Chinese pre-date European developments, there is no evidence of their direct influence in the West.1

European terminology has a particular history that it is essential to understand in order to define and explain what we mean by forensic medicine now. Most of the descriptive titles in the field have specific national origins, and the earliest texts in the Western world were Italian, of which the two most influential works had general titles which ‘emphasized the interrelationship of the subject to both medicine and the law’. In 1598 Fortunatus Fidelis (1551-1630) of Palermo published a fairly comprehensive volume on forensic medicine

entitled De relationibus medicorum (On the Relations of Doctors), but this was quickly superseded by the text of Paolo Zacchia (1584-1659), who was the medical consultant to the Rota Romana, the Papal Court of Appeals under canon (church) law. Published in 1621 and expanded in subsequent editions, his Questiones Medico-Legales (Medico-legal Problems) compiled information on a vast range of medical and legal subjects, and outlined actual cases brought before the Rota. This was the first text to use the hyphenated adjective ‘medico-legal’ to describe the field, but the term today is so common that many writers delete the hyphen.2