Forensic medicine in germany: past and present

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Introduction.

This article continues the series of publications on the state of forensic medicine in the world, its past, present and future, based on the unique English-language publication "History of Forensic Medicine" under the general editorship of Doctor of Medical Sciences, Professor Burkhard Madea. Doctor of Medical Sciences, Professor Vladimir Alexandrovich Klevno and Doctor of Medical Sciences, Associate Professor Viktor Yuryevich Nazarov participated in the compilation of this work on behalf of the forensic public of Russia. The first articles of the publication cycle were devoted to the organization of forensic medical examination of the United States of America, England and China. In the current article, together with professors Burkhard Madea, Joanna Proisisch-Wösner, Gunter Geserik, Ingo Wirth and Eberhard Lignitz, we will highlight the development and structure of the forensic expert service in the Federal Republic of Germany (Germany) from the emergence to the present.

General structure of the forensic service.

In the Federal Republic of Germany, more than 82 million inhabitants live on 357 thousand square kilometers. In accordance with the Constitution, the Federal Republic consists of 16 federal states with their own governments and partially their own laws. Most laws, especially criminal and civil law, are regulated equally throughout the country. However, in the Federal Länder, some legislation concerning the dead has differences, especially in areas of medical and legal interest, such as burials of the dead, external examination of the corpse, sectional examination, issuance of death certificates, etc.

Most forensic research is carried out with the participation of university institutes of forensic medicine (in Russian practice - analogues of the departments of forensic medicine). Since there are no universities with medical faculties in Brandenburg and Bremen, they do not have a university institute of forensic medicine, but a municipal or state institute, respectively.

On average, in the whole country, one university institute is more or less responsible for 2-3 million inhabitants.

History of forensic medicine in Germany

The Criminal Code of Carolina (Constitutio Criminalis Carolina) since 1532 is the birth time of forensic medicine in Germany, since this criminal law and the Code of Criminal Procedure first mention medical experts. They had to investigate cases of post-traumatic death where the causal relationship between trauma and death was unclear or cases of medical negligence were suspected. Already in the XVII century, books on forensic medicine began to be published by professors who lectured at German universities. Johannes Bon (1640-1718) in Leipzig published, under the influence of Paolo Zacchias (1584-1659), two major books on forensic medicine ("De renuntione vulnum," seu vulnemum lethalium expressen, Leipzig 1689; De officio medici duplici, clinici nimirum ac forensis, Лейпциг 1704). Another early work on forensic medicine in Germany was Gottfried Welsch's (1618-1690) book "Iustificatio vulnerability lethalium judicium," published in Leipzig 1684. Welsh and Paul Ammann (1634-1691) taught in Leipzig and it should be noted that it was the Leipzig Medical Faculty at that time that made a significant contribution to the development of forensic medicine.

Professors at the Leipzig Faculty of Medicine were the first to recommend forensic autopsies in cases where no signs of external violence were even visible, especially in cases of intoxication. Autopsies were performed only by doctors with extensive experience. However, after this first heyday of forensic medicine in the 17th century, there was a lull and it took some time before the institutes and departments of forensic medicine were founded.

In the 19th century, in most universities, forensic medicine was taught by professors who were mainly responsible for another medical discipline, for example, at the University of Bonn (founded in 1818), In the 19th century, in most universities, forensic medicine was taught by professors who were mainly responsible for another medical discipline, for example, at the University of Bonn (founded in 1818), either gynecologists or pharmacologists. German surgeon Theodor Billroth (1826 - 1894) wrote in a book on the teaching and teaching of medicine in German-speaking universities (1876) that there is no need to teach forensic medicine in universities at all, since it is not a science in itself, but rather a compilation of other independent sciences and is used only for solving judicial issues. This opinion of Billroth not only did not disappear with time, but is still found today. Pathologists (in Prussia - Rudolf Virchow (1821 - 1902), in Austria - Karl von Rokitansky (1804 - 1878)) and many other professors of a number of clinical disciplines, who were afraid of losing part of their work, showed particular resistance against independent institutes of forensic medicine.

By 1820, supporters of separate institutes of forensic medicine had become predominant in the medical community and the first institute of Forensic Medicine (Unterrichtsanstalt für Staatsarzneikunde) was founded in 1833. In 1924, forensic medicine became a mandatory discipline in medical examinations. It was a real breakthrough as a Professor at the institutes began to have the opportunity to conduct their own forensic investigations.

As a result, there is a practice where one university institute is responsible for forensic research for 2-3 million residents.

In the 19th century, forensic autopsies were carried out mainly by district doctors. In various German states (for example, Prussia and Bavaria), standard procedures for sectional studies were developed and published. In Prussia, the clinical pathologist Rudolf Virchow wrote a book on autopsy techniques with special reference to medical and legal practice ("Die Sektions-Technik im Leichenhause des Charité-Krankenhouses mit besonderer Rücksicht auf gerichtsärztliche Praxis"). The autopsy regulations contained rules that determined the course of the study, indicated which tools should be used, the scope of the sectional study, what should be taken into account when opening newborns, etc. The rules for forensic research of cadavers were revised from time to time in the German countries during the period under review and were an early attempt to standardize forensic research and organize quality control.

As early as the 19th century, forensic autopsies in Prussia were performed by two doctors. And currently, in accordance with paragraph 87 of the Code of Criminal Procedure, forensic autopsies are performed by two doctors. During the 3rd Reich (1933-1945), most forensic experts were influenced by National Socialism and were partly involved in war crimes. After the Second World War, German professors who were caught actively helping the Nazis were dismissed from the service. The history of forensic medicine in the Nazi era is discussed below.

German Society of Forensic Medicine

The German Society of Forensic Medicine was founded in 1904 in Breslau at the request of Georg Puppe (1867-1925) from Königsberg. Already at the beginning of the 19th century, federal associations were founded, such as the Badische Medical Officers association or the Staatsarzneikunde association in the Kingdom of Saxony. These federal associations were already publishing their own journals at the time.

In 1822, the association "Deutsche Naturforscher und Özte"was founded in Leipzig. Forensic medicine became the 25th section of the Society of German Naturalists and Physicians and retained its status until 1904. At a meeting in Breslau, the German Society for Legal Medicine was founded. The founding committee consisted of Professors Karl Ipsen (1866-1927) from Innsbruck, Julius Kratter (1848-1926) from Graz, Adolf Loesser (1851-1926) from Breslau, Georg Puppe from Königsberg, Fritz Strassmann (1858-1940) from Berlin, and Emil Ungar (1849-1934) from Bonn. The charter of the newly founded Society was adopted by the assembly at the first meeting of the German Society of Forensic Medicine in Meran at 2 p.m. on September 25, 1905. At the first meeting in Meran, the founding members addressed their" distinguished colleagues "with a note:" The purpose of this Society should be to create a center for joint scientific research and to promote the personal association of specialists... The German Society of Forensic Medicine should be a center for all those who are keenly interested in this science, which is so extremely important for the public good." Fritz Strassmann, a Berlin professor and head of the "Unterrichtsanstalt für Staatsarzneikunde", was elected as the first president of the Society. From 1905 to the present, the annual meetings of the German Society of Forensic Medicine have always been held in September. The meetings were interrupted by the First and Second World War. After the First World War, the next meeting was held in 1920, after the Second World War, the first meeting was held in 1951 in Berlin. Since forensic experts from Austria and Switzerland, who are members of their own national societies, attend and contribute greatly to the scientific meetings of the German Society of Forensic Medicine, every third meeting is held either in Switzerland or in Austria. Today, the president of the German Society of Forensic Medicine is elected for a three-year term. The Company's home page can be found at: http://www.dgrm.de/.

While the annual meeting of the German Society of Forensic Medicine is always held in the fall, regional meetings are held in the spring. There are currently two regional areas: northern Germany and southern Germany (with Austria, part of Switzerland, and the Upper Rhine region).

The partners of the German Society of Forensic Medicine are societies from related fields. For example, the German Society for Road Medicine (http://www.med.uniheidelberg.de/rechtmed/rmed-vm/vm_start.htm), and the Society of Toxicological and Forensic Chemistry (http://www.gtfch.org/), which hold their scientific meetings every two years.

The founding of the German Society of Forensic Medicine took place at the 67th meeting of the German Naturalists and Physicians in Breslau in 1904. Karl Ipsen (1866-1927), Julius Kratter (1848-1926), Adolf Loesser (1851-1926), Georg Puppe (1867-1925), Emil Ungar (1849-1934), and Fritz Strassmann (1858-1940) were chosen as the provisional board of the Society. They were respected scientists in their field, working at various universities in Germany and Austria.

History of forensic medicine in the Weimar Republic

After the abdication of Kaiser Wilhelm II (1859 - 1941), Philipp Scheidemann (1865 - 1939) proclaimed the "German Republic", soon followed by Karl Liebknecht (1871 - 1919) and his proclamation of the "Free Socialist Republic of Germany". Due to the war troubles in Berlin, the National Assembly met in Weimar from 6 February to 30 September 1919. The Parliamentary-Democratic Constitution was ratified on July 31 and signed by Reich President Friedrich Ebert (1871-1925) on August 11. This Weimar Republic existed from 1919 to 1933, when the National Socialists took over power in Germany.

At the time of the German Empire, forensic medicine only had independent departments in 8 universities. During the Weimar Republic, independent institutes of forensic medicine were founded in 10 other universities (Greifswald and Jena in 1919, Bonn and Marburg in 1922, Munster and Dusseldorf in 1925, Würzburg in 1926, Heidelberg and Frankfurt in 1927, Halle in 1928). However, the foundation of the departments provoked the resistance of independent institutes of forensic medical expertise, which refused to cooperate with the medical faculties of universities. The situation improved in the 1920s in the sense that the regulations for doctors ' examinations included forensic medicine (July 25, 1924), the exam had to be oral, conducted on 1 day and with only 1 examiner. The candidates had to show that they had knowledge of the most important issues of forensic medicine, as they might be needed by a medical practitioner, and that they knew the rules of working as forensic experts, as well as some aspects of medical law.

The time of the Weimar Republic was characterized by many political assassinations. So, on August 26, 1921, the politician Matthias Erzberger (1875-1921) (a member of the Zentrum party) was first beaten and then actually executed with shots to the head. In the summer of 1922, Foreign Minister Walter Rathenau (1867-1922) was killed in his open car, apparently due to his efforts in favor of a balanced policy towards the Eastern countries. On August 9, 1931, two policemen were killed in an attack near the headquarters of the German Communist Party at Bulauplatz in central Berlin. An autopsy later revealed that they had been shot in the back. One of the two perpetrators was Erich Mielke (1907-2000), who would later become Minister of State Security in the GDR.

In Bavaria, on February 21, 1919, Prime Minister Kurt Eisner (1867-1919) was shot. Hermann Merkel (1873-1957), professor of forensic medicine in Munich since 1914, conducted an autopsy on this victim of the revolutionary events. The surviving notes and sketches that Merkel himself made during the autopsy are an example of forensic accuracy.

The leading department in those years was the Department of Forensic Medicine at the University of Berlin. In the years between World War I and Hitler's seizure of power, the department in Berlin produced many publications, mostly written by Fritz Strassmann, his son Georg Strassmann (1890-1972), and later by Paul Fraenkel and Waldemar Weimann (1893-1965).

Forensic medicine was able to turn into a subject with an unquestionable right to exist, it not only served as a mandatory course for students, but also united scientists from different fields.

Forensic medicine during National Socialism.

With the rise to power of the National Socialist German Workers ' Party, Germany's forensic medicine fell into dark times. The Nazis forced forensic experts to expel from their ranks persons with "non-Aryan" origin, primarily Jews. Forensic experts were members of the eugenics courts. They were responsible for sterilization without the consent of the patients. In general, forensic medicine during the Third Reich was under the complete control of the National Socialists.

After the outbreak of World War II, forensic experts were employed as medical consultants to the army. They were supposed to give, for example, expert opinions in cases of self-harm.

But despite numerous examples of the criminal subordination of German forensic doctors to the Nazi system, their work still retained its scientific character.

The Institute of Military Forensic Medicine was founded on June 5, 1940, and is now part of the Military Medical Academy (reopened in 1935) as a center for forensic medicine. From May 1, 1938, it was led by Gerhart Panning (1900 - 1944). A bloody executioner, he conducted experiments on Soviet soldiers (primarily Russians, Jews, Communists), testing the effects of various ammunition on them, shooting, first of all, at the limbs and calculating the time for which a Red Army soldier would die, the limit of pain shock, etc. This story is among the most heinous crimes committed by doctors of the Nazi Party. Quite a few forensic specialists between 1939 and 1945 were not only supporters of the Nazi ideology, but also committed crimes like Panning.

Prosecution of forensic doctors of "non-Aryan" origin.

When the National Socialists seized power, anti-Semitism was imposed as part of German government policy, along with the eradication of all constitutional principles. The general elections to the Reichstag in March 1933 were followed by a wave of anti-Jewish laws and acts of terrorism. Anti-Semitism didn't even stop at universities. At the beginning of the National Socialist regime, Jewish teachers were persecuted for their racial origin and were prevented from continuing to teach. On April 7, 1933, a law was passed under the title "The Law for the Restoration of the Professional Civil Service", which led to widespread removal from office and revocation of licenses for training Jews. Statistics show that by the winter of 1934/35, at least 1,145 German university teachers (14.34%) had been dismissed, including 313 full professors.

On September 1, 1941, a decree was issued, according to which Jews were required, as of September 19, to visibly wear a yellow star with the inscription "Jew"on the outside of their clothing. Also, by the same decree, Jews were not allowed to move from their registered place of residence without the permission of the police. Many forensic experts, including university professors, could not survive the dismissals and absurd demands and committed suicide. The fate of the remaining doctors of "non-Aryan" blood was also unenviable, almost all of them died in concentration camps.

Features of forensic medicine in the German Democratic Republic (GDR).

The administrative structure of the Soviet zone as of July 1945 consisted of the states of Brandenburg, Mecklenburg, Saxony, Sachsen-Anhalt, and Thuringia. The area was home to six universities, Berlin, Greifswald, Halle-Wittenberg, Jena, Leipzig, and Rostock. Saxony and Thuringia experienced a change of powers in the summer of 1945, the American troops withdrew in compliance with the inter-allied agreement and took with them numerous scientists, including forensic doctors, who continued to work in Leipzig and Jena.

In October 1945, the University of Jena was the first to resume teaching in the Soviet zone. All the other universities were gradually re-opened in February 1946. All but Rostock University had their own institute of forensic medicine. Five university institutes in the Soviet zone resumed research and maintenance in the early summer of 1945, despite the effects of the war on all of them. Their equipment and facilities made it possible to conduct high-level sectional studies of corpses, chemical analyses and forensic investigations.

The legal system in the Soviet zone since 1945 has been focused on the standardization of forensic examinations, based on generally accepted legal provisions on the mandatory autopsy in any unclear case of death. The GDR, after its founding on October 7, 1949, immediately adopted these rules and added some provisions. The updated version came into force on December 3, 1951.

It was only a few years before the administrative structure of the GDR was completely abolished. The GDR Parliament decided on 23 July 1952 to abolish the administrative states and replace them with 14 administrative regions plus East Berlin as an additional entity.

On November 1, 1961, the amended "Regulations on Medical post-mortem examination"were published. Currently, all legal conditions are provided for the so-called administrative autopsy of any doubtful case of death, which means a mandatory forensic examination of the corpse, carried out under the supervision of local health authorities. The "Regulation on Forensic Medical Examination" of 4 December 1978, together with its provisions on the completion of death certificates, entered into force on 1 January 1979, and was henceforth to be applied in forensic medical investigations.

The traditional German Criminal Procedure Law continued to operate in the early period of the GDR. The first Code of Criminal Procedure of the GDR was issued on 2 October 1952, and section 69 applies to forensic autopsies. The Second Code of Criminal Procedure of the GDR entered into force on 12 January 1968, and its section 45 provided for all the important rules on post-mortem examination and examination of the corpse. The GDR Code of Criminal Procedure has been explained in more detail by the Ministry of Justice. This commentary described specific details regarding the scope and purpose of the autopsy, including the rule that the three main body cavities must be opened in any forensic examination of a corpse. Other legal provisions concerning medical and legal duties relate to the mandatory medical examination of living persons. They were formalized in section 66 of the 1952 Code of Criminal Procedure and section 44 of the 1968 Code of Criminal Procedure.

The implementation of the above-mentioned regulatory documents also provided for mandatory medical examination of living persons. So, in 1967, the "Provision on the mandatory exclusion of suspicion of committing punishable acts against life or health"came into force.

The structure of the organization of the forensic medical service remained more or less constant in the early years of the GDR, but then underwent changes related to the organizational approaches to conducting forensic examinations with a focus on the Soviets Union. On December 19, 1975, a regional institute was established in Schwerin to coordinate the work of forensic medical institutions. Within a few years, five institutes affiliated with universities have developed into high-quality centers for expert education and forensic research. The Institute of Forensic Medicine was incorporated into the University of Rostock on 1 July 1958. Now each of the universities of the GDR had its own institute of forensic science.

On July 8, 1954, the Council of Ministers of the GDR adopted a resolution, according to which Medical academies were established in Dresden, Erfurt and Magdeburg. Each of them was gradually joined by institutes of forensic medicine. The Department of Forensic Medicine was added to the National People's Army Central Military Hospital in Bad Saarow in 1972. In 1981, it was elevated to the status of a military medical academy.

The general curriculum for forensic medicine was presented to the public at the 4th Conference of Regional and Provincial Health Institutions on January 13, 1946. It was legally introduced by the Soviet Military Administration in Germany for all six universities of the GDR and was gradually improved.

By 1976, the curriculum included 53 hours of lectures on forensic medicine and an oral exam for medical students, as well as 14 hours of lectures on forensic odontology for dental students. Optional lectures on forensic medicine were organized for law students.

The regulations on obtaining a specialty in forensic medicine entered into force on January 31, 1955 (amended on April 16, 1956). The specialization in forensic medicine was introduced as one of the 29 disciplines of medical specialization achievable after three years of postgraduate education. The next regulation on medical specialization was issued on February 1, 1967 and provided for five years of postgraduate education for all medical disciplines. On August 11, 1978, a new regulation was issued that provided for 4-5 years of flexible specialization. The rules for training specialists were laid down in the educational program prepared by the Academy of Postgraduate Medical Education - an organ of the Ministry of Health. Post-graduate education culminated in a colloquium at the Central Board of Examiners in Forensic Medicine, which was headed and supervised by Otto Prokop (1921 - 2009) until 1987. He was succeeded by Hans - Peter Kinzl. The Board consisted of several university professors who acted as examiners for the candidates. The colloquium was usually held on two levels for several hours. The candidate had to start with a lecture on a topic that he chose from three options, followed by a second level-an oral exam.

Another program of postgraduate education was also introduced to improve the skills of young dentists in the theoretical and experimental areas of forensic dentistry. On the basis of the Regulations of 1978, graduates of dentists were granted a special permit to pass dental specialization in 12 disciplines, including forensic medicine. This specialization has been available since 1979. In addition, the Academy of Medical Postgraduate Education of the GDR conducted training in toxicological chemistry, including four to five years of training, an exam and obtaining the status of "chemist in medicine".

Forensic specialists participated in a number of central research projects of the Ministry of Health. In 1987, a research project called "Health damage caused by accidents" was launched in the GDR in response to a WHO initiative aimed at reducing accident rates worldwide. In this context, a project called "Fatal Accidents" was launched under the leadership of Wolfgang Durwald (1924-2014).

The idea of creating a professional society of forensic medical experts of the GDR was supported by Gerhard Hansen (1910-1978). Seventy-three well-known scientists have declared their willingness to join the new society. Representatives of all the institutes eventually attended the founding meeting of the Society of Forensic Medicine of the GDR in Berlin, on January 19, 1967. The Constitution of the society was adopted, and the Council elected for a term of two years. The Board consisted of a Chairman, a Vice-Chairman, a Secretary and three members. Later, the composition of the Council was increased, and the term of office increased to four years. From the very beginning, the Society consisted of representatives of forensic medicine, pathological anatomy, criminology and law.

Scientific events conducted by the society included two bilateral symposia with the People's Republic of Poland (1977, 1980), two bilateral symposia with the USSR (1977, 1984), several symposia in honor of Prokop (1981, 1986) and Durwald (1989), one symposium on the 20th anniversary of the Society of Forensic Medicine of the GDR (1987) and several symposia on the anniversaries of the institutes.

Contact with the International Academy of Forensic and Social Medicine was established by the Society of Forensic Medicine of the GDR immediately after the foundation of the latter. The national representative has been delegated since 1967. Durwald was vice president of the Academy from 1976 to 1979. However, the existing restrictions on international contacts proved to be an obstacle to full-fledged international relations.

The" Prize of the Society of Forensic Medicine of the GDR "and the" Richard Coquel Medal "were established by the Society to recognize"outstanding scientific achievements and outstanding services in forensic medicine". On September 28, 1990, an application was submitted for the dissolution of the Society, for which 85.7% of the members voted. The society was officially dissolved at the 10th annual Conference in Dresden on 27 November 1990. Forensic medicine in the GDR has a remarkable track record. Despite the constant problems with the supply and purchase of equipment, the GDR forensic experts managed with energy and special perseverance not only to create institutes of forensic medicine in almost all regions, but also to conduct forensic research at the highest professional level, conduct many scientific events and gain international recognition.

Many prominent scientists have contributed to the development of forensic medicine in Germany, we cite only a few of them: Kasper, Johann Ludwig (1796-1864), Emil Ungar (1849-1934), Fritz Strassmann (1858-1940), Berthold Muller (1898-1976), Otto Prokop (1921-2009), Steffen Berg (1921-2011). The journals on forensic medicine published in Germany are part of their works.

Publishing activities.

The main German journals in forensic medicine are "Rechtsmedizin", "Archiv für Kriminologie"and " Blutalkohol". The journal of Forensic Medicine is also the official organ of the German Society of Forensic Medicine. The predecessor of this journal was founded in 1852 by Johann Ludwig Kasper as "Vierteljahrsschrift für gerichtliche und öffentliche Medicin" (Quarterly Journal of Legal and Public Medicine), ceased publication in 1921. In continuation, the German Journal of Complex Legal Medicine (Deutsche Zeitschrift für die gesamte gerichtliche Medizin) was founded. In 1928, a special section was created under the subtitle "Referent", which summarized the latest literature. The name of the Journal was changed several times in accordance with the name of the German Society of Forensic Medicine. Since 1990, the Journal has been called Rechtsmedizin (Forensic Medicine). Most of the articles in this journal are published in German, with an English abstract. The journal covers the entire field of forensic medicine - from thanatology, pathology, toxicology to medical malpractice. Recently, the journal contains a separate section on continuing medical education (CME). Another special section of the journal is an overview of the latest legislation.

The journal Archive of Criminology was founded in 1898 as "Archiv für Kriminal-Anthropologie und Kriminalistik" (Archive of Criminal Anthropology and Criminalistics), it is probably one of the oldest still existing scientific journals of its kind worldwide. This journal mainly publishes reports on rare or interesting cases.

The magazine "Blutalkohol" ("Alcohol, Drugs and Road Safety") is the official journal of the German Society for Road Medicine. The journal is edited by the Union against Alcohol and Drugs. The journal is distributed not only to specialists in the field of forensic and road medicine, but also to lawyers, as it contains a large section with recent legislation related to alcohol and drugs.

In the GDR, in 1967, its own magazine "Kriminalistik und crimessische Wissenschaften"was founded. The magazine ceased publication in 1996 with the number 85.

Textbooks on forensic medicine.

The first books on forensic medicine were published already in the XVII century by Leipzig professors Bohn, Ammann and Welsch. The titles of their books were in Latin (ex. Bon's textbook-De renuntione vulnerum vulnerum seu vulnerum lethalium exemen or Ammann's Praxis vulnerum lethalium, sex decadibus historiarum rariorum, utplurimum trumaticarum cum cum cribrationibus singularibus adornata). Johannes Nicolai Pfizer (1634-1674), a district medical officer in Nuremberg, is believed to have written the first textbook on forensic medicine in German. Published in a second edition in 1684 with the title "Vernünftiges Wundurtheil", wie man Nämlich von allen Wunden des menschlichen Leibs gründlichen Bericht, ob solche gefährlich, tödlich oder nicht, vor Gericht Gericht und anderswo (A reasonable judgment on injuries, how to give a thorough account of all injuries to the human body in court and elsewhere to classify them as dangerous, deadly or not).

A new type of book, mainly based on personal experience, was the textbook of Johann Ludwig Kasper "Practicches Handbuch der gerichtlichen Medizin" (Practical Textbook of Forensic Medicine) with its first edition in 1857. Casper's textbook was later edited by his nephew and successor, Karl Liman. The book was a two-volume book. Casper also published an atlas of forensic medicine. The 9th edition of Kasper's textbook was edited by Adolf Schmidtmann (1851-1911) as a three-volume "Handbuch Gerichtliche Medizin" (1905). In 1895, Fritz Strassmann, the first president of the German Society of Forensic Medicine and professor of forensic medicine at the University of Berlin, published his own textbook of forensic medicine, the second edition of which was edited jointly with his son Georg Strassmann in 1931.

One of the world's leading textbooks was that of Eduard Ritter von Hofmann. "Lehrbuch der Gerichtlichen Medicin" (Textbook of Forensic Medicine), published in 1878, the last edition was edited by his student Albin Haberda (1868 - 1933) in 1927. In 1898, von Hofmann also published an Atlas of Forensic Medicine (Atlas der Gerichtlichen Medizin) with several drawings by the artist Arthur Schmitson (1857 -?).

In the twentieth century, the publication of textbooks on forensic medicine in Germany took on a regular character in accordance with the requirements of science at this stage.

The publisher Schmidt-Römhild in Lübeck publishes a series of books dedicated to the field of modern medicine. One of them is Arbeitsmethoden der Medizinischen und Naturwissenschaftlichen Kriminalistik (Methods of medical and natural science criminalistics). To date, more than 20 volumes of this series have been published on various topics of forensic medicine and criminology. Another published series - Rechtsmedizinische Forschungsergebnisse (Research in Forensic Medicine) has more than 30 volumes. Lehmann's Media Berlin has also been publishing books in the field of forensic medicine for many years.

Education.

Forensic medicine is a compulsory discipline for students of medical universities in Germany. It is taught both in lectures and seminars. Special emphasis is placed on practical classes in small groups.

Medical students, as well as students of natural sciences (biologists, biochemists, chemists) can prepare a doctoral dissertation in the institutes of forensic medicine, which takes mainly 3-4 years. Specialization in forensic medicine takes at least five years (60 months). Of these 60 months, 6 should be spent in clinical pathology, 6 in psychiatry or forensic psychiatry. Another 6 months can be spent on pathology or public health, pharmacology, toxicology, or psychiatry. 3.5 years are given to forensic medical examination. According to the regulations of medical councils, at least 400 complete external examinations of corpses with a detailed description must be carried out. It is necessary to carry out 25 visits to the crime scene, to conduct at least 300 forensic autopsies, at least 2000 histological studies. In 200 cases, an oral or written report must be prepared for participation in the court. In at least 10 cases, examinations of blood traces should be carried out, and at least 25 forensic osteological and odontological examinations should be carried out. After completing the training, two forensic experts and one doctor of the medical chamber are given an oral examination at the local medical council, which lasts at least half an hour, before which the doctor of the medical chamber and the board of examiners study the written reports that the candidate must submit to the exam.

Toxicologists can also qualify as forensic toxicologists in institutes of forensic medicine in accordance with the regulations of the Gesellschaft für toxikologische und crimessische Chemie (GTFCh) (Society for Forensic and Toxicological Chemistry).

Forensic medicine in Germany at the present stage.

Currently, the main routine work in the field of forensic medicine is carried out by university institutes of forensic medicine (the name "Institute of Forensic Medicine of the university" - in the Russian scientific community corresponds to the name "Department of Forensic Medicine of the university"). The German Forensic Medical Service is designed in such a way that theory and practice are not separated in it. All active forensic medical experts are employees of university institutes, and universities, in turn, have a very large autonomy, independently choosing the heads of the relevant forensic medical institutes. There is no centralized management of the forensic medical service in Germany. The financing of forensic medical activities is always local, land-based, from two sources: from a particular university and from the prosecutor's office.

Currently, there are 28 university institutes of forensic medicine in Germany, which employ about 350 scientists. There are 6 state or municipal institutes, which employ about 40-50 scientists. In addition, there are four private institutes working mainly in the field of genetics (paternity testing, blood stain research).

In Bavaria, some forensic doctors are attached to the court; they have to do the work of reviewing criminal cases. They are employed either as psychiatrists or specialists in the field of forensic medicine. In the latter case, they also conduct forensic examinations of the corpses.

Examination of living persons in Germany on the basis of institutes of forensic medicine is practically not carried out, examinations of victims are carried out by ordinary doctors, including in the emergency departments of hospitals. In cases of rape, the examination of the victims is carried out by gynecologists in the conditions of the duty gynecological departments.

The rate of dissection studies of corpses in Germany has been declining over the years. Today, only 5% of all deaths are autopsied, of which 2% are forensic autopsies, and 3% are pathologic-anatomical autopsies. The frequency of research varies between institutes. Several institutes of forensic medicine have a high level of autopsies of bodies - about 2000 per year, other institutes conduct no more than 200 forensic autopsies per year. These different indicators are based both on the area for which the Institute of Forensic Medicine is responsible, and on the decisions of the prosecutor, who is free to make decisions about conducting a forensic examination of the corpse.

Part of chemical research (primarily on alcohol) they are also conducted on the basis of institutes of forensic medicine. In Germany, only a few German universities have their own independent departments of forensic psychiatry (Berlin, Essen, Munich, Tuebingen). In the case of murder or other criminal offences, forensic psychiatric examinations are carried out mainly by forensic psychiatrists.

Most of the 16 federal states of Germany have specialized police laboratories for laboratory tests of blood stains and additional tests, such as determining the range of a shot, analyzing traces after arson, determining the content of a drug, etc.

Also at the federal level, these police laboratories create DNA databases.

Part of the analysis of the stains is also carried out by the institutes of forensic medicine, and the data obtained is recorded and compared with the DNA database in the responsible police laboratory.

Conclusions.

Summing up all the above, we can conclude that the forensic medicine of Germany for its centuries-old history has found the optimal balance of science and practice in its activities, which puts it in the first ranks of the best forensic medical services in the world.

 

About the authors

Vladimir A. Klevno

Moscow Regional Research and Clinical Institute

Email: vladimir.klevno@yandex.ru
ORCID iD: 0000-0001-5693-4054
SPIN-code: 2015-6548
http://www.klevno.ru/

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Yuri V. Nazarov

Bureau of Forensic Medical Examination; North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: naz532@yandex.ru
ORCID iD: 0000-0002-4629-4521
SPIN-code: 2390-8227

MD, Dr. Sci. (Med.)

Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015; Saint Petersburg

References

Supplementary files