Extensive forensic examinations are conducted at the National Bureau of Expertise.

The objects of research in the forensic examination department can be:

• human corpse,
• living person,
• medical documents,
• case materials,
• human organs and/or tissues or their parts,
• material evidence of biological origin.

Complex examinations also have a significant weight among the forensic examinations carried out in the department. Iravaban.net discussed these and other topics with Karen Mkhitaryan, the head of the forensic examination department of the National Bureau of Expertise.

Medical error: “Such cases are equated with a national security issue”

Examinations in medical error cases are carried out by a commission. I must sadly note that their number is increasing. There are several factors for this increase. One of them, I think, is the increase in the legal awareness of the population, and the other is the increase in information flows.

These are the most complex types of forensic examination.

As a result of the examination, it becomes necessary to determine the proper or improper performance of medical care and service provided to the person, the improper performance of professional duties by the medical worker or avoidance of its performance, which led to consequences, and establishes criminal liability for the latter.

In these cases, apart from clarifying the issue of improper performance or non-performance of the medical worker’s professional actions, it is very difficult to assess their causal connection with the adverse outcome.

In many advanced countries, such cases are equated with a national security issue, because the quality of medical care and service provided to the population must be high. If this quality is low in any country, it becomes a national security issue.

The expert’s conclusion in such cases becomes the main, and in some cases, the only evidence for the resolution of the case.

Forensic medicine and the medical community

We consider doctors as colleagues. However, being objective and impartial when conducting forensic examinations, giving a scientifically substantiated conclusion is a legal obligation of a forensic expert.

Collegial relationships or doctors being our colleagues should not and do not hinder conducting an objective examination.

On the one hand, they are our colleagues, on the other hand, they are our compatriots.

Doctors know each other, we know many of them. If the expert cannot be impartial, the Criminal Procedure establishes appropriate procedures in the form of a self-recusal institution.

Character traits that are specific to a forensic doctor

I must highlight a special character trait that a forensic expert should have:

it is high discipline.

Of course, apart from professional knowledge and practical skills, a forensic doctor must have high discipline, a responsible approach to their own work.

I say this taking into account the nature of the work and the importance of the expert’s conclusion obtained as a result of the work in the justice system.

Forensic examination of a corpse

This examination is mandatory in cases of violent death, as well as suspected violent death. During the examination, the forensic expert must answer the questions posed by the body conducting the proceedings.

First, the corpse is examined externally, then an internal examination is performed. There are also additional research methods that are carried out as needed. This is forensic biological, forensic chemical, forensic histological research, which is very important.

First of all, the cause of death of the person, the presence of bodily injuries, their nature, location, and dimensions must be determined. In addition, their causal connection with death should be assessed.

There are cases when a person has bodily injuries, but death is conditioned by a completely different circumstance not related to the injury.

Difficulties of a forensic doctor’s work

The work itself is quite difficult.

Citizens have the impression that the work of a forensic expert is black and dark.

It should be approached coldly. Given its importance in people’s destinies, a forensic expert should not be guided by emotions in their work.

The work is also harmful, as during this process the expert not only deals with corpses, but also with various chemical substances that are harmful to health.

Our work is considered harmful by the legal norms established by the state. Along with all this, no special privileges are established for forensic experts.

Burn the body or bury it?

The question should be viewed from different perspectives. If we look at cremation from a medical and ecological point of view, I don’t view it negatively.

However, considering our religion, traditions and other circumstances, I don’t consider cremation quite acceptable in this regard.

From a medical point of view, the process is neither problematic nor wrong.

Preferred part of the work

I do my work with love, although due to work we deal with sad phenomena. I realize the importance of the work and the significance of the expert’s conclusion given as a result of it in the field of justice.

Much has been said about forensic examinations in medical error cases. Also considering that my first postgraduate narrow specialization is in the field of clinical medicine, these types of examinations are more familiar to me.

Although, I wish there was no need for examinations in such cases at all.

Examinations are also performed in cases of newborn deaths, as well as we have given conclusions regarding persons of advanced age.

We have also had examinations in cases of deaths of unborn fetuses, which were appointed in cases related to medical errors. The body conducting the proceedings needed to find out why the fetal death occurred, whether there were failures in the course of pregnancy management and medical care provision, if yes, what kind and by whom, as well as the causal connection of the allowed omissions and/or errors with the unfavorable outcome, etc.

The number of repeated and additional examinations is also quite large. There are cases when during such examinations, conclusions are obtained that differ from the conclusions of the primary examination.

How in-demand is the profession of a forensic doctor?

We can conduct an objective analysis of the number of people wishing to obtain the profession of a forensic expert. The National Bureau of Expertise is the base for judicial medicine of the clinical residency of the National Institute of Health. I cannot consider the number of young specialists, doctors wishing to acquire specialties to be small.

Since 2019, the department has been operating, there is a certain number of applicants for clinical residency, 4, 3, 2 persons during the year, who have already received higher medical education. They apply, and if accepted, receive postgraduate narrow professional education. I think the interest of young doctors in this regard is great because we have a sufficient number of applicants.

I am pleased to note that young specialists who have completed clinical residency join both our staff and the staff of the Forensic Scientific and Practical Center of the Ministry of Health.

For years, the specialty has been of interest to male representatives, but in recent years, interest from female representatives has also been noticed.

At this moment, our 4 clinical residents receiving postgraduate education are female representatives.

Yevgenya Hambardzumyan