Table Of ContentSIMPSON’S FORENSIC
MEDICINE
Professor CEDRIC KEITH SIMPSON CBE (1907–1985) MD (Lond), FRCP,
FRCPath, MD (Gent), MA (Oxon), LLD (Edin), DMJ. Keith Simpson was the first
Professor of Forensic Medicine at the University of London and undoubtedly
one of the most eminent forensic pathologists of the twentieth century. He spent
all his professional life at Guy’s Hospital, and he became a household name
through his involvement in many notorious murder trials in Britain and over-
seas. He was made a Commander of the British Empire in 1975. He was a superb
teacher, through both the spoken and the printed word. The first edition of this
book appeared in 1947 and in 1958 won the Swiney Prize of the Royal Society of
Arts for being the best work on medical jurisprudence to appear in the preceding
ten years.
Professor Simpson updated this book for seven further editions. Professor
Bernard Knight worked with him on the ninth edition and, after Professor
Simpson’s death in 1985, updated the text for the tenth and eleventh editions.
Richard Shepherd updated Simpson’s Forensic Medicine for its twelfth edition
in 2003. Jason Payne-James and Richard Jones have updated the 13th and this
edition.
SIMPSON’S FORENSIC
MEDICINE
14th Edition
Edited by
Professor Jason Payne-James,
LLM, MSc, FFFLM, FRCS,
FRCP, FCSFS, RCPathME, FFCFM(RCPA), DFM, LBIPP, Mediator
Specialist in Forensic & Legal Medicine & Consultant Forensic Physician
Honorary Clinical Professor, William Harvey Research Institute
Queen Mary University of London
Consultant Editor-in-Chief, Journal of Forensic & Legal Medicine
Lead Medical Examiner, Norfolk & Norwich University
Hospital NHS Foundation Trust, Norwich
Director, Forensic Health Services Ltd, Southminster, United Kingdom
Richard Jones,
BSc(Hons), MBBS, PgCUTL, FRCPath, FHEA,
MCIEH, MFFLM, MRSPH
Clinical Senior Lecturer in Forensic Pathology
Wales Institute of Forensic Medicine
Cardiff University School of Medicine
College of Biomedical and Life Sciences, Cardiff
Home Office-Registered Forensic Pathologist,
Honorary Consultant Forensic Pathologist
Cardiff and Vale University Health Board, Cardiff, United Kingdom
iv
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Library of Congress Cataloging-in-Publication Data
Names: Payne-James, Jason (Forensic physician), editor. | Jones, Richard (Forensic pathologist), editor.
Title: Simpson’s forensic medicine / edited by Professor Jason Payne-James and Dr. Richard Jones.
Other titles: Forensic medicine
Description: 14e. | Boca Raton : CRC Press, 2019. | Preceded by Simpson’s forensic medicine / Jason Payne-James
… [et al.]. 13th ed. c2011. |
Includes bibliographical references and index.
Identifiers: LCCN 2019014218| ISBN 9781498704298 (pbk. : alk. paper) | ISBN 9780367333195 (hardback : alk.
paper) | ISBN 9781315157054 (ebook)
Subjects: | MESH: Forensic Medicine
Classification: LCC RA1051 | NLM W 700 | DDC 614/.1--dc23
LC record available at https://lccn.loc.gov/2019014218
Visit the Taylor & Francis Web site at
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Contents
About the authors vii 14 Identification of the living and the dead 198
Contributors viii
15 Restraint and control techniques 208
Preface ix
Acknowledgements x 16 Police custodial healthcare 217
17 Sexual assault, genitoanal injury and
1 Principles of forensic practice 1 female genital mutilation 229
2 The ethics of medical practice 13 18 Safeguarding and protection
of children and vulnerable adults 244
3 Medicolegal aspects of death 30
19 Transportation medicine 257
4 Violence in society, medicolegal
investigation of death and the autopsy 40 20 Torture and cruel, inhuman and degrading
t reatment 271
5 The appearance of the body after death 55
21 Principles of forensic science and crime
6 Death from natural causes 69
scene investigation 276
7 Deaths and injury in infancy 83
22 Principles of toxicology 295
8 Assessment, classification and
23 Alcohol 302
d ocumentation of injury 105
24 Licit and illicit drugs 307
9 Ballistic injuries 133
25 Medicinal poisons 321
10 Regional injuries and patterns of injury 149
26 Miscellaneous poisons 325
11 Pressure to the neck and asphyxia deaths 162
12 Heat, cold and electrical trauma 177 Index 333
13 Immersion and drowning 191
v
About the authors
Jason Payne-James and co-edited a large number of internationally
is an independent recognised publications including the first and
Specialist in Forensic second editions of the Encyclopaedia of Forensic
and Legal Medicine and Legal Medicine; Forensic Medicine: Clinical
with a range of and Pathological Aspects; Symptoms and Signs of
research and clini- Substance Misuse (1st, 2nd and 3rd editions); he co-
cal interests. From authored the Oxford Handbook of Forensic Medicine
a clinical perspec- and co-edited Age Estimation in the Living and Current
tive, Jason has been Practice in Forensic Medicine (1st and Volumes);
a forensic physician and Monitoring Detention, Custody, Torture and
for almost three Ill-treatment. He designed the ForensiGraph and the
decades. Previously, ForensiDoc App.
he worked in hospital
medicine, predomi-
nantly in surgical, Richard Jones is a
trauma and gastroenterological specialties. He taught forensic pathologist
anatomy at the London Hospital Medical College. His with a particular
interests include injury, wound and scar documenta- interest in education,
tion and interpretation, imaging of injury and scars, and is a Fellow of the
clinical and ethical aspects of healthcare in custody, Higher Education
complaints against healthcare professionals, forensic Academy. He is com-
evidence collection, restraint and less-lethal systems, mitted to providing
miscarriages of justice, harm and death in custody and educational materi-
torture. als in forensic sci-
He has published on a wide range of subjects includ- ence, medicine and
ing healthcare in custody, torture, death in custody, pathology to a broad
use-of-force, TASER photo-documentation and irri- audience online,
tant spray. He acts an expert witness in these areas in including via a web-
the UK and overseas. Jason was President of the Faculty site ‘Forensic Medicine for Medical Students’ www.
of Forensic & Legal Medicine of the Royal College of forensicmed.co.uk. In addition to co-authoring the
Physicians (2015–2017); Present of the World Police 13th Edition of Simpson’s Forensic Medicine he has
Medical Officers (2011–2014); he is Honorary Clinical published peer-reviewed articles in the forensic med-
Professor at the William Harvey Research Institute, ical literature, including on the development of teach-
Queen Mary University of London; external Consultant ing for medical students on safeguarding vulnerable
to the UK National Crime Agency and National Injuries patients at risk of abuse or neglect, and complexity in
Database; Consultant Editor-in-Chief of the ‘Journal of forensic pathology. As a UK Home Office-accredited
Forensic & Legal Medicine’; Member of the Executive forensic pathologist, he attends scenes of suspicious
Committee of the European Council of Legal Medicine; deaths, and performs medico-legal autopsies for
Visiting Professor at the University of Belgrade, Serbia. police authorities and coroners. He is a member of the
He is an independent member of the Scientific Advisory Training and Education Subcommittee of the Faculty
Committee on the Medical Implications of Less-Lethal of Forensic & Legal Medicine of the Royal College
Weapons. He is a member of the International Forensic of Physicians, and was a UK Consulting Editor/
Expert Group of the International Rehabilitation Editorial Board Member of Medicine, Science and the
Council for Torture Victims. Law (2011–2017). He was a Specialist Reviewer for the
In addition to this, and the 13th Edition of Welsh Child Protection Systematic Review Group
Simpson’s Forensic Medicine, Jason has co-authored (2006–2013).
vii
Contributors
Soren Blau PhD Andrew Parry BSc (Hons)
Senior Forensic Anthropologist Senior Reporting Forensic Scientist
Victorian Institute of Forensic Medicine Cellmark Forensic Services
Melbourne, Australia Abingdon, UK
Romina Carabott Sabine Maguire
Forensic Odontologist Honorary Lecturer
Formerly of Expert Forensics Ltd Division of Population Medicine
Cardiff Medicentre School of Medicine
Heath Park Cardiff University
Cardiff, UK Cardiff, UK
Sam Evans Denise Syndercombe-Court
Chief Photographer Professor of Forensic Genetics
School of Dentistry Department of Analytical, Environmental and
College of Biomedical & Life Sciences Forensic Sciences
Cardiff University King’s College London
Heath Park Franklin-Wilkins Building
Cardiff, UK London, UK
Tina Lovelock CChem FRSC MCSFS
Interpretation Lead, Chemistry Lead
& Senior Reporting Forensic Scientist
Cellmark Forensic Services
Abingdon, UK
viii
Preface
The broad range of subjects embraced by the terms This, the 14th edition of Simpson’s Forensic Medicine,
‘forensic medicine’ since the first edition of Keith has been revised to assist all those groups; not merely
Simpson’s eponymous Forensic Medicine was published doctors and other healthcare professionals. We hope
in 1947 has expanded considerably. Most forensic prac- it provides a solid introduction and background to the
titioners from any background will, at some stage, be principles of practice for those embarking on careers in
asked ‘have you cut up any dead bodies recently?’ as forensic settings, for those in practice and for those who
there remains a belief that this is the main function of may not be from a forensic background but whose daily
those working in forensic medicine. In practice, how- workload brings them into contact with situations that
ever, the pathological side of forensic medicine is small require an awareness of such matters. This probably
compared to the number and workload of those work- applies to most healthcare professionals.
ing in the clinical (living) aspects of forensic medicine. Within this edition, each chapter provides recom-
The fields of safeguarding, insurance medicine, and mendations to access more detailed information about
refugee medicine, for example, could be considered a subject, whether online, as peer-reviewed journal
to be aspects of ‘forensic medicine’. There is a general articles, or substantive publications. We hope this
move to capture this trend by referring to either ‘foren- edition of Simpson’s will encourage readers to further
sic & legal medicine’ or ‘legal & forensic medicine’. The explore the world of forensic medicine and its many fac-
terms are interchangeable but reflect the general view ets. We all work within multiprofessional settings, and
that this is a defined and extensive area of medicine in forensic terms, each of us provides a small piece of
that warrants its own specialty status, on a par with all the jigsaw in the investigation and resolution of a case.
other mainstream specialties. Whatever the specialty It is, therefore, essential to have a good awareness of
is called, doctors and other healthcare professionals the roles and limitations of our knowledge base, and
working in these areas need to have a basic knowledge when and where we should defer to other colleagues.
and understanding of medical ethical principles, of rel- Although the perspective provided in this book is gen-
evant law and the many aspects of forensic science. This erally from the point of view of a doctor, we hope we
we hope to provide. have identified common issues for all practitioners. We
Earlier editions of Simpson’s have been directed know our readership originates from a variety of differ-
predominantly at a medical readership. This has now ent countries and contrasting legal systems. Examples
changed as forensic disciplines have expanded and that we provide of relevant regulations, law, codes and
the role of forensic medicine and sciences has grown. practice will, of necessity, predominantly be derived
Much of this growth is related to a greater public aware- from the England & Wales jurisdictions. However, every
ness of the essential roles that these disciplines play in reader must make themselves familiar with those that
a fair justice system. Although forensic medicine has apply within their own professional setting, their own
a long history of involvement with the criminal justice country and their own jurisdiction. We also strongly
systems, this role has also been extended into many advise, in an age when many guidance documents are
parts of the civil justice system including family law. kept online as evolving and developing resources, to
This has been accompanied by a dramatic growth in check always that you are using the most up-to-date
undergraduate and postgraduate courses with a foren- version.
sic element. It is crucial that students and practitioners Any mistakes or misinterpretations are those of the
in such settings are able to understand how their area authors who will happily receive comment and criti-
of work or study interrelates and interacts with others cism on any aspect of the content. We hope that readers
in different settings. Whether one is a budding foren- will find that this new edition of Keith Simpson’s classic
sic practitioner, law enforcement officer, healthcare text addresses your needs.
professional, lawyer, or someone who, by the nature Jason Payne-James
of their work, will at some stage (like it or not) become Richard Jones
involved in forensic matters, there is an increasing need September 2019
to be aware of, and understand, the basics of forensic
medicine and how it relates to the other specialties.
ix
