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WPMO Conference Report 2002
Journal of Clinical Forensic Medicine (2002) 9, 107108 doi: 10.1054/jcfm.2002.0560, available online at http://www.idealibrary.com on
CONFERENCE REPORT
WPMO Conference Report 2002 The Sixth International Conference in Clinical Forensic Medicine of the World Police Medical Of®cers was held in Sydney, Australia between 17th and 22nd March 2002. The city of Sydney was a spectacular location for a conference under the Presidency of Dr William Ryan and Co-Chaired by his wife Dr Patricia Ryan. The conference had delegates from 16 countries and the programme was made up of keynote presentations, invited speakers, specialist sessions, original research papers and poster presentations. On the ®rst day of the conference Bill Ryan introduced the NSW Police Commissioner Peter Ryan who welcomed the delegates to Sydney and formally opened the conference. The ®rst session was chaired by Professor Eric Baccino, current President of the International Academy of Forensic Sciences (see Diary Dates). The keynote presentations were given by Chief Justice JH Phillips QC, Chair of the Board of Control of the National Institute of Forensic Science in Victoria, who spoke of his vision of forensic science in Australia in 2025 and Mr Nicholas Cowdery the Director of Public Prosecutions in NSW. He gave a detailed explanation of the usefulness of DNA technology and spoke of the establishment of the Innocence Panel in NSW looking at DNA evidence. Specialist sessions included: Importation ± of drugs and people, the latter a very topical subject in Australia; Xenografting in Clinical Organ Transplantation; Disaster Victim Identi®cation and Terrorism; Ethics and Practice at Autopsy; Fire Investigation; Sex Crimes and the Internet; Driving and the Law and Nanotechnology. It is impossible here to detail all the information at the conference but I shall highlight a number of papers which were of particular interest and/or relevance to clinical forensic practitioners. Dr David Wells from the Victorian Institute of Forensic Medicine spoke of the need to increase the number of practitioners utilising postgraduate programmes and to develop a continuing education programme ideally internationally, shared by practitioners in other forensic specialities. He also said that the Journal of Clinical Forensic Medicine was a very important resource in the ®eld. There was a need for more original research
papers to be submitted and forensic practitioners must support the Journal in this way. Dr Michael Knight gave an overview of the changes to the police surgeon services in the United Kingdom in recent years noting how it will not be possible to evaluate the success or failure of the various schemes for some time. Furthermore direct comparisons will always be very dif®cult and made more so by a forces' view of the merits or otherwise of its own system and the inherent need for self-justi®cation of the choice of that system. Dr Michael Peel spoke of the increasing number of requests for doctors and other health care professionals to documents allegations of torture. He reminded us once more of the importance of a thorough history, allowing the doctor to associate physical ®ndings with the history, and the consistency between the two. It is reasonable to assume that in most women who have been tortured there has been a sexual aspect to their torture and he quoted his recent research where 25% of men who had been tortured had been sexually assaulted during their detention and about 5% had been raped. The health implications of people-smuggling presented by Dr Smith from the NSW refugee health service discussed the transit factors such as the unhealthy environment in which they are smuggled, the risks of the transport methods and other factors such as dehydration and lack of food. On arrival persons smuggled are, of course, of illegal status and vulnerable. Open to exploitation with lack of access to health care. There are also risks to the host community in that formal health checks are by-passed and the introduction of exotic diseases is a potential concern. Federal Agent Shane Castles presented the Australia Federal Police's response to illicit drug importation into Australia. There is at present a shortage of heroin in Australia in part because of the ``Afghan Roller Coaster''. This has resulted in higher prices, decreased availability and purity, decrease in large seizures by the police although an increase in smaller seizures. There has been a partial replacement of heroin with cocaine and other drugs and increased entry into treatment programmes with a decrease in criminal activity. He stated that Australia was 107
108
Journal of Clinical Forensic Medicine
probably alone in this situation of heroin shortage and compared it directly with the UK where the heroin price is low, with high availability and a large number of deaths from overdose. Meanwhile cocaine overproduction world wide has resulted in an increase in cocaine consumption in Australia with easy availability in Sydney. Dr Matt Ryan from the Victorian Institute of Forensic Medicine posed the question ``Do resuscitation attempts in children who die, cause injury?''. He concluded that although minor injuries such as bruises and abrasions are common, serious injury is extremely rare. Dr Guy Norfolk from Bristol showed videos of three cases where the CCTV recordings have proved vital in resolving investigations into two separate deaths in custody and the medical assessment of a detainee's ®tness to be interviewed. The role of the Sexual Assault Nurse Examiner (SANE) was presented by Dr Taylor from the University of Hong Kong Department of Nursing Studies. She described how the interview by a nurse may be carried out with police and prosecutor present in high pro®le cases and explained the training of the nurses. Dr Cathy Lincoln from the Sexual Assault Resource Centre (SARC) in Perth discussed the use of alternative light sources to identify biological ¯uids and suggested that the variation in ¯uorescence amongst biological ¯uids may be useful to differentiate forensically useful ¯uids in clinical forensic practice. There was a presentation from Mr Mark Beltchev relating to the custodial nursing service with the Victoria Police which was set up in August 1998. In September 2001 plans were made to extend the scope of the nursing practice with Nurse Practitioner Pilots. All the nurse involved are highly experienced (15 years post registration) and the Nurse Practitioner has been de®ned as ``... a registered nurse educated for advanced practice who is an essential member of an interdependent health care team and whose role is determined by the context in which he/she practices.'' The intention is not to replace doctors but to provide better care and better health outcomes. Part of the problem is the medical practitioners in Victoria have private practices which makes it dif®cult for them to travel from their practice to attend to the ``clients''. Obviously a different scenario to the ``immediately contactable and available to attend'' on-call forensic medical examiners now seen in many areas of the UK. The nursing teams currently working in the UK in the police custodial situation may bene®t from looking at the Australian experience. There were a number of interesting papers on substance misuse. Dr Robin Moffat reminded us of the dangers of promiscuous prescribing of controlled
drugs. This author discussed the forensic aspects of substance misuse from a UK perspective highlighting that a careful and well-documented history and examination including of the mental state are essential to try to establish the degree of substance misuse and/or dependence in order to provide safe and effective care for the detainee. The results of the recent UK government sponsored research into the in¯uence of cannabis and alcohol on driving were presented with a discussion of the pros and cons of setting criteria for a condition and impairment. The Custodial Medicine Unit of the Victoria Police manages the health care of prisoners in police custody. Over 1800 consultations annually are for drug and alcohol problems. Dr Blaher presented their research into best practice of these problems and the subsequent production of guidelines and protocols for the staff on the management of drug and alcohol withdrawal stressing how important it is to be consistent in the management of substance misuse detainees in custody. Ms Petroulias presented more detail of ``The Custodial Drug Guide: Medical Management of People in Custody with Alcohol and Drug Problems (2001)''. Professor Helen Whitwell suggested that the use of the term ``shaken baby syndrome'' needed reevaluation. Recent research ®ndings have raised issues which need exploration. The absence of diffuse axonal injury suggests that re-evaluation of the force necessary to produce brain damage is required. The social programme, always an essential part of any conference, was excellent. Starting with a reception at the hotel on Sunday evening, followed by a reception with the Honourable Michael Costa, Minister for Police, on the Monday evening with spectacular views over the harbour, and ending with the conference dinner on the Friday where it was announced that the next WPMO President is Dr David McLay who will host the conference in Dunblane, Scotland, in 2005. Conferences are a great way to see the world. In recent years in the quest for knowledge (!) I have visited New York and San Francisco (AAFS), Harrogate, North Yorkshire, Vancouver and Sydney (WPMO) and Darwin (AAPAPMO). The next major conference is the IAFS meeting in Montpellier where the APS will be holding the Autumn Symposium on Friday 6th September 2002. MARGARET M STARK President Elect of the Association of Police Surgeons Epsom, UK
CONFERENCE REPORT
WPMO Conference Report 2002 The Sixth International Conference in Clinical Forensic Medicine of the World Police Medical Of®cers was held in Sydney, Australia between 17th and 22nd March 2002. The city of Sydney was a spectacular location for a conference under the Presidency of Dr William Ryan and Co-Chaired by his wife Dr Patricia Ryan. The conference had delegates from 16 countries and the programme was made up of keynote presentations, invited speakers, specialist sessions, original research papers and poster presentations. On the ®rst day of the conference Bill Ryan introduced the NSW Police Commissioner Peter Ryan who welcomed the delegates to Sydney and formally opened the conference. The ®rst session was chaired by Professor Eric Baccino, current President of the International Academy of Forensic Sciences (see Diary Dates). The keynote presentations were given by Chief Justice JH Phillips QC, Chair of the Board of Control of the National Institute of Forensic Science in Victoria, who spoke of his vision of forensic science in Australia in 2025 and Mr Nicholas Cowdery the Director of Public Prosecutions in NSW. He gave a detailed explanation of the usefulness of DNA technology and spoke of the establishment of the Innocence Panel in NSW looking at DNA evidence. Specialist sessions included: Importation ± of drugs and people, the latter a very topical subject in Australia; Xenografting in Clinical Organ Transplantation; Disaster Victim Identi®cation and Terrorism; Ethics and Practice at Autopsy; Fire Investigation; Sex Crimes and the Internet; Driving and the Law and Nanotechnology. It is impossible here to detail all the information at the conference but I shall highlight a number of papers which were of particular interest and/or relevance to clinical forensic practitioners. Dr David Wells from the Victorian Institute of Forensic Medicine spoke of the need to increase the number of practitioners utilising postgraduate programmes and to develop a continuing education programme ideally internationally, shared by practitioners in other forensic specialities. He also said that the Journal of Clinical Forensic Medicine was a very important resource in the ®eld. There was a need for more original research
papers to be submitted and forensic practitioners must support the Journal in this way. Dr Michael Knight gave an overview of the changes to the police surgeon services in the United Kingdom in recent years noting how it will not be possible to evaluate the success or failure of the various schemes for some time. Furthermore direct comparisons will always be very dif®cult and made more so by a forces' view of the merits or otherwise of its own system and the inherent need for self-justi®cation of the choice of that system. Dr Michael Peel spoke of the increasing number of requests for doctors and other health care professionals to documents allegations of torture. He reminded us once more of the importance of a thorough history, allowing the doctor to associate physical ®ndings with the history, and the consistency between the two. It is reasonable to assume that in most women who have been tortured there has been a sexual aspect to their torture and he quoted his recent research where 25% of men who had been tortured had been sexually assaulted during their detention and about 5% had been raped. The health implications of people-smuggling presented by Dr Smith from the NSW refugee health service discussed the transit factors such as the unhealthy environment in which they are smuggled, the risks of the transport methods and other factors such as dehydration and lack of food. On arrival persons smuggled are, of course, of illegal status and vulnerable. Open to exploitation with lack of access to health care. There are also risks to the host community in that formal health checks are by-passed and the introduction of exotic diseases is a potential concern. Federal Agent Shane Castles presented the Australia Federal Police's response to illicit drug importation into Australia. There is at present a shortage of heroin in Australia in part because of the ``Afghan Roller Coaster''. This has resulted in higher prices, decreased availability and purity, decrease in large seizures by the police although an increase in smaller seizures. There has been a partial replacement of heroin with cocaine and other drugs and increased entry into treatment programmes with a decrease in criminal activity. He stated that Australia was 107
108
Journal of Clinical Forensic Medicine
probably alone in this situation of heroin shortage and compared it directly with the UK where the heroin price is low, with high availability and a large number of deaths from overdose. Meanwhile cocaine overproduction world wide has resulted in an increase in cocaine consumption in Australia with easy availability in Sydney. Dr Matt Ryan from the Victorian Institute of Forensic Medicine posed the question ``Do resuscitation attempts in children who die, cause injury?''. He concluded that although minor injuries such as bruises and abrasions are common, serious injury is extremely rare. Dr Guy Norfolk from Bristol showed videos of three cases where the CCTV recordings have proved vital in resolving investigations into two separate deaths in custody and the medical assessment of a detainee's ®tness to be interviewed. The role of the Sexual Assault Nurse Examiner (SANE) was presented by Dr Taylor from the University of Hong Kong Department of Nursing Studies. She described how the interview by a nurse may be carried out with police and prosecutor present in high pro®le cases and explained the training of the nurses. Dr Cathy Lincoln from the Sexual Assault Resource Centre (SARC) in Perth discussed the use of alternative light sources to identify biological ¯uids and suggested that the variation in ¯uorescence amongst biological ¯uids may be useful to differentiate forensically useful ¯uids in clinical forensic practice. There was a presentation from Mr Mark Beltchev relating to the custodial nursing service with the Victoria Police which was set up in August 1998. In September 2001 plans were made to extend the scope of the nursing practice with Nurse Practitioner Pilots. All the nurse involved are highly experienced (15 years post registration) and the Nurse Practitioner has been de®ned as ``... a registered nurse educated for advanced practice who is an essential member of an interdependent health care team and whose role is determined by the context in which he/she practices.'' The intention is not to replace doctors but to provide better care and better health outcomes. Part of the problem is the medical practitioners in Victoria have private practices which makes it dif®cult for them to travel from their practice to attend to the ``clients''. Obviously a different scenario to the ``immediately contactable and available to attend'' on-call forensic medical examiners now seen in many areas of the UK. The nursing teams currently working in the UK in the police custodial situation may bene®t from looking at the Australian experience. There were a number of interesting papers on substance misuse. Dr Robin Moffat reminded us of the dangers of promiscuous prescribing of controlled
drugs. This author discussed the forensic aspects of substance misuse from a UK perspective highlighting that a careful and well-documented history and examination including of the mental state are essential to try to establish the degree of substance misuse and/or dependence in order to provide safe and effective care for the detainee. The results of the recent UK government sponsored research into the in¯uence of cannabis and alcohol on driving were presented with a discussion of the pros and cons of setting criteria for a condition and impairment. The Custodial Medicine Unit of the Victoria Police manages the health care of prisoners in police custody. Over 1800 consultations annually are for drug and alcohol problems. Dr Blaher presented their research into best practice of these problems and the subsequent production of guidelines and protocols for the staff on the management of drug and alcohol withdrawal stressing how important it is to be consistent in the management of substance misuse detainees in custody. Ms Petroulias presented more detail of ``The Custodial Drug Guide: Medical Management of People in Custody with Alcohol and Drug Problems (2001)''. Professor Helen Whitwell suggested that the use of the term ``shaken baby syndrome'' needed reevaluation. Recent research ®ndings have raised issues which need exploration. The absence of diffuse axonal injury suggests that re-evaluation of the force necessary to produce brain damage is required. The social programme, always an essential part of any conference, was excellent. Starting with a reception at the hotel on Sunday evening, followed by a reception with the Honourable Michael Costa, Minister for Police, on the Monday evening with spectacular views over the harbour, and ending with the conference dinner on the Friday where it was announced that the next WPMO President is Dr David McLay who will host the conference in Dunblane, Scotland, in 2005. Conferences are a great way to see the world. In recent years in the quest for knowledge (!) I have visited New York and San Francisco (AAFS), Harrogate, North Yorkshire, Vancouver and Sydney (WPMO) and Darwin (AAPAPMO). The next major conference is the IAFS meeting in Montpellier where the APS will be holding the Autumn Symposium on Friday 6th September 2002. MARGARET M STARK President Elect of the Association of Police Surgeons Epsom, UK