When the Hidden Issue of Elder Abuse Leads to Death

Mazzotti, Matteo; Fais, Paolo; Amadasi, Alberto; Pelletti, Guido; Giovannini, Elena; Giorgetti, Arianna; Pelotti, Susi

doi:10.1097/paf.0000000000000700

Cited by 5 publications

(1 citation statement)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, not surprisingly, in most cases the home was the place where death from non-natural causes of minors occurred. This finding is fully consistent with the fact that the home is very often the place where direct or indirect violence is perpetrated against minors [ 2 ], as is also the case for other vulnerable population groups, such as the elderly [ 20 , 21 ] or women [ 22 ].…”

Section: Discussionsupporting

confidence: 80%

Are autopsies on minors a taboo?: The experience of Milan in a 19-year retrospective study

Tambuzzi,

Crudele,

Maggioni

et al. 2023

Int J Legal Med

View full text Add to dashboard Cite

Forensic autopsy is an important tool for the proper management of non-natural deaths in minors. However, it seems that autopsy in minors is a practice which may not be performed routinely. In this framework, we conducted a study analyzing autopsies of minors (under 18 years of age in Italy) performed at the Institute of Forensic Medicine in Milan in the period 2001–2019. For the period 2015–2019, we extrapolated all deaths due to non-natural causes in minors to investigate how many and which of these deaths were not subjected to forensic autopsy. Of the total, 344 minors (235 males and 109 females) underwent autopsies, with an overall downward trend of about 80% since 2004. Most autopsies occurred between the ages of 0 and 1 year, and the fewest between the ages of 5 and 9 years. The place of death was home in most cases, and accidental death was most common, followed by natural death, suicide, and homicide, with prevalence varying by age group. Blunt force trauma predominated among accidental death in all age groups, followed by asphyxia. Similar findings were observed for suicides, although there was a more differentiated pattern for suicides between the ages of 15 and 17 years. Among homicides, blunt force trauma, asphyxia, and gunshot wounds were fairly evenly distributed across all age groups. Between 2015 and 2019, a total of 86 minors died of a non-natural cause, and a forensic autopsy was performed in only 33 cases (38%). Our data shows that fewer and fewer autopsies are being performed over the last years, which indicates a dangerous lack of forensic investigation of children and adolescent deaths, with enormous implications for prevention of child abuse.

show abstract

Section: Discussionsupporting

confidence: 80%

Are autopsies on minors a taboo?: The experience of Milan in a 19-year retrospective study

Tambuzzi,

Crudele,

Maggioni

et al. 2023

Int J Legal Med

View full text Add to dashboard Cite

show abstract

How to prove neglect in the context of the post-mortem examination

Lutz

Klinger

Holz

et al. 2023

Forensic Sci Med Pathol

View full text Add to dashboard Cite

Understanding the causes, extent, and period of neglect is not only a medical but also a forensic task when it comes to legal investigations. In this study, we evaluated 46 autopsied cases where there was clear evidence of physical neglect during the last period of the deceased’s life. The age of the deceased ranged from 21 to 96 years; most of them were female (71.7%). The majority of cases (89.9%) took place in a domestic environment, with partners or relatives providing care. The most frequent post-mortem findings were pressure sores, followed by inflammatory skin changes, and signs of malnutrition and dehydration. Neglect was the cause or co-cause of death in 23% of the cases. More than half of the deceased showed severe contamination of the skin surface by excrement, and in almost 40% of the cases, fly infestation was found. The majority of insects belonged to the group of house flies (Diptera: Muscidae), mainly the common house fly, Musca domestica. By analyzing the entomological evidence, it was possible to prove an insect infestation period of at least several days ante-mortem. Since the period of neglect may be relevant in terms of legal proceedings, the present work demonstrates the particular importance of insect traces in providing this evidence. While prosecution and conviction of caregivers remain challenging, it is all the more essential that entomology and legal medicine collaborate on the analysis of findings of neglect.

show abstract