Læknablaðið - 15.03.1980, Síða 41

LÆKN ABLADID
61
A. Keith Mant M.D.
THE ROLE OF THE PATHOLOGIST IN
THE INVESTIGATION OF ROAD TRAFFIC
ACCIDENTS *
Mr. Chairman, Ladies and Gentlemen,
I am indeed deeply conscious of the honour
you have accorded me by inviting me to
deliver the Niels Dungal Memorial Lecture.
The man to whose memory this lecture is
dedicated was a truly remarkable and versa-
tile pathologist, whose interests included,
amongst others, immunisation and the epide-
miology of malignancy. Although Professor
Dungal had no immediate forensic appoint-
ment I see from the previous list of lecturers
that I am, in fact, the third forensic pathologist
to be honoured, having been preceeded by my
old friends and colleagues, Professor Harald
Gormsen and Professor Jorgen Dalgaard.
Professor Dungal and I had one common
interest — the cultivation of orchids. I under-
stand that he was one of the very first to
culture orchids in Iceland.
What I am to say in my address is
essentially information I have gathered perso-
nally over some thirty-five years of forensic
pathology. There will not be a long biblio-
graphy as I am speaking mainly from per-
sonal experience and views.
I was asked to speak about some aspects of
road traffic accidents and I have chosen as my
subject »The Role of the Pathologist in the
Investigation of Road Traffic Accidents«. The
reason I have chosen this title is that I find
that in many parts of the world I visit, the
purpose of an autopsy examination upon a
fatal traffic casualty is believed to be unneces-
sary as it is considered that it provides no
useful information which could assist in the
overall investigation of the accident. In most
areas of the United Kingdom, and certainly in
the Greater London and Home Counties
region, a full autopsy examination is carried
out on every road fatality, irrespective of the
* Minningarfyrirlestur prófessors Níelsar Dungal, fluttur í
Háskóla íslands 27. júní 1979. A. Keith Mant er prófessor í
réttarlæknisfræöi við Lundúnaháskóla og starfar við Guy’s
Hospital. Erindið barst ritstjórn 15/09/1979, sent í prent —
smiðju 05/10/79.
age of the deceased or the circumstances of
the accident. A blood and urine alcohol
examination is performed as a routine in all
cases where the deceased is 14 years or over,
if death occurs within 12 hours of the accident.
Omitting proof of identity of the victim — a
problem which is outside the context af this
address — the purpose of the autopsy is to
ascertain:
(I) the cause of death;
(II) the presence of natural disease:
(III) the pattern of injuries;
(IV) thc presence of drugs and/or alcohol;
(V) the presence of traces of other scientific
evidence in hit-and-run cases.
The cause of death is obviously of prime
importance as the investigators must know
whether or not death was directly due to the
accident.
I shall first deal with the very important,
and often misunderstood, role of natural
disease in fatal road traffic accidents. Follow-
ing his autopsy examination a pathologist
must be prepared to give his opinion that if
natural disease were present did this disease
contribute to:
(I) the accident?
(II) death?
or, if the deceased had not been involved in
the accident, would the expectation of life be
shortened by this disease?
I learned very early in my professional
career that, although one examines a number
of persons every year who have died whilst
driving a vehicle, the driver frequently man-
aged to stop his vehicle or, if it were involved
in an accident, the injuries to the driver, his
vehicle or other property were usually mini-
mal. The chance of some other person being
injured as a result of this collapse was remote.
Some years ago much publicity was given in
the National Press to a fatal accident in which