GERECHTELIJKE GENEESKUNDE EN CRIMINALISTIEK
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1
,2
,1. JUSTITIE EN GENEESKUNDE...............................................................................................................................................15
1.1 JUSTITIE.............................................................................................................................................................................15
1.1.1 Het gerecht............................................................................................................................................................15
DE STRAFPROCEDURE .................................................................................................................................................. 16
NEDERLANDSTALIGE ARRONDISSEMENTEN:............................................................................................................... 16
1.1.2 Strafrecht...............................................................................................................................................................18
VERLOOP STRAFRECHTELIJK ONDERZOEK ................................................................................................................... 19
STRAFRECHTELIJK ONDERZOEK (STRAFRECHT = VERVOLGING VAN MISDRIJVEN, WIJ BETALEN DIT ONDERZOEK VIA
ONS BELASTINGGELD).................................................................................................................................................. 19
BURGERLIJK RECHT (BURGERLIJK RECHT = ELKE BURGER DIE SCHADE HEEFT GELEDEN (VAAK MATERIËLE) HEEFT
RECHT OP SCHADEVERGOEDING) ................................................................................................................................ 20
1.2 FORENSISCHE WETENSCHAPPEN/CRIMINALISTIEK.................................................................................................................21
1.2.1 Forensische wetenschappen ..............................................................................................................................21
FORENSISCHE WETENSCHAPPEN ................................................................................................................................. 21
1.2.2 Forensische geneeskunde ...................................................................................................................................22
Constitutio Criminalis Carolina .................................................................................................................................... 22
Taakomschrijving ......................................................................................................................................................... 22
Forensische medische wetenschappen ....................................................................................................................... 23
Forensische psychiatrie................................................................................................................................................ 23
1.3 UITOEFENEN VAN DE GENEESKUNDE ...................................................................................................................................24
1.3.1 Algemeen ...............................................................................................................................................................24
1.3.2 Beroepsgeheim.....................................................................................................................................................24
Spreekrecht in geval van .............................................................................................................................................. 25
Toepassing.................................................................................................................................................................... 26
1.3.3 Medische aansprakelijkheid ...............................................................................................................................26
1. Burgerrechtelijke aansprakelijkheid ........................................................................................................................ 27
2. Strafrechtelijke aansprakelijkheid............................................................................................................................ 27
3
,2. ONDERZOEK OVERLIJDEN ..................................................................................................................................................29
2.1 VOORAF ............................................................................................................................................................................29
2.1.1 Wetsarts en onderzoek overlijden.....................................................................................................................29
2.2 OVERLIJDEN IN BELGIË .......................................................................................................................................................29
2.2.1 Wetten ...................................................................................................................................................................29
Ambtenaar burgerlijke stand ....................................................................................................................................... 31
2.2.2 Ambtenaar burgerlijke stand .............................................................................................................................31
2.2.3 Vaststelling overlijden .........................................................................................................................................32
Begrippen ..................................................................................................................................................................... 33
Gerechtelijk-geneeskundig bezwaar tegen begrafenis of crematie? .......................................................................... 34
Verdacht/gewelddadig overlijden ............................................................................................................................... 34
Crematie: decreet lijkbezorging................................................................................................................................... 35
Tekortkomingen (gebrek aan kritische zin) ................................................................................................................. 35
Foutieve klassering – aard + oorzaak overlijden.......................................................................................................... 35
PRAKTIJKVOORBEELDEN (CASUÏSTIEK) ........................................................................................................................ 36
2.3 ONDERZOEK ‘VERDACHT’ OVERLIJDEN.................................................................................................................................36
Uitgangsvragen ............................................................................................................................................................ 36
Uitgangspunten............................................................................................................................................................ 36
Afstappingsparadox ..................................................................................................................................................... 37
2.4 FORENSISCH POST MORTEM ONDERZOEK ............................................................................................................................38
Principes forensisch pm onderzoek ............................................................................................................................. 39
Forensisch pm onderzoek ter plaatse.......................................................................................................................... 39
2.4.1 Medicolegaal onderzoek .....................................................................................................................................39
2.4.2 Uitwendige lijkbeschouwing ter plaatse ..........................................................................................................40
2.4.3 Autopsie = golden standard ...............................................................................................................................40
Gerechtelijke autopsie ................................................................................................................................................. 40
Inwendig onderzoek (autopsie) ................................................................................................................................... 40
aanvullende onderz oeken............................................................................................................................................ 41
2.4.4 Forensische postmortem-opdrachten ..............................................................................................................42
Forensisch nut van de autopsie ................................................................................................................................... 42
Autopsie-ratio .............................................................................................................................................................. 43
2.5 ONGEWOON STERFGEVAL ..................................................................................................................................................43
2.5.1 Ongewoon sterfgeval ..........................................................................................................................................43
2.5.2 Ongevallen (soort-, arbeids-, verkeers-, huis-…).............................................................................................44
Ongevallen vlaanderen ................................................................................................................................................ 45
2.5.3 Zelfdoding..............................................................................................................................................................45
Bijzondere zelfdodingen .............................................................................................................................................. 45
2.5.4 Doding (nullum crimen, nulla poene sine leg e) ..............................................................................................46
Statistiek: 1/5 TOT ¼ ONJUIST GEKLASSEERD.............................................................................................................. 46
Bijzondere situaties...................................................................................................................................................... 47
2.5.5 Diogenes syndroo m .............................................................................................................................................48
Plots/onverwacht/onverklaard overlijden................................................................................................................... 48
2.5.6 Plotse (cardiovasulaire) Dood (sudden adult death syndro me) ...................................................................48
Functionele hartdood .................................................................................................................................................. 48
Bijzondere situaties...................................................................................................................................................... 49
Plotse niet-cardiale dood ............................................................................................................................................. 49
SUDEP: schuimzwam.................................................................................................................................................... 50
SUD/SADS..................................................................................................................................................................... 50
Wiegendood (SUDDEN INFANT DEATH SYNDROME) .................................................................................................. 50
Wet van 26 maart 2003 ............................................................................................................................................... 51
KB 27 april 2007 (Art. 4) ............................................................................................................................................... 51
Onderzoek wiegendood ............................................................................................................................................... 52
Forensisch onderzoek ‘wiegendood’ ........................................................................................................................... 52
4
,3. THANA TOLOGIE ...................................................................................................................................................................53
3.1 DOOD EN STERVEN.............................................................................................................................................................53
Definitie........................................................................................................................................................................ 53
Doodsfasen................................................................................................................................................................... 53
Vitale functies .............................................................................................................................................................. 54
Hersenen ...................................................................................................................................................................... 54
Doodscriteria ................................................................................................................................................................ 54
Hersendood.................................................................................................................................................................. 55
3.2 POSTMORTEM VERANDERINGEN.........................................................................................................................................56
3.2.1 Lijkvlekken .............................................................................................................................................................56
Verplaatsbaar- & wegdrukbaarheid............................................................................................................................. 56
3.2.2 Lijkstijfheid ............................................................................................................................................................58
ATP-hypothese ............................................................................................................................................................. 58
Tijdsverloop.................................................................................................................................................................. 59
Beïnvloedende factoren............................................................................................................................................... 59
Info over ....................................................................................................................................................................... 60
3.2.2 Lijkafkoeling (centrale temperatuur) ................................................................................................................60
Lijkafkoeling ................................................................................................................................................................. 60
Methode van Henssge ................................................................................................................................................. 62
Andere veranderingen ................................................................................................................................................. 62
Elektrische en chemische spierprikkelbaarheid........................................................................................................... 63
3.2.3 Ontbinding (putrefactie) .....................................................................................................................................63
Beïnvloedende factoren............................................................................................................................................... 64
Entomologie ................................................................................................................................................................. 65
3.2.4 Diervraat................................................................................................................................................................66
Diervraat....................................................................................................................................................................... 66
Skelettering .................................................................................................................................................................. 67
3.2.4 Mummificatie .......................................................................................................................................................68
3.2.5 Adipocire................................................................................................................................................................68
5
,4. IDENTIFICA TIE ......................................................................................................................................................................69
4.1 A LGEMEEN ........................................................................................................................................................................69
4.1.1 Noodzaak van identificatie.................................................................................................................................69
4.1.2 Prinicpes van identificatie...................................................................................................................................69
4.1.3 Persoonsbeschrijving ...........................................................................................................................................69
Bijzondere hulpmiddelen ............................................................................................................................................. 70
4.2 W ETENSCHAPPELJKE METHODEN........................................................................................................................................71
4.3 IDENTIFICATIE-TYPES..........................................................................................................................................................72
4.4 RAMPEN – KENMERKEN .....................................................................................................................................................72
Interpol procedures ..................................................................................................................................................... 72
Standaardformulier interpol ........................................................................................................................................ 72
Vergelijking ante mortem – post mortem ................................................................................................................... 73
4.5 INDIVIDUELE IDENTIFICATIE.................................................................................................................................................74
Niet-criminele postmortem schade............................................................................................................................. 74
4.6 CRIMINELE MUTILATIE........................................................................................................................................................74
Criminele verdwijnign/ververging ............................................................................................................................... 74
Types van criminele mutilatie ...................................................................................................................................... 75
Criminele mutilatie: problemen................................................................................................................................... 76
4.9 VONDST VAN SKELET/BEENDEREN.......................................................................................................................................76
Geslacht........................................................................................................................................................................ 76
Leeftijd ......................................................................................................................................................................... 77
Odontologisch onderzoek (gebit) ................................................................................................................................ 77
4.9 FORENSISCH ONDERZOEK ‘VERDWIJNING’............................................................................................................................77
6
,5. ASFYXIE..................................................................................................................................................................................78
5.1 W AT .................................................................................................................................................................................78
5.2 KLASSIEKE ASFYXIETEKENS ..................................................................................................................................................79
5.3 VORMEN VAN ASFYXIE .......................................................................................................................................................80
5.3.1 Atmosferische verstikking...................................................................................................................................80
5.3.2 Mechanische verstikking: gestoorde O 2 -opname...........................................................................................80
5.3.3 Inwendige verstikking .........................................................................................................................................80
5.4 VERSTIKKINGSPROCES ........................................................................................................................................................80
5.4.1 Smoring ..................................................................................................................................................................81
5.4.2 Luchtwegenconstructie .......................................................................................................................................82
Oorzaken ...................................................................................................................................................................... 82
5.4.3 Versmachting ........................................................................................................................................................82
Aard overlijden............................................................................................................................................................. 83
Posturale asfyxie .......................................................................................................................................................... 83
5.4.4 Samendrukking van de hals ...............................................................................................................................83
Anatomie hals .............................................................................................................................................................. 84
5.5 MECHANISME OVERLIJDEN.................................................................................................................................................84
Armgrepen (restraint holds) ........................................................................................................................................ 85
5.5.1 Verhanging............................................................................................................................................................86
Fenomenen .................................................................................................................................................................. 86
Pathologie .................................................................................................................................................................... 86
Verhanging, snoerteken............................................................................................................................................... 87
Verhanging- vitale tekens ............................................................................................................................................ 87
Aard overlijden............................................................................................................................................................. 87
Onderzoek verhanging ................................................................................................................................................. 87
Bijzondere aandacht indienen ..................................................................................................................................... 88
5.5.2 Strangulatie...........................................................................................................................................................89
Jeu de foulard............................................................................................................................................................... 89
5.5.3 Wurging .................................................................................................................................................................89
5.5.4 Plotse dood en onder bedwang houden ..........................................................................................................90
Excited delirium ........................................................................................................................................................... 91
Conclusies..................................................................................................................................................................... 91
5.5.5 Auto-erotische asfyxie.........................................................................................................................................91
Parafilie/parafernalia ................................................................................................................................................... 92
5.5.6 Co-intoxicatie ........................................................................................................................................................92
CO-Hb % in bloed wordt bepaald door ........................................................................................................................ 93
CO-intoxicatie............................................................................................................................................................... 93
5.5.7 CN-intoxicatie .......................................................................................................................................................94
Mechanisme overlijden................................................................................................................................................ 94
Forensische aspecten................................................................................................................................................... 94
7
,6. WATERLIJK - VERDRINKING ...............................................................................................................................................95
6.1 A LGEMEEN WATERLIJK .......................................................................................................................................................95
6.1.1 kentekens van verblijf in water..........................................................................................................................95
6.1.2 Postmortale verschijnselen ................................................................................................................................96
6.1.3 Verblijfsduur in water..........................................................................................................................................96
6.2 EIGENLIJKE VERDRINKING ...................................................................................................................................................97
6.2.1 Verdrinkingspro ces: 5 fasen ...............................................................................................................................97
Fase III en verdrinkingstekens (typische verdrinking).................................................................................................. 98
6.2.2 Bloedveranderingen ............................................................................................................................................98
6.2.3 Droge verdrinking ................................................................................................................................................99
6.3 ONEIGENLIJKE VERDRINKEN (BADETOD) ........................................................................................................................... 100
6.3.1 Verdrinkingstekens ........................................................................................................................................... 100
6.3.2 Forensisch onderzo ek ....................................................................................................................................... 100
6.3.3 Diatomeeëntest ................................................................................................................................................. 101
6.3.4 Aard van overlijden ........................................................................................................................................... 101
Hoe verloopt forensisch onderzoek........................................................................................................................... 101
6.3.5 Casussen ............................................................................................................................................................. 102
Dood in badkamer...................................................................................................................................................... 103
8
,7. HITTE, BRA NDLIJK, ELEKTROCUTIE, KOUDE… .............................................................................................................. 104
7.1 HITTE, BRANDLIJK ........................................................................................................................................................... 104
7.1.1 Overhitting ......................................................................................................................................................... 104
7.1.2 Verbranding ....................................................................................................................................................... 104
BRANDWONDEN – ERNST.......................................................................................................................................... 105
BRANDWONDEN – GRAAD......................................................................................................................................... 105
CONTACTDUUR EN ERNST BRANDWONDEN ............................................................................................................. 106
UITGEBREIDHEID........................................................................................................................................................ 106
OVERLEVING IFV TBSA & LEEFTIJD............................................................................................................................. 107
7.1.3 Brandlijk- brandto rso ....................................................................................................................................... 107
VERLOOP VERKOLING BIJ 650 – 1000 °C.................................................................................................................... 108
DOODSOORZAAK....................................................................................................................................................... 109
DOODSOORZAAK (overlijden DOOR BRAND) ............................................................................................................ 109
Brandlijk: AARD VAN OVERLIJDEN ............................................................................................................................. 109
7.1.4 Forensisch onderzo ek brand ........................................................................................................................... 110
7.1.5 Fenomeen ‘brand’ ............................................................................................................................................. 110
VERLOOP WONINGBRAND......................................................................................................................................... 111
BRANDTEMPERATUREN ............................................................................................................................................. 111
BRANDOORZAKEN...................................................................................................................................................... 111
AARD BRAND.............................................................................................................................................................. 112
BRANDSTICHTING ...................................................................................................................................................... 112
Forensisch onderzoek brand...................................................................................................................................... 112
ONDEZOEK BRANDPLAATS......................................................................................................................................... 112
ONDERZOEK BRANDLIJK............................................................................................................................................. 113
BRANDLIJK – VITALE TEKENS...................................................................................................................................... 113
BRANDLIJK: BETEKENIS CO......................................................................................................................................... 113
7.2 EXPLOSIE........................................................................................................................................................................ 114
7.2.1 Definitieve ontploffing ..................................................................................................................................... 114
7.2.2 Drie componenten ............................................................................................................................................ 114
7.2.3 Type letsels bij explosie .................................................................................................................................... 115
7.2.4 Destructief trauma (disruptie) ........................................................................................................................ 115
7.2.5 Explosie-trauma (short distance-missile injury)........................................................................................... 115
7.3 ELEKTROCUTIE................................................................................................................................................................ 116
7.3.1 Factoren voor elektrocutie .............................................................................................................................. 116
7.3.2 Elektrische stroo m a = v / ω (wet van ohm) ................................................................................................. 117
7.3.3 Toepassing wet van ohm ................................................................................................................................. 117
7.3.4 Electrocutie ........................................................................................................................................................ 117
7.3.5 Aard overlijden .................................................................................................................................................. 118
7.3.6 Bliksem................................................................................................................................................................ 118
7.4 HYPOTHERMIE................................................................................................................................................................ 119
7.4.1 Thermoregulatie................................................................................................................................................ 119
7.4.2 Oorzaken ............................................................................................................................................................ 119
7.4.3 Mechanisme (fysiopathologie) ....................................................................................................................... 120
7.4.4 Letsels (pathologie)........................................................................................................................................... 120
7.4.5 Aard overlijden .................................................................................................................................................. 120
HIDE AND DIE-SYNDROOM ........................................................................................................................................ 121
9
, 8. FORENSISCHE TRAUMA TOLOGIE................................................................................................................................... 121
Dodingsmiddelen (cijfers België) .............................................................................................................................. 121
KRACHT → schade → letsel....................................................................................................................................... 122
Aard van de verwondingen (types) ............................................................................................................................ 122
Uitwendig vs. Inwendig trauma ................................................................................................................................. 123
Ernst van de verwondingen ....................................................................................................................................... 123
Trauma – mechanisme overlijden.............................................................................................................................. 124
Beoordeling ................................................................................................................................................................ 125
8.O.1 Stomp trauma ................................................................................................................................................... 126
Stompe letsels ............................................................................................................................................................ 127
8.1 OVERLIJDEN DOOR STOMP TRAUMA................................................................................................................................. 132
8.1.1 Schedelhersentrauma ...................................................................................................................................... 133
8.1.2 Differentiaal diagnose: geweld vs. val .......................................................................................................... 134
8.2 L OKALISATIE: HOEDRANDZONE (VAL ) ............................................................................................................................... 136
8.3 A ANTAL.......................................................................................................................................................................... 136
CCT bij val (hoofd in beweging) ................................................................................................................................. 137
CCT bij slag(en) : letsels op plaats van impact .......................................................................................................... 137
8.4 ‘VAL UIT HOOGTE’ .......................................................................................................................................................... 137
Plaats van primair impact .......................................................................................................................................... 139
8.4.1 Scherp trauma ................................................................................................................................................... 139
1. Snijwonde............................................................................................................................................................... 140
2. Steekwonde............................................................................................................................................................ 142
8.4.2 Half scherp trauma ........................................................................................................................................... 146
8.4.3 Schottrauma (ballistisch trauma)................................................................................................................... 147
1. Ballistiek - kogelpatroon ........................................................................................................................................ 148
2. Ballistiek – jachtpatroon ........................................................................................................................................ 157
FORENSISCH ONDERZOEK.......................................................................................................................................... 160
10
___________________________________________________________________________________________
1
,2
,1. JUSTITIE EN GENEESKUNDE...............................................................................................................................................15
1.1 JUSTITIE.............................................................................................................................................................................15
1.1.1 Het gerecht............................................................................................................................................................15
DE STRAFPROCEDURE .................................................................................................................................................. 16
NEDERLANDSTALIGE ARRONDISSEMENTEN:............................................................................................................... 16
1.1.2 Strafrecht...............................................................................................................................................................18
VERLOOP STRAFRECHTELIJK ONDERZOEK ................................................................................................................... 19
STRAFRECHTELIJK ONDERZOEK (STRAFRECHT = VERVOLGING VAN MISDRIJVEN, WIJ BETALEN DIT ONDERZOEK VIA
ONS BELASTINGGELD).................................................................................................................................................. 19
BURGERLIJK RECHT (BURGERLIJK RECHT = ELKE BURGER DIE SCHADE HEEFT GELEDEN (VAAK MATERIËLE) HEEFT
RECHT OP SCHADEVERGOEDING) ................................................................................................................................ 20
1.2 FORENSISCHE WETENSCHAPPEN/CRIMINALISTIEK.................................................................................................................21
1.2.1 Forensische wetenschappen ..............................................................................................................................21
FORENSISCHE WETENSCHAPPEN ................................................................................................................................. 21
1.2.2 Forensische geneeskunde ...................................................................................................................................22
Constitutio Criminalis Carolina .................................................................................................................................... 22
Taakomschrijving ......................................................................................................................................................... 22
Forensische medische wetenschappen ....................................................................................................................... 23
Forensische psychiatrie................................................................................................................................................ 23
1.3 UITOEFENEN VAN DE GENEESKUNDE ...................................................................................................................................24
1.3.1 Algemeen ...............................................................................................................................................................24
1.3.2 Beroepsgeheim.....................................................................................................................................................24
Spreekrecht in geval van .............................................................................................................................................. 25
Toepassing.................................................................................................................................................................... 26
1.3.3 Medische aansprakelijkheid ...............................................................................................................................26
1. Burgerrechtelijke aansprakelijkheid ........................................................................................................................ 27
2. Strafrechtelijke aansprakelijkheid............................................................................................................................ 27
3
,2. ONDERZOEK OVERLIJDEN ..................................................................................................................................................29
2.1 VOORAF ............................................................................................................................................................................29
2.1.1 Wetsarts en onderzoek overlijden.....................................................................................................................29
2.2 OVERLIJDEN IN BELGIË .......................................................................................................................................................29
2.2.1 Wetten ...................................................................................................................................................................29
Ambtenaar burgerlijke stand ....................................................................................................................................... 31
2.2.2 Ambtenaar burgerlijke stand .............................................................................................................................31
2.2.3 Vaststelling overlijden .........................................................................................................................................32
Begrippen ..................................................................................................................................................................... 33
Gerechtelijk-geneeskundig bezwaar tegen begrafenis of crematie? .......................................................................... 34
Verdacht/gewelddadig overlijden ............................................................................................................................... 34
Crematie: decreet lijkbezorging................................................................................................................................... 35
Tekortkomingen (gebrek aan kritische zin) ................................................................................................................. 35
Foutieve klassering – aard + oorzaak overlijden.......................................................................................................... 35
PRAKTIJKVOORBEELDEN (CASUÏSTIEK) ........................................................................................................................ 36
2.3 ONDERZOEK ‘VERDACHT’ OVERLIJDEN.................................................................................................................................36
Uitgangsvragen ............................................................................................................................................................ 36
Uitgangspunten............................................................................................................................................................ 36
Afstappingsparadox ..................................................................................................................................................... 37
2.4 FORENSISCH POST MORTEM ONDERZOEK ............................................................................................................................38
Principes forensisch pm onderzoek ............................................................................................................................. 39
Forensisch pm onderzoek ter plaatse.......................................................................................................................... 39
2.4.1 Medicolegaal onderzoek .....................................................................................................................................39
2.4.2 Uitwendige lijkbeschouwing ter plaatse ..........................................................................................................40
2.4.3 Autopsie = golden standard ...............................................................................................................................40
Gerechtelijke autopsie ................................................................................................................................................. 40
Inwendig onderzoek (autopsie) ................................................................................................................................... 40
aanvullende onderz oeken............................................................................................................................................ 41
2.4.4 Forensische postmortem-opdrachten ..............................................................................................................42
Forensisch nut van de autopsie ................................................................................................................................... 42
Autopsie-ratio .............................................................................................................................................................. 43
2.5 ONGEWOON STERFGEVAL ..................................................................................................................................................43
2.5.1 Ongewoon sterfgeval ..........................................................................................................................................43
2.5.2 Ongevallen (soort-, arbeids-, verkeers-, huis-…).............................................................................................44
Ongevallen vlaanderen ................................................................................................................................................ 45
2.5.3 Zelfdoding..............................................................................................................................................................45
Bijzondere zelfdodingen .............................................................................................................................................. 45
2.5.4 Doding (nullum crimen, nulla poene sine leg e) ..............................................................................................46
Statistiek: 1/5 TOT ¼ ONJUIST GEKLASSEERD.............................................................................................................. 46
Bijzondere situaties...................................................................................................................................................... 47
2.5.5 Diogenes syndroo m .............................................................................................................................................48
Plots/onverwacht/onverklaard overlijden................................................................................................................... 48
2.5.6 Plotse (cardiovasulaire) Dood (sudden adult death syndro me) ...................................................................48
Functionele hartdood .................................................................................................................................................. 48
Bijzondere situaties...................................................................................................................................................... 49
Plotse niet-cardiale dood ............................................................................................................................................. 49
SUDEP: schuimzwam.................................................................................................................................................... 50
SUD/SADS..................................................................................................................................................................... 50
Wiegendood (SUDDEN INFANT DEATH SYNDROME) .................................................................................................. 50
Wet van 26 maart 2003 ............................................................................................................................................... 51
KB 27 april 2007 (Art. 4) ............................................................................................................................................... 51
Onderzoek wiegendood ............................................................................................................................................... 52
Forensisch onderzoek ‘wiegendood’ ........................................................................................................................... 52
4
,3. THANA TOLOGIE ...................................................................................................................................................................53
3.1 DOOD EN STERVEN.............................................................................................................................................................53
Definitie........................................................................................................................................................................ 53
Doodsfasen................................................................................................................................................................... 53
Vitale functies .............................................................................................................................................................. 54
Hersenen ...................................................................................................................................................................... 54
Doodscriteria ................................................................................................................................................................ 54
Hersendood.................................................................................................................................................................. 55
3.2 POSTMORTEM VERANDERINGEN.........................................................................................................................................56
3.2.1 Lijkvlekken .............................................................................................................................................................56
Verplaatsbaar- & wegdrukbaarheid............................................................................................................................. 56
3.2.2 Lijkstijfheid ............................................................................................................................................................58
ATP-hypothese ............................................................................................................................................................. 58
Tijdsverloop.................................................................................................................................................................. 59
Beïnvloedende factoren............................................................................................................................................... 59
Info over ....................................................................................................................................................................... 60
3.2.2 Lijkafkoeling (centrale temperatuur) ................................................................................................................60
Lijkafkoeling ................................................................................................................................................................. 60
Methode van Henssge ................................................................................................................................................. 62
Andere veranderingen ................................................................................................................................................. 62
Elektrische en chemische spierprikkelbaarheid........................................................................................................... 63
3.2.3 Ontbinding (putrefactie) .....................................................................................................................................63
Beïnvloedende factoren............................................................................................................................................... 64
Entomologie ................................................................................................................................................................. 65
3.2.4 Diervraat................................................................................................................................................................66
Diervraat....................................................................................................................................................................... 66
Skelettering .................................................................................................................................................................. 67
3.2.4 Mummificatie .......................................................................................................................................................68
3.2.5 Adipocire................................................................................................................................................................68
5
,4. IDENTIFICA TIE ......................................................................................................................................................................69
4.1 A LGEMEEN ........................................................................................................................................................................69
4.1.1 Noodzaak van identificatie.................................................................................................................................69
4.1.2 Prinicpes van identificatie...................................................................................................................................69
4.1.3 Persoonsbeschrijving ...........................................................................................................................................69
Bijzondere hulpmiddelen ............................................................................................................................................. 70
4.2 W ETENSCHAPPELJKE METHODEN........................................................................................................................................71
4.3 IDENTIFICATIE-TYPES..........................................................................................................................................................72
4.4 RAMPEN – KENMERKEN .....................................................................................................................................................72
Interpol procedures ..................................................................................................................................................... 72
Standaardformulier interpol ........................................................................................................................................ 72
Vergelijking ante mortem – post mortem ................................................................................................................... 73
4.5 INDIVIDUELE IDENTIFICATIE.................................................................................................................................................74
Niet-criminele postmortem schade............................................................................................................................. 74
4.6 CRIMINELE MUTILATIE........................................................................................................................................................74
Criminele verdwijnign/ververging ............................................................................................................................... 74
Types van criminele mutilatie ...................................................................................................................................... 75
Criminele mutilatie: problemen................................................................................................................................... 76
4.9 VONDST VAN SKELET/BEENDEREN.......................................................................................................................................76
Geslacht........................................................................................................................................................................ 76
Leeftijd ......................................................................................................................................................................... 77
Odontologisch onderzoek (gebit) ................................................................................................................................ 77
4.9 FORENSISCH ONDERZOEK ‘VERDWIJNING’............................................................................................................................77
6
,5. ASFYXIE..................................................................................................................................................................................78
5.1 W AT .................................................................................................................................................................................78
5.2 KLASSIEKE ASFYXIETEKENS ..................................................................................................................................................79
5.3 VORMEN VAN ASFYXIE .......................................................................................................................................................80
5.3.1 Atmosferische verstikking...................................................................................................................................80
5.3.2 Mechanische verstikking: gestoorde O 2 -opname...........................................................................................80
5.3.3 Inwendige verstikking .........................................................................................................................................80
5.4 VERSTIKKINGSPROCES ........................................................................................................................................................80
5.4.1 Smoring ..................................................................................................................................................................81
5.4.2 Luchtwegenconstructie .......................................................................................................................................82
Oorzaken ...................................................................................................................................................................... 82
5.4.3 Versmachting ........................................................................................................................................................82
Aard overlijden............................................................................................................................................................. 83
Posturale asfyxie .......................................................................................................................................................... 83
5.4.4 Samendrukking van de hals ...............................................................................................................................83
Anatomie hals .............................................................................................................................................................. 84
5.5 MECHANISME OVERLIJDEN.................................................................................................................................................84
Armgrepen (restraint holds) ........................................................................................................................................ 85
5.5.1 Verhanging............................................................................................................................................................86
Fenomenen .................................................................................................................................................................. 86
Pathologie .................................................................................................................................................................... 86
Verhanging, snoerteken............................................................................................................................................... 87
Verhanging- vitale tekens ............................................................................................................................................ 87
Aard overlijden............................................................................................................................................................. 87
Onderzoek verhanging ................................................................................................................................................. 87
Bijzondere aandacht indienen ..................................................................................................................................... 88
5.5.2 Strangulatie...........................................................................................................................................................89
Jeu de foulard............................................................................................................................................................... 89
5.5.3 Wurging .................................................................................................................................................................89
5.5.4 Plotse dood en onder bedwang houden ..........................................................................................................90
Excited delirium ........................................................................................................................................................... 91
Conclusies..................................................................................................................................................................... 91
5.5.5 Auto-erotische asfyxie.........................................................................................................................................91
Parafilie/parafernalia ................................................................................................................................................... 92
5.5.6 Co-intoxicatie ........................................................................................................................................................92
CO-Hb % in bloed wordt bepaald door ........................................................................................................................ 93
CO-intoxicatie............................................................................................................................................................... 93
5.5.7 CN-intoxicatie .......................................................................................................................................................94
Mechanisme overlijden................................................................................................................................................ 94
Forensische aspecten................................................................................................................................................... 94
7
,6. WATERLIJK - VERDRINKING ...............................................................................................................................................95
6.1 A LGEMEEN WATERLIJK .......................................................................................................................................................95
6.1.1 kentekens van verblijf in water..........................................................................................................................95
6.1.2 Postmortale verschijnselen ................................................................................................................................96
6.1.3 Verblijfsduur in water..........................................................................................................................................96
6.2 EIGENLIJKE VERDRINKING ...................................................................................................................................................97
6.2.1 Verdrinkingspro ces: 5 fasen ...............................................................................................................................97
Fase III en verdrinkingstekens (typische verdrinking).................................................................................................. 98
6.2.2 Bloedveranderingen ............................................................................................................................................98
6.2.3 Droge verdrinking ................................................................................................................................................99
6.3 ONEIGENLIJKE VERDRINKEN (BADETOD) ........................................................................................................................... 100
6.3.1 Verdrinkingstekens ........................................................................................................................................... 100
6.3.2 Forensisch onderzo ek ....................................................................................................................................... 100
6.3.3 Diatomeeëntest ................................................................................................................................................. 101
6.3.4 Aard van overlijden ........................................................................................................................................... 101
Hoe verloopt forensisch onderzoek........................................................................................................................... 101
6.3.5 Casussen ............................................................................................................................................................. 102
Dood in badkamer...................................................................................................................................................... 103
8
,7. HITTE, BRA NDLIJK, ELEKTROCUTIE, KOUDE… .............................................................................................................. 104
7.1 HITTE, BRANDLIJK ........................................................................................................................................................... 104
7.1.1 Overhitting ......................................................................................................................................................... 104
7.1.2 Verbranding ....................................................................................................................................................... 104
BRANDWONDEN – ERNST.......................................................................................................................................... 105
BRANDWONDEN – GRAAD......................................................................................................................................... 105
CONTACTDUUR EN ERNST BRANDWONDEN ............................................................................................................. 106
UITGEBREIDHEID........................................................................................................................................................ 106
OVERLEVING IFV TBSA & LEEFTIJD............................................................................................................................. 107
7.1.3 Brandlijk- brandto rso ....................................................................................................................................... 107
VERLOOP VERKOLING BIJ 650 – 1000 °C.................................................................................................................... 108
DOODSOORZAAK....................................................................................................................................................... 109
DOODSOORZAAK (overlijden DOOR BRAND) ............................................................................................................ 109
Brandlijk: AARD VAN OVERLIJDEN ............................................................................................................................. 109
7.1.4 Forensisch onderzo ek brand ........................................................................................................................... 110
7.1.5 Fenomeen ‘brand’ ............................................................................................................................................. 110
VERLOOP WONINGBRAND......................................................................................................................................... 111
BRANDTEMPERATUREN ............................................................................................................................................. 111
BRANDOORZAKEN...................................................................................................................................................... 111
AARD BRAND.............................................................................................................................................................. 112
BRANDSTICHTING ...................................................................................................................................................... 112
Forensisch onderzoek brand...................................................................................................................................... 112
ONDEZOEK BRANDPLAATS......................................................................................................................................... 112
ONDERZOEK BRANDLIJK............................................................................................................................................. 113
BRANDLIJK – VITALE TEKENS...................................................................................................................................... 113
BRANDLIJK: BETEKENIS CO......................................................................................................................................... 113
7.2 EXPLOSIE........................................................................................................................................................................ 114
7.2.1 Definitieve ontploffing ..................................................................................................................................... 114
7.2.2 Drie componenten ............................................................................................................................................ 114
7.2.3 Type letsels bij explosie .................................................................................................................................... 115
7.2.4 Destructief trauma (disruptie) ........................................................................................................................ 115
7.2.5 Explosie-trauma (short distance-missile injury)........................................................................................... 115
7.3 ELEKTROCUTIE................................................................................................................................................................ 116
7.3.1 Factoren voor elektrocutie .............................................................................................................................. 116
7.3.2 Elektrische stroo m a = v / ω (wet van ohm) ................................................................................................. 117
7.3.3 Toepassing wet van ohm ................................................................................................................................. 117
7.3.4 Electrocutie ........................................................................................................................................................ 117
7.3.5 Aard overlijden .................................................................................................................................................. 118
7.3.6 Bliksem................................................................................................................................................................ 118
7.4 HYPOTHERMIE................................................................................................................................................................ 119
7.4.1 Thermoregulatie................................................................................................................................................ 119
7.4.2 Oorzaken ............................................................................................................................................................ 119
7.4.3 Mechanisme (fysiopathologie) ....................................................................................................................... 120
7.4.4 Letsels (pathologie)........................................................................................................................................... 120
7.4.5 Aard overlijden .................................................................................................................................................. 120
HIDE AND DIE-SYNDROOM ........................................................................................................................................ 121
9
, 8. FORENSISCHE TRAUMA TOLOGIE................................................................................................................................... 121
Dodingsmiddelen (cijfers België) .............................................................................................................................. 121
KRACHT → schade → letsel....................................................................................................................................... 122
Aard van de verwondingen (types) ............................................................................................................................ 122
Uitwendig vs. Inwendig trauma ................................................................................................................................. 123
Ernst van de verwondingen ....................................................................................................................................... 123
Trauma – mechanisme overlijden.............................................................................................................................. 124
Beoordeling ................................................................................................................................................................ 125
8.O.1 Stomp trauma ................................................................................................................................................... 126
Stompe letsels ............................................................................................................................................................ 127
8.1 OVERLIJDEN DOOR STOMP TRAUMA................................................................................................................................. 132
8.1.1 Schedelhersentrauma ...................................................................................................................................... 133
8.1.2 Differentiaal diagnose: geweld vs. val .......................................................................................................... 134
8.2 L OKALISATIE: HOEDRANDZONE (VAL ) ............................................................................................................................... 136
8.3 A ANTAL.......................................................................................................................................................................... 136
CCT bij val (hoofd in beweging) ................................................................................................................................. 137
CCT bij slag(en) : letsels op plaats van impact .......................................................................................................... 137
8.4 ‘VAL UIT HOOGTE’ .......................................................................................................................................................... 137
Plaats van primair impact .......................................................................................................................................... 139
8.4.1 Scherp trauma ................................................................................................................................................... 139
1. Snijwonde............................................................................................................................................................... 140
2. Steekwonde............................................................................................................................................................ 142
8.4.2 Half scherp trauma ........................................................................................................................................... 146
8.4.3 Schottrauma (ballistisch trauma)................................................................................................................... 147
1. Ballistiek - kogelpatroon ........................................................................................................................................ 148
2. Ballistiek – jachtpatroon ........................................................................................................................................ 157
FORENSISCH ONDERZOEK.......................................................................................................................................... 160
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