I was reading an article on “Medical Homicide and Extreme Negligence” in my recent edition of The American Journal of Forensic Medicine and Pathology (no link). Having had a case of medical neglect found to be homicide by an inquest jury it was nice to review some of the pertinent definitions. We will continue to watch for other medical cases along with our “more usual” investigations:
Reckless endangerment…the conscious disregard of a known substantial likelihood of injury to the patient
Criminal neglect typically is defined as the failure to provide timely, safe, adequate, and appropriate services, treatment, and/or care to a patient.
In instances of extreme medical negligence, a homicide manner of death is appropriate because the fatality is due to criminal acts (or inactions) of another.
I stand by the jury verdict in our case and will not hesitate to rule similarly in the future if I feel that the case meets these definitions.
Natural deaths…natural disease... Therapeutic complications…predictable complications…appropriate medical therapy…Accidents…unanticipated complications and/or inappropriate therapies…Homicides…death at the hand of another person or death due to the hostile or illegal act or inaction of another person.
Our ruling of a homicide does not mean criminal prosecution should or will occur, but, importantly such a ruling:
…also furthers one of the major goals of the medicolegal death investigation system, which is to safeguard the public health.
(American Journal of Forensic Medicine and Pathology, March 2009; 30: 18-22)
Most of the tens of thousands of deaths annually attributed to "accident" are caused by "undue delay" in necessary treatment, according to a senate panel. These "accidents" appear to be "medical homide" according to your definition. What do you think, Dr. Keller?