Browsing by Subject "Post-mortem"

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    Ethical considerations in forensic genetics research on tissue samples collected post-mortem in Cape Town, South Africa
    (BioMed Central, 2017-11-29) Heathfield, Laura J; Maistry, Sairita; Martin, Lorna J; Ramesar, Raj; de Vries, Jantina
    Background: The use of tissue collected at a forensic post-mortem for forensic genetics research purposes remains of ethical concern as the process involves obtaining informed consent from grieving family members. Two forensic genetics research studies using tissue collected from a forensic post-mortem were recently initiated at our institution and were the first of their kind to be conducted in Cape Town, South Africa. Main body: This article discusses some of the ethical challenges that were encountered in these research projects. Among these challenges was the adaptation of research workflows to fit in with an exceptionally busy service delivery that is operating with limited resources. Whilst seeking guidance from the literature regarding research on deceased populations, it was noted that next of kin of decedents are not formally recognised as a vulnerable group in the existing ethical and legal frameworks in South Africa. The authors recommend that research in the forensic mortuary setting is approached using guidance for vulnerable groups, and the benefit to risk standard needs to be strongly justified. Lastly, when planning forensic genetics research, consideration must be given to the potential of uncovering incidental findings, funding to validate these findings and the feedback of results to family members; the latter of which is recommended to occur through a genetic counsellor. Conclusion: It is hoped that these experiences will contribute towards a formal framework for conducting forensic genetic research in medico-legal mortuaries in South Africa.
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    Open Access
    Ethical considerations in forensic genetics research on tissue samples collected post-mortem in Cape Town, South Africa
    (2017) Heathfield, Laura J; Maistry, Sairita; Martin, Lorna J; Ramesar, Raj; de Vries, Jantina
    BACKGROUND: The use of tissue collected at a forensic post-mortem for forensic genetics research purposes remains of ethical concern as the process involves obtaining informed consent from grieving family members. Two forensic genetics research studies using tissue collected from a forensic post-mortem were recently initiated at our institution and were the first of their kind to be conducted in Cape Town, South Africa. MAIN BODY: This article discusses some of the ethical challenges that were encountered in these research projects. Among these challenges was the adaptation of research workflows to fit in with an exceptionally busy service delivery that is operating with limited resources. Whilst seeking guidance from the literature regarding research on deceased populations, it was noted that next of kin of decedents are not formally recognised as a vulnerable group in the existing ethical and legal frameworks in South Africa. The authors recommend that research in the forensic mortuary setting is approached using guidance for vulnerable groups, and the benefit to risk standard needs to be strongly justified. Lastly, when planning forensic genetics research, consideration must be given to the potential of uncovering incidental findings, funding to validate these findings and the feedback of results to family members; the latter of which is recommended to occur through a genetic counsellor. CONCLUSION: It is hoped that these experiences will contribute towards a formal framework for conducting forensic genetic research in medico-legal mortuaries in South Africa.
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    Open Access
    Investigating post-mortem redistribution of drugs in a cohort of suspected unnatural deaths in Cape Town South Africa
    (2024) Clegg, Liza; Kirk, Gavin; Hlela, Marie Belle Kathrina Mendoza
    Introduction: The interpretation of post-mortem toxicological analysis results is complex, specifically, due to the phenomenon of post-mortem redistribution (PMR). The later needs to be taken into consideration when determining if, and to what extent a drug contributed to death. Additionally, case specific features also play a role and therefore no specific drug concentration can be deemed ‘fatal'. The accumulation of drugs in specific body areas before and around death creates drug reservoirs, influencing redistribution after death. However, patterns like concentration ratios between cardiac and peripheral blood aid in understanding PMR tendencies of specific drugs. By contributing data to the larger knowledge pool, we can better understand how different drugs behave in the post-mortem seeing, thereby assisting toxicologists and pathologists to come to a rational conclusion regarding the post-mortem toxicological results on a case-by-case basis. Methods: This study is the first of its kind in South Africa, aiming to investigate the extent of PMR of common drugs of use and misuse. To this end, paired admission femoral blood and autopsy femoral and cardiac blood samples were tested on a quantitative LC-MS/MS panel of 31 commonly misused drugs. Results: A total of 109 suspected unnatural cases admitted to the mortuary were included, of which 61 (56%) yielded positive toxicology results. The data was analysed using SPSS Version 28. The most common analytes detected were acetaminophen (n=13; 21.3%), 11-nor-9-carboxy-Δ⁹- tetrahydrocannabinol (THC-COOH) (n=20; 37.8%), amphetamine (n=30; 49.2%), methaqualone (n=33; 54.1%) and methamphetamine (n=33; 54.1%). Males represented the majority of cases in the cohort and the mean age of individuals testing positive was 33 years (SD: 10 years). Cardiac/peripheral (C/P) ratios were calculated and significant pairwise differences with Bonferroni correction were found for amphetamine, methamphetamine and nor-carboxy-tetrahydrocannabinol, corresponding with current literature. Additionally, where the literature was previously lacking data on the PMR of methaqualone, this study suggested that it is less likely to undergo PMR.