of December 20, 2004 No. 875/1
About approval of Rules of the organization and production of forensic medical examination
For the purpose of implementation of the Law of the Republic of Kazakhstan "About health care system", I ORDER:
1. Approve the enclosed Rules of the organization and production of forensic medical examination.
2. To department of treatment-and-prophylactic work, accreditation and information analysis (Nersesov A. V.) provide state registration of this order in the Ministry of Justice of the Republic of Kazakhstan.
3. To direct to administrative department (Akrachkov D. V.) this order to official publication after its state registration in the Ministry of Justice of the Republic of Kazakhstan.
4. To impose control of execution of this order on the Vice-minister of Dikanbayevu S.A.
5. This order becomes effective from the date of its official publication.
|
Minister |
Dosayev E. A. |
|
It is approved Minister of Internal Affairs Republic of Kazakhstan of December 28, 2004. |
|
Approved by the order of the Minister of Health of the Republic of Kazakhstan of December 20, 2004 No. 875/1 About approval of Rules of the organization and production of forensic medical examination
1. These rules determine procedure for the organization and production of forensic medical examination in the Republic of Kazakhstan.
2. Production of forensic medical examination (daleeekspertiz) is performed by the forensic scientist whose competence enters:
1) examination of corpse in cases of violent death;
2) examination of corpse in case of suspicion on use of violence or under other circumstances causing need of research of corpse for medicolegal procedure;
3) examination of the victims, persons accused and other persons for determination of nature and weight of harm to health, age, sexual conditions and permission of other questions requiring knowledge of the field of forensic medicine;
4) examination of physical evidences using laboratory methods of research;
5) examination on materials of investigation verification, criminal, administrative and civil cases, and also for private prosecution.
3. The forensic scientist is involved as the specialist in the field of forensic medicine in participation in initial and other investigative actions: to survey of corpse on site its detection (incident), exhumation, to withdrawal of samples for comparative research, to carrying out investigative experiment, and also for conducting examination in judicial session, giving explanation on earlier medicolegal researches conducted by it.
4. Purpose of forensic medical examination is made according to the current legislation of the Republic of Kazakhstan.
5. Forensic medical examination is made by one or several experts depending on type and complexity of examination.
6. In case of production of examination out of body of judicial examination heads of the medical organizations provide forensic scientists with accommodation for examination production (morgue, medical office in polyclinic) and give other necessary assistance.
7. Bodies (person who appointed examination) render assistance in transfer of the taken objects to laboratory divisions of body of judicial examination.
8. Bodies (person who appointed examination) by the forensic scientist's challenge for participation in initial and other investigative actions, provide it the vehicle.
9. The forensic scientist performs the functions within the serviced territory. In cases of spontaneous and technogenic catastrophes, other extraordinary events by order of the head of the Center of forensic medicine the forensic scientist can be temporarily sent out of limits of the territory. Heads of branches of the Center of forensic medicine in regions shall establish interchangeability of forensic scientists for their leave or disease.
Forensic medical examinations in the Center of forensic medicine are made after conducting the previous examinations in branches of the Center of forensic medicine.
10. In case of complexity of examination and need of the solution of special questions the forensic scientist no more days having the right in time from the beginning of production of examination to declare the petition in the face of (body), appointed examination, need of participation in it of the corresponding specialists.
11. If in the course of conducting forensic medical examination there is need for production of medicolegal laboratory researches for permission of the questions raised before the forensic scientist or which arose at it personally, then, based on the resolution of bodies of inquiry, the investigator, the prosecutor or court which is available for it, he sends objects to the relevant laboratory division of body of judicial examination. At the same time the forensic scientist fills in the form in which refers to the provided resolution, specifies the short facts of the case, objective data revealed in case of examination, the purpose of laboratory research. After receipt of results of laboratory research the expert opinion (daleezaklyucheniye) is drawn up.
12. If there is need to consult person subjected to forensic medical examination, inspection at the specialist doctor working in other organization of health care person (body) who appointed examination who provides its carrying out, with the subsequent provision to the expert of results of inspection without delay is in writing informed of it.
13. If in the course of conducting forensic medical examination objects which in character can become physical evidences and objects of separate medicolegal, criminalistic or other examination are revealed, they are subject to the description in the conclusion and transfer on receipt to person (body) which appointed forensic medical examination.
14. Objects for expert researches, including physical evidences, are subject to strict accounting and storage. The expert takes all measures depending on him for their safety.
15. From corpse any parts, internals, fabrics, blood, urine and other circles for the medicolegal laboratory researches necessary for production of this examination can be taken.
16. When conducting forensic medical examination in court the forensic scientist constitutes the conclusion in writing. The copy of the conclusion attach to the documents of examination which are in archive of expert organization.
17. In case of the wrong interpretation by participants of legal procedure of the conclusion drawn by the expert, the forensic scientist shall declare it in the course of judicial session.
18. Results of forensic medical examination draw up according to requirements of the current legislation.
19. The conclusion consists of the following Sections: the prolog including summary of the facts of the case, research part and conclusions.
20. In the prolog it shall be specified:
1) time and production site of examination;
2) the examination conditions of production important for expert research (lighting, air temperature and another);
3) the resolution based on which examination is made;
4) surname, name, expert's middle name, post, education, specialty and length of service in the specialty, qualification category, academic degree, academic status;
5) in case of examination of corpse - surname, name, middle name, age of the dead; in case of examination of the victims, persons accused and others litsfamiliya, name, middle name, age, residence, the identity document; in case of examination according to case papers and examination of physical evidences - the name and number of criminal or civil case, quantity of volumes, sheets of case, the list of the objects and samples which arrived for examination;
6) persons which are present at examination production;
7) the signature of the forensic scientist about its procedural law, obligations and about the warning of criminal liability for making obviously false conclusion;
8) the list of the questions raised on permission of examination;
9) the facts of the case stated in edition of person (body) which appointed examination.
21. Research part shall contain the detailed description of process of research of all provided objects of expert research and actual data found at the same time. In it the applied research methods are stated, and objective registration is used (pictures, planimetric schemes with designation of damages). The structure of research part is determined by type of the carried-out expertize.
This Section, in particular, includes:
1) in case of examination of corpse - the description of clothes and data of outside research of corpse; internal research of cavities, bodies and fabrics; the withdrawn objects transferred to the investigator for carrying out other types of examinations; the list of the objects directed to laboratory research; results of the conducted laboratory researches with indication of dates of their carrying out and receipt of researches by the expert of results in the form of the expert opinion, and also the analysis of medical and other documents if those were presented;
2) in case of examination of the victims, persons accused and others the litspodrobny description of all objective medical data revealed in the course of expert inspection: specifying about the direction the expert inspected to doctors of other specialties, on radiological and other researches, and also results of these inspections and researches; the description of clothes if it was researched, then damages and imposings on it; the list of the objects directed to laboratory research, and also results of these researches; dates of additional inspections and researches, receipts of their results by the expert, forming of conclusions in the conclusion shall be celebrated;
3) in case of examination of physical evidences - the detailed description of physical evidences and the traces which are available on them, statement of the applied methods of research and the received results on each type of research, with indication of the used reagents, the equipment and the equipment, process of the analysis. In research part also describe research of samples for comparison;
4) in case of examination on materials of criminal, administrative and civil cases - detailed statement of the actual data necessary for the subsequent expert analysis;
5) in case of examination on cases on professional activity of health workers the data received when studying the authentic medical and other documents important for case (in the absence of authentic documents, expertize is carried out based on the copy of documents) join.
22. The prolog including the facts of the case, and research part constitute together the protocol of the expert opinion.
The protocol is signed by one or several experts depending on type and complexity of examination making forensic medical examination.
23. Conclusions in the conclusion are the scientifically based opinion of the expert formulated based on results of the examination made by it namely:
1) the forensic scientist after receipt of all results of laboratory and additional expert researches in time no more than 3 days formulates conclusions in the form of answers to the questions confronted (body) which appointed examination. They shall contain also expert evaluation of the objective data revealed in the course of the research which, according to the expert, matter for case. They should be stated clearly, specifically, avoiding, whenever possible, special medical terms. Expert judgment on each conclusion shall be motivated, proved by actual data;
2) in cases of impossibility to draw the conclusion on the questions posed which are going beyond special knowledge, or the provided materials are not suitable or insufficient for making the conclusion and cannot be executed, the expert constitutes the motivated message on it and sends it to the body or person who appointed examination.
24. Introduction and research part of the conclusion is constituted directly in the course of conducting examination. It is necessary to specify date of creation at once after the end of all researches.
25. The conclusion is constituted at least in duplicate, one of which is transferred to person (body) which appointed examination, and another remains stored in archive of body of judicial examination.
Examination of physical evidences is drawn up in production process of expert researches by entries in the working magazine based on which after the end of expert researches the relevant document is constituted.
26. The conclusion is issued to body (person) who appointed examination or according to their written order to the other person or sent by mail right after the end of examination.
27. It is forbidden to substitute the conclusion for different brief information and statements, and also to use unconfirmed forms and forms of biographical type for creation of the above-stated medicolegal documents, to draw the conclusion on external examination of corpse or its incomplete research.
28. Terms of conducting examinations are determined by their type, amount and nature of expert researches. Duration of completion date of examinations depends on types of the conducted different laboratory researches. Duration of examination shall not exceed one month from the date of obtaining from bodies of inquiry, the investigator, prosecutor or court of all required materials.
29. Terms of production of examinations can constitute:
in case of production repeated, commission, complex экспертиздо 30 days;
in case of examination of corpses - up to 30 days, but no more than in three days after receipt of the last result of additional methods of laboratory researches;
in case of examination of the living persons requiring additional researches and medical documentation - up to 30 days;
in case of examination of the living persons who are not requiring additional researches and medical documentation - up to 5 days.
30. In cases when production of examination cannot be completed at the scheduled time, before its expiration the forensic scientist through the head of body of judicial examination shall warn in writing about it person (body) who appointed examination, having specified the reason and approximate term of its completion, but no more than one month.
31. According to medical signs (criteria) of harm to health provided by the penal legislation of the Republic of Kazakhstan, and also methodical instructions, the expert when conducting forensic medical examination establishes weight of the done harm to health.
For establishment of weight of harm to health one of signs of this harm suffices. In the presence of several qualifying signs weight of harm to health is established on that sign which corresponds to bigger weight of harm to health.
(Injuries), either the diseases or pathological conditions which resulted from impact of different factors of external environment understand violation of anatomic integrity of bodies (fabrics) or their physiological functions as harm to health: mechanical, physical, chemical, biological, mental.
It is necessary to understand condition of organism in case of which clinically expressed painful changes of local and (or) general nature caused by specific injury or disease, that is when there is violation of anatomic integrity or physiological function of bodies and fabrics come to light as disorder of health.
The percent of permanent loss of general working capacity as a percentage owing to different injuries is established according to the table of percent of permanent loss of general working capacity as a result of different injuries according to appendix 1 to these rules.
It is necessary to understand set of the inborn and acquired capabilities of the person to the action directed to receipt of socially important result in the form of certain product, product or service as general working capacity.
It is necessary to understand capability to work in the profession as professional working capacity or another equal to it on payment and on qualification.
32. The qualifying signs (criteria) of severe harm to health are:
1) danger of harm to health to human life;
2) not the life-threatening damages which entailed severe harm to health on effect after any impacts:
loss of sight, speech, hearing or any body, or loss of its functions by body;
indelible disfiguration of person;
the disorder of health connected to considerable permanent loss of general working capacity on one third at least (33% and above);
complete loss of professional working capacity;
termination of pregnancy;
mental disturbance (mental disease);
disease of drug addiction or toxicomania.
33. Life-threatening harm to health should be considered both bodily harms, and the pathological conditions which resulted from impact of different external factors which can threaten the victim's life.
Prevention of the death caused by delivery of health care, self-help or mutual assistance and also confluence of accidental circumstances, shall not be taken into account in case of assessment of danger to life.
34. To harm to health, life-threatening, belong:
1) the getting skull wounds, including without injury of brain;
2) the opened and closed fractures of bones of the code and the basis of skull, the cracks only of outside plate of the code of skull and fractures of the bones of facial skeleton which are not part of brain skull, changes of parts of the trellised, wedge-shaped bones participating in forming of brain skull except for isolated;
3) bruise of brain of heavy degree, bruise of brain of average degree in the presence of symptoms of defeat of trunk department of brain;
4) epidural, subdural, subarachnoidal, intracerebral and intra ventricular hemorrhage in the presence of life-threatening conditions;
5) the wounds getting into the vertebral canal including without injury of spinal cord;
6) fractures dislocations or fractures of bodies, or bilateral changes of arches of cervical vertebrae, and also unilateral changes of arches of the first and second cervical vertebrae, including without dysfunction of spinal cord;
7) dislocations of cervical vertebrae; the incomplete dislocations of cervical vertebrae which are followed by life-threatening conditions or dysfunction of spinal cord;
8) the closed injuries of spinal cord to cervical department which are followed by life-threatening condition and dysfunction of spinal cord;
9) fracture or fracture dislocation of one or several chest or lumbar vertebras with dysfunction of spinal cord or with availability of clinically established shock of heavy degree and other life-threatening conditions;
10) the closed damages of chest, lumbar and sacral segments of spinal cord which are followed by heavy spinal shock or malfunction of pelvic bodies;
11) the wounds getting into gleam of throat, gullet, throat, trachea, and also open damages of thyroid and thymic glands;
12) the opened and closed fractures of cartilages of throat and trachea which are followed by life-threatening conditions;
13) the thorax wounds getting into pleural cavity, cavity of pericardium or cellulose of sredosteniye including without internal injury (hypodermic emphysema cannot be considered as sign of the getting wound when the phenomena haemo-pnevmotoroksa are absent);
14) the stomach wounds getting into abdominal cavity (cavity of peritoneum and zabryushinny space) including without internal injury;
15) the wounds getting into cavity of bladder, the upper and average departments of rectum, and also extensive open damages of all layers of the lower department of rectum;
16) the opened and closed wound (gap) of internal body of chest or belly cavities, or zabryushinny space (kidneys, adrenal glands, pancreas), either diaphragm, or prostate gland, or mochetochnik, or webby part of urethra;
17) bilateral changes of back half ring of basin with gap of podvzdoshnokresttsovy joint and violation of continuity of pelvic ring, or double changes of pelvic ring in front and back parts with violation of its continuity;
18) open fractures of long tubular bones in diaphyseal part (humeral, femoral, tibial, both bones of forearm);
19) open fractures of beam, elbow and fibular bones; weight of harm to health in case of the closed fractures of humeral, femoral and tibial bones, and also the closed injuries of large joints (humeral, elbow, luchezapyastny, coxofemoral, knee, talocrural) is established depending on the danger to life, frustration duration caused by them to health, or on the basis of permanent disability;
20) injury of large blood vessel: aortas, sleepy (general, internal, outside), subclavial, humeral, femoral, subnodal arteries or veins accompanying them;
21) damage of peripheral vessels (the head, person, neck, forearm, brush, foot shin) is qualified depending on the specific danger to life caused by them (for example, massive blood loss, shock of heavy degree and others);
22) the damages which entailed life-threatening conditions: shock of heavy degree (III, IV degree); coma of different etiology; the massive blood loss which caused collapse; sharp heart or vascular failure; collapse; heavy extent of violation of brain blood circulation; sharp kidney or acute liver failure; sharp respiratory insufficiency of heavy degree; gnoynoseptichesky conditions; the disorders of regional or organ blood circulation which led to heart attack of internals, gangrene of extremities; embolisms (gas or fatty) brain vessels; thrombembolia; combination of life-threatening conditions;
23) thermal burns of the third, fourth degree with the area of defeat exceeding 15 percent of surface of body; burns of the third degree more than 20 percent, burns of the second degree over 30 percent of surface of body, and also the burns of the smaller area which are followed by life-threatening conditions (effects of burns shall be estimated without plastic and recovery surgeries);
24) chemical burns (concentrated acids, caustic alkalis, other toxic agents) which caused in addition to local, all-toxic action, life-threatening;
25) poisonings with chemicals (poisons) or pathological conditions caused by biological agents and which entailed life-threatening conditions;
26) the sdavleniye of bodies of neck and other types of mechanical asphyxia which are followed by the expressed signs of the life-threatening phenomena (disorder of brain blood circulation, consciousness loss, amnesia and others) if it is established by objective data.
35. Not the life-threatening damages relating to severe harm to health on outcome and effects are: loss of sight, speech, hearing or any body, or loss of its functions by body:
1) it is necessary to understand total persistent blindness on both eyes or decrease in visual acuity to photoperception as loss of sight; loss of sight on the single eye;
2) loss of sight on one eye involves loss of its function by body and therefore treats severe harm to health; loss of one healthy (sighted person) eyeball is loss of body and also belongs to severe harm to health;
3) the injury of blind eye which demanded its removal is estimated depending on duration of disorder of health, with obligatory specifying about indelibility of damage;
4) it is necessary to understand loss of capability as loss of the speech to express the thoughts the articulate sounds clear for people around, or as a result of loss of voice;
5) it is necessary to understand complete deafness or such irreversible condition when the victim does not hear informal conversation at distance of 3-5 cm from auricle as loss of hearing. Loss of hearing on one ear is estimated as loss of its function by body and therefore treats severe harm to health;
6) should be understood as loss of any body, or loss of its functions by body:
loss of hand, leg, that is, their department from trunk or loss of functions by them owing to paralysis or other condition excluding their activities (it is necessary to understand as anatomic loss of hand or leg as department from trunk of all hand or leg, and brush and foot);
the loss of productive capability consisting in loss of capability to copulation or loss of capability to fertilization, conception, pregnancy incubation, child-bearing and chest (natural) feeding;
loss of one small egg regarded as loss of body;
7) in case of injuries of face the expert establishes their weight according to the signs containing in these rules; besides, it shall determine whether damage is izgladimy, or indelible (it is necessary to understand considerable reduction or possibility of disappearance of visible effects of injury as izgladimost: expressivenesses of hems, deformations, violations of mimicry and others, eventually or under the influence of conservative (not surgical) treatment; if their elimination requires surgery (cosmetic or plastic surgery), then damages on face are considered as indelible; in case of indelibility establishment the expert shall note in the conclusion that if such effects are acknowledged as court or the investigator disfiguring face, damages should be estimated as led to severe harm to health);
8) considerable permanent loss of general working capacity more than on one third (more than 33 percent):
the amount of considerable permanent loss of general working capacity in case of damages is established after the defined injury outcome (according to the table of percent of disability as a result of different injuries according to the appendix N 1 to these rules;
9) at children disability is determined, proceeding from the general provisions established by these rules;
at disabled people considerable permanent loss of general working capacity in connection with the received injury is determined as at almost healthy people, irrespective of disability and its group;
10) in case of complete loss to professional trudosposobnostiopredelenia it is made according to requirements of establishment by medico-social commissions of experts of extent of loss of professional working capacity workers, the sustained injuries or other damages of health connected with execution of labor obligations by them;
11) termination of pregnancy, irrespective of its term, is severe harm to health if it is not connected with specific features of organism, and costs in direct causal relationship with damage;
12) diagnostics of mental disturbance (mental disease), drug addiction, toxicomania is performed by psychiatric, narcological and toxicological examination, but their communication with traumatized, and also assessment of weight of harm to health owing to sincere disease, drug addiction and toxicomania is made by the commission of forensic scientists which if necessary joins the psychiatrist, the narcologist, the toxicologist (it is necessary to understand mental disease (mental disease) as mental disturbance; the group of mental diseases shall not join the reactive conditions (psychoses, neurosises) connected with damage of nervous system; damage is qualified as severe harm to health, only if it entailed development of mental disease, regardless of duration of its current and degree of curability).
36. The qualifying signs (criteria) of harm to health of average weight are:
1) long disorder of health - for the term of over three weeks (more than 21 day) (effects in the form of disease or malfunction of any body, lasting over three weeks (more than 21 day), directly connected with damnification to health belong to long disorder of health);
2) considerable permanent loss of general working capacity (10 - 33 percent inclusive).
37. The qualifying signs (criteria) of little harm to health are:
1) short-term disorder of health - not over three weeks - no more than 21 day;
2) insignificant permanent loss of general working capacity - less than 10 percent.
38. Beating is the violent acts which caused physical pain, but did not entail short-term disorder of health or insignificant permanent loss of general working capacity.
The forensic scientist does not determine the fact of beating. If as a result of beating on body of the victim there are damages, they are estimated on weight of harm to health, proceeding from regular signs. If beating does not leave behind any objective traces, then the forensic scientist in the conclusion notes claims of the victim, specifies that objective signs of damages are not revealed.
39. Tortures represent actions as a result of which harm can be done to health.
Tortures are the actions connected with repeated or systematic causing pain (shchipaniye, section, drawing multiple small damages by different blunt and sharp objects, impact of chemical, physical factors and other similar actions).
The forensic scientist does not determine the torture fact, it shall determine:
1) availability, nature and localization of damages;
2) distinctions in prescription of drawing them;
3) the tool, the mechanism and signs of method of causing damages (according to medical data).
In case of permission of question of weight of harm to health the forensic scientist is guided by relevant provisions of these rules.
40. Medicolegal assessment of weight of harm to health is carried out by the forensic scientist by physical examination of the victim based on the resolution of judicial investigating bodies.
41. Production of examination is performed according to medical documents (to the card of the inpatient, the individual card of the outpatient and others) in the presence of the full documents containing exhaustive data on nature of damage, its clinical current and other data necessary for examination production.
42. In exceptional cases, when medicolegal assessment of weight of harm to health causes difficulties in connection with contradictory data of medical documents on nature, effects, disease duration criminal prosecution authority or the court provides the victim's appearance for examination by the forensic scientist.
43. The forensic scientist identifies the personality of osvidetelstvuyemy person according to the document certifying her; finds out from osvidetelstvuyemy person of circumstance of causing damages; claims and, if necessary, other data; studies case papers and medical documents. All obtained data are fixed in the expert opinion.
44. If to the expert necessary medical documents and other case papers are not submitted, he within a day from the moment of emergence of need for it, declares to person or body which appointed examination, the petition for provision of missing materials.
45. When conducting forensic medical examination the expert shall use only authentic medical documents (in the absence of authentic documents, the expert assumes as a basis copies of medical documents). In necessary cases he can use data of the additional researches conducted with involvement of the corresponding specialists.
In these cases in the expert opinion it is specified where when also who in addition inspected osvidetelstvuyemy person what facts at the same time are determined and to what conclusions the specialist came. The conclusion is constituted by the expert taking into account results of this inspection.
46. In case of medicolegal assessment of weight of harm to health the expert gives answers to all questions containing in the resolution.
47. Duration of disorder of health is determined taking into account the data containing in medical documents. Estimating nature and duration of disease or violation of the functions connected with damage suffered to health the expert shall proceed from the objective data including established in the course of conducting examination.
48. The forensic scientist shall estimate critically data of medical documents as duration of treatment of the victim can be not proved by nature of injury, its clinical manifestation, and on the other hand, the refusal of the victim of leaf of disability and premature appearance at work at personal desire can take place. In all these cases the forensic scientist shall estimate duration of disease and its weight, proceeding from objective clinical data.
Duration of disorder of health, duration of treatment and temporary disability are different concepts and not always match on terms.
49. In case of assessment of weight of the harm to health done to person having any disease it is necessary to consider only effects of the caused injury. At the same time the expert shall determine influence of injury on disease (exacerbation of disease, its transition to more severe form and so forth). If necessary this issue is resolved by the commission of experts with participation of the corresponding specialists of clinical profile.
50. In the presence of the damages which arose from numerous traumatic impacts, the weight of harm to health caused by each traumatic impact is estimated separately.
In cases when multiple damages mutually burden each other, make cumulative assessment of weight of harm to health.
In case of different prescription of emergence of damages assessment of weight of each of them is made separately.
51. In case of damage of healthy pair part of body or pair body only effects of the caused injury, without the broken function of the pair part of the same name of body or other pair body of the same name are subject to assessment.
In case of damage of part of body with fully or partially earlier lost function consider only injury effects.
52. If in case of survey of the victim the expert finds signs of different origin of harm to health, he establishes, than each of them is caused.
If signs of harm to health have different prescription, it should be noted not momentariness of their drawing and to specify terms of causing and weight of each of them separately.
Disclaimer! This text was translated by AI translator and is not a valid juridical document. No warranty. No claim. More info
Database include more 50000 documents. You can find needed documents using search system. For effective work you can mix any on documents parameters: country, documents type, date range, teams or tags.
More about search system
If you cannot find the required document, or you do not know where to begin, go to Help section.
In this section, we’ve tried to describe in detail the features and capabilities of the system, as well as the most effective techniques for working with the database.
You also may open the section Frequently asked questions. This section provides answers to questions set by users.
The document ceased to be valid according to the Order of the Minister of Health of the Republic of Kazakhstan of May 20, 2010 No. 368