Full Professor
of Legal Medicine
Services
When deciding to address a legal dispute ("judicial," "healthcare," "insurance-social," and "private insurance"), one must be aware of the risks and challenges inherent in the process.
My professional consultancy aims to do just that: prepare various clients, whether institutional or private, to respond to the quality and evidentiary requirements of the legal system.
The experience gained over decades of scientific research, teaching, and practical assistance at the University and the Hospital of Padua leads me to the conclusion that there is no better method than this: providing scientific and professional data produced and validated according to the criteria of evidence, quality, expertise, and the biomedical-legal and forensic multidisciplinarity.
Thematic Areas
There are areas within the field of Biomedical-Legal Sciences to which I have focused my interest due to personal sensitivities toward certain types of topics. I have dedicated studies and in-depth research, resulting in some particularly well-received scientific publications.
I always like to emphasize that we Forensic Doctors are men of science, but we are also simply human beings with personal experiences and stories that sometimes influence our professional choices. In any case, in such a delicate work sector, what makes the difference is not your specialization but the relentless pursuit of excellence.
Medical Professional Liability
The term "medical malpractice," coined in journalistic language, commonly refers to dysfunctions and errors that occur within the healthcare system. Law 24/2017, known as the Gelli-Bianco law, which regulates the safety of healthcare and healthcare-related risks, stipulates that in cases of professional liability, it is the "assessment by the forensic doctor" that evaluates the causes and damages related to errors in the conduct of healthcare personnel. The methodological rigor in this area of forensic medical assessment is outlined in the "Methodological-Assessment Guidelines and Criteria-Evaluation Guidelines" [1] and is applied by the national [2] and international forensic medical scientific and professional community.
Civil Liability and Personal Injury
The report by the National Association of Insurance Companies (ANIA) [3] highlights that in 2020, 5.5 billion euros were paid out to compensate victims of car accidents. This enormous figure illustrates how much work there is still to be done in terms of prevention and road safety education. In this specific field, I have applied a systematic methodology, as evidenced by a consistent body of scientific work published in the Guidelines in the International Journal of Legal Medicine [4-5], which forms the basis for assessing and evaluating personal injury.
Medical-Legal Offenses/Crimes of Relevance
The role of the medical examiner has become increasingly important within the criminal investigation, during which the Judge and the Public Prosecutor can appoint a technical consultant for the understanding of matters that require specific skills, but the parties involved (prosecution and defense) can provide the contribution of their own consultants. The use of scientific evidence is essential if one wants to reach conclusions of high probability or certainty. In this context, autopsy tests are placed, aimed at establishing the cause, the time and the means that caused death, also making use of radiological investigations, through multidisciplinary assessment protocols developed at an international level, useful for achieving the maximum scientific-technological evidence that can be produced in court [6-9].
Fitness for Driving
To return to the topic of prevention and road safety education, of great importance is the assessment that the legal doctor has the duty to carry out in the evaluation of the psycho-physical requirements for obtaining a driving license in relation to the possible consumption of alcohol and/or drugs or in the evaluation of specific conditions such as the physically disabled, subjects over 65, newly licensed drivers or holders of a professional license and subjects affected by diabetes. In this area, I have been applying for more than a decade the systematic method illustrated in the Methodological-Assessment, Criteriological-Evaluation Guidelines edited by the University of Padua [10], the accuracy of which has seen exponential growth in recent years, thanks to the use of cutting-edge instruments and methods, recognized in the international scientific panorama.
Alcohol - Drugs - Psychoactive Substances - Doping & Anti-Doping
The increasing use and abuse of alcoholic, psychotropic, and narcotic substances have led to a significant rise in the types and varieties of acute/chronic intoxications. A concerning effect of this phenomenon is the subsequent increase in risky behaviors (workplace accidents, driving under the influence, episodes of violence, risky sexual behaviors, alteration of consciousness, etc.). One of the main tasks of the forensic doctor is to assess disorders resulting from substance use by recognizing and identifying physical or psychological symptoms that indicate dependence on alcohol, drugs, psychoactive substances, and doping agents.
Identification and Certification of Asylum Seekers
There are those who flee from war, those who flee from hunger, those who flee from abuse and violence. Migratory flows from the poorest and most disadvantaged regions of the planet are constantly increasing. In 2021, the competent Territorial Commissions received 53,609 applications for International Protection, but only 50% of these applications were examined. A growing humanitarian emergency that makes the intervention of the legal doctor increasingly indispensable, competent to ascertain and define the possible existence of previous torture or injuries suffered, as well as the current clinical conditions and the related therapeutic and/or assistance needs of the asylum seeker. In my activity of identification, diagnosis and certification of conditions of vulnerability and/or psycho-physical fragility, I have adopted the Assessment Protocol published in 2017 by the International Journal of Legal Medicine [11].
Bibliography
[1] Ferrara SD, Baccino E, Bajanowski T, Boscolo-Berto R, Castellano M, De Angel R, Pauliukevičius A, Ricci P, Vanezis P, Vieira DN, Viel G, Villanueva E; EALM Working Group on Medical Malpractice. Malpractice and medical liability. European Guidelines on Methods of Ascertainment and Criteria of Evaluation. Int J Legal Med. 2013 May;127(3):545-57.
[2] Viero A, Montisci M. Prospettive della responsabilità sanitari alla luce della cd legge Gelli Bianco (L.24/2017). L’apporto medico-legale. Responsabilità Medica. Diritto e pratica clinica. 2018; 2: 223-227.
[3]https://www.ania.it/documents/35135/126701/L%27Assicurazione+Italiana+2020-2021.pdf/e4fa652e-dda7-8c9c-96ef-1e4468d4f903?version=1.0&t=1626333153413
[4] Ferrara SD, Baccino E, Boscolo-Berto R, Comandè G, Domenici R, Hernandez-Cueto C, Gulmen MK, Mendelson G, Montisci M et al. Members of the IALM Working Group on Personal Injury and Damage. Padova Charter on personal injury and damage under civil-tort law: Medico-legal guidelines on methods of ascertainment and criteria of evaluation. Int J Legal Med. 2016 Jan;130(1):1-12.
[5] Ferrara SD, Ananian V, Baccino E, Banczerowski P, Bordignon D, Boscolo-Berto R, Domenici R, Gorriz Quevedo J, Graw M, Hell W, Hernandez Cueto C, Knudsen PJ, Masiero S, Montisci M et al. Whiplash-Associated Disorders: Clinical and medico-legal guidelines on the methods of ascertainment. Int J Legal Med. 2016 Jan;130(1):13-22.
[6] Cecchetto G, Bajanowski T, Cecchi R, Favretto D, Grabherr S, Ishikawa T, Kondo T, Montisci M et al. Back to the Future - Part 1. The medico-legal autopsy from ancient civilization to the post-genomic era. Int J Legal Med. 2017 Jul;131(4):1069-1083.
[7] Montisci M, Cecchetto G, Viel G. Post-mortem assessment and evolutionary role of the autopsy. In Dagan KH. Autopsy. What do we learn form corpses). IntechOped Ed, 2022, Cap. 3.
[8] Giorgetti A, Giraudo C, Viero A, Bisceglia M, Lupi A, Fais P, Quaia E, Montisci M et al. Radiological investigation of gunshot wounds: a systematic review of published evidence. Int J Legal Med. 2019 Jul;133(4):1149-1158.
[9] Visentin S, Pelletti G, Dengo C, De Matteis M, Montisci M. Post-autopsy computed tomography. Pros and cons in a firearm death. Forensic Sci Int. 2017 Jul;276:e16-e19.
[10] Ferrara SD, Snenghi R, Boscolo M, Linee guida Metodologico-Accertative Criteriologico-Valutative Idoneità alla guida & sostanze psicoattive, Piccin ed., Padova 2006.
[11] Visentin S, Pelletti G, Bajanowski T, Ferrara SD. Methodology for the identification of vulnerable asylum seekers. Int J Legal Med. 2017 Nov;131(6):1719-1730.