Medical Examination

Medical Examination, examination of living persons with the aim of determining the presence or absence of any physiological or pathological conditions in the body. Medical examination plays a significant role in the daily activities of a physician, clarifying the clinical diagnosis of disease, and is likewise very important in the protection of the health of a collective; for example, preliminary medical examination is applied in certain professions with the aim of preventing or removing persons suffering from contagious diseases; it also has importance in the examination of workers in harmful industries for the precise accounting of occupational diseases; medical examination upon entering marriage (see Venereal diseases); medical examination to establish the fact of vaccination against smallpox, birth, etc. In forensic medical practice, medical examination takes on a specific character, since data that are not taken into account at all in purely clinical examination or have only secondary significance acquire special interest; in this case, in addition to confirming a known condition, its connection with a criminal act is also clarified; moreover, medical examination provides the basis for qualifying the findings in accordance with the norms of current legislation. Medical examination is very frequently resorted to in forensic medical practice (in the RSFSR, for one autopsy examination, there are five medical examinations) and in the most diverse cases, such as: establishing the severity of injuries, maiming, rape and corruption, venereal infection, physical condition of health, mental diseases, fact of intoxication, for determining sex, age, physical development, virginity, pregnancy and postpartum period, paternity, etc. Medical examinations are conducted in criminal cases, civil cases (paternity), administrative cases (appointment and removal of guardianship) in accordance with the corresponding articles of the Criminal Procedure Code of the RSFSR (articles 189-195, 1931 edition) on the basis of a series of instructions, rules and orders of the People's Commissariat of Health, People's Commissariat of Justice, People's Commissariat of Internal Affairs, and according to the requirements of health authorities, investigation bodies, courts, at the request of private individuals and their legal representatives (parents, guardians) or the victims themselves. In particular, for the medical examination of a victim or suspect, investigation bodies (militia, etc.) and investigation authorities (investigator) invite a forensic medical expert through health departments, and in the event of such a call being impossible, the nearest physician. Medical examination is conducted by the expert, as a rule, in daylight in the presence of representatives of judicial-investigative authorities or militia and two witnesses. In emergency cases in the absence of representatives of investigation and inquiry, the expert has the right to testify with the participation of a representative of local administration and 2 witnesses. The conducting the investigation or inquiry does not attend the medical examination of persons of the opposite sex if the examination involves the exposure of covered parts of the body (except in cases where the person being examined does not object to this). The investigator, witnesses and other persons present at the examination have the right to express their opinion on those actions of the physician that seem doubtful to them; their opinions are recorded in the protocol. Medical examination is conducted by one or several experts in a commission manner - depending on the objectives of the examination (see Expertise). Under the departments of medical expertise in administrative centers, in particular in Moscow, there are offices (forensic medical outpatient clinics) for the examination of living persons. Medical examination also takes place in determining temporary and permanent loss of working capacity (see Social-labor expertise). In case of insufficient completeness, unclearness and therefore unsatisfactoriness of the medical examination, as well as due to new circumstances in the case or changes in health condition that have occurred after the first medical examination, a re-examination is appointed both on the initiative of the investigator and at the request of the accused (article 174 of the Criminal Procedure Code), parents, guardians, institutions, various organizations, etc. Thus, medical examination of living persons has important significance in the matter of forensic medical 'Expertise.'

V. Vladimirsky-, »,

Medical examination in military-medical practice is conducted for the most diverse reasons, but its main and most responsible task is to determine the fitness or unfitness for military service due to health conditions of various military contingents. As a rule, medical examination of these contingents is conducted by physicians, but in some exceptional cases in the absence of a physician, it may be entrusted to a paramedic. Depending on the reason for medical examination of military contingents, it may be conducted by one physician or several with the participation of a representative of the command (medical commission). The unit physician conducts medical examination on his own initiative or at the suggestion of the command, while the medical commission only at the suggestion of the command or the attending physician, if the patient was under stationary treatment. Medical examination of those called up for military service is conducted by draft commissions in accordance with the law on compulsory military service. Medical examination is regulated by a special instruction, issued by orders of the Revolutionary Military Council of the USSR. The instruction contains instructions on the technique and basic methodology of medical examination (examination of hearing, visual acuity, anthropometric measurements, etc.). Medical examination of military contingents must be complete and impartial with the application of all available methods in the given situation, which eliminates the possibility of missing persons who, due to their health condition, are incapable of military training, as well as the possibility of challenging the conclusions by interested parties as based on incomplete data about the health condition. Medical examination may be outpatient, but in diagnostically difficult cases, by decision of the commissions, the person examined may be directed for research and observation to a medical institution, although the conclusion of the latter is not decisive and serves only as material for the conclusion of the commission, which may disagree with the conclusions of the medical institution. To facilitate the work of physicians in medical examination of military contingents, in addition to instructions, manuals and guidelines are published. Lit.: Leibovich Ya., Handbook of Forensic Medical Expertise, M.-L., 1931.