Importance of information in forensic toxicology

Information in forensic toxicology plays a very important role. The forensic pathologist usually seeks toxicologic analyses on basis of the information available at the time of the medicolegal autopsy. Such information may be obtained from different sources: hospitals, authorities, relatives, friends, or neighbors of the deceased and, obviously, macroscopic findings at the time of the autopsy. In order to evaluate the relative importance of these different sources of information, the authors have studied, retrospectively, results of 580 postmortem examinations performed at the Institute of Legal Medicine of Lisbon, wherein toxicologic analyses had been requested. These cases pertain to the years 1987 and 1988, but do not include alcohol determination in the blood in cases of traffic accidents. In 274 (47.4%) of the 580 cases, there were positive findings while in the remaining 306 (52.6%) findings were negative. In cases with positive findings, circumstances and factors, which may have influenced the pathologist's decision to request toxicologic analysis, are discussed. In more than half the cases, hospital information was the decisive factor, while in approximately 25% of the cases, autopsy findings were the justification. In contrast, it is worth mentioning that in approximately 45% of the cases with analytical negative results, requests were made, in cases of blank autopsies, for toxicologic analyses in order to exclude the possibility of poisoning. It is interesting to note that in the same proportion requests were justified on grounds of hospital information. Some of the factors that may explain this apparent discrepancy are discussed. Finally, the relevance of background information is emphasized at the level of the interpretation of analytical results, whether positive or negative.(ABSTRACT TRUNCATED AT 250 WORDS)