referat infanticide fix
TRANSCRIPT
The Differences of Infanticide and Child Murder (Non Infanticide)Lecturerdr. Arif Rahman Sadad, Sp. F, Msi. Med, SH, DHMResident
dr. Ricka Brillianty Zaluchu
MEMBERS OF GROUP
Christy Imelda Margaretha M Ketut Suwadiaya Vania Petrina Febrina Ernawati Ketut Wida Komalasari Supri Suryadi
INFANTICIDE
Act of a mother who kill her baby at the time of birth or as soon as after birth because the mother fear that the other people will discover that the mother has given birth.
CRITERIA OF INFANTICIDE
The perpetrator must be biological mother The victim must be own baby The killing must be done at the time of birth
or shortly thereafter The motive is frightened of the other people
discovered she has given birth and do not want to be ashamed
THE BASIC LAW OF INFANTICIDE IN INDONESIA
Pasal 341. Seorang ibu yang karena takut akan ketahuan melahirkan anak pada saat anak dilahirkan atau tidak lama kemudian, dengan sengaja merampas nyawa anaknya, diancam karena membunuh anak sendiri dengan pidana penjara paling lama tujuh tahun.
Pasal 342. Seorang ibu yang untuk melaksanakan niat yang ditentukan karena takut akan ketahuan bahwa ia akan melahirkan anak, pada saat anak dilahirkan atau tidak lama kemudian merampas nyawa anak sendiri dengan rencana, dengan pidana penjara paling lama sembilan tahun.
Pasal 343. Bagi orang lain yang turut serta melakukan kejahatan yang diterangkan dalam pasal 342 KUHP diartikan sebagai pembunuhan atau pembunuhan berencana.
Forensic examinatio
n
Viable or not
the infant livebirth or
stillbirth
signs of nursing
Aterm or not
Sign of injuries
How long the baby has been
lived
Cause of death
1.Livebirth or Stillbirth
Livebirth: is a complete release of conception products, which after separation, baby breathe or show any other signs of life regardless of gestational age or condition of the placenta.
Stillbirth: is death of conceptus before exiting or incurred by the mother, regardless of gestational age (either before or after the age of 28 weeks gestation in the womb). Characterized by not breathing infants or there’s no signs of life, such as heart rate, umbilical cord pulse or skeletal muscle movements
SIGNS OF LIFE
a. Breathing Diaphragma position:
- breathing infants: diaphragma location at costae 5 or 6.
- not breathing infants : diaphragma location at costa 3 or 4.
Lungs macroscopic- Breathing infants: pink color, not
homogenous(mottled), sponge-like consistency, - Not breathing infants: red purples color,
homogenous, rubbery consistency
Lungs Floating test“no touch technique”Principle – Specific gravity of an unrespired lung is 1040
to 1056. it is heavier than a respired lung whose specific gravity is 940. The foetal lungs therefore sink in water and those that have breathed, float.
A negative result does not mean definitely stillbirth so that sometimes need a histopatologic examination to ensure stillbirth or livebirth
Pulmonary floating test less reliable if it was obviously decomposed, so the test is not recommended
1. Remove the tounge through
lower jaw2. pull towards ventrocaudal until palatum mole appear
then separated from the
palatum durum
3. Releas Faring, laring,
esophagus and trakea from fascia that
attached on vertebrae
4.Tied Esofagus and trakea
under cricoid cartilage
5. Organ expulsion of
the tongue to the lung by
using forceps or pincers and scalpel surgery
6. Tied esophagus
above diaphragma
then cut above the band
7. Put it in the water and
whether float or sink
8. Sequentialy separated and put in water: left and right lungs,each lobes, Five
small pieces of periphery of each lobes
9. If small pieces of lung are float, apply
pressure on small pieces of
lung with cardboard and then put them again in water
Lungs microscopicLungs preparat fixation with formalin 10%, and
histopatologic stain with Hematoxilin eosinGlands-like structure is sign that infant’s lung have
not yet reached 26 weeks gestationSpecific sign for unrespired lungs of infant is
projection of cushion-like form that increase with thin base that looks club-like.
Check for presence of meconeum and amnion fluid
NO. Unrespired lungs Respired lungs
1 Small volume, collapse, attach to the vertebra, dense consistency, no crackles
Volume 4-6x larger, partially covering the heart, such as the consistency of rubber foam (crackles positive)
2 Sharp edge Blunt edge
3 Homogeneous color, purplish red
Pink color
4 If the lungs are squeezed under water there isn’t gas bubbles came out or when there was a decay the bubble is large and different
Bubble gas soft and same size
5 No alveoli which expands on the surface
Visible alveoli, sometimes separated each other
6 If it is squeezed less blood come out and forthy (except when there is decay)
When it is squeezed a lot of frothy blood came out although decaying not yet shown (the blood volume is twice much than before breath)
7 Lung weight less than 1/70 BW
Lung weight approximately 1/35 BW
8 All parts of the lungs sank in water
Parts of the lungs that inflate floating in the water.
SIGNS OF LIFE
b. CryingCries that sounded not mean the baby is born alive
because crying sound can occur either in uterus or vagina
c. Muscle movementThis situation must be witnessed by witnesses,
because in post mortem could not be proven.d. blood circulation, heart beat and
haemoglobin changeIncludes functional evidence that is umbilical cord
pulse and heart rate (there must be a witnesses)and anatomical evidence that is changes in Hb and
changes in the ductus arteriosus, foramen ovale and the ductus venosus
e. gaster and intestine contentWhen there is foreign body found in gastric baby
which can only be entered due to swallowing reflex, then this is evidence of life (livebirth)
f. placenta condition- presence or absence of umbilical cord pulse after
birth(there must be a witnesses)- drying of umbilical cord, position and type of knot,
how umbilical cord was cutg. skin conditionMaceration can occur when a baby has died a few
day in the uterus(8-10 days)
Evidence of intra uterine fetal death:a. Ante partum rigor mortis which often cause
difficulties during childbirthb. Maceration, is softener of infant in amniotic fluid
marked by: Brownish-red color (green color on decaying) White cuticule, often made bulae with reddish fluid. Limber bones and detached from soft tissueMaceration occur when the infant was dead 8-10
days in uterus
NOT SIGNS OF NURSING
The body is still covered by blood
The placenta is still attached to the umbilical cord and still connected with umbilicus.
If the placenta does not exist, then the end of the cord seems irregular, it can be known by putting the end of the cord to the surface of the water.
There are vernix caseosa on the forehead and in the area there are crease skin, such as crease armpits, groin and the back of the buttocks.
VIABILITY
•Ages of gestation ≥28 weeks.•Body Length ≥ 35 cm.
•Body Weight ≥ 2500 gram.•Fronto-occipital circumference ≥ 32 cm.
•No severe birth defects. Example: anensefalus, esophageal stenosis
Aterm baby
Eksternal Characteristics
Center of Bone Reinforcement
Interpretation of age
gestation
EKSTERNAL CHARACTERISTIC Ears
Cartilage auricle was formed perfectly and when folded quickly returned to its original form.
Breast
Well defined nipple, areola protruding above the surface of the skin and areolas diameter > 7 mm.
Fingernails
Finger nails was passed over fingertips, and relatively hard so that the palm examiner firmly felt the scratch.
Foot Soles line
There are lines on the entire sole of the foot, from the front to the heel. We assessed lines that wide and deep.
Genitals eksterna
Male : testicles was move perfectly to scrotum, and scrotal skin rugae was perfectly form. Female: labia minora was well covered by labia majora
Hair
hair is relatively rough, each strand separated from each other and looked shiny. Hairline on forehead was obvious.
Skin opacity
In mature infants, the fat tissue under the skin is thick enough so that a rather large blood vessels in the abdominal wall does not look or seem vague.
Processus xiphoideus
In mature infants processus xiphoideus bent to dorsal.
Eyebrows
In mature infants, eyebrows was complete..
OSSIFICATION CENTER
• Distal femur, proximal tibia, and cuneiform cuboideum ossification appears at 36 weeks gestation.
• Talus and calcaneus ossification appears at 28 weeks gestation.
INTERPRETATION OF BONE AGE
De Haas Formula•First 5 months of head-heel length in centimeters is equal to the square of the number of months.
•Last 5 months, the length of the body is the same as the number of months multiplied by the number 5.
Arey Formula •Age (months) = length of the head - heels (cm) x 0.2•Age (months) = length of the head - buttocks (cm) x 0.3
Finnstrom Formula •Using length oksipito-frontal head circumference .•Gestational age = 11.03 + 7.75 (head circumference lenght)
Cause of natu
ral death
Bleeding
Solusio Plasenta
Malforma tion
Immaturity,
congenital disease
Larynx eous
spasm
Eritroblas tosis
foetalis
Accidental death
Mother death
Stranggulation of
umbilical cord
Long duration
of delivery
Traumatic
Homicide
STRANGULATION
BLUNT TRAUMA TO THE HEAD
DROWNING
SMOTHERING
SHARP TRAUMA
POISONED
EXAMINATION OF THE MOTHER
POST PARTUM SIGNS
•a. New rips on the genitals•b. Ostium uteri can be passed by fingertips•c. Bleeding from the uterus•d. Uterine size•e. Breasts secrete milk•f. Hyperpigmentation of aerola mamma•g. Striae gravidarum
HOW LONG THE BABY HAS BEEN
DELIVERED•a. size of the uterus return to its original size in 2-3 weeks•b. lochia: 1-3 days post partum coloured red, 4-9 days post partum coloured white, 10-14 days post partum there is no sap childbirth•c. genital laceration heals in 8-10 day
Sign of Partus Precipitatus
• a. rips on the genitals• b. invertio uterine• c. rips of umbilical cord• d. injuries to the baby's head that
may cause bleeding under the scalp or within the skull
Histopathology examination
HOW TO PROVE SUSPECT IS THE MOTHER OF THE BABY?
CHECK THE TIME OF HAVING GIVEN BIRTH CHECK BLOOD TYPE DNA EXAMINATION
CHILD MURDER
Murder of the child when his age more than 1 day in life by father, mother and step parents as perpetrator.
In Indonesia Infanticide vs Non infanticide Motive Perpetator Time of death Victim
THE FACT
In 2007 there are 470 cases child abuse in Indonesia, 67 were killed while 23 was a rape cases with family were the perpetator.
In 2004 there are 27 children were killed by their parents in Canada with father, mother and step parents as perpetator.
MOTIVEMOTIVE
RESNIK CLASSIFICATION
AltruismAcute
PsychosisUnwante
d children
Spousal revenge
Accidental
ALTRUISM Is a murder commited
out of love to reliave the real or imagined suffering of the children
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Jordan was a divorce mother kill her own son because of her financial problem.
She think after her death,her son will have sexual abuse by her ex-husband
Acute Psychosis
Major Depresive
Schizophrenia
Unwanted Children
SHE DIDN’T WANT YOU
ACCIDENTAL
Unintentional death due to child abuse
Generally following
with BATTERED
CHILD SYNDROME
Injuries sustained by a child as a
result of physical abuse
SPOUSAL
REVANGE!!!!
BOUGET AND GAGNE CLASIFFICATION
PerpetratorPerpetrator
CHILD MURDER BY MOTHER
It happen usually with depression and have a lack of mental and material support.
Many factor can lead mother to do child murder.
Factor
Financial problem
Conflict with family
member
Abusive adult
relationship
Being primary
caregiver
Limited social
support
POSTPARTUM DEPRESSION
New mother + Giving
a birth =JOYFULL
DEPRESSED
POSTPARTUM DEPRESSION
Baby blue
Postpartum
depression
Postpartum
psychosis
1. Sleep disorder
2. Mood swing3. Feeling of
vulnerability
1. Anxiety2. Irritabality3. Fatigue4. Felling Guillty
1. Extreme confussion
2. Agitation3. Feeling
hopeless4. Hallucination
s occur
CHILD MURDER BY FATHER
Bourget and Gagne found there is 77 case of child murder by his father in Quebec while in different
research they found there is 24 case of child murder by his mother in Quebec.
Father more often do a childmurder than mother
FACTOR
1.Financial Problem
2.Insecure Married
3.Afraid of Separation
THE FACT
There is lack of reseach of child murder by father
There is no spesific basic law about child murder (non infanticide) in Indonesia, then basic law of child murder refer to KUHP pasal 338, 339, 340, 344, and children law.
Pasal 338“ Barang siapa dengan sengaja merampas nyawa orang lain, diancam karena pembunuhan dengan pidana penjara paling lama lima belas tahun.” Pasal 339“Pembunuhan yang diikuti, disertai atau didahului oleh suatu perbuatan pidana, yang dilakukan dengan maksud untuk mempersiapkan atau mempermudah pelaksanaannya, atau untuk melepaskan diri sendiri maupun peserta lainnya dari pidana dalam hal tertangkap tangan, ataupun untuk memastikan penguasaan barang yang diperolehnya secara melawan hukum, diancam dengan pidana penjara seumur hidup atau selama waktu tertentu, paling lama dua puluh tahun.”
Pasal 340Barang siapa dengan sengaja dan dengan rencana terle bih dahulu merampas nyawa orang lain, diancam karena pembunuhan dengan rencana, dengan pidana rnati atau pidana penjara seumur hidup atau selama waktu tertentu, paling lama dua puluh tahun.” Pasal 344“Barang siapa merampas nyawa orang lain atas permintaan orang itu sendiri yang jelas dinyatakan dengan kesungguhan hati, diancam dengan pidana penjara paling lama dua belas tahun.”
UNDANG-UNDANG PERLINDUNGAN ANAK
Pasal 13(1) Setiap anak selama dalam pengasuhan orang tua, wali, atau pihak lain mana pun yang bertanggung jawab atas pengasuhan, berhak mendapat perlindungan dari perlakuan:a. diskriminasi;b. eksploitasi, baik ekonomi maupun seksual;c. penelantaran;d. kekejaman, kekerasan, dan penganiayaan;e. ketidakadilan; danf. perlakuan salah lainnya.2) Dalam hal orang tua, wali atau pengasuh anak melakukan segala bentuk perlakuan sebagaimana dimaksud dalam ayat (1), maka pelaku dikenakan pemberatan hukuman.
CONCLUSION
We can see the differences of infanticide and child murder (non infanticide) from 4 aspects:- Perpetrator,- Victim- Time - Motive - Basic law
Forensic examination must be done to the suspect (biological mother) and the victim (the baby).
Purpose of the examination are to identify Baby is live birth or stillbirth. The baby is viable or not. The baby is aterm or not. There is sign of nursing or not. Cause of death