Anil Aggrawal's Internet Journal of Forensic Medicine, Vol 12, No. 1, (January - June 2011); Forensic Medicine 2011: A New Era: Challenges in Research (Editorial by Carmen Lee Fernandes, South Africa)
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Ref: Fernandes CL. Forensic Medicine 2011: A New Era: Challenges in Research (Editorial). Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology, 2011; Vol. 12, No. 1 (January - June 2011): ; Published January 1, 2011, (Accessed: 

Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology

Volume 12, Number 1, January - June 2011

Editorial

Forensic Medicine 2011: A New Era: Challenges in Research

-Carmen Lee Fernandes, BSc. (Cell Biology), M. Med. Sc. (Human Anatomy)
Independent Practice and Researcher
Chelmsford Medical Centre, 107 Chelmsford Road, Durban. 4001
South Africa
Postal Address: PO box 61, Umhlanga Rocks, 4320
Telephone +27827820223, Fax: +27312018889

Email: carmenfern@mweb.co.za


Carmen Lee Fernandes, South Africa
Carmen Lee Fernandes, South Africa

The beauty of the discipline of Forensic Medicine is its multifaceted nature and its extension and relevance into many branches of medicine. Of note is its medical, social and legal relevance. What is surprising though, is the general lack of funding for research, the limited fellowships and -in comparison to other medical disciplines- its lack of priority as an academic field.

It's an issue that those of us in the field of Forensic Medicine need to be aware of. To be aware is to be enlightened and on this topic many of us can make a difference by raising the profile of Forensic Medicine and all its related fields. Consequently, one aims to raise funding and make solid investment into forensic research. After all, given the significance of our field to many legal systems, to disciplines such as sociology and psychology and mostly to clinical medicine; its imperative that we do not go unnoticed and that we have the opportunities and recognition (and funding!) afforded to other areas of medicine.

In recent years forensic medicine has had a research output that has sometimes been described as insufficient and of poor quality.1 This finding was based on a study of impact factors and external funding. Of course this is a harsh statement but Madea et al (2006) make a good point that forensic medicine has different tasks compared to clinical medicine. " The main difference between basic subjects, clinical and forensic medicine is not a lack of scientific efficiency in forensic medicine but is a result of the questions asked, the available methods and specific aims. Etiologic and pathogenetic research is of only limited relevance in forensic medicine. Thus, forensic medicine is excluded from these research fields, which are mainly supported by external funding. In forensic medicine research mainly means applied research regarding findings, the probative value and reconstruction as well as examination at different points of intersection between medicine and law. Clinical types of research such as controlled randomized, prospective cross-sectional, cohort or case-control studies can only rarely be applied in forensic medicine due to the area specific research fields."1
Editorial by Carmen Lee Fernandes, South Africa - Pullquotes
. . .With the current worldwide recession resulting in many healthcare budget cutbacks, research conducted by medical schools and related institutions will no doubt be adversely affected. Professional staffing will be decreased and research opportunities will no doubt suffer. . .

With the current worldwide recession resulting in many healthcare budget cutbacks, research conducted by medical schools and related institutions will no doubt be adversely affected. Professional staffing will be decreased and research opportunities will no doubt suffer. The funding for forensic research, given its current lack of priority, may all but dry up. Furthermore, research with human participants -for example in the USA- is under public scrutiny more than ever before. " Increasing criticism of the research enterprise in the United States has created strong pressure to provide oversight and review". Various groups ranging from government agencies to the press to concerned citizens and academics are paying very close attention to factors such as investigator compliance. There is pressure to meet accreditation, organizational and educational standards. In a recent published paper ominously entitled: "The New Research Ethic: Will Oversight Requirements Sink Forensic Research" the authors express worry that this increasing pressure on biomedical investigations involving human subjects may require such vigilant monitoring that forensic research will suffer. Particularly since forensic research is often conducted with a more vulnerable population such as prisoners or chronic care patients. Federal regulations require increased consent and monitoring procedures.2

The worry really is; with financial cutbacks, more stringent research requirements and control, will fields such as forensic research survive?

Editorial by Carmen Lee Fernandes, South Africa - Pullquotes
. . .What we need, is to be accountable for protection of the basic rights of research subjects. This accountability needs to extend to every stage of the investigation. If we are faced with stringent regulation that limits our research and limits the participation of subjects in forensic research, then we need to have "our ducks in a row", so to speak, and ensure that our participating institutions have complied with research requirements, quality control, review control etc. so that research is approved. . .

What we need, is to be accountable for protection of the basic rights of research subjects. This accountability needs to extend to every stage of the investigation.3 If we are faced with stringent regulation that limits our research and limits the participation of subjects in forensic research, then we need to have "our ducks in a row", so to speak, and ensure that our participating institutions have complied with research requirements, quality control, review control etc. so that research is approved. The benefit of having all systems in place is the ease of process, the greater likelihood of obtaining finance for forensic research and importantly, allowing for subjects to benefit from the research outcomes.

While different countries have different academic institutional review processes and different sources and allocation of internal and external funding , a common theme appears in the field of Forensic Medicine : lack of funding for forensic medicine; insufficient academic output compared to other disciplines and the need for better regulation of forensic research.

We need a more strategic and integrated approach to raising the profile of Forensic Medicine in the clinical spheres and forensic research in the medical and scientific arena. Perhaps we need revised universal methodology for issues such as regulation of research. If we overcome the problem in each of our countries first - by centralizing and dealing with the relevant issues in forensic research and then putting in place better regulation for forensic research-we will make progress towards improved international communication and international standards.
Editorial by Carmen Lee Fernandes, South Africa - Pullquotes
. . .Areas of improvement could be a revival of Academic Forensic Medicine by the creation of more research positions such as offering PHD and research fellowship positions. The amount of PHD and fellowship research in Forensic Medicine pales in significance when compared to other clinical disciplines such as Cardiology. . .

Other areas of improvement could be a revival of Academic Forensic Medicine by the creation of more research positions such as offering PHD and research fellowship positions. The amount of PHD and fellowship research in Forensic Medicine pales in significance when compared to other clinical disciplines such as Cardiology. In medicine, internationally, there have been many unhealthy relationships between pharmaceutical companies and departments and doctors. Much of that is set to change as legislation clamps down on unethical relationships that exist between medical schools, doctors and drug companies. In the US for example the Association of American Medical Colleges has proposed tough new rules governing interactions between companies and medical schools.

What does this mean for Forensic Medicine? Perhaps it's an opportunity to level the playing fields when it comes to funding of Academic Forensic Medicine and research. It is our opportunity now to co- operate with research regulations, maintain transparency and develop the discipline. Its time to centralize nationally, communicate internationally and invest in our research. Research on regulation of forensic research is pivotal. It is a changing time and an opportunity for Forensic Medicine to get the recognition that it so rightly deserves.

References

(1) Madea B, Saukko P, Musshoff F : Tasks of Research in Forensic Medicine - Different Study Types in Clinical Research and Forensic Medicine Forensic Sci Int. 2007 Jan 17;165(2-3):92-7. [Pubmed - www.pubmed.gov [ElsevierLink]  []  (Back to [citation 1] [citation 2in text)

(2) Candilis PJ, Arikan R, Noone SB, Holzer JC: The New Research Ethic: Will Oversight Requirements Sink Forensic Research? J Am Acad Psychiatry Law. 2005; 33(3):361-7. [Pubmed - www.pubmed.gov [JAAPL Link]  []  (Back to [citationin text)

(3) Young JL: Commentary: Refusing to Give up on Forensic Research: J Am Acad Psychiatry Law. 2005; 33(3): 368-70. [Pubmed - www.pubmed.gov [JAAPL Link]  []  (Back to [citationin text)


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