of January 12, 2012 No. 33
About the organization and conducting forensic medical examinations in the Kyrgyz Republic
For the purpose of implementation of the Law of the Kyrgyz Republic "About protection of public health in the Kyrgyz Republic" the Government of the Kyrgyz Republic decides:
1. Approve enclosed:
- Rules of production of forensic medical examination of physical evidences and establishment of relationship in judicial and biological departments of laboratories of the center of forensic medical examination;
- Rules of the organization complex medico-criminalistic and medico-autotechnical expertizes in judicial and expert organizations of the Ministry of Justice of the Kyrgyz Republic and the Ministry of Health to the Kyrgyz Republic.
2. To the Ministry of Health of the Kyrgyz Republic to resolve the organizational, financial and other matters following from this resolution within the means provided by the republican budget to the Ministry of Health of the Kyrgyz Republic for 2011 in a month.
3. Publish this Resolution in official mass media.
4. To impose control of execution of this Resolution on department of social security, health care, work and migration of Government office of the Kyrgyz Republic.
Approved by the Order of the Government of the Kyrgyz Republic of January 12, 2012 No. 33
1. Forensic medical examination serves the purposes and tasks of justice. At the same time its activities are directed to every possible assistance of health care to bodies in improvement of quality of the medical help to the population and holding preventive actions.
Forensic medical examination and other types of medicolegal work are performed according to the legislation of the Kyrgyz Republic on health care, the penal, criminal procedure, civil and civil and procedural legislation, orders and other documents published by the Ministry of Health of the Kyrgyz Republic.
2. Forensic medical examination is made in centers/departments of forensic medical examination which are under authority of the Ministry of Health of the Kyrgyz Republic.
The Ministry of Health of the Kyrgyz Republic performs organizational and methodical, practice and administrative guidance of forensic medical examination of the Kyrgyz Republic.
3. Are within the competence of forensic medical examination:
- examination of corpses in cases of violent death;
- medicolegal research of corpses in case of suspicion on use of violence or under other circumstances causing need of production of research of corpse for medicolegal procedure;
- examination of the victims, persons accused and other persons, and also medicolegal survey of citizens for determination of nature and weight of harm to health, age, sexual condition and other questions requiring knowledge of the field of forensic medicine;
- examination of physical evidences by application of laboratory methods of research of objects;
- examination on materials of criminal and civil cases.
4. As the specialist the forensic scientist is recruited in initial and other investigative actions; to survey of corpses on the scene (detection), exhumation, to survey, withdrawal of samples for comparative research, etc.
5. Medicolegal, judicial and chemical examinations and other types of medicolegal work are made by the specialists holding positions of doctors-forensic scientists, medikokriminalist of the forensic scientists managing structural divisions of centers/departments of forensic medical examination (further - forensic scientists).
The procedure for the admission to work on the specified positions is determined by the Ministry of Health of the Kyrgyz Republic.
6. In production of forensic medical examinations the professorskoprepodavatelsky structure of departments of forensic medicine, specialists of the organizations of health care and other departments can be recruited. In case of accomplishment of the specified work these persons by the procedural provision are experts.
7. Forensic medical examination is made under the resolution of the investigator, prosecutor, judge, and also by determination of court.
According to the motivated written order of the investigator, prosecutor medicolegal researches and medicolegal surveys for the purpose of identification of the signs forming the basis for initiation of legal proceedings can be made.
8. The technique of carrying out separate types of forensic medical examinations is determined by the special rules, instructions and methodical instructions approved by the Ministry of Health of the Kyrgyz Republic.
9. Criminal procedure and the civil Procedure Code provides conducting primary, additional and repeated examination, and also commission and complex examination.
Additional forensic medical examination is appointed in case of insufficient clarity or completeness of the conclusion, and also emergence of new questions concerning earlier researched circumstances, charged to the same or other expert.
Repeated forensic medical examination is appointed in case of doubt in correctness of the expert opinion, charged to other expert or other experts. Conducting repeated examination cannot be entrusted to the forensic scientist making primary examination.
Commission examination is appointed in cases of need of production of difficult expert researches and is carried out by several experts of one specialty (profile).
Complex examination is appointed in cases if knowledge of different industries of knowledge are necessary for carrying out researches. It is carried out by experts of various specialties within the competence.
10. Forensic medical examination is carried out by one or several experts, if necessary - experts of various specialties.
Need of participation in production of examination of several experts is determined by degree of complexity and nature of case (large volume of expert research, examination of corpse of the foreign citizen, examination of the exhumed corpse, repeated examination of corpse).
11. If the members of experts in specific case are not stipulated by person who appointed examination it is appointed by the head of the center of forensic medical examination, his deputy for expert work or the head of department (department).
12. Participation of several experts, if necessary - various specialties, is obligatory when conducting the following forensic medical examinations:
3) examination by determination of permanent disability;
4) primary examination in particularly complex cases.
Forensic medical examinations on cases on criminal prosecution of health workers for professional offenses, and also examinations by determination of permanent disability and repeated forensic medical examinations are made only in the republican center of forensic medical examination and its branches and cannot be carried out in city and district departments of forensic medical examination.
Copies of Expert opinions in cases of conducting the examinations specified in subitems 1 and 2 of Item 12 of these rules immediately are represented for control to the chief forensic scientist.
13. The investigator who appointed examination has the right to be present at production of forensic medical examination (or the representative sent them); he is informed of examination production time by the expert. Presence of the investigator in case of examination of corpse is fixed in "Expert opinion".
In case of absence of the investigator to the appointed term forensic medical examination is made in its absence if the further delay can negatively affect quality of examination.
The investigator is not present at examination of person of other floor if examination is followed by exposure of witnessed.
14. Presence of the person accused and other persons in case of production of forensic medical examination is allowed only with the permission of the investigator.
Doctors of the treatment-and-prophylactic organizations, students of medical academies of post-qualifying education, students of medical and legal higher educational institutions can be present at forensic medical examination of corpse with the permission of the head of the expert organization (division). In the course of forensic medical examination of corpse the forensic scientist has no right to offer to strangers explanations and to answer the questions connected with examination.
15. In case of examination production not based on bureau of forensic medical examination, heads of the treatment-and-prophylactic organization provide forensic scientists with accommodation for examination production (morgue, medical office in polyclinic), provide glasswares, container, packaging and other materials for preparation and packaging of the objects intended for laboratory research and give other necessary assistance.
The investigator, the prosecutor render assistance in transfer of the specified objects to medicolegal laboratory.
16. Upon the demand of the investigator, the prosecutor and court the forensic scientist is recruited in initial and other investigative actions, namely: to survey of corpse on the scene (detection), exhumation, to survey, withdrawal of samples, carrying out investigative experiments.
With participation in initial and other investigative actions the forensic scientist performs the activities not as the expert and as the specialist in the field of forensic medicine. He renders assistance to the investigator in detection, fixing and withdrawal of proofs, draws the attention of the investigator to the circumstances connected with detection, fixing and withdrawal of proofs and gives the explanations connected with it, gets acquainted with the protocol and signs it.
Activities of the specialist are regulated criminal procedure and grazhdanskoprotsessualny by codes.
17. The forensic scientist shall be for accomplishment of examination and participation in initial and other investigative actions on challenge of investigation authorities, the prosecutor, court. For evasion or refusal without reasonable excuse of production of examination or participation in initial and other investigative actions, and also the forensic scientist bears responsibility for making obviously false conclusion in accordance with the established procedure.
The forensic scientist performs the functions, as a rule, within the served territory.
18. After receipt of the resolution or determination about purpose of examination the head of the medicolegal expert organization or division (the director of the center of forensic medical examination or the manager of city, regional, district, interdistrict department of forensic medical examination of corpses, or the manager of district department) charges production to her specific specialist (or to specialists) and explains them the rights, obligations and responsibility of the forensic scientist.
When conducting examination in court of the right and obligation of the forensic scientist and his responsibility the chairman in judicial session explains.
19. Forensic scientist is the uninterested person in criminal case designated by the investigator, court or according to their requirement, the head of the expert organization for permission of the questions which arose in case of production of the investigation or legal proceedings. The expert can be appointed from among persons offered by participants of process or is invited by the parties.
The forensic scientist has no right to take part in production of examinations, initial and other investigative actions, researches and survey if he is victim, the civil claimant or the defendant, the witness or is in the related relations, in job or other dependency from the person accused, the victim, the civil claimant or the defendant and their representatives and also provided by the law of other bases for the branch as the expert and immediately shall declare it to the head or person or body which appointed examination.
20. The forensic scientist in case of production of examination for permission of questions has the right:
- get acquainted with the case papers relating to examination subject;
- receive necessary objects and samples for comparative research and making the conclusion;
- require provision to it the additional materials necessary for making the conclusion, or conducting examination with participation of other experts. If the forensic scientist finds that the materials provided to him by the investigator, the prosecutor or court are insufficient for permission of the questions raised before it he reports what materials and documents are necessary for it for examination production. In case of failure to provide them, he in writing reports to the bodies which appointed examination about the reasons of impossibility to draw the conclusion on the questions posed. If it has no opportunity to draw the conclusion only on single questions, then specifies about it in "Expert opinion" or in "The act of medicolegal (judicial and chemical) examination";
- refuse making the conclusion if the questions posed go beyond its special knowledge;
- be present at production of investigative actions and ask the questions relating to subject of the expertize which is carried out by it;
- participate in legal proceedings on the questions relating to examination subject. If in case of examination production the forensic scientist establishes the circumstances important for case concerning which to it questions were not raised, he has the right to specify them in the conclusion.
21. The forensic scientist shall:
- be on challenge of the investigator, court;
- provide the objective conclusion on the questions raised before it;
- not disclose the evidence;
- observe procedure in case of production of investigative actions and during judicial session;
- in case of absence of the expert without valid excuse cash penalty can be imposed on him;
- in case of refusal or evasion of the expert from accomplishment of the obligations without valid excuse, for making obviously false conclusion, he bears responsibility according to the Criminal code of the Kyrgyz Republic.
22. The forensic scientist has no right:
- conduct negotiations with participants of process on the questions connected with conducting examination;
- to independently collect materials for research;
- conduct researches which can entail complete or partial destruction of the provided objects or change of their appearance or the main properties if on it there was no special permission of the investigator, court.
23. If in the course of conducting forensic medical examination there is need for production of medicolegal laboratory researches for permission of the questions raised before the forensic scientist or arising at it personally, then, based on the resolution which is available for it, determination or the written proposal of the investigator, the prosecutor or court it sends objects to laboratory of the center of forensic medical examination. At the same time the forensic scientist fills in the corresponding form in which specifies the short facts of the case, objective data which are found out in case of examination, the purpose of laboratory research.
24. If there is need to consult person subjected to forensic medical examination or medicolegal survey at the specialist doctor working in other healthcare institution it send to this organization with the corresponding letter signed by the director of the center or the head of department (department) of the center, or the forensic scientist.
26. In the course of forensic medical examination by the expert the objects in character able can be revealed to become physical evidences and subject of separate medicolegal, criminalistic or other examination.
These objects are subject to the description in "Expert opinion" or in "The act of medicolegal (judicial and chemical) examination" and transfer on receipt to person who appointed forensic medical examination for the subsequent direction for the corresponding examination.
27. Objects of medicolegal research, including physical evidences, are subject to strict accounting and storage. The expert shall take all measures depending on him for their safety. The procedure for storage and destruction of objects of research and physical evidences are determined by special rules.
28. From corpse any parts, internals and fabrics, blood, urine, etc. for medicolegal laboratory researches can be taken.
Withdrawal for the medical and scientific purposes of cadaveric fabrics, bodies and blood when it cannot prevent the correct medicolegal diagnostics in case of initial and, perhaps, repeated research of corpse is allowed. About withdrawal of fabrics, bodies, blood the corresponding entry in "Expert opinion" or in "The act of forensic medical examination" is made, with indication of that is withdrawn.
29. The forensic scientist can be interrogated by the investigator for explanation or amendment of the conclusion drawn by him; the forensic scientist can state the answers with own hand.
30. By consideration of criminal and civil cases in courts the forensic scientist can be called for making the conclusion and interrogation on the medicolegal expert researches made at stage of pretrial investigation, and also for conducting examination in court investigation.
31. The forensic scientist subpoenaed takes part in the judicial session according to the procedure regulated Criminal procedure and Civil and procedural by codes of the Kyrgyz Republic. He has the right to get acquainted with the case papers relating to examination subject, to ask questions to the victims, persons accused and witnesses in connection with production of forensic medical examination.
32. When conducting forensic medical examination in court the conclusion is constituted by the forensic scientist in writing, announced by it in judicial session and transferred to court. The copy of the conclusion joins the documents of examination which are in archive of the center of forensic medical examination.
The forensic scientist has the right to include in the conclusion conclusions based on the circumstances of a matter, being within its competence, but on which to it questions were not raised.
33. If several experts participate in production of examination, then opportunity to confer among themselves shall be provided to them.
If experts came to unanimous conclusion, then results of examination can be stated in the conclusion signed by all experts; in case of disagreement between experts they represent the separate conclusions.
34. In case of the wrong interpretation by participants of legal procedure of the conclusion drawn by the expert, the forensic scientist shall declare it in the course of court investigation.
35. Results of all types of forensic medical examination including judicial and chemical, are drawn up by the document which according to the codes existing Criminal procedure and Civil and procedural hereinafter is referred to as: "Expert opinion" or "Act of forensic medical (judicial and chemical) examination".
Both of these documents have identical structure. They consist of the following Sections: the prolog including summary of the facts of the case, research part and conclusions (or the conclusions if the statement of forensic medical examination is drawn up).
36. In the prolog shall be specified:
- time and production site of examination;
- the examination conditions of production important for expert research (lighting, air temperature, etc.);
- the resolution or determination based on which examination is made;
- surname, name, expert's middle name, post, education, specialty and length of service, qualification category, academic degree, academic status;
- in case of examination of corpse - surname, name, middle name, age of the dead; in case of examination of the victims, persons accused and other persons - surname, name, middle name, age, residence, the document proving the identity; in case of examination according to case papers and examination of physical evidences the name and number of criminal or civil case, quantity of volumes, sheets of case, the list of the objects and samples which arrived for examination;
- persons which are present at examination production;
- the forensic scientist's subscription about explanation to it procedural law and obligations and about its responsibility;
- the list of the questions raised on permission of examination.
37. In "Facts of the case" data which are necessary for the forensic scientist during the carrying out expert researches and creation of conclusions (conclusion) are stated; in case of examination of corpse - investigative data and contents of medical documents: in case of examination of the victims, persons accused and other persons - medical poll witnessed and claims (survey of children is carried out in the presence of parents or teachers), investigative data and contents of medical documents; in case of examination of physical evidences - investigative data and contents of medical documents.
38. Research part shall contain the detailed description of process of research and all actual data found at the same time. In it the applied methods of research are stated and objective registration is used (pictures, planimetric schemes, etc.). The structure of research part is determined by type of the carried-out expertize. This Section includes:
1) in case of examination of corpse - the description of clothes and data of external examination of corpse; internal research of cavities, bodies and fabrics; the withdrawn objects transferred to the investigator for carrying out other types of examinations; the list of the objects directed to laboratory research; the list of the fabrics and bodies withdrawn for transplantation and also in the scientific and educational purposes, with the description of the made intervention and specifying that is withdrawn; results of the conducted laboratory researches, with indication of dates of their carrying out and receipt of researches by the expert of acts;
2) in case of examination of the victims, persons accused and other persons - the detailed description of all objective medical data revealed in the course of expert inspection, specifying about the direction the expert witnessed to doctors of other specialties, on radiological and other researches, and also results of these inspections and researches; the description of clothes, and also damages and imposings on it in case the clothes were researched; the list of the objects (dabs, etc.) directed to laboratory research, and also results of carrying out additional inspections and researches and receipt of their results by the expert;
3) in case of examination of physical evidences - the detailed description of physical evidences and the traces which are available on them, statement of the applied methods of research and the received results on each type of research, with indication of the used reagents, the equipment and the equipment, process of the analysis. In research part also the research of the provided samples is described;
4) in case of examination on materials of criminal and civil cases - detailed statement in the form of "Facts of the case" of the actual data necessary for the expert analysis.
In case of examination on cases on professional activity of health workers in "Facts of the case" the data received when studying authentic medical and other documents, important for case join.
39. The prolog, the facts of the case and research part constitute together the Expert opinions protocol or "Act of medicolegal (judicial and chemical) examination".
The protocol is signed by the forensic scientist and persons mentioned in the prolog of the document.
40. Conclusions in "Expert opinion" and the conclusion in "The act of medicolegal (sudebnokhimichesky) examination" are the evidence-based opinion of the expert formulated based on results of the examination made by it.
Conclusions (conclusion) are constituted based on the objective data established in the course of examination, the expert analysis of the facts of the case and data of medical science. The specified objective data shall follow from introduction and research parts of the protocol.
Conclusions (conclusion) are drawn up according to the questions raised on permission of the expert. They shall contain also expert evaluation of the objective data revealed in the course of examination which, according to the expert, matter for case. They should be stated clearly, specifically, avoiding, whenever possible, special medical terms. Expert judgment on each conclusion shall be motivated, proved by actual data.
41. The prolog, the facts of the case and research part of "Expert opinion" or "Act of medicolegal (judicial and chemical) examination" is constituted directly in the course of conducting examination. Conclusions of "Expert opinion" and the conclusion of "The act of medicolegal (judicial and chemical) examination" shall be constituted with indication of date of their creation, after the end of all researches (Item 43 of these rules).
42. "Expert opinion" or "The act of medicolegal (judicial and chemical) examination" are constituted at least in duplicate, one of which is given to bodies of inquiry, the investigator, the prosecutor or court, and another - remains stored in the center of forensic medical examination.
Examination of physical evidences is drawn up in production process of expert researches by entries in the working magazine based on which after the end of expert researches the relevant document is constituted.
43. The result of research is issued to the investigator, the prosecutor, court which appointed forensic medical examination about what the mark to whom becomes and when "Expert opinion" or "The act of medicolegal (judicial and chemical) examination" is issued.
Terms of conducting examinations are determined by type, amount and nature of expert researches. The longest on term are examinations of physical evidences and examination of corpses that is caused by carrying out laboratory researches. However and these examinations shall be made within no more than one month from the date of obtaining from the investigator, the prosecutor or court of all required materials.
In case of excess of this term the reason shall be explained with the forensic scientist to the body which appointed examination and the director of the center of forensic medical examination.
44. It is forbidden to substitute "Expert opinion" or "The act of medicolegal (sudebnokhimichesky) examination" for various brief information and statements, and also to use unconfirmed forms and forms of biographical type for creation of the above-stated medicolegal documents.
45. When implementing medicolegal work on the written order of the investigator, the prosecutor, court (Item 7 of these rules), and also in case of production of laboratory researches of the objects directed by forensic scientists (Item 25 of these rules) the statement medicolegal (judicial and chemical) research" or "The act of medicolegal survey" is drawn up ". Procedure for execution of these documents same, as concerning "Expert opinion" or "The act of medicolegal (judicial and chemical) examination" (Items 38-44 of these rules). However, the forensic scientist in these cases does not grant subscription about explanation to him procedural law and obligations, and also about responsibility.
46. Positions of doctors of forensic scientists (over position of the director and the deputy director) are established from calculation:
in the republican center of forensic medical examination and the regional centers of forensic medical examination of the Ministry of Health of the Kyrgyz Republic:
- 1 medical rate on 80 carried-out commission and complex forensic medical examinations a year;
- 1 medical rate on 110 medicolegal researches of corpses a year;
- 400 departures on the scene in year;
- 800 medicolegal surveys of the victims, persons accused, etc. persons in year;
- at least one position on one rural district.
47. Positions of forensic scientists in department of medicolegal research of physical evidences (medicolegal laboratory) are established from calculation:
- in department of judicial and biological research of physical evidences - 1 medical rate on each 1750 objects of research in year;
- in medico-criminalistic department - 1 medical rate for each 50 examinations and 500 photox-ray photographed objects in year (osvidetelstvuyemy, corpses, medicines, separate physical evidences, etc.);
- in judicial and chemical department - 1 medical rate on each 55 complete analyses in year.
"Research object" is understood as one spot (blood, sperms, etc.), each place of any site of the physical evidence from which material for one type of research is taken: one hair, etc.
48. The position of the doctor of the forensic scientist in judicial and histologic department of department of medicolegal research of corpses is established from calculation: 1 position on everyone 400 histologically the researched corpses in year.
The obligation of the doctor-forensic scientist (histologist) includes also the organization of histologic researches by doctors - forensic scientists on places, control of their work and carrying out consultation.
49. The position of the head of department - the doctor-forensic scientist is established (in addition):
- in organizational and methodical department;
- in inspection department of quality of examinations;
- in department of commission and complex examinations;
- in department of medicolegal survey of the victims, persons accused and other persons (out-patient clinic), and also in department of medicolegal research of corpses - in the presence in staff of each department of 5 and more positions of doctors-forensic scientists.
In case of establishment of position of the head of department of medicolegal survey of living persons and position of the head of department of medicolegal research of corpses positions of managers district (interdistrict and city) are considered by departments of forensic medical examination;
- in department of medicolegal research of physical evidences (medicolegal laboratory) - in the presence in staff of department (laboratory) of 5 and more positions of doctors-forensic scientists;
- in the presence in department of medicolegal research of physical evidences (medicolegal laboratory) of 3 positions of managers of departments, the position of the head of department is not established (laboratory). Obligations of the head of department (laboratory) in this case are assigned by the order of the director of the center of forensic medical examination to one of managers of department.
Managers of departments in the presence in staff of department to 8 positions of doctors-forensic scientists (including the manager's position) perform work of the doctor of the forensic scientist of at least 50% of load of the expert, and in the presence of 8 and more positions - only on particularly complex examinations.
50. The position of the manager of department - the doctor-forensic scientist of department of medicolegal research of physical evidences (medicolegal laboratory) is established in the presence in staff of department 3 and more positions of doctors-forensic scientists instead of one of these positions.
The manager of department of department of medicolegal research of physical evidences (medicolegal laboratory) performs work of the expert in the presence in staff of department of positions of doctors-forensic scientists (including the manager's position):
- 3-4 positions - of 75% of load of the expert;
- 5-6 positions - of 50% of load of the expert;
- 7 and more positions - carry out only particularly complex examinations.
51. Positions of nurses on servicing of outpatient appointment in the center of forensic medical examination are established from calculation: 1 position to each position of the doctor-forensic scientist of department of medicolegal survey of living persons.
52. Positions of laboratory assistants of department of medicolegal research of corpses with sudebnogistologichesky department (morgue) are established from calculation:
- Position 0,5 - to each position of the doctor-forensic scientist;
- 1 position - to each position of the forensic scientist of judicial and histologic department.
53. Positions of medical registrars are established from calculation: on 1 position to each 5 positions of doctors-forensic scientists on survey of living persons and to each 5 positions of the doctors-forensic scientists making researches of corpses.
54. Positions of laboratory assistants of all departments of department of medicolegal research of physical evidences (medicolegal laboratory) are established from calculation: 1 position to each position of the doctor-forensic scientist.
55. The position of the nurse, paramedic or laboratory assistant is established from calculation - 1 position to each position of the doctor-forensic scientist in areas (the cities where there is no center), including positions of managers district (interdistrict, city) departments of forensic medical examination.
It is not obligatory for medical registrar to have medical education, in the area (city) department of forensic medical examination if there is no forensic scientist's doctor, then there is no need for the medical registrar, the nurse and the laboratory assistant.
56. Positions of nurses (hospital attendants) are established from calculation:
- Position 0,5 - to each position of the doctor-forensic scientist on survey of living persons and to each position of the doctor-forensic scientist on research of corpses;
- Position 0,5 - to each position of the doctor-forensic scientist in department of medicolegal research of physical evidences (medicolegal laboratory);
- 1 position - to each position of the doctor-forensic scientist in areas (the cities where there is no center), including positions of managers district (interdistrict, city) departments of forensic medical examination.
For servicing of the morgue making acceptance of corpses day and night 2-3 positions of nurses (hospital attendants) are in addition established during the work with possibility of dream days at night.
57. Terms of conducting examinations are determined by their type, amount and nature of expert researches. Duration of completion date of examinations depends on types of the conducted various laboratory researches. Duration of examination shall not exceed one month from the date of obtaining from bodies of inquiry, the investigator, prosecutor or court of all required materials.
58. Terms of production of examinations can constitute:
- in case of production of repeated, commission, complex examinations - up to 30 days, within two months production according to case papers of large volume requiring difficult researches with attraction in production of several doctors of other specialties;
- in case of examination of corpses - up to 30 days, but no more than in three days after receipt of the last result of additional methods of laboratory researches;
- in case of examination of the living persons requiring additional researches and medical dokumentatsiido 30 days;
- in case of examination of the living persons who are not requiring additional researches and medical documentation - up to 5 days.
59. In cases when production of examination cannot be finished at the scheduled time, the forensic scientist, through the head of body of judicial examination, shall warn in writing about it person (body) who appointed examination, having specified the reason and approximate term of its completion, but no more than one month. In case of medicolegal survey of the victims, persons accused and other persons - no more than 5 days.
Approved by the Order of the Government of the Kyrgyz Republic of January 12, 2012 No. 33
1. Medicolegal determination of weight of harm to health is made according to the penal and criminal procedure legislation of the Kyrgyz Republic and these rules.
2. From the medico-legal point of view, it is necessary to understand the violation of anatomic integrity or physiological function of bodies and tissues of the person which resulted from impact of various factors of external environment as harm to health: mechanical, chemical, physical, biological, mental.
3. Forensic medical examination of weight of harm to health is carried out only based on the resolution of the investigator, the prosecutor or by determination of court. In the presence of the written order of bodies of prosecutor's office, inquiry and court medicolegal survey can be carried out.
4. In case of forensic medical examination of weight of harm to health constitute "Expert opinion", and in case of medicolegal survey - "The act of medicolegal survey".
5. Forensic medical examination (survey) of weight of harm to health is carried out by the forensic scientist by physical examination osvidetelstvuyemy. At the same time surely identify the personality osvidetelstvuyemy according to the passport or other document replacing it; the passport or the document replacing it shown osvidetelstvuyemy are specified in "Expert opinion" ("Act"). In some cases the identity of osvidetelstvuyemy can be proved by employees of judicial investigating bodies. In case of impossibility to prove the identity the specified methods - paste the photo of "Conclusion" ("Act"), osvidetelstvuyemy on the title page, and assure seal of department.
6. When conducting forensic medical examination (survey) the expert shall use authentic medical documents. Use of the copies and statements (provided by judicial investigating bodies), on condition of reflection in the last exhaustive data on harm to health and their clinical current is in exceptional cases allowed. These documents shall be certified by the signature of the doctor and seal of the medical organization.
7. If necessary medical documents to the expert are not submitted, he declares to person or body which appointed examination, the petition for provision of the corresponding materials. In necessary cases the forensic scientist, in addition to direct inspection of the victims, can send them to the medical organizations for carrying out consultations, clinical and tool inspections.
8. Heads and doctors of the treatment-and-prophylactic organizations shall render to the forensic scientist who is carrying out forensic medical examination, assistance in carrying out consultations, clinical and tool inspections. The expert reflects the data obtained at the same time in "Expert opinion" ("Act") and has the right to use them in case of formulation of conclusions.
9. When conducting forensic medical examination of weight of harm to health the forensic scientist shall give answers to all questions containing in the resolution (determination of court), except for those for which solution the expert has no necessary data or which go beyond its competence.
10. In case of production of medicolegal survey the forensic scientist shall reveal and describe the available damages, their nature from the medical point of view (grazes, bruises, wounds, etc.), localization, properties, prescription and the mechanism. Other issues are resolved only when conducting forensic medical examination.
11. The criminal code of the Kyrgyz Republic differentiates three degrees of harm to health: severe harm to health, less severe harm to health and little harm to health. Besides, the Criminal code of the Kyrgyz Republic provides special method of damnification to health - torture.
12. The qualifying signs of weight of harm to health are:
- harm to health, life-threatening;
- duration of disorder of health;
- permanent loss of general working capacity;
- loss of any body or loss of its functions by body;
- loss of sight, speech, hearing;
- termination of pregnancy;
- indelible obezobrazheniye of person;
- mental disease or other disorder of health.
For establishment of weight of harm to health availability of one of the qualifying signs suffices. In the presence of several qualifying signs weight of harm to health is established on that sign which corresponds to bigger severity of harm to health.
13. Harm to health, life-endangering at the time of drawing is life-threatening or in case of its regular current, coming to an end with death. Prevention of death as a result of delivery of health care does not change assessment of harm to health as life-threatening.
14. Duration of disorder of health is determined by duration of temporary disability (temporary disability). In case of examination of weight of harm to health consider both temporary, and permanent disability.
15. From the medicolegal point of view, loss of general working capacity should be considered or in case of determined outcome, or with duration of disorder of health over 120 days.
16. In case of determination of percent of permanent loss of general working capacity the forensic scientist is guided by the table of permanent disability.
Permanent loss of general working capacity consists in irreversible loss of functions in the form of activity restriction (loss of the congenital and acquired capabilities of the person to self-service) and to working ability of the person irrespective of its qualification and profession (specialty) (loss of the congenital and acquired capabilities of the person to the action directed to receipt of socially important result in the form of certain product, product or service).
17. At children disability is determined proceeding from the general provisions established by these rules.
18. Duration of temporary disability is determined taking into account the data containing in medical documents. The forensic scientist, estimating nature and duration of disease or violation of the functions connected with damage suffered to health shall proceed from the objective medical data including established in the course of conducting examination.
The forensic scientist shall estimate critically data of medical documents as duration of treatment of the victim can be not proved by nature of injury. If the disease duration specified in medical documents does not answer nature of the caused bodily harm and is not confirmed by objective data, the expert notes this circumstance in the conclusions and establishes degree of harm to health, proceeding from the available data.
On the other hand, the refusal of the victim of leaf of disability and premature appearance at work at personal desire can take place. In all these cases the forensic scientist shall estimate duration of disease and its weight, proceeding from objective data.
19. In case of production of forensic medical examination concerning the living person having kakoyelibo the disease preceding injury or damage of part of body with fully or partially earlier lost function only the harm done to health of the person, caused by injury and prichinno with it connected is considered.
20. The deterioration in the state of health of the person caused by nature and weight of injury, poisoning, disease, late terms of initiation of treatment, its age, the accompanying pathology and other reasons is not considered as damnification to health.
21. The deterioration in the state of health of the person caused by defect of delivery of health care is considered as damnification to health.
22. In the presence of the damages which arose from the numerous traumatic impacts caused demonstrated by several persons weight of harm to health estimate separately.
In cases when multiple damages mutually burden each other, make cumulative assessment of weight of harm to health.
In case of different prescription of emergence of damages assessment of weight of each of them is made separately.
23. In case of damage of part of body with fully or partially earlier lost function consider only injury consequences.
24. In case of damage of healthy pair part of body or pair body only consequences of the caused injury, without the broken function of the pair part of the same name of body or other pair body of the same name are subject to assessment.
26. Severity of the harm done to health of the person is not determined if:
- in the course of physical examination of living person, studying of case papers and medical documents it is not possible to determine essence of harm to health;
- at the time of physical examination of living person the outcome of harm to health, not the life-threatening person is not clear;
- living person concerning whom forensic medical examination is appointed was not and cannot be brought to forensic medical examination, or living person refuses physical examination;
- medical documents are absent, or they do not contain sufficient data, including results of tool and laboratory methods of researches without which are not represented possible to judge nature and severity of the harm done to health of the person.
In similar cases the forensic scientist in the conclusions states the reasons which are not allowing to determine weight of harm to health specifies what data are necessary for it for the solution of this question (medical documents, results of additional researches, etc.), and also determines the term of repeated survey.
27. Creation of any preliminary conclusions containing presumable judgment of severity of harm to health is not allowed.
"Expert opinion" ("The act of medicolegal survey") is handed out to person who appointed examination under list.
28. Sign of severe harm to health is life-threatening harm to health, and in the absence of this sign - damnification consequence to health:
- loss of sight, speech, hearing;
- loss of any body or loss of its functions by body;
- indelible obezobrazheniye of person;
- considerable permanent loss of general working capacity on one third at least;
- termination of pregnancy;
- mental disease or other disorder of health.
To health refer damages, diseases, pathological conditions which entailed permanent loss of general working capacity on one third at least to severe harm.
29. Harm to health, life-threatening the person who in character directly creates threat for life, and also the harm to health which caused development of life-endangering condition (further - harm to health, life-threatening the person).
Harm to health, life-threatening the person, creating directly threat for life:
1) the wound of the head (hairy part, century and okologlaznichny area, nose, ear, cheek and visochnonizhnechelyustny area, other areas of the head) getting into skull cavity including without injury of brain;
2) code change (frontal, parietal bones) and (or) skull bases: cranial pole (forward, average or back) either occipital bone, or the upper wall of eye-socket, or trellised bone, or wedge-shaped bone, or temporal bone, the crack of external bone plate of the code of skull and fractures of facial bones except for isolated: nose, lower wall of eye-socket, plaintive stone, malar bone, upper jaw, alveolar shoot, palatal bone, lower jaw;
3) intra cranial injury: razmozzheny substances of brain; diffusion aksonalny injury of brain; bruise of brain of heavy degree; traumatic intracerebral or intra ventricular hemorrhage; bruise of brain of average degree either traumatic epiduralny, or subduralny, or subarakhnoidalny hemorrhage in the presence of all-brain, focal and stem symptoms;
4) the wound of neck getting into gleam of throat or throat, either cervical department of trachea, or cervical department of gullet; wound of thyroid gland;
- the opened and closed fractures of cartilages of throat; thyroid or cricoid, either cherpalovidny, or nadgortanny, or rozhkovidny, or trakhealny cartilages with gaps mucous, being followed by shock of heavy degree either disorders of breath or other life-endangering phenomena;
5) change of cervical department of backbone: fracture of body or bilateral change of arch of cervical vertebra, either fracture of body of the II cervical vertebra, or unilateral change of arch of I or II cervical vertebras, or multiple fractures of cervical vertebras, including without dysfunction of spinal cord;
6) dislocation of one or several cervical vertebras; traumatic gap of intervertebral disk at the level of cervical department of backbone with sdavleniye of spinal cord;
7) bruise of cervical department of spinal cord with violation of its functions;
8) the wound of thorax getting into pleural cavity or into pericardium cavity or in sredosteniye cellulose, including without internal injury;
9) the closed damage (razmozzheniye, separation, gap) of bodies of chest cavity: heart or lung, either bronchial tubes, or chest department of trachea, traumatic haemo pericardium or pheumothorax, or gemotoraks, or haemo pheumothorax; diaphragm or lymphatic chest channel, or thymus;
10) multiple bilateral fractures of edges with violation of anatomic integrity of framework of thorax or multiple unilateral fractures of edges on two and more anatomic lines with formation of the mobile site of chest wall as "the costal valve";
11) change of chest department of backbone; fracture of body or arch of one chest vertebra with dysfunction of spinal cord or several chest vertebras;
12) dislocation of chest vertebra; traumatic gap of intervertebral disk in chest department with sdavleniye of spinal cord;
13) bruise of chest department of spinal cord with violation of its function;
14) the wound of stomach getting into abdominal cavity including without internal injury;
15) the closed damage (razmozzheniye, separation, gap): abdominal organs - spleen or liver, or (and) gall bladder, either pancreas, or stomach, or small intestine, or obodochny gut, or rectum, or big epiploon, or bryzheyka of thick and (or) small intestine; bodies of zabryushinny space - kidney, adrenal gland, mochetochnik;
16) the wound of lower back and (or) basin getting into zabryushinny space with damage of bodies of zabryushinny space: kidney or adrenal gland, either mochetochnik, or the pancreas or which is descending and horizontal part of duodenum, or the ascending and descending obodochny gut;
17) change of lumbar and sacral department of backbone, body or arch of one or several lumbar and (or) sacral vertebras with syndrome of "horse tail";
18) dislocation of lumbar vertebra; traumatic gap of intervertebral disk in lumbar, lumbar and sacral department with syndrome of "horse tail";
19) bruise of lumbar department of spinal cord with syndrome of "horse tail";
20) damage (razmozzheniye, separation, gap) of pelvic bodies: the opened and (or) closed injury of bladder or webby part of urethra, either ovary, or uterine (fallopian) tube, or uterus, or other pelvic bodies (prostate gland, seed bubbles, semyavynosyashchy channel);
21) the wound of wall of vagina or rectum, or crotch getting into cavity and (or) cellulose of small pelvis;
22) bilateral changes of forward pelvic half ring with violation of continuity: fractures of both pubic and both sciatic bones like "butterfly": fractures of bones of basin with violation of continuity of pelvic ring in back department: vertical changes of sacrum, podvzdoshny bone, the isolated gaps sacral podvzdoshnogo joints; fractures of bones of basin with violation of continuity of pelvic ring in forward and back departments: unilateral and bilateral vertical changes of forward and back departments of basin on one party (change Malgenya); diagonal perelomyvertikalny changes in forward and back departments of basin on counter parties (Vollyumye's change); various combinations of fractures of bones and gaps of joints of basin in forward and back departments;
23) the wound getting into the vertebral canal cervical or chest, either lumbar, or sacral department of backbone including without injury of spinal cord and "horse tail";
24) the opened or closed injury of spinal cord: complete or incomplete break of spinal cord; razmozzheniye of spinal cord;
25) injury (gap, separation, section, traumatic aneurism) of large blood vessels: aorta or carotid (general, external, internal), either subclavial, or axillary, or humeral, or podvzdoshny (general, external, internal), either femoral, or popliteal artery and (or) the main veins accompanying them;
26) stupid injury of reflexogenic zones: areas of throat, area of carotid sine, areas of solar plexus, area of genitalia in the presence of clinical and morphological data;
27) thermal or chemical, either the electric, or beam burns of the III-IV degree exceeding 15 percent of surface of body; the burns of III degree exceeding 20 percent of surface of body; the burns of the II degree exceeding 30 percent of surface of body; the burns of the smaller area which were followed by development of burn disease; burns of airways with the phenomenon of hypostasis and narrowing of glottis;
28) burns the chemical compounds (concentrated by acids, caustic alkalis, various cauterizing substances) defiant, in addition to local, all-toxic action, life-endangering;
29) freezing injuries of the III-IV degree with the area of defeat exceeding 15 percent of surface of body; freezing injuries of III degree with the area of defeat exceeding 20 percent of surface of body; freezing injuries of the II degree with the area of defeat exceeding 30 percent of surface of body;
30) the radiation injuries which are shown serious sharp radiation illness and extremely heavy degree.
30. Harm to health, life-threatening the person, caused disorder of the vital functions of human body which cannot be compensated by organism independently and usually comes to an end with death (further - life-endangering condition):
2) coma of II-III degree of various etiology;
3) sharp, plentiful or massive blood loss;
4) sharp heart and (or) vascular failure of heavy degree, or heavy extent of violation of brain blood circulation;
5) sharp kidney or sharp hepatic, either sharp nadpochechnikovy insufficiency of heavy degree, or sharp pankreonekroz;
6) sharp respiratory insufficiency of heavy degree;
7) it is purulent - septic condition: sepsis or peritonitis, either purulent pleurisy, or phlegmon;
8) the disorder of regional and (or) organ blood circulation leading to heart attack of internal body or gangrene of extremity; embolism (gas, fatty, fabric, or thrombembolia) vessels of brain or lungs;
9) sharp poisoning with chemical and biological substances of medical and not medical application, including drugs or psychotropic drugs, either sleeping medicines, or the medicines operating mainly on cardiovascular system, or alcohol and its substitutes, either technical liquids, or toxic metals, or toxic gases, or the food poisoning which caused life-endangering condition, provided in subitems 1-8 of this Item;
10) different types of mechanical asphyxia; consequences of general impact of high or low temperature (heatstroke, sunstroke, general overheating, overcooling of organism); consequences of impact of high or low atmospheric pressure (barotrauma, lacunar disease); consequences of impact of technical or atmospheric electricity (electric trauma); the consequences of other forms of adverse effect (dehydration, depletion, organism overstrain) which caused life-endangering condition, given in subitems 1-8 of this Item.
31. Sight loss - total persistent blindness on both eyes or such irreversible condition when as a result of injury, poisoning or other external impact the person had deterioration in sight that corresponds to the visual acuity equal to 0,04 below.
Loss of sight on one eye represents loss of its functions by body and belongs to severe harm of health.
Post-traumatic removal of one eyeball which had sight to injury is also estimated on the basis of permanent loss of general working capacity.
Determination of severity of the harm done to health of the person as a result of loss of blind eye is carried out on the basis of duration of disorder of health.
32. Loss of the speech - irreversible loss of capability to express thoughts the articulate sounds clear for people around.
33. Hearing loss - complete persistent deafness on both ears or such irreversible condition when the person does not hear informal conversation at distance of 3-5 cm from auricle.
Loss of hearing on one ear as loss of its functions by body belongs to severe harm to health.
34. Loss of any body or loss of its functions by body:
1) loss of hand or leg, i.e. their department from trunk or permanent loss of functions by them (paralysis or other condition excluding their functions); loss of brush or foot is equated to loss of hand or leg;
2) the loss of productive capability which is expressed at men in capability to copulation or fertilization at women - in capability to copulation or conception, either incubation, or child-bearing;
3) loss of one small egg.
35. Termination of pregnancy - the termination of course of pregnancy irrespective of term caused by damage suffered to health, with development of abortion, pre-natal death of fruit, premature birth or caused need of medical intervention.
Termination of pregnancy as a result of diseases of mother and fruit shall be in direct cause and effect relationship with damage suffered to health and shall not be caused by specific features of organism of the woman and fruit (diseases, pathological conditions) which were available before damnification to health.
If the external reasons caused need of termination of pregnancy by medical intervention (uterus scraping, Cesarean section and other), then these damages and the come consequences are equated to termination of pregnancy and estimated as severe harm to health.
36. Mental disturbance (both "temporary mental disturbance", and "chronic mental disturbance") which emergence shall be in cause and effect relationship with damage suffered to health i.e. to be its consequence.
37. Diagnostics of mental or other disturbance of health is performed by psychiatric, narcological and toxicological examinations, but their communication with traumatized, and also assessment of weight of harm to health owing to mental disease or other disorder of health is made by the commission of forensic scientists which if necessary joins the psychiatrist, the narcologist, the toxicologist (it is necessary to understand mental disease (mental disease) as mental disturbance; the group of mental diseases shall not join the diseases connected with damage of nervous system, jet conditions (psychoses, neurosises); damage is qualified as severe harm to health if only it entailed development of mental disease, regardless of duration of its current and degree of curability).
38. Indelible disfiguration of person.
Severity of the harm done to health of the person expressed in indelible disfiguration of his face is determined by court.
Production of forensic medical examination is limited only to establishment of indelibility of this damage, and also its medical consequences.
It is necessary to understand such injuries of face which do not disappear independently eventually (without surgical elimination of hems, deformation, violations of mimicry and other, or under the influence of not surgical methods) as indelible changes and their elimination requires surgery (for example, cosmetic transaction).
39. Considerable permanent loss of general working capacity on one third at least (permanent loss of general working capacity over 33 percent).
To the severe harm of health causing considerable permanent loss of general working capacity on one third at least irrespective of outcome and rendering (non-rendering) medical care, refer the following damages:
1) open fracture of humeral bone: intra articulate (shoulder heads) or circumarticular (anatomic neck, under - and chrezbugorkovy), or surgical neck or diaphysis of humeral bone;
2) open fracture of the bones constituting elbow joint;
3) the opened or closed change of vertluzhny hollow with shift;
4) the opened or closed change of proximal department of femur: intra articulate (change of head and neck of hip) or extra articulate (mezhvertelny, chrezvertelny changes), the change of big and small spits except for isolated;
5) the opened or closed femur diaphysis change;
6) the opened or closed fracture of the bones constituting knee joint, except for patella;
7) open change of diaphysis of tibial bone;
8) the opened or closed fracture of anklebones of both tibial bones in combination with change of articulate surface of tibial bone and gap of disteel intertibial sindesmoz with incomplete dislocation and dislocation of foot;
9) compression fracture of two and more adjacent vertebras of chest or lumbar department of backbone with dysfunction of spinal cord and pelvic bodies;
10) open dislocation of shoulder or forearm, either brushes, or hip, or shin, or foot with gap of the copular device and capsule of joint.
40. Signs of less severe harm to health are:
1) lack of danger to life;
3) long disorder of health;
4) considerable permanent loss of general working capacity less than on one third.
41. It is necessary to understand the temporary disability which is directly connected with damage as long disorder of health, lasting over 3 weeks (more than 21 day).
42. Less than on one third it is necessary to understand permanent disability from 10 percent to 33 percent as considerable permanent disability inclusive.
43. Sign of little harm to health are:
1) short-term disorder of health;
2) insignificant permanent loss of general working capacity.
44. The little harm to health is subdivided:
- causing the little harm to health which entailed the short-term disorder of health which is directly connected with damage lasting more than 7 days, but not over 3 weeks (no more than 21 day) or insignificant permanent loss of general working capacity to 10 percent;
- the causing little harm to health which did not entail short-term disorder of health, lasting less than 7 days or insignificant permanent loss of general working capacity.
The note to the Sections "Less Severe Harm to Health" and "Little Harm to Health".
The fracture of bones of nose is estimated as little harm to health, in cases of violation of nasal breath assessment is carried out according to the medicolegal table of percent of disability.
The closed changes of cartilaginous part of edges and 11, of the 12th edge are estimated on duration of disorder of health.
45. Tortures represent actions from which harm to health can result.
46. The forensic scientist does not determine the torture fact. However it shall determine:
- weight of the harm to health done by tortures as which understand causing physical or mental sufferings by systematic drawing beating or other violent acts (long causing pain shchipaniye, section, causing multiple, including small damages by blunt or sharp objects, vyryvaniye of hair, impact of thermal factors and other similar actions);
- availability, nature of damages, their localization, the tool and origins of damages, prescription and not simultaneity of their drawing, weight of harm to health in causing cases by its method having character of torture.
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