History of Forensic Medicine in Hungary
Forensic medicine – formerly medical jurisprudence – developed out of necessity together with the state affairs and law and order. In the feudal system trepassing against an individual was regarded a private affair, without interference by the governmental power. Standardized prosecution could not be established, therefore the seeds of forensic medicine could only be detected in the laws of the Arpad dynasty rulers and the kings of Hungary from different dynasties. In 1035 King Istvan I separated premeditated from unintentional murder, in 1252 King Istvan II separated the „vulnus mortiferum” and „vulnus non mortiferum” types, in 1274 King Laszlo III declared the wounds untreatable by experienced specialists fatal, in 1370 the Szepes Bill of Rights decreed the judicial inspection of the wound. 6q 1 The work of Karoly V German Emperor „Peinliche Halsgerichtsordnung” written in 1532 had great effect on the development of forensic medicine. The work „Praxis criminalis” written by Ferdinand II in 1656 contained provisions as to the employment and functioning of compulsory and regular medical experts. The law determined the establishment of Hungarian forensic medicine. An outstanding personality was Karoly Rayger, who in 1680 was among the first to describe the so-called lung tolerance test (tüdő légpróba) which is still in practice today. A law was passed in 1726 regarding the questions of forensic autopsies and in 1788 related to coroner’s inquests. In 1793 the Council of Governor-General brought a rule to include forensic medicine in the training of medical students. In 1807 the role of physicians in the rules of court was regulated by law. In the year 1872 the forensic doctors received letters of commission from the Ministry of Justice. A law was passed in 1876 to formulate crowner’s quest, autopsy and professional action in the rules of law and order. A Forensic Medical Council was established in 1890 to resolve adverse medical expert opinions. In 1883 a law was passed to bind forensic medical practice to qualification. In 1896 forensic psychiatry became a medical expert activity, and the National Institute of Monitoring and Psychiatry was established. The section devoted to the life of the universities comprises the period between the two World Wars.
Till the 1960s, a so-called designated judicial expert system functioned in Hungary – also including medicine – with the employment of respective specialists for a fixed fee when necessary. The Minister of Justice appointed the expert to the court of justice through tender, first temporarily then permanently after faultless activity. The regular judicial experts became public servants from 1950 and from then on they were not paid any extra fees. An important stage in the regulation of the institutional system was that the judicial experts worked together with the county/metropolitan/municipal courts and district courts. By the beginning of the 1960s there was a demand for work as an expert to become a profession and main occupation. Besides the university departments of forensic medicine, construction of a system of Offices of Forensic Medical Experts began in 1965, supervised by the Ministry of Justice. Working along with the experts of these Offices were also the experts of the university departments and those working within the Ministry of Internal Affairs, as permanent experts. There was diversification among the medical experts since they belonged to the three portfolios: judicial, home affairs and health, with all their legal consequences. In the 1970s the judicial expert system widened further, then in 1992 the Department of Judicial Expert Institution was established, which was modified to Institute of Judicial Experts and Research in 2006. As the consequence of the restructuring of the police force, the technical management and supervision throughout the nation became the task of the chief medical officer. The technical management and operation of the criminal police medical officer service was continuous between 1999-2006 despite changes in its organization and statutory provision. Owing to the reform of the Internal Affairs portfolio, in 2006 the police force belonged to the Judicial portfolio and its name was modified to Ministry of Justice and Law Enforcement. From January 1, 2007, the XLVII Act of 2005 on judicial expert activity partially excluded the police medical officers in the service of the police force from judicial medical expert activity. Medical expert activity was transferred to the judicial expert system of the Ministry of Justice.
The university departments assumed characteristic conditions among the judicial medical experts. With the reform of the higher education system, the various departments became part of the educational portfolio. Their role in the gradual and post-gradual training of forensic medicine remained unchanged as a university privilege, as did also the official appointments regarding both autopsies and patient examinations. A legislative provision pertaining to the organizational structure and operational order of the judicial expert system is to be expected in the near future. This will contain the legal status of the participants of the expert system, thus the universities, as well as the univocal definition and location of the scope of duties within the newly structured judicial expert system.
The history of Hungarian forensic medicine is functionally connected to the university departments of forensic medicine.
Department of Forensic Medicine of the Semmelweis University, Budapest
The legal predecessor of the Faculty of Medicine of the Semmelweis University was the Medical Faculty of Nagyszombat established in 1770, with five departments. It did not have a department of forensic medicine. During the 23 years till 1793 the curriculum was taught by the lecturers following the example of the medieval Italian universities, within the frame of the „main professions”, surgery and obstetrics (József Jakab Plenk 1770-1783) and pathology and medical practice (Mihály Shoretics 1770-1784).
József Jakab Plenk was the first tutor of obstetrics and surgery at the Nagyszombat Medical Faculty, he published his book on forensic medicine entitled „Elementa Medicinae et Chirurgiae Forensis” in 1871 and his work „Toxicologia seu doctrina de venernis et antidotis” on forensic medical toxicology in 1875 in Vienna. His books were used at foreign universities as well. The leaders of the Faculty of the Nagyszombat University accepted the new subject „State medicine” (forensic medicine and medical public administration) as an independent field of science in 1793. The first lecturers, tutors of theoretic medicine were Ferencz Schraud (1793-1802), then Ferencz Bene Sen. (1802-1816).
Mention should be made of Ferencz Schraud, who published three books on forensic medicine: „Aphorismi de politia medica” (1795), „De forensibus judicum et medicorum relationibus. In vicem introductionis ad medicinam forensem disserit” (1797) and „Elementa medicinae forensis” (1802).
With all probability, however, the first work on forensic medicine is linked to János Jakab Neuhold (1700-1738), whose writing „Introduction ad jurisprudenciam” only remained in the form of a manuscript. Neuhold was the chief medical officer of Komárom county and a member of the German Academy of Natural Sciences.
Ferencz Bene Sen. published his books „Elementa policae medicae” in 1807 and „Elementa medicinae forensis” in 1811.
The Department was headed by Sándor K. Ajtai between 1822 and 1915 (figs 1,2). He worked in Vienna with Rokitansky, then became leader of the pathology department of the Szent Rókus Hospital. From 1874 to 1882 he was director of the Department of Forensic Medicine in Cluj. He became the first director of the Department of Forensic Medicine of the Medical Faculty of the Royal Hungarian University of Sciences opened in Budapest on January 1, 1890. He established the units of forensic psychiatry and chemistry within the Department in 1872 and 1892. His name is linked to the elaboration in 1902, then the introduction in 1904 of the forensic medicine examination system.
Balázs Kenyeres headed the Department from 1915 till 1935 (fig 3). He started his career as a pathologist in the department of Sándor K. Ajtai. In 1895 he was appointed head of the Cluj department, then in 1915 of the Budapest department. He was a scholastic personality, six of his students qualified as university lecturers. He was member of the Hungarian Academy of Sciences. He played a decisive role in the expansion of the material proof branch of science, his contribution is still of standing value internationally. He was founder of the scientific journals „Archiv für Kriminologie” and „Kriminalistische Monatsheft” as well as of the „Gesellschaft für Kriminologie” society. His publications „Sachliche Bewewie bei der Klärung von Todesfällen” and „Gerichtliche Medizin” came out in 1935. In 1905 and 1935 he published his textbook „Forensic Medicine” in three volumes. He became honorary member of the Imperial Academy of Halle in 1930.
The next head of the Department following Balázs Kenyeres was Ferenc Orsós from 1935 to 1944 (fig 4), director of the Department of Pathology and Forensic Medicine of the University of Debrecen between 1918-1935. He was the first to describe vital reactions and connective tissue metachromasia. He was also the chief specialist of personal identification work in Kaytni, Poland. Together with the University, in 1944 he settled in Halle. He was pronounced a war criminal by the people’s court in 1946 and was deprived of all his positions, including his academic membership. Despite pressure from the Sovjet Union, the Americans did not give him over to the Hungarian authorities. In 1946 he received invitation to become tutor of artistic anatomy at the University of Mainz. His publication „Kunstgeschichte und Kunstanatomie” appeared in 1950. He died in Mainz in 1962 and was buried in the university parcel.
Between the period 1946-1955 Gyula Incze headed the Department.
He was extensively involved in studies on the pathology of electrical injuries and the biological effects of electricity. His diatome study results for the verification of drowning in water won him recognition all over Europe. As the consequence of the 1956 street battles, the Department located on Üllői street sustained serious damages. In 1956-57 the assigned director of the Department was Dr. László Haranghy, head of the 2nd Department of Pathology of the Semmelweis Medical University, who had both training in and practical knowledge of forensic medicine.
From 1958 till 1969 Dr. Sándor Ökrös became director of the Department, invited from Debrecen by the Budapest Faculty. He was a student of Ferenc Orsós, receiving significant pathology training and was an illustrious representative of forensic pathology. He spent a longer period of time in Vienna in the Institute of Haberda, becoming friends for life with Breitenecker. His scientific activities were prominent, and worthy of note were his researches on the papillary pattern appearing also as a book: „The Heredity of Papillary Pattern”.
In the years between 1969 and 1992 Dr. Endre Somogyi became the director of the Department, who was an extremely dynamic personality with wide international relations. He showed particular interest towards the introduction of new morphological research techniques. He made significant contributions to our knowledge on the pathomechanism of fine structural tissue damage developing on the effect of electricity. He received recognition on several accounts both nationally and internationally. His fruitful scientific work is denoted by 241 publications and 20 books and book-chapters, respectively. His textbook Forensic Medicine had 6 editions. He was Rector of the University from 1985 till 1989, in two cycles. Together with Péter Sótonyi, he edited the book „Sudden Cardiac Death” published in 1984.
His department successor became Péter Sótonyi, who was head of the Department from 1992 till 2003. His basic pathology training determined his activities and attitude. He improved the Department with new laboratories (DNA, scanning electron microscopy and immunohistochemistry). From his scientific activities it is worth mentioning his studies on the cytochemical analysis of the localization of heart glycosides as well as on the cell model of isolated cardiac muscle. Several universities appointed him h.c. doctor and honorary senator, respectively. He conducted a Ph.D. school programme at the Semmelweis University. He was Rector of the University between 2000-2003, from then on he became Rector Emeritus. Three editions of his textbook „Forensic Medicine” were published. He became member of the Hungarian Academy of Sciences. He was director of the National Institute of Forensic Medicine till 2003, which was then taken over by Éva Keller. His Ph.D. dissertation was prepared in the United States. He habilitated at the Semmelweis University in 1999. He won a research fellowship from the American Heart Association for the years 1993-94. His scientific interest focused on drug-induced brain alterations. Upon invitation from the Case Western Reserve University he spent one year at the neuropathology department. Building on the traditions of the institution, he expanded the laboratory system. Further, he introduced Insurance Medicine into the profile of the Department.
Department of Forensic Medicine of the University of Debrecen
University education at Debrecen can be traced back 400 years. The new University of Debrecen expanded with a medical faculty was opened in 1918. Till 1946 the pathology and forensic medicine units were one department, after which they were separated. The two departments were directed by Ferenc Orsós between 1919 and 1935. He started his career at the Department of Pathology of the Budapest University. He was an excellent pathologist, with pathology based forensic medicine operating under his guidance. His conclusions regarding vital reactions are still cited in today’s literature (Die vitalen Reaktionen und ihr gerichtsmedizinische Bedeutung. Beiträge z. Path.Anat.u.z.Allgem. Pathol. Bd XCV, 163, 1935). Upon invitation from the Budapest Medical Faculty, in 1935 he took over the Department of Forensic Medicine in Budapest. Between 1936-1944 László Jankovich was director of the Department of Forensic Medicine functioning within the organizational unit of the Pathology Department. His scientific activities focused on the morphology of alterations occurring on the effect of alkali poisoning.
Between the period 1945-1957 Sándor Ökrös was the assigned, then the appointed director of the independent Department of Forensic Medicine. He was one of the most successful members of the Orsós school. His researches were manifold, including studies on skull trauma-related liquor circulation problems, the role of Paccini-granules, the traumatic alterations of the hypophysis and the hypophysis stem (nyél). He carried out significant studies on the traumatic alterations of muscle tissue by means of polarization optical analysis, and also noteworthy were his studies on the alterations of the protein components actin and myosin. He started research on ujjlécrajzolat ?? in Debrecen. He became head of the Budapest department in 1958, upon invitation.
His pupil, János Nagy, became director of the Department from 1957 till 1961 by assignment, then from 1961 till 1980 by appointment. His scientific researches involved the questions of alcohol breakdown and detectability. He elaborated the error potentials of the Harger technique, he modelled a semi-quantitative method for the determination of alcohol and ether. His name is linked to the elaboration of the Nagy-Zsigmond probe. Between 1980-2000 László Buris headed the Department, as assigned director for the first two years, then by appointment. He established widespread international connections with the United States and Israel. He also established an Eastern-Central European toxicological reference centre at the Department. He is member of several international societies and sub-committee member of the European Council. His english handbook entitled „Forensic Medicine” was published by Springer.
The next head of the Department was Mihály Varga from 2000-2006. He was a specialist with extensive knowledge on pathology, formerly leader of the pathology unit of a large hospital. At the Department he was member then head of a work group researching alcoholic liver damage. He died at an early age due to severe diabetes. The present director of the Department by assignment is László Herczeg.
Department of Forensic Medicine of the University of Pécs
The medical faculty was established in 1918 at the Hungarian Royal Erzsébet University of Sciences in Bratislava. King Karoly IV conferred the title of full professor on Béla Entz and appointed him director of the University’s Departments of Pathology and Forensic Medicine. After Trianon the medical faculty moved to Budapest, then from 1923 it finally settled in Pécs. The first complete academic year of the medical faculty in Pécs was in 1924/25. Béla Entz directed the two Departments till 1948 when they became independent.
Béla Entz, an outstanding pupil of Antal Genersich, was also an outstanding personality of pathology and paleopathology. He learnt at the Universities of Budapest, Vienna and Berlin. He was member of the Hungarian Academy of Sciences. He won state fellowships to the Universities of Dresden and Munich, performing scientific research work. From 1934 he put Konrád Beöthy in charge of the Department of Forensic Medicine.
From l948 till 1958 Konrád Beöthy was director of the Department of Forensic Medicine. Between 1927-1929 he worked in Vienna at the Department of Haberda, then of Entz. He habilitated in 1931 and became private tutor in 1932. Between 1945-1948 he was university professor at the Department of Forensic Medicine in Cluj and Marosvásárhely. Upon invitation, from September 1, 1948 he became director of the independent Department in Pécs. From his scientific activities his researches on the pathogenesis of silicosis and the rehabilitation of the injured are of significance.
From l958 Lóránt Tamáska became head of the Department, until his departure to Germany in 1961. He worked as a medical expert in Augsburg, Cologne, Aachen, Lübeck and Düsseldorf. He was a pupul of Ferenc Orsós. In the years 1961-62
Gyula Farkas was the assigned head of the Department.
The next appointed director became Robert Budvári from 1962 till 1976. He was the pupil of Gyula Incze in Budapest. His field of interest was blood alcohol research and serology. He was the director of the National Institute of Medical Experts between 1976-1978. In the years 1976-77 Péter Guth headed the Department.
From 1977 László Harsányi was the director till his death in 1992. He was a Gyula Incze pupil. His researches focused on forensic osteology, the comparative analysis of skeletal findings as well as medical expert identification. Together with Vilmos Földes he wrote the book „Medical expert identification”. He played significant role in the identification of the victims of the reprisals after the 1956 events (e.g. Imre Nagy, Pál Maléter). The next department head became Árpád Németh in 1992, who started at the Department of Pathology. His researches were significant in the field of respirational distress syndrome and hyalin membrane disease. He died young in 1993.
Department of Forensic Medicine of the University of Szeged
Following World War I, the József Ferenc University of Sciences had to move from Cluj to Szeged in 1921.
From 1921-1925 Károly Demeter headed the Department, who was the pupil of Balázs Kenyeres. Then after Kenyeres moved to Budapest, he became director of the Department of Forensic Medicine in Cluj. His studies on radiography and histology gave him international acclaim. His researches on shot wounds are noteworthy from criminalistic point of view as well. He summarized and increased the number of tests for
the demonstration of blood. From 1925 till 1934 László Jankovich was head of the Department. In Budapest he worked with Generisch, Budai and Kenyeres. Among his successful pupils were Gyula Incze and Gyula I. Fazekas, the later directors of the Budapest and Szeged Departments. His comparative pathological and forensic pathological studies on the central nervous system alterations developing on the effect of poisoning were prominent. In 1934 he became head of the Szeged Department.
Between 1934-1945 the Department of Pathology and Forensic Medicine was directed by the well-known pathologist, József Baló, the discoverer of the elastase enzyme. From his activities in the field of forensic medicine, outstanding were his studies on the mechanism of fatty embolism as well as his studies on the effect of ammonia poisoning on blood hematogenesis. At the department, the scientists of forensic medicine in theory and practice were Incze and Fazekas. In 1945 József Baló moved to Budapest where for a few months he was head of the Department of Forensic Medicine, then he took over the leadership of the First Institute of Pathology and Experimental Cancer Research. Between 1946-1973 Gyula I. Fazekas was head of the independent forensic medicine department. His scientific activities were manifold, worthy of note are his studies on endocrinology, the free total-histamine content of embryonal bones and injuries. As acknowledgement of his scientific researches he was elected member of numerous foreign scientific societies and academies. His book written together with his co-worker Ferenc Kósa „Forensic Fetal Osteology” appeared in 1978.
From 1973 till 1993 Vilmos Földes directed the Department, who was a Sándor Ökrös pupil. He was called from the Debrecen Department to become head of the Crime Laboratory of the National Police Force, of which he was leader till 1973. He was the dean of the Medical Faculty for two cycles. His scientific research work mainly focused on criminalistics. Together with László Harsányi he wrote the book „Medical Expert Identification”. Tibor Varga, director of the forensic medicine department in Budapest, became head of the department by invitation, from 1994. He established the foundations of modern analytical laboratories, with a new toxicology as well as DNA laboratory functioning at the department. His main field of scientific research involved the vital reactions of heart muscle injury, the clinical and comparative morphological characteristics of alcohol and drug abuse furthermore, the problems of medical science related to road traffic. He was president of the Forensic Medicine Committee of the Health Scientific Council. In 2005 he edited the book „Health Insurance”. In 1994 István Bajnoczky became the assigned director, then from 1997 the appointed head of the department. He was the pupil of Gyula I. Fazekas, between 1967-1977 he was co-worker at the department in Szeged, then upon invitation he became director of the Department of Judicial Experts in Győr. He led both the Pécs and Győr Departments for many years. He was the worthy and distinguished follower of the „personal identification school of Pécs” founded by Harsányi, and his name is linked to the upgrading of the video-superimposition technique. Regarding medical expert identification he improved the scientific methods of personal identification.
Structure, education, finance, research
At each medical faculty of the universities, the structure, educational subjects and number of weekly hours are practically the same at all the forensic medicine departments. The subject is taught in the 5th year, with 1 hour lecture and 1.5 hours practice weekly. The textbook used is compiled by all the four universities. There are two semesters, ending with an examination. At the Faculty of Dentistry the subject is taught in the 4th year, one hour weekly, in one semester and ending with a final exam.
Financing of the university departments comes from various channels. Prior to 1989 the universities belong to the Ministry of Health, after that date they were moved to the education portfolio. Departmental financing on the one part depends on the number of enrolled students on the other part, is made up of the medical expert activities (autopsies, expert opinions, laboratory activities). The university contributes to the infrastructural functioning using its own sources. Scientific activities are financed from both national and international funds. The departments have close to similar work profiles, thus their structure is also nearly the same. The pathology laboratory is connected to the autopsy room activities. The laboratory of serology and genetics carries out the studies on determination of origin matters and the criminalistic examination of biological specimens. Studies on samples from both autopsies and living persons are performed in the laboratory of toxicology. The laboratories of antropology and genetics are where the matters related to personal identification are resolved. Tests on living persons and expert opinions on such cases are carried out at the clinical forensic medicine unit, with advice from clinical experts as well. This is also true for forensic psychiatry and psychology.
Criminal police medical officer service
The XIV. municipal law of 1876 determined the „police medical officer” tasks, among others the sphere of police autopsies, the involvement of experts in crime cases, offences, petty offences and suicides. According to the law, the forensic medicine experts were to work together with the police medical officers in police inquests in the case or suspicion of crimes.
In 1922 the official autopsies became the duty of the so-called public health service medical doctors. From 1936 the medical doctor-police autopsies were performed by the assigned health officer. After 1945 the reorganization of the police medical officer service began. The criminal and authority police medical officer service was established at county level. From September 1, 1963 the police autopsies practically became the exclusive task of the police medical officers. The system functioned within the frame of the Home Ministry’s Health Department, which became a Subdepartment in 1976. The basic, specialist and Ph.D. training of crime medical doctors was at the Department of Forensice Medicine of the Semmelweis Medical University. The activities of the crime medical officers were quite significant nationally, with around 2000 inquests, 7-8000 autopsies and 30-35000 studies on living persons. As of July 1, 1990 the service functioned within the Health Department of the National Police Force. Following reorganizations in 1999 national controlling and technical supervision became the task of the chief medical inspector of the Police Force, Dr. Tamás Csatai, who at the same time also became chief of the new department. Between the period of 1999-2006, the crime medical police officers carried on with their work of helping the activities of the criminal investigation authorities, despite the difficulties due to the structural and legislative provisional changes taking place in the country. Determination of their affiliation and tasks according to European Union practice, however, became more and more pressing. A new situation emerged in the history of the criminal police medical officer service with the entry on January 1, 2007 of the XLVII. Law of 2005, which states that the police medical officers in the service of the police force are excluded from the forensic medical expert activity.
The criminal police medical officer service was completely financed from the state budget. Outstanding personalities of the service were Dr. Aurél Steczik, Dr. Ödön Szedlák, Dr. István Földes, Dr. Pál Krajcsovics, Dr. Lajos Debreczeni and Dr. Tamás Csatai. Their scientific activities were in the scope of clinical forensic medicine and forensic pathology. The scientific works of the service were published in the journal „BM Orvos” and presented at the „Police Medical Officer Scientific Days” organized every three years. The scientific activities of the service were organized by the Scientific Medical Council of the Ministry of Internal Affairs. One of the basic practical and scientific institutes of the criminal police medical officer system was the Department of Criminal Experts and Research established in 1990, which belonged to the Ministry of Internal Affairs. Its legal predecessor from 1950 was the Criminal Technical and Registry Subdivision of national jurisdiction functioning within the Budapest Police Headquarters, then from 1962 the Criminal Technical Institute. From 1994 till 2004, it again belonged to the National Police Headquarters, then from 2004 it functioned within the Ministry of Internal Affairs, while from the middle of 2006 – when the police force was incorporated as part of the Ministry of Justice and Law Enforcement – it became its back office. The department has 158 co-workers and an annual of around 40.000 issued expert opinions, with criminal technology units of high standard regarding both technology and personnel. The most up-to-date instrumental analytical devices are available at the department, including optical microscopy, scanning electron microscopy, micro-spectrophotometry, and modern techniques are also available for identification analysis, technical separation, as well as automated DNA-typing methods. Regarding criminal techniques, significant results have been obtained in the following fields: blood group and DNA characterizations, researches on writing and ballistics, criminalistic utilization of X-ray studies. Both in respect to practical activities and scientific research, emphasis is laid on the physical-chemical examination of micro-sized material residues as well as on the qualitative and quantitative determination of drugs. In 1989, the department’s scope of expert activities widened with the transfer from the Registry Department of the Dactyloscopy Unit, which has an automated fingerprint identification system. The dactyloscopic data base and registry system of Hungary functions at this unit. Till the end of 2006, the system had registered the fingerprints of 800.000 individuals. All units of the department take part continuously in the international quality control system, with excellent qualifications. The department is member of the European Network of Forensic Science since the year 2000, working actively together with the DNA, dactyloscope, drug accreditation work groups and also carrying out activities in the field of classic criminology. Within the frame of international collaboration, the department works together with the Interpol and Europol regarding the standardization of fingerprint and DNA data bases. The scientific achievements of the department are significant, both in respect to publications and participations at international congress. As ministry back office, the entire financing of the department comes from state budget and directly from ministry budget, respectively.
Throughout its existence, outstanding personalities of the department have been Dr. Imre Kertész, Dr. Vilmos Földes and Dr. Zsófia Santura.
Within the armed forces, the Hungarian Army has its own department of judicial medical experts, functioning within the Central Army Hospital as the Department of Military Judicial Medical Experts founded in 1949. The department is in close connection with the pathology department of the institution. It carries out high standard judicial medical expert duties occurring within the armed forces. It is maintained from the budget of the Ministry of National Defence. The leaders of the department have always been forensic medicine experts with pathology qualifications (Dr. Viktor Fáber, Dr. György Dallos, and currently Dr. Miklós Molnár).
Department of Judicial Experts and Research
At present there are 12 judicial expert departments functioning in Hungary within the frame of the Department of Judicial Experts and Research. These were established between the years 1964-2001 by the Ministry of Justice. In 9 of these departments forensic medical expert activities are being carried out, including human biology, medicine, antropology, molecular biology and toxicology. The predecessor of the system was the Medical Experts Office founded in l952 by the Ministries of Health and Justice and functioning within the Budapest City Court. The Judicial Medical Experts Office, the Auditor Experts Office and the Technical Experts Office were established in 1965, all three based in Budapest. In the beginning, the office gave exclusively medical and psychiatric expert opinions, later giving psychological expert opinions as well. In 1975 a judicial determination of origin unit was also added to the office, followed by a DNA laboratory, and personal identification expert analyses started with the participation of biologists and antropologists. The horizontal network of the Experts Department of the Ministry of Justice covering the whole country was started in 1970. From the 10 district judicial experts departments, the Minister of Justice established the Experts Office of Judicial Departments in the year 1992 with the purpose of tending to the administrative, economic, personnel management and registration tasks of the experts departments functioning within the Ministry of Justice. In 2006 the name of the office was changed to Department of Judicial Experts and Research. As an independent publicly financed institution, the department manages the administrative, economic, personnel management and registration tasks of the experts institution functioning as a system in 12 points around the country. It ensures the conditions of appropriate functioning within the budget. The basic activity and designation of the experts departments is to provide for official appointments in cases in which it is mandatory by law to conduct an inquiry of evidence ex officio. Further tasks are making official appointments in cases defined by special legislative provision as well as the preparation of judicial expert opinion upon commission. Units of the Department of Judicial Experts and Research are found in Budapest, Miskolc, Győr, Veszprém, Szolnok, Kaposvár, Kecskemét and Szombathely. Important roles were played in the establishment of the institutional system by Dr. Árpád Szabó, Dr. Tibor Varga, and the current director of the department, Dr. Éva Susa.
A further activity of the Experts Departments is ongoing applied researches so as to provide sound professional background for the preparation of grounded expert opinions, in accordance with the current state of science. Expert activities backed by human biology laboratories are given special emphasis in the experts department system. By means of a grant given by the European Union, the accreditation process of the laboratories are in progress. A considerable number of publications come from the departments, and they also actively participate in both national and international conferences.
From the experts departments functioning within the network, the earliest was the Department of Toxicology, established in 1872 as the National Department of Synthetic Chemistry (Művegyészet). Its founding is linked to the name of Dr. Emil Felletár, who was appointed „national synthetic chemist” by the Minister of Justice at the time. The toxicology analyses from all over the country are performed by toxicochemists at this well equipped department. They were the first in the world to announce that the substance presumed as strychnine could be the decaying product, the so-called „corpse alkaloid” of the nitrogen-containing bases found in the body. It was also at this department that attention was called to the error of the detection method. The department had been renamed several times, last in 2006 to the Toxicology Department of the Institute of Judicial Experts and Research.
The department is in an independent building with a post-mortem and a drug unit. It has a team of highly qualified experts and a pool of high standard instruments, carrying out its activities on a national basis. In general it has an annual of around 9000 cases, from which 1200-1300 require post-mortal examination, the rest are comprised of biology specimen tests from living persons, mostly for the demonstration of drugs and psychotropic substances.
The main fields of research at the department are studies on the changes in concentration of drugs in relation to storage time, studies on the toxic effect of the light stabilizer Tinivin, and studies on the disposition processes of opiates in hair samples.
Outstanding personalities of the department have been Dr. Emil Felletár, Dr. József Jahn, Dr. Rezső Fridli, Dr. Ödön Szép, Dr. József Antal, Dr. Endre Faragó, Dr. András Benkő and Dr. Gábor Somogy.
Chamber of Judicial Experts
The CXIV. Law of 1995 brought to life an autonomously functioning establishment of representative interest, the Chamber of Judicial Experts. Membership is obligatory for the judicial experts, who are also obliged to enroll in the register of professional experts. Certification of compliance with the requirements is the duty of the Chamber.
In 1999 an order issued by the Ministry of Health established a Board of Judicial Medical Experts, modified in 2004 to Professional Board of Forensic Medicine and Judicial Medical Experts, as the professional advisory board giving opinions and recommendations in the health field.
In 1993, within the frame of the State Public Health and Medical Officer Service, the Ministry of Health also established a chief medical officer inspector system in the field of forensic medicine, ensuring the official supervision of the judicial medical expert activity.
Conditions of expert activity
Inclusion in the register of judicial medical experts is by application to the Ministry of Justice and Law Enforcement, involving an examination following the lodgement of all necessary documents – university diploma, certificate of specialist qualification, curriculum vitae, verification of practical experience within the field, etc. The specialists listed by profession in the register may be appointed to give expert opinion. Experts who give opinions individually or within an economic company and not within an institution are obliged to provide further documentation necessary for operation, such as invoicing, taxation, etc.
Hungarian Society of Forensic Doctors
In 1905 the Hungarian Association of Forensic Doctors was founded in Budapest with Sándor K. Ajtai as president. It was the predecessor of the Hungarian Society of Forensic Doctors established at the Péter Pázmány University of Sciences in 1928, the first president being Balázs Kenyeres, director of the Budapest Department of Forensic Medicine. After World War II. the Hungarian representatives of forensic medicine functioned as a section of the Hungarian Society of Pathologists. In 1966 it became an independent society, with Dr. Endre Somogyi as its first president.
Upon the recommendation of the professional-political committee of the society a psychiatry section was formed in 1967 with György Polner as president, then a transport-medical section in 1969, the president of which became Róbert Budvári. In 1975 an insurance medical section was established, with president László Kalabay. Every three year, the society holds a scientific meeting – so far the XIth – lasting for several days, with international attendance. Presidents of the society have been Endre Somogyi, János Nagy, László Buris, István Bajnoczky, Tibor Varga.
In 2000 the Forum of Young Forensic Doctors was established, holding meetings annually in Szeged, Pécs, Veszprém, Miskolc, Kaposvár and Debrecen. The society founded a medal and Pro progressione et conformatione medicinae forensis plaquette of Sándor K. Ajtai and Gyula Incze to award the members demonstrating outstanding scientific activities. As recognition of their scientific contribution to the development of Hungarian Forensic Medicine, honorary memberships have been given to J. Göller, B. Brinkmann, S. Pollak, V. Schneider (Germany), Gromov (Sovjet Union), P. Saukko (Finland), T. Nagai (Japan), T. Krompecher, W. Bär (Switzerland), B. Ludes (France) and F. Longauer (Slovakia). The society actively took part in the organization
of the international congresses of the International Academy of Forensic Medicine held in Hungary in 1967, 1985, 2006. It is the founding organizer of the Alps-Adria-Pannonia collaboration and scientific meetings which started in 1991. In Hungary, international scientific meetings were organized in 1991 (Pécs), 1997 (Veszprém) and 2002 (Visegrád).
National Institute of Forensic Medicine
The National Institute of Forensic Medicine was established in 1975 by the Minister of Health in agreement with the Ministers of Internal Affairs and National Defence and the public prosecutor. The institute is a publicly financed institution, with its headquarters at the Department of Forensic Medicine of the Semmelweis University. The institute became the methodological postgraduate base institution of the Ministry of Health in the fields of forensic medicine, forensic psychiatry and judicial medical expert activity. The institute can not issue expert opinions. Its most important task regulated by law is to elaborate and determine the professional directives of the methods and techniques to be used in judicial medical expert practice, issuing methodologies and professional information in order to provide help for the forensic medical experts. Another important task of the institute is to establish a uniform approach where possible according to the law. The institute has issued a total of 21 methodology letters, which are continuously being complemented according to the latest developments in science – especially regarding the ones on laboratory studies. Related to its field, the institute takes part in the theoretical-methodological control of research work, as well as in the modernization of specialist training and postgraduation. It prepares analyses of the departments functioning in the field of forensic medical expert and psychiatric expert activities. It collects data within its field and prepares statistical analysis of these.
Upon approval by the Ministries of Health and Justice, the methodology letters and directives are published in the Health, Judicial and Prosecution Bulletins. The Institute has also published the methodologies in the form of a book. The director of the institute was appointed by the Health Minister, the first director being Endre Somogyi followed by Péter Sótonyi.
The forensic medicine reviewing system
The rules of prosecution were regulated by the „Constitutio Criminalis Theresiana” issued on December 31, 1769 in the area of the Habsburg Empire. It ordered the reviewing of contradictory medical testimonies by appointed university medical faculties, so as to promote the evaluation of such cases by the court. In the beginning the so-called „Fakultätsgutächten” was prepared on the basis of the position taken by the faculty council. Within Hungarian territory, first the Budapest, then the Cluj medical faculty received the right to submit reviews. Following the compromise of 1867, the National Council of Public Health was established in 1868 under the control of the Ministry of Internal Affairs. Among its tasks was the reviewing of medical-forensic medical cases presented to this council, as well as the giving of malpractice related opinions. In 1890 the Ministry of Justice established the Council of Forensic Medicine based on the XI. Law of 1890. The purpose of the council was to give opinion, being exclusively in the service of the judicial authorities. In the majority of cases it was solely a reviewing body in the various criminal and civil cases. The council legally ceased in 1951. The new law placed the reviewing in the scope of authority of the Health Scientific Council functioning under the supervision of the Ministry of Health. At the time of 1954, the cases forwarded to the Ministry of Health for taking up position by the judicial authorities were to be passed on to the Judicial Committee formed within the Health Scientific Council.
The first president of this Judicial Committee was Dr. Frigyes Doleschal, followed by Dr. Imre Zoltán, Dr. György Berentey and Dr. Tibor Varga. The members of the committee were appointed by the Minister of Health upon common agreement with the Minister of Justice, the public prosecutor and the president of the supreme court. The committee functioned under the supervision of the Ministry of Health, with the cases reviewed in court supervised by the Ministry of Justice.
The court was never bound by the opinions formed by the Judicial Committee, it was always free to balance unreservedly, coming to a different opinion, in which case, however, it was always to give good reason for doing so.
From January 1, 2006 the XLVII. Law of 2005 related to judicial expert activity made changes to the reviewing system. This was necessary since the more than two centuries old establishment no longer conformed with the procedural requirements. Corporative appearance in court was not possible, the principle of directness was thus impaired. Conflicting expert opinions could not be argued in court at the hearings. The new corporation according to the valid law became the Board of Judicial Experts functioning within the medical field. The president and members are to be appointed for a period of five years by the Minister of Justice, based on recommendations from the Health Minister. The detailed rules of procedure are determined by the 8/2006./II.26/ statute of the Ministry of Justice. The current president is Dr. Tibor Varga.
Hungarian periodicals on morphology, pathology and forensic medicine
In Hungary there is no scientific periodical devoted entirely to forensic medicine. Before 1990 two morphology journals, the Acta Morphologica Academiae Scientiarum Hungaricae and the Morfologiai és Igazságügyi Orvosi Szemle (Reviews on Morphology and Forensic Medicine) published articles on forensic medicine and the related fields. The political changes and milder atmosphere allowed for the Hungarian scientists to publish without discrimination in foreign periodicals with higher impact factors. The Acta Morphologica published its articles in English, it was reviewed in Current Contents – Life Sciences, and had an impact factor. The other journal Morfologiai és Igazságügyi Orvosi Szemle published articles from all fields of forensic medicine in Hungarian, with summaries in English, German and Russian. Both periodicals peer-reviewed its articles to be published.
Following privatization, the new publisher stopped publication of these two journals in 1992, referring to financial causes.
The periodical Pathology, Oncology & Research published in English was launched in 1995, with articles chiefly from the field of forensic pathology. At present it has an impact factor of 1.162.
The periodical of the Hungarian Chamber of Judicial Experts was founded in 2002, containing experts-related news as well as changes of the law and their interpretations. It publishes short review articles in Hungarian from the different fields of expert activity, including forensic medicine.
System of specialist training
In 1883 a law was passed that forensic medicine could only be practiced by qualified persons, who had to qualify before a board appointed by the court of justice. In 1904 a government regulation was passed on the qualification of specialists, the examination subjects and the conditions of qualification. In 1999 a governmental order regulated the conditions of obtaining specialist qualification.
Under the terms of the regulation the specialists are obliged to continuously undertake postgraduate courses. Accordingly, every five years 200 credit points are to be presented to the Hungarian Medical Chamber for accreditation for the next five-year cycle to be able to work as an expert. Registration, acceptance of credit points, as well as accreditation of the postgraduate courses are done at the universities, within a separate system.
Applicants can take a secondary specialist exam in forensic psychiatry if they have already taken a basic exam in psychiatry, and in forensic clinical psychology if they have had a basic exam in clinical mental-hygiene. The requirements are contained in the regulations.
Prof. Dr. Peter Sótonyi Semmelweis University
Department of Forensic Medicine
Üllői út 93