FORENSIC TOXICOLOGY AND ELEMENTS OF FORENSIC MEDICINE
Academic Year 2026/2027 - Teacher: NUNZIATA GIUSEPPA ELISABETTA BARBERAExpected Learning Outcomes
1. Knowledge and understanding
Upon successful completion of the course, students will demonstrate that they have acquired:
- The fundamental concepts of poison, toxicity, and the evolution of acute and chronic poisonings.
- The core principles of xenobiotic pharmacokinetics (absorption, distribution, metabolism, and excretion).
- Theoretical knowledge of the main classes of drugs of abuse and toxicants (alcohol, opiates, cannabis, cocaine, amphetamines, carbon monoxide, psychotropic drugs).
- The regulatory-legal and ethical framework governing the professional liability of healthcare professionals (professional secrecy, medical reports, official referrals, expert witness reports, and court-appointed technical consultations).
2. Applying knowledge and understanding
Students will be able to:
- Apply chemical-toxicological investigation methodologies for the forensic diagnosis of poisoning.
- Independently perform extraction techniques from complex biological matrices in the laboratory to isolate drugs and illicit substances.
- Select and implement appropriate analytical protocols for the identification and quantification of toxicants in biological and non-biological materials.
- Operate in compliance with current legal procedures, with specific reference to cases of driving under the influence of alcohol or drugs.
3. Making judgments
Students will develop the ability to:
- Critically evaluate the suitability and effectiveness of a specific analytical technique based on the available biological matrix.
- Correctly interpret laboratory analytical results for the diagnosis of poisoning or fatal venefiction.
- Formulate methodologically sound judgments regarding forensic issues and professional liability.
4. Communication skills
Students will be able to:
- Present toxicological and forensic issues using appropriate technical and legal terminology.
- Draft official legal documentation clearly and rigorously, such as medical reports, official notifications, and expert consultation papers.
- Effectively communicate the findings of a toxicological investigation to both specialists (medical doctors, magistrates) and non-specialists.
5. Learning skills
Students will acquire the methodological tools necessary to:
- Independently stay updated on the evolution of legislation regarding controlled substances and professional liability.
- Deepen their knowledge of technological and instrumental innovations applied to forensic toxicological chemistry.
- Critically consult scientific literature and international guidelines within the field of Forensic Medicine.
Course Structure
Classroom lectures and lab tutorials
Required Prerequisites
None.
Detailed Course Content
Lectures
Concept of poisonDiagnosis of poisoning
Introduction to pharmacokinetics (absorption, distribution, metabolism, and excretion of drugs)
Methodology of chemical-toxicological investigation
Carbon monoxide
Substances of abuse: ethyl alcohol, opiates and derivatives, cannabis, cocaine, amphetamines, hallucinogens, psychotropic drugs, volatile substances
Legislative aspects of controlled substances (narcotics)
Ethyl alcohol and driving
Detection of controlled substances in biological and non-biological materials
Fundamentals of healthcare professional liability
Professional secrecy (medical confidentiality)
Forensic Lesionology / Medico-Legal Injury Studies
Professional Secrecy / Medical Confidentiality
Voluntary Interruption of Pregnancy
Informed Consent and Advance Healthcare Directives - DAT
Crimes of Homicide and Personal Injury
Death: Phenomenology and Legislation
Laboratory Practice
Detection of controlled substances in biological and non-biological materials
Extraction techniques from complex biological matrices for the detection of: antidepressants and antipsychotics; nitrogenous organic substances of an alkaloid nature
Extraction techniques from complex biological matrices for the detection of: benzodiazepines; morphinics; cocaine and metabolites; methadone; cannabinoids; ethyl alcohol, methyl alcohol, and volatile organic substances
Textbook Information
Bertol E, Mari F, Lodi F, Marozzi E. Trattato di tossicologia forense. CEDAM, Padova, 2000.
Bertol E. Analitica tossicologia. Aspetti tecnici interpretativi, giuridici e deontologici, Esculapio, 2011.
Medicina legale e delle assicurazioni II edizione, Norelli-Buccelli-Fineschi, Piccin editore
Course Planning
| Subjects | Text References | |
|---|---|---|
| 1 | Concept of poison | Bertol E, Mari F, Lodi F, Marozzi E. Trattato di tossicologia forense. CEDAM, Padova, 2000.Bertol E. Analitica tossicologia. Aspetti tecnici interpretativi, giuridici e deontologici, Esculapio, 2011. |
| 2 | Diagnosis of poisoning | Bertol E, Mari F, Lodi F, Marozzi E. Trattato di tossicologia forense. CEDAM, Padova, 2000.Bertol E. Analitica tossicologia. Aspetti tecnici interpretativi, giuridici e deontologici, Esculapio, 2011. |
| 3 | Introduction to pharmacokinetics (absorption, distribution, metabolism, and excretion of drugs) | Bertol E, Mari F, Lodi F, Marozzi E. Trattato di tossicologia forense. CEDAM, Padova, 2000.Bertol E. Analitica tossicologia. Aspetti tecnici interpretativi, giuridici e deontologici, Esculapio, 2011. |
| 4 | Methodology of chemical-toxicological investigation | Bertol E, Mari F, Lodi F, Marozzi E. Trattato di tossicologia forense. CEDAM, Padova, 2000.Bertol E. Analitica tossicologia. Aspetti tecnici interpretativi, giuridici e deontologici, Esculapio, 2011. |
| 5 | Carbon monoxide | Bertol E, Mari F, Lodi F, Marozzi E. Trattato di tossicologia forense. CEDAM, Padova, 2000.Bertol E. Analitica tossicologia. Aspetti tecnici interpretativi, giuridici e deontologici, Esculapio, 2011. |
| 6 | Substances of abuse: ethyl alcohol, opiates and derivatives, cannabis, cocaine, amphetamines, hallucinogens, psychotropic drugs, volatile substances | Bertol E, Mari F, Lodi F, Marozzi E. Trattato di tossicologia forense. CEDAM, Padova, 2000.Bertol E. Analitica tossicologia. Aspetti tecnici interpretativi, giuridici e deontologici, Esculapio, 2011. |
| 7 | Legislative aspects of controlled substances (narcotics) | Bertol E, Mari F, Lodi F, Marozzi E. Trattato di tossicologia forense. CEDAM, Padova, 2000.Bertol E. Analitica tossicologia. Aspetti tecnici interpretativi, giuridici e deontologici, Esculapio, 2011. |
| 8 | Ethyl alcohol and driving | Bertol E, Mari F, Lodi F, Marozzi E. Trattato di tossicologia forense. CEDAM, Padova, 2000.Bertol E. Analitica tossicologia. Aspetti tecnici interpretativi, giuridici e deontologici, Esculapio, 2011. |
| 9 | Detection of controlled substances in biological and non-biological materials | Bertol E, Mari F, Lodi F, Marozzi E. Trattato di tossicologia forense. CEDAM, Padova, 2000.Bertol E. Analitica tossicologia. Aspetti tecnici interpretativi, giuridici e deontologici, Esculapio, 2011. |
| 10 | Fundamentals of healthcare professional liability | Medicina legale e delle assicurazioni II edizione, Norelli-Buccelli-Fineschi, Piccin editore |
| 11 | Professional secrecy (medical confidentiality) | Medicina legale e delle assicurazioni II edizione, Norelli-Buccelli-Fineschi, Piccin editore |
| 12 | Forensic Lesionology | Medicina legale e delle assicurazioni II edizione, Norelli-Buccelli-Fineschi, Piccin editore |
| 13 | Death: Phenomenology and Legislation | Medicina legale e delle assicurazioni II edizione, Norelli-Buccelli-Fineschi, Piccin editore |
| 14 | Personal Injury | Medicina legale e delle assicurazioni II edizione, Norelli-Buccelli-Fineschi, Piccin editore |
| 15 | Informed Consent and Advance Healthcare Directives - DAT | Medicina legale e delle assicurazioni II edizione, Norelli-Buccelli-Fineschi, Piccin editore |
| 16 | Voluntary Interruption of Pregnancy | Medicina legale e delle assicurazioni II edizione, Norelli-Buccelli-Fineschi, Piccin editore |
| 17 | Detection of controlled substances in biological and non-biological materials | Bertol E, Mari F, Lodi F, Marozzi E. Trattato di tossicologia forense. CEDAM, Padova, 2000.Bertol E. Analitica tossicologia. Aspetti tecnici interpretativi, giuridici e deontologici, Esculapio, 2011. |
| 18 | Extraction techniques from complex biological matrices for the detection of: antidepressants and antipsychotics; nitrogenous organic substances of an alkaloid nature | Bertol E, Mari F, Lodi F, Marozzi E. Trattato di tossicologia forense. CEDAM, Padova, 2000.Bertol E. Analitica tossicologia. Aspetti tecnici interpretativi, giuridici e deontologici, Esculapio, 2011. |
| 19 | Extraction techniques from complex biological matrices for the detection of: benzodiazepines; morphinics; cocaine and metabolites; methadone; cannabinoids; ethyl alcohol, methyl alcohol, and volatile organic substances | Bertol E, Mari F, Lodi F, Marozzi E. Trattato di tossicologia forense. CEDAM, Padova, 2000.Bertol E. Analitica tossicologia. Aspetti tecnici interpretativi, giuridici e deontologici, Esculapio, 2011. |
Learning Assessment
Learning Assessment Procedures
The assessment consists of an oral examination (interview) during which 3 questions will be asked, covering at least 3 different topics of the syllabus. The exam will be based on the established program and on the laboratory experiences carried out during the practical training sessions.
The examination aims to verify:
- i) the level of basic knowledge of the core principles of forensic medicine;
- ii) the ability to apply this knowledge to solve specific problems related to fields of forensic medicine (problem-solving and independent judgment);
- iii) clarity of expression;
- iv) proficiency in medico-scientific terminology.
Grading Criteria
The final grade will be assigned based on the following parameters:
- Grade 29-30 and cum laude: The student has an in-depth knowledge of the main pathological entities, is able to promptly, correctly, and critically integrate and analyze the presented scenarios, independently solving highly complex diagnostic problems. They possess excellent communication skills and master medico-scientific and anatomopathological terminology.
- Grade 26-28: The student has a good knowledge of the main pathological entities, is able to integrate and analyze the presented scenarios in a critical and linear manner, solves complex diagnostic problems quite independently, and presents topics clearly using appropriate medico-scientific and anatomopathological terminology.
- Grade 22-25: The student has a fair knowledge of the main pathological entities, though limited to the primary topics. They can integrate and analyze the presented scenarios critically, though not always in a linear manner, and present the topics fairly clearly with a reasonable command of language.
- Grade 18-21: The student possesses the minimum required knowledge of the main pathological entities, shows a modest ability to integrate and critically analyze the presented scenarios, and presents the topics with sufficient clarity, although their command of specific terminology is underdeveloped.
- Fail (Esame non superato): The student does not possess the minimum required knowledge of the core contents of the course. Their ability to use specific terminology is scarce or non-existent, and they are unable to independently apply the acquired knowledge.
Examples of frequently asked questions and / or exercises
(Please note: The following are only a few examples of exam questions)
Professional Framework and Professional Profiles
Classification of intentional personal injuries, Classification of negligent personal injuries, Battery and Personal Injury, Definition of Disease/Illness, Duration of the illness, Incapacity to attend to ordinary occupations, Danger to life, Permanent weakening of an organ, Certain or probable incurable disease, Loss of a sense or the use of an organ, Loss of a limb or mutilation rendering the limb useless, Loss of the capacity to procreate, Severe and permanent speech impediment, Deformation, Disfigurement
Law 219/2017 (Informed Consent and Advance Healthcare Directives)
Classification of post-mortem changes (taphonomy), Algor mortis - Post-mortem cooling, Rigor mortis - Post-mortem rigidity, Livor mortis - Post-mortem hypostasis (lividity), Common transformative phenomena, Special transformative phenomena
Blunt force trauma.
Major trauma / Major structural injuries
Firearms injuries from single-projectile ammunition: entrance wound, wound track, exit wound, macroscopic and microscopic characteristics.
Firearms injuries from pellet/shotgun ammunition, macroscopic and microscopic characteristics.
Sharp force trauma / Injuries from bladed weapons: incised wounds (cuts), chopping wounds, puncture wounds, stab wounds.
Mechanical asphyxias, Mechanical asphyxia by hanging, Cutaneous compression furrow (ligature mark), Suffocation, Manual strangulation (throttling), Ligature strangulation, Drowning
Principles of toxicology and topics covered during the lectures and laboratory practical sessions.