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In May 1998 Western Australia amended its abortion law which is now the most liberal in the country. The new law allows an abortion up to 20 weeks gestation if the woman has given informed consent and will either suffer serious personal family or social consequences if the pregnancy continues or if the pregnancy endangers her physical or mental health. Informed consent is required unless health reasons make it "impracticable" for the woman to give consent. In this case informed consent includes counseling about the medical risk involved with abortion and with carrying the pregnancy to term the offer of a referral for additional counseling before the woman makes a decision to abort and the offer of additional counseling after an abortion or after giving birth. The medical practitioner who provides the information for informed consent purposes may not conduct or assist in the abortion procedure. In cases where abortions are sought after 20 weeks gestation two medical practitioners from a panel of six must agree that the a severe medical condition suffered by the mother or the fetus justifies the procedure.

1997 has been notable for the consolidation of two major trends in forensic medicine. The first is the increasing contribution of forensic pathology to prevention of injury. As early as 1915,William Brend wrote about coroners and autopsies thus " . . . if prevention of deaths is not now regarded as the main purpose to be served by inquests, the inquiry becomes of relatively little value". The role of the forensic pathologist in non-suspicious cases, particularly in relation to issues of public health and safety, is little understood by the general public, or the legal or medical community. Apart from acting as a safety valve for high-running public emotions, and on occasion allaying suspicion, the coroners' system could be said to serve little other purpose, the criminal and civil jurisdictions having whittled away at what history left of its ancient functions (Cordner). Even so forensic pathology still allows itself to be hamstrung by the legal adversarial paradigm which emphasises the individual and has less interest in the community (Ranson). However, in September, 1997, the Australian Coroners Society unanimously endorsed a plan from Monash University to administer a National Coroners Information System. The Monash group consists of its departments of forensic medicine and of epidemiology and preventative medicine, and the Monash University Mass grave site excavation at Accident Research Centre. The proposal is based on the premise that coroners can be more effective if they can learn from and apply the experience of coroners who have dealt with the same type of case. More importantly, policymakers and researchers wanting up-to-date national data on classes of deaths reported to coroners will now be able to access such data through the system. Using the Internet will allow low-cost hardware to be used at over 500 coroners' courts across the country. The database will contain fully researchable records of entire autopsy reports, police death reports, and coroners' findings as well as the results of laboratory tests and demographic data. Current Australian issues which will be advanced by such a system include: intravenous drug deaths, suicide, medical-treatment-related deaths and health care audit, death in custody, sudden infant death and workplace deaths. The second trend moves from the general to the particular. July, 1997, was the 50th anniversary of the conclusion of the evidence at the trial in Nuremberg of the

Nine deaths involving oxycodone were investigated to assess the contribution of this opiate to these fatalities. All except one of the bodies were subjected to a full autopsy by specialist pathologists with a subsequent thorough toxicological examination. No significant anatomical pathology was found at autopsy. All deaths gave concentrations of oxycodone in femoral blood higher than expected following normal therapeutic use. In three cases no other drug in toxic concentrations was detected. Two cases involved the presence of a high concentration of a benzodiazepine and in a further two cases a high concentration of alcohol in addition to other drugs in therapeutic concentrations were present. One case involved methamphetamine in significant concentrations and another involved high concentrations of oxazepam in combination with pethidine. In all cases the presence of oxycodone was given as a factor contributing to the death. In only one case were there circumstances clearly indicating suicide. Our observations suggest that oxycodone is at least as toxic as other opiates and will cause deaths if misused.

Postmortem blood and liver concentrations of clomipramine were determined in ten cases by high performance liquid chromatography (HPLC). Blood concentrations ranged from 0.21 to 4.9 mg/L, and liver concentrations from 7.0 to 320 mg/kg. Two cases associated with clomipramine toxicity were clearly differentiated from other cases by the analysis of liver. The concentrations of clomipramine in these two cases were 3.3 and 1.8 mg/L in blood, and 280 and 320 mg/kg in liver. The liver concentrations were 10 to 30 fold greater in the deaths associated with drug toxicity compared with the other cases. One case, where cardiac blood was collected in place of femoral blood, showed a high blood concentration (4.9 mg/L), but an arguably therapeutic liver concentration (13 mg/kg). The analysis of femoral blood together with liver provides the best guide as to the significance of post-mortem clomipramine concentrations.

The deaths of 10 heroin addicts who died within days of starting a methadone maintenance programme administered by general practitioners are reported. The starting dose was 20 - 25 mg/day in 2 cases and 50 or more mg/day in 7. There was no increase in dose in 6 cases. Death occurred after a mean of 3 days. The cases were autopsied with subsequent full toxicological analysis. There was no anatomical cause of death in 5 cases whereas bronchopneumonia was present in the other 5 cases. In all cases methadone was present in concentrations in the range previously reported for fatalities attributed to methadone (mean 0.65 mg per litre in blood). Five subjects had additional drugs present including 1 with benzodiazepines, 2 with alcohol and 2 with benzodiazepines and morphine. The causes of death were given as methadone toxicity or a combination of methadone toxicity and bronchopneumonia. It is recognised that methadone causes respiratory depression and may therefore predispose to the development of bronchopneumonia. These observations highlight the dangers of methadone in the first days of maintenance programmes. This particularly applies when the starting doses are high and subjects have not demonstrated tolerance to opiates in an unsupervised situation.