Conclusion

The significant feature when considering possible natural causes of death of an individual in police custody is that some diseases can lead to rapid collapse and death with no warning in a young individual who is apparently fit and well immediately before the collapse. There is no method that the police can use to determine which of the individuals they encounter will be suffering from any of these diseases or from a genetic abnormality that may lead to electrical disturbances within the myocardium. Indeed, many of these disease processes can only be diagnosed after complex medical testing and after taking a full medical history.

That many of these diseases are rare in the age group that is most likely to be detained in custody places additional burdens on the police officers who are required to care for them and also on the doctors required to examine and treat them in the police station. The difficulties that these cases present to the pathologist lie in the need to have an awareness of all of the possible natural causes of sudden death and a careful determination and, if necessary, exclusion of all of these causes (cardiac, neurological, and endocrine) before forming the conclusion that some other factor has resulted in death.

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