Clinical Examination as Medicolegal Proof of Alcohol Intoxication

Evidence-based survey of the elimination rates of ethanol from blood with applications in forensic casework

“…On the other hand, what is well documented is that people who drink large amounts of alcohol daily exhibit few outward signs and symptoms of drunkenness despite them having a high BAC when tested [198][199][200]. For example, when apprehended drivers were examined by a physician or police surgeon, apart from the smell of alcohol on the breath, many were judged ''not under the influence of alcohol'' despite then having a BAC of 200-300 mg/100 mL [201]. Because of their continuous exposure to high concentrations of ethanol, the brain receptors have adapted to the presence of alcohol and these individuals have developed a cellular tolerance to the sedative and impairment effects of the drug [202].…”

Effects of Alcohol on Fitness to Drive

“…The determination of ethanol in blood provides a more objective way to judge overconsumption of alcohol compared with the use of clinical tests of drunkenness. The latter suffer from the problem of subjectivity and outcome often depends on the training and experience of the person making the tests (Penttila and Tenhu 1976).…”

“…Other traffic safety innovations for other drugs. Observations were made about the person's general appearance, pulse rate, orientation in time and space, ataxia (Romberg's test), speech, finger and hand movements, and reactions of pupils to light, as well as some simple psychomotor tests (Penttila and Tenhu 1976). After these tests were made, the physician concluded whether the individual showed none, slight, moderate or a high degree of being under the influence of alcohol.…”

Cause and manner of death and phase of the blood alcohol curve

“…Over-consumption of alcohol and drunkenness are common findings when unnatural deaths are investigated in clinical and forensic medicine [2,3]. Many studies verify that the signs and symptoms of alcohol intoxication and drunkenness are more pronounced at higher BAC, albeit with large inter-subject variations [4,5].…”