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Book Review: Medical-Legal Aspects of Alcohol (4th Edition)

Medical-Legal Aspects of Alcohol incorporates scientific evidence and legal casework dealing with alcohol to form a reference book that can be used for both medical and forensic purposes. This is the 4th revised edition of the original text Medicolegal Aspects of Alcohol in Biological Specimens with thorough considerations of how alcohol can be involved in clinical or forensic science. The book is set up in an outline format and starts off teaching about the science and analysis of ethanol (alcohol), leading to motor vehicle involvement, and ending with chapters regarding litigation and testing for alcohol at the workplace. The pharmacology and analytical methods of determining alcohol levels form the foundation of the book. Tables and figures help clarify the evidence and research which is cited throughout the text. Many of the authors contributed to the original edition and continue to publish their novel findings to provide current and unique research in the study of alcohol. Most of them hold doctoral degrees and are based on teaching institutions or state crime authorities. Editor and contributing author James C. Garriott, PhD, is a consulting toxicologist. Several points are repeated throughout the book. The physical and chemical properties of alcohol determine its pharmacological, pharmacokinetic, and pharmacodynamic characteristics, as well as the reasoning behind using specific laboratory procedures to test for alcohol in bodily fluids and tissues. Time plays a pivotal role in determining the alcohol level of a specimen. The analyses performed in a forensic environment on fluid and tissue samples need to be sensitive and specific for the presence and quantity of alcohol. Documentation of analytical procedures and chain-of-custody of evidential specimens are crucial if prosecution is to occur. There is very large interand intra-individual variation in blood alcohol concentrations (BAC). The first section of the book includes chapters about the chemical and pharmacological basis of alcohol. A description of the different types of drinking alcohols and how ethanol exerts its effects within the human body is discussed. A brief description of some drug–alcohol interactions is offered. The pharmacokinetic properties of alcohol are thoroughly presented, allowing even those readers with little experience in this area of science to understand the processes of absorption, distribution, metabolism, and elimination of alcohol in human beings. The next section incorporates the analytical methods used to detect alcohol and the bodily specimens that are taken for the analyses. The different fluid and tissue samples (blood, urine, breath, brain, vitreous humor, saliva, and so on) are compared and contrasted to show the biochemical similarities and differences between them when alcohol is present. There are many different types of procedures that can be performed to approximate a BAC or breath alcohol concentration (BrAC), such as infrared spectroscopy and gas chromatography. Analyses performed on the specific fluid or tissue must have ample validity if the results are to be used in a court of law. The final chapters of the text cover forensic and legal implications of alcohol consumption, specifically the toxic effects of the drug on motor vehicle operation and psychomotor performance. There is ample epidemiologic and judicial evidence to support testing of alcohol in bodily specimens and to charge people with misdemeanors or felonies when their judgment is impaired to the point that they operate a motor vehicle while under in the influence of alcohol. The roles and responsibilities of prosecuting and defending attorneys, as well as those for expert witnesses, are described. Finally, testing of alcohol in the workplace is discussed, to shed light onto the idea that specific employees are prone to forensic and legal implications of alcohol screening and testing. There is plenty of primary literature listed at the end of the chapters, some of which comes directly from the authors’ own research. Ample judicial rulings