vol.50 Department of Forensic Medicine

The history of this department began on May 26, 1923, when Dr. Kumao Yamagami was appointed as the first professor. Since then, the department has developed under Dr. Shokichi Ueno, Dr. Ginjiro Saito, Dr. Toru Suzutani, Dr. Takehiko Takatori, and Dr. Koichi Terazawa, and after 100 years, Dr. Kotaro Matoba was appointed as the seventh professor on March 1, 2023. The first to fourth generations of professors hailed from other universities, followed by Professor Tatehiko Takatori (5th), Professor Koichi Terazawa (6th), and Professor Kotaro Matoba (7th), all of whom were from Hokkaido University. Currently, the department comprises 16 members: one professor, one lecturer, one assistant professor, and one technical staff member; three research fellows, one medical assistant technician, one technical assistant, five administrative staff members, as well as one specially appointed assistant professor physician and one dentist from the Center for Cause of Death Investigation, who conduct daily work and research.

The field of forensic medicine is facing a nationwide shortage of human resources. In Hokkaido, there are only five physicians specializing in forensic medicine. The number of forensic physicians has continually declined from the seven when Professor Matoba was a graduate student 20 years ago. In recent years, the number of unnatural deaths has rapidly increased with the rising number of fatalities, with 9,000 unnatural deaths occurring annually in Hokkaido. The number of judicial autopsies has increased three- to four-fold due to an increase in the autopsy rate of unnatural deaths as a result of a 2014 Cabinet decision to promote the investigation of cause of death by government policy. This has dramatically increased the burden on forensic physicians. Since 2017, when the number of judicial autopsies peaked in Japan, the department has also performed nearly 400 autopsies yearly, although this number has fluctuated. Professor Matoba says, “The number of unnatural deaths is expected to increase further in the future due to the aging of the population and the increasing unmarried rate. The training of forensic physicians is an urgent issue, as more forensic physicians are expected to play an active role in the future.”

In response to recent advances in analytical instruments, research in forensic medicine has focused on post-mortem imaging using multi-slice CT equipment and rapid and highly sensitive drug toxicology tests using mass spectrometry. The department has also introduced such equipment and used it to conduct research. These instruments are not only applied to work and research activities related to forensic medicine, but also to various other specialized fields and clinical departments of Hokkaido University Hospital, including post-mortem imaging, medical safety activities, emergency medicine, surgical training, contributing to the development of Hokkaido University through this wide range of applications.

In terms of forensic practice, as mentioned above, the number of forensic autopsies has been increasing in recent years, presently exceeding 1,000 every year, led by a record number of 1,370 in 2022. Professor Matoba says, “The impact of COVID-19 has been particularly significant. It seems that the increasing rate has grown steeper since the pandemic.”
The department also contributes to public health in the region by diagnosing cases of unnatural death on autopsy as those related to COVID-19 (approx. 100 cases) and streptococcal toxic shock syndrome (3 cases) based on CT imaging, biochemical tests, and antigen/PCR tests, and reporting these to the related public health centers and other institutions.