Sunday, February 16, 2020

Legal System in Malaysia


Dear friends in this Whatsapp Chat Group 


Our tutor Dr. Susan Gurney at the University of Cambridge has asked us students from various countries around the world to write a summary of the legal system in each of our respective country.

This is just as one of the many daily and weekly tasks  we need to undertake and submit as part of our course in forensic investigation (forensic toxicology)

This is a wake up call for me as I have no clue myself, and I am sure you too have not much clue as most of us are not in the legal profession

So I like to share my knowledge with you to wake you up also.

This is the beauty of a chat group where we can share knowledge after a research

Unfortunately a lot send rubbish and videos to us in chat groups.

So I need to neutralize them with something that is solidly academic.



Legal System in Malaysia (Part 1)
by Lim Ju Boo - Saturday, 15 February 2020, 7:15 PM

Dear Dr. Susan

You have asked me a very difficult question as I am not in the legal field, and I really do not have much idea how our legal system in Malaysia works.

But I shall try my level best using plain simple language from sources I read here and there and understand.

The legal system in my country, Malaysia is very complex

It is mainly based on the common law legal system.

But there are also state laws enacted by the State Legislative Assemblies which applies in the particular state.

The constitution of Malaysia also provides for a unique dual justice system—the secular laws (criminal and civil) and sharia (Islamic) laws even though there a controversy whether or not Malaysia is a secular or an Islamic country since it is a multiracial country for sure with many types of religion being practiced here even though the majority of the population are Muslims


The reason why the law of Malaysia is mainly based on the common law legal system was because it is the direct result of the colonization of Malaya, Sarawak, and North Borneo by Britain between the early 19th century to 1960s.


However, the supreme law of the land is the Constitution of Malaysia that sets out the major legal framework and rights of all Malaysian citizens.


The Federal laws are enacted by Parliament of Malaysia and this applies throughout the country even though it may have a dual system.


Then there are also state laws enacted by the State Legislative Assemblies which applies in the particular state


On the dual system of law in this country this is provided in Article 121(1A) of the Constitution of Malaysia.


Article 3 also provides that Islamic law is a state law matter with the exception for the Federal Territories of Malaysia.


 Islamic law refers to sharia law, and in Malaysia it is known and spelled as syariah. The court is known as the Syariah Court.


Looking at the Malaysian legal system as a whole, sharia law plays a relatively small role in defining the laws on the country. It only applies to Muslims.


With regards to civil law, the Syariah courts has jurisdiction in personal law matters, for example pertaining to marriage, inheritance, and apostasy.


In some states there are sharia criminal laws, for example there is the Kelantan Syariah Criminal Code Enactment 1993.


Their jurisdiction is however limited to imposing fines for an amount not more than RM 5000 (925.33 Pound sterling) and imprisonment to not more than 3 years.


They cannot impose capital or death sentence on any criminal or murder cases such as in Alex and Linda hypothetical murder case Cambridge University gave us. 


Such cases has to be referred to the High Court, then  to the Appeal Court and finally the Federal (Supreme) Court that will have the final say by applying the Federal Constitution, the highest Constitution of the land that applies to all major criminal and murder cases


 In August 2007, the then Chief Justice of Malaysia proposed to replace the current common law application in Malaysia with sharia law, but this was turned down


I am a long retired medical researcher, not in the legal profession. So I hope I have summarized something out of my field to the best of my ability.


Thank you

--------------------------------------

Dear Dr. Susan,

Part 2

Just some further information on what I have written earlier at the 5th week  student forum

The hierarchy of courts in this country (Malaysia) begins from the lowest court, namely the Magistrates' Court where minor offences like stealing, traffic offences, burning rubbish in public, and owners of dogs allowing them to chase and bite others are heard here.


The next higher court is the Sessions Court where cases on civil matter involving motor vehicle accidents, disputes between landlord and tenant and distress action and other matters where the amount in dispute does not exceed RM 250,000.00 are heard here.


In the Malaysian legal system, for more serious offenses such as drug and human trafficking, and murder cases that may result in a capital punishment (death sentence) they are then referred to the High Courts


If a convicted person is not happy with the sentence hand down by a High Court, he / she may appeal to the next highest court which is the Court of Appeal where the sentence of the lower court (magistrate and session courts) may be upheld or overturned


If he is still not satisfied, he / she may also have his / her case heard in the highest court that is, the Federal Court which is the apex or the Supreme Court of the land


But if any judgment by the apex court (Federal Court) is handed down, then there is no more further avenues available for him / her to appeal. Then that sentence including a death sentence is confirmed


In Malaysia currently death sentence is imposed for drug trafficking, murder, kidnapping, human smuggling, treason against the King and country, and other similar serious offences


However they are now trying to have the capital sentence (death sentence) abolished


But this has caused a tremendous outcry among some sectors of the public especially among members of families whose loved ones were murdered - quite understandable.


In fact some families publicly said that if the death sentence is abolished, and if the murderer of their family members was let off the gallows, they themselves would personally kill the murderer. They blamed government as insensitive 


So the decision whether or not to abolish the death sentence in this country is still being debated, maybe abolished only for some other offences such as for drug offences


In Malaysia we currently do not have a jury system anymore.

We had one but it was abolished in 1995


Hence if a death sentence is heard in the apex court (Federal Court), instead of a jury, 2 or 3 or even more senior judges will sit on the bench to make the decision


That sentence will be final


Thank you for your question.  It has helped me to learn something about our own legal system which I never knew before


Tuesday, February 4, 2020

Therapeutic and fatal doses of drugs


Below is one of the many countless student discussions posted by this author as a current student in Forensic Toxicology in during the 3rd week into the course at the University of Cambridge

Q. What is a toxin?

A. A toxin is a poison of biological origin, normally a protein expressed by the organism

For instance, botulinum toxin is a neurotoxic protein produced by the bacterium Clostridium botulinum.

 Another example, is tetanus toxin, an extremely potent neurotoxin produced by Clostridium tetani  in anaerobic conditions and this toxin causes tetanus (lock jaw in humans)

Other examples are mycotoxins, for instance aflatoxin B and G expressed by the microfungi , Aspergillus flavus, that in small doses over long exposure can cause liver cancer, and in large doses in one sitting causes acute liver failure

Others are the different types of neurotoxins and haematoxins expressed by vipers and cobras. The list goes on and on.
 
Q. What are the therapeutic and fatal doses of the various poisons and drugs given in the list 

A. As far as the therapeutic and lethal doses of other poisons and drugs are concerned here are just two examples

Poison                                 Therapeutic dose                                                                             Lethal dose

Arsenic                                 Arsenic trioxide 0.15 mg/kg IV                                                    70 to 200 mg mg/kg/day

Paracetmaol                       1-2 tablets bd – tds (twice or three times a day                  10–15 g (20–30 tab)

For arsenic this is found in a few medicinal preparations

For instance, Salvarsan, an organic arsenical, was introduced in 1910 by Nobel laureate, physician and founder of chemotherapy, Paul Ehrlich. His compound, which was one of 500 organic arsenic compounds, cured syphilis.

Today, arsenic compound is still used in the treatment of trypanosomiasis. Therapeutic doses of these compounds depends on the formulation and preparation

For instances for acute promyelocytic leukemia (APL), arsenic trioxide at a dose of 0.15 mg/kg body weight is given IV until bone marrow remission; not to exceed 60 days.

Other formulation such as Tretinoin is given at 22.5 mg/m²

Arsenic exerts its toxicity by inactivating up to 200 enzymes, especially those involved in cellular energy pathways and DNA synthesis and repair.

But what is more important is the long term exposure to arsenic in the soil and drinking water

WHO estimated through drinking water, more than 200 million people globally are exposed to higher than safe levels of arsenic (1). The areas most affected are Bangladesh and West Bengal (1). Exposure is also more common in people of low income and minorities (2).

 Acute poisoning is uncommon (1). The toxicity of arsenic has been described as far back as 1500 BC in the Ebers papyrus (3).

The acute minimal lethal dose of arsenic in adults is estimated to be 70 to 200 mg or 1 mg/kg/day (4)

As far as paracetamol is concerned, the therapeutic dose as an analgesic is normally 1 -2 tablets x tds. But this depends on age

An overdose of 10–15 g (20–30 tablets) of paracetamol can result in fatal hepatotoxicity (5, 6).

Patients who are malnourished, have been fasting, take enzyme inducing drugs, or regularly drink alcohol to excess are at higher risk of liver damage.

Again the fatal dose depends on a person's body weight, age and other drug interaction. For instance if a person takes 5 g of paracetamol together with alcohol, that dose probably would be the lethal dose for him, especially if he / she is a small child.

Similarly, if he already has a liver disorder, and his kidneys are already compromised with low GFR, low creatinine and urea clearance,  the lethal dose for paracetamol can be would be much lower than 20 -30 tablets in one dose.  It all depends on the patho-physiology state of an individual

The same can be said for strychnine.   A few minutes after ingestion, strychnine is excreted unchanged in the urine, and accounts for about 5% of a sublethal dose given over 6 hours (Boyd et al., (1983)

Higher doses over a longer period are fatal. Again this depends on the body weight

I think it is very difficult to give any strict and specific values for all these drugs / poisons especially the lethal doses because it is not possible for us to carry studies on lethal doses using human subjects.

Most of toxicological studies are done using animal models, and their lethal dosage per kg of body weight are then extrapolated into humans

Then again, the biochemistry and genetic make-up of animal models may not necessary be the same for humans. But that is the best we can do. We can’t carry out toxicological trails on humans

There are many other methods used for evaluating toxicity. One common method is to determine the LD 50 (lethal dosage of a substance that kills 50 % of a population in experimental animals),

Toxicologists can also use cell cultures and cell lines studies  in vivo exposure, skin sensitization tests, Draize test, open epicutaneous test, optimization test, split adjuvant test, guinea pig maximization test (GPMT), Buehler test, and murine local lymph node assay (LLNA)…etc. etc.

Normally we would use some of these studies such as developmental toxicology in embryotoxicity studies, genetic toxicity testing, neuro-toxicological evaluation,  two-generation reproduction toxicity studies, carcinogenicity testing, subchronic oral toxicity testing to better understand their toxico dynamics and toxicokinetics (how they act on the body). The list goes on.

Most of these we would focus on the various experimental animal models and methods used for toxicity testing. It depends what we want to evaluate

These pre-clinical toxicity testing helps the toxicologist to calculate out “No Observed Adverse Effect Level” which is needed to initiate the clinical evaluation of  products under investigation such as a novel drug to be marketed much later after 10 - 15 years from cell-lines studies on toxicity, clinical efficacy, to various phrases of clinical trials. It takes a very long time at high cost in R & D before approval by FDA can be obtained

On the issue of adverse drug reaction and toxicity, post marketing pharmaco vigilance is still observed and in place

So I cannot tell you exactly what each dose, therapeutic, fatal or otherwise would be for the various poisons and drugs given in the list because of so many confronting factors 

Some poisons like arsenic, lead and mercury are accumulative at very low doses over many years, or they can also be acute at high doses if administered in a single dose

I would like to leave this very complicated and very lengthy subject here as this is a very complicated and controversial issue

There are already too many studies and published literature on this with some studies contradicting each other.

            

References:

1. Naujokas, Marisa F.; Anderson, Beth; Ahsan, Habibul; Aposhian, H. Vasken; Graziano, Joseph H.; Thompson, Claudia; Suk, William A. (3 January 2013). "The Broad Scope of Health Effects from Chronic Arsenic Exposure: Update on a Worldwide Public Health Problem". Environmental Health Perspectives. 121 (3): 295–302.

2.  Joca, L; Sacks, JD; Moore, D; Lee, JS; Sams R, 2nd; Cowden, J (2016). "Systematic review of differential inorganic arsenic exposure in minority, low-income, and indigenous populations in the United States". Environment International. 92-93: 707–15.

3.  Howie, Frank (2013). Care and Conservation of Geological Material. Routledge. p. 135. ISBN 9781135385217. Archived from the original on 2017-09-10.

4. https://pmj.bmj.com/content/79/933/391.full

5.            Prescott LF. Paracetamol overdosage: pharmacological considerations and clinical management, Drugs, 1983, vol. 25 (pg. 290-314)

Google ScholarCrossrefPubMed

6              BMJ Group, British National Formulary 59 March 2010, 2010LondonBMJ Group; Pharmaceutical Press

7.  Boyd RE, Brennan PT, Deng JF, Rochester DF & Spyker DA (1983). Strychnine poisoning.  Am. J. Med., 74: 507-512.

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