Do you know medico-legal complexities of Poisoning?

When a patient of poisoning is brought to a Doctor, even though it is a medico-legal case, medical responsibilities of the doctor assume first importance i.e. saving the life of the patient.

Legal duties always take a back seat in such instances.

Read the conversation between a Doctor- Dr.Curious and Mr.Legal-Lawyer (Names changed!).Both of them discuss all medico-legal aspects of a poisoning case.

Dr.Curious meets Mr.Legal

Dr.Curious- Do I have the right to say NO to a poisoning case?

Mr.Legal - It depends- Doc!

Every doctor has a right to choose a patient (i.e. he can refuse to treat any patient).But no doctor shall refuse to treat a patient in an emergency be it poisoning or something else.

However, if you are a doctor working in a government hospital can never refuse treatment to a patient of poisoning- emergency or otherwise.

Dr.Curious- I have never before dealt with a poisoning case. I only remember basics of management of poisoning cases from my college days. What must I do if I encounter an emergency of poisoning?

Mr.Legal- It is always advisable to consult a senior colleague in cases of doubt or otherwise, however, a Doctor is protected against any harm done in good faith to a patient in an emergency situation, legally as per Section 92 IPC.

So in the absence of a senior/experienced Doctor, you must do what you can for the suspected case of poisoning.

Even after recovery or the patient becoming stable it is advised that the patient is observed for at least 24 hours to avoid suits of negligence being filed against.

Dr.Curious- Is it mandatory to inform police/authorities regarding a poisoning case?

Mr.Legal- If working in a government hospital, you are bound to inform the legal authorities of all the cases of poisoning regardless of their manner, either suicidal/accidental/homicidal.

A private medical practitioner, on the other hand, is not legally bound to inform the legal authorities of all the cases of poisoning. You only have a legal obligation to inform in homicidal cases (murder/attempt to murder) of poisoning as per Section 39 Cr.P.C.

 If you are sure the case is suicidal/ accidental in nature you need not inform any authority.

However, as you can never be sure about the manner of poisoning (unless your surname is Holmes!), to be on the safe side, always inform the legal authorities about any case of poisoning.

Dr.Curious- Thanks for your advice, Mr.Lawyer, however, I’d be better off knowing the punishment or penalty in case I am not able to inform the authorities and provide information regarding a poisoning case.

Mr.Legal- Failure to inform the police in a case of homicidal poisoning makes you liable for prosecution under Section 176 IPC [punishment is simple imprisonment of 1 month or fine of Rs. 500/- or both].

Similarly if the police during investigation demands details of a case of poisoning and you do not provide the same, you can be penalized under Sections 193 IPC [punishment is imprisonment of either description up to 7 years with fine] and 202 IPC [punishment is imprisonment of either description up to 6 months or fine or both].

And don’t even think of providing false information. It will make you liable to be punished under Section 177 IPC [punishment is of simple imprisonment for 6 months or fine of Rs. 1000 or both].

Dr.Curious- That was great information. Any parting statement of Dos and Dont's?

Mr.Legal-Yes.

First and Foremost forget about Doctor – Patient privilege. Save yourself the pain of legal trouble by making sure of a few safeguards. 

Never fail to inform the authorities of a case of poisoning having come to you.

Second, collect materials like vomitus, the first returning fluid of stomach wash, feces, blood, urine etc. and preserve for chemical analysis. Dispatch it to the nearest forensic science laboratory asap. In the case of any unavoidable delay, properly preserve it.

In the case of an imminent death, arrange for the recording of a Dying declaration.

In the circumstance of death in a case of poisoning, whether or not the police was informed of the case or not due to any reason, DO NOT ISSUE death certificate.

Hand over the dead body to the legal authorities for a medico-legal Autopsy.

Mr.Legal- Nice speaking to you.

Dr.Curious -That was swell Mr.Legal. Care for a drink someday.

Mr.Legal- Sure--someday.

The author can also be reached at lawfullofit@gmail.com