Need for reforms in Medico legal practice

Medical evidence is a very important piece of the puzzle of the Judicial System. It is noteworthy that the Hon’ble Court of Law decides the final verdict regarding the manner of death and the various opinions submitted on the manner of death are based on medical evidence as well. Owing to the inferior level of medico-legal proficiency, the post mortem examination system is deficient leading to mistakes in opinions concluded by them and ultimately injustice.

There are no adequate arrangements for the investigation of the majority of medico-legal cases. There is a fine uniform Judicial Procedure throughout the country, which makes it absolutely incumbent on us to regularize our heterogeneous, irregular medico-legal practice immediately. The Survey Committee Report on Medico-Legal Practices in India has determined as to how far the medico-legal practitioner has been of help in the administration of Justice. Various reports clearly reveal the extent and intensity of the dark shadows in the picture of the medico-legal practices in India.

We all have to admit most regretfully that the medico-legal practice encountering deplorable conditions for the following reasons:

1. Shortage of trained personnel in the profession;
2. Absence of some required facilities;
3. Absence of any incentive for the practitioner to take interest in the work;
4. Want of literature, standards and research on the subject with an Indian bias which is very important as in many cases foreign standards cited in literature do not apply to our conditions, e.g., time of death, age, determination, etc.

It is observed that medical officers without any scientific indication or necessity for such an examination are sending many specimens for toxicological analysis; this is largely due to their lack of knowledge of pathology. Similarly the investigating police officers also are observed to collect far too many specimens of bloodstains, etc., in some cases, which do not warrant such a procedure. The volume of work in some laboratories is so great in relation to the staff available, that there is considerable delay in all-toxicological examinations. These delays are partly due inadequacy of staff and also due to the lack of knowledge and experience in the medico-legal field.

Medico-Legal Investigation System

There are following types of medico-legal investigation systems, namely,

1. The Police Inquest under Section 174, Criminal Procedure Code (Act No. V of 1898)
2. The Coroners Inquest under the Coroner’s Act (IV of 1871) (not followed in India now)
3. The Magistrate's inquest under section 176 of the Cr.P.C.

The Police Inquest: The Police Officer, generally of the rank of a Sub-Inspector of Police, on the receipt of information of an accident or other unnatural death of any person, proceeds to the place of the incident after informing the concerned Magistrate. In the presence of two or more witnesses, the Police Officer holds an inquest to draft a report of the incident about the apparent cause of the death. The Police Officer forwards the body for post-mortem examination only in the case of suspected foul play or uncertainty regarding the cause of death.

In India the participation of medical officer in the investigation of crime is often restricted only to the performance of a post-mortem examination. Inspection of the body at the scene of crime is most essential to a proper medico-legal autopsy. It is regretted that the present system is defective in this respect as it is not practicable for the medical officer to visit the scene of crime and has to depend on the police requisition or inquest report.

The Central Medico-legal Advisory Committee recommended that wherever possible, the Medico-legal Professional should visit the scene of crime.

It should also be made compulsory for the Police Officer to send bodies for post-mortem examination after every inquest. To implement this, it may be necessary to amend sub- Section 174 (3) Cr. P.C.

Coroners Inquest - This system was introduced in India after the advent of the British rule. The Coroners Act enacted in 1871 was made applicable to the old presidency towns of Madras, Bombay and Calcutta. According to the Coroners Act, the Coroner with the help of a jury holds an inquest in cases of unnatural or suspicious, deaths or in cases of deaths occurring in a jail within the jurisdiction of his court. The Coroner is authorized by law to order a post-mortem examination of body to be made by any medical man, usually the police surgeon, who is summoned to give evidence on oath. He then records evidence and gives a verdict as to the cause of death.

However, this system is not followed in India anymore.

The Magistrate's inquest- The Magistrate's Inquest is held under section 176 of the Cr.P.C. This means an inquiry conducted by a magistrate to ascertain certain matters of fact. The law specifically directs the Magistrate to hold an inquest in following three types of cases:

1. Death happening in Police custody
2. Suicide by a woman within seven years of her marriage
3. Death of a woman within seven years of her marriage in any predicament raising a reasonable doubt that some other person committed an offence in relation to the woman.

The Magistrate can also hold an inquest in any other case of death in which he deems fit.

Medico-Legal Post-Mortem Examination

As realists, we are all aware that most of the medico-legal post-mortem examination is undertaken by untrained and inexperienced medical officers.

The pathologist or medical officer may interest himself only in determining a mortal lesion as the direct cause of death, but a forensic pathologist has to solve many other questions. The latter has to operate not only with actual findings in the case, but with an adjudication of further possibilities has to reconstruct the case, based on facts and findings. An almost mathematical precision is demanded of a forensic pathologist to determine facts, which are of no interest to a pathologist. This explains the surprising nature of conclusions drawn from special investigations made by forensic pathologists.

The one most important factor in the stalemate in the medico-legal practice in our country is the lack of Medico-legal Institutes or full time Department of Forensic Medicine in Medical Colleges imparting post-graduate training in Forensic Medicine.

Consequently, suspects may not get sure and it is possible that criminals may escape or an innocent convicted.

The fallacious idea that any medical officer or even a pathologist without any medico-legal training is qualified to undertake medico-legal post-mortem examinations needs correction in the first instance.

All medico-legal services must be mandated by professionals specialized in Forensic Medicine & Toxicology. This will not only strengthen the medico-legal investigation system but will also help in guiding both police and judiciary.

By: Navin Kumar Jaggi & Aashna Suri