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INVITED REVIEW Medicolegal Death Investigation in India: An Overview
Abstract
Every suspicious death in India is investigated, with one of the objectives being determining the manner of death. The autopsy is an integral part of the death investigation. Death investigations are accomplished in the form of inquests, which are conducted and directed by the police or, in some cases, by a magistrate. The police and the autopsy physician generally share their findings before opinions are reached, and the courts rely on autopsy physician testimony. In general, the autopsy physician opines only on the cause of death. In the Indian legal and medicolegal systems, manner of death is determined by the police. Unlike in the United States, where the certifier of death must record a manner of death on the death certificate, in India the manner of death is largely a legal (rather than medical) determination. Acad Forensic Pathol. 2015 5(3): 443-446
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This study was done in Department of Forensic Medicine and Toxicology, Mahatma Gandhi Memorial Medical College, Indore (MP) from January to December 2012. Out of total 1931 post-mortem conducted in 2012, 82 cases were alleged homicidal in nature. Purpose of this study was to know the cause of death, pattern of weapon used for homicidal purpose, gender distribution, age distribution and seasonal distribution in homicidal death. Males were victim in 78.95 %( 64) of cases and females in 21.05 %( 18) of cases included in our study. In present study 64.63% (53) of total victims were in age group of >18-40 years. Most of the cases, 46.34% (38) were seen in summer (March-June) season. Most common cause of death was hemorrhage and shock 46.34 %( 38) followed by asphyxia and cranio-cerebral injury 20% each. Blunt weapons were most commonly used for homicidal purpose 31.71% (26). No case of homicidal death was seen in female by fire arm. Maximum number of autopsies were conducted on Thursday 20.73 %.
A Medico-legal autopsy is conducted to ascertain the cause of death, time of death, identification of the deceased, etc. in unnatural and/or suspicious deaths. However, the very purpose for which an autopsy is conducted may either not be served or appear to be poorly served in many a cases. In such times, another autopsy is requested and conducted on an already autopsied body commonly known as second autopsy. Rules are still unclear & varying for medico legal autopsy at different places resulting in unwarranted issues. This has resulted in a surge seen in cases of second autopsy or re-postmortem examination. With no rules governing the conduct of even a second autopsy and the sorry state of medico-legal autopsies as such in India, a lot of issues, wanted and unwanted, creep up while conduct of a second autopsy. An effort is made to draw attention towards the issues associated with the conduct of a second autopsy in India and few suggestions proposed to overcome those difficulties.
Homicide is a serious crime committed against humans and its detection, solution and adjudication are important to the entire society. This study was therefore taken up, to estimate the incidence of homicides and to determine the trends in committing homicide. This was a prospective, observational study done on alleged homicide cases autopsied between July 2007 and July 2009. All alleged cases of homicides, other than those in which death was caused by rash and negligent act, were included. Data collected was expressed as proportions and/or percentages. Total autopsies done were 9248, of which 300 were alleged homicide autopsies (3.24%). Highest number of homicide victims was in the age group of 21-30 years (42.33%). In 69% & 61.3% of homicides, the assailant was a known person & blunt or sharp weapons caused injuries respectively. As most of the homicides were family centered, early detection and prevention is important.
Homicide has become a common practice re-flecting anger in southern India. The purpose of this study was to identify the potential risk fac-tors and susceptible victims. This retrospective study analyses the data of 590 cases. Our study revealed that the victims were mostly males of 21 -30 years, married (63.56%), illiterates (44.07%), low socioeconomic status and belong to rural areas. The laborers and farmers were almost eq-ually affected in males and housewives in fe-males. Outdoor incidents were more (61.86%). Majority of victims were innocent (82.20%) with no previous history of cognizable offence. Blood alcohol was found positive in 30.23% of victims. Sharp cutting weapons were mostly used, with hemorrhage and shock being the most common cause of death. Previous enmity and familial dis-harmony were the two common causes behind such heinous crime. Most victims had injuries over multiple body parts. Some potential risk factors and their preventive measures pointed at the end.
Kautilya's Arthaśăstra deals mainly the art of government, duties of Kings, ministers, officials and methods of diplomacy. It also deals with branches of internal and foreign policies, civil, military, commercial, fiscal, judicial etc. By name and popularity of the book, scholars believe this as seed of political science and Economics. Surprisingly, it also has the descriptions of many Ayurvĕda herbs, metals, herbomineral preparations and poisonous substances. This book also deals with medico legal autopsy and Toxicology. The main aim of this article is to highlight the descriptions of forensic medicines and toxicology.
Context:
: The medical profession is one of great antiquity in India. However, the history of medicine and, in particular, the role of medicine in the administration of justice in India has not been discussed very much. The present paper attempts to fill in this lacuna and traces the medicolegal practice from ancient times to British India.
Source:
: This paper is based on archival materials collected from the Tamilnadu State Archives, Chennai, and Madras Medical College Library, Chennai, and University of Madras Library, Chennai.
Main observations:
: The medical men in ancient India were considered as men of wisdom, and one of the ancient Tamil hymns equates the doctor-patient relationship to that of the dedicated love of a devotee to God. Kautilya's Arthashastra gives a list forensic evidence for establishing the cause of death and describes the necessity of autopsy in establishing the cause of death. In British India, the early incidence of custodial death and its certification by medical practitioners, issuance of medical certificate and wound certificate, and medicolegal autopsy are documented. The most outstanding contribution of India to legal medicine during this period is modern dactylography. It is recorded that there was a high ratio of homicidal poisonings in India.
The incidence of suicide and homicide is on the increase worldwide, including India. One million people die annually due to suicides and homicides alone. A comparison of the results between suicides and homicides was performed. From a total of 5773 medicolegal deaths reported at an Apex medical centre of Nagpur University over a period of three years 1998-2000, only 241 cases (4.2%) were homicidal deaths in comparison to 1127 cases (19.5%) of suicidal deaths with suicide rate of 23.1/100,000 per year and homicide rate of 4.9/100,000 per year. Poisoning, burning, hanging and drowning forms the major methods of suicide in contrast to blunt trauma, sharp trauma, burning, and strangulation in homicide. Combined methods were more common in homicide as compared to suicide. Predominance of male was present in all methods of suicide and homicide, except burning. In general, male predominance was seen in both suicidal and homicidal deaths with peak age 21-30 years in suicides in contrast to 31-40 years in homicides. At younger age 11-20 years, the victims of suicide outnumbered the victims of homicide; but at extremes of ages below 10 years and above 60 years, homicides were relatively more common than suicides. Married victims were predominant in both types of deaths. Quarrel and revenge were the common precipitating cause/motive for homicide in comparison to chronic illness and mental illness for suicide. Majority of the accused were having close family relationship with the victims of suicide in contrast to homicides in which most of the assailant were having no family relationship with the victims. 'Acquaintance' were the accused in majority of the victims of homicides in contrast to 'self' in suicides. Most of the victims of homicide were killed outdoor in contrast to victim's own domicile in suicides. In both suicidal and homicidal deaths, most of the victims were found in summer season, but the peaks were noticed in the months of April and May in suicidal deaths and October in homicidal deaths.
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