Introduction and Scope of Forensic Medicine

Dekal  V

SECTION 1

1Medical Jurisprudence

SECTION OUTLINE

Chapter 1: Introduction and Scope of Forensic Medicine
Chapter 2: The Indian Legal System
Chapter 3: Medical Ethics and the Law
Chapter 4: Consent and Medical Negligence2

Introduction and Scope of Forensic MedicineCHAPTER 1

DEFINE FORENSIC MEDICINE (FM1.1)

Forensic medicine or legal medicine also called as state medicine.
The word “Forensic” originates from the Greek which means “open forum” a public debating place (court of law).
Forensic medicine is a branch of medical science which deals with the application of medical knowledge to help or aid in the administration of justice.
It is a branch of medical science which bridges the law and medicine. In short, the subject deals with the Medical Aspects of the Law.

Forensic medicine can be broadly divided into:
- Clinical forensic medicine: Deals with the examination of the living individuals, such as cases of sexual offences, wound certificate, age estimation, medical leave certificate, etc.
- Forensic pathology: Deals with interpretation of autopsy findings in the medicolegal investigation of death (Forensic Thanatology—study of death).

DEFINE MEDICAL JURISPRUDENCE (FM1.1)

Juris: Law; Prudentia: Knowledge.
Medical jurisprudence deals with the legal responsibilities of the physician with reference to those particularly arising from physician–patient relationship, such as medical negligence, consent, rights and duties of doctors, serious professional misconduct, etc. (in short, it deals with the Legal Aspects of Practice of Medicine).4
Medical jurisprudence deals with the laws which govern the practice of medicine hence any violation of the said law relating to medical practice will attract penal action and punishment against the doctor as per the provisions of the Indian Penal Code.

DEFINE MEDICAL ETHICS AND ETIQUETTE (FM1.1)

Medical ethics deals with the moral principals which should guide the members of the medical profession in their dealings with each other, towards their patients and the State.
Medical etiquette deals with the conventional laws of courtesy observed between the members of the medical profession.

DESCRIBE THE HISTORY OF FORENSIC MEDICINE (FM1.2)

Ancient Medical Texts

Manu (3100 bc) was the first traditional king and lawgiver in India. His famous treatise “Manusmriti” lays down various laws prevailing in those days.
The “Atharva Veda” gives details about remedies for various conditions. They were able to treat wounds, burns, poisoning, snake bite and insanity.
Vedas prescribe rules and punishment for offences and physicians were recognized.

Medicolegal Work in Ancient India

The first treatise on Indian medicine was the “Agnivesa Charaka Samhita” (700 bc).

“Charaka Samhita” lays down an elaborate code regarding the training, duties, privileges and social status of the physicians. It also gives a detailed description of various poisons, signs and symptoms and treatment for various poisoning.
This is considered as the origin of medical ethics; charaka samhita also prescribes punishment for the physicians who practice wrong treatment.

Kautilya's Arthashastra (460 to 377 bc)

This is the oldest of Indian codes. It States that death can be caused by three ways:
1. Stopping the breathing by four ways (strangling, hanging, asphyxiation or drowning)
2. Physical injuries in two ways (by beating or by throwing from a height)
3. Poisoning (poisons, snake or insect bite, or narcotic drugs)
Kautilya's arthashastra describes the necessity of Autopsy in establishing the cause of death. It states that a postmortem shall be conducted on any case of sudden (unnatural) death, after smearing the body with oil to bring out bruises, swellings and other injuries.

Medicolegal Work in British India

The earliest hospital was established by Sir Edward Winter in Chennai in 1664 for treatment of sick soldiers.
The first medical school was established in 1822 at Calcutta and was later converted into medical college in 1835. The second oldest medical college in the country was the Madras Medical College, Chennai.
The incidence of custodial death and its certification by medical practitioners was reported in Chennai in 1678.
The earliest medical certificate was issued by Edward Bulkley and Samuel Browne, after examining Mr John Nicks on August 16th 1693.

WHAT IS THE SCOPE OF FORENSIC MEDICINE? (FM1.2)

Forensic medicine deals almost entirely with crimes against human beings. In 5present days. Almost all the offences against the human body requires medical opinion in order to deliver an impeccable justice in the court of law. The primary interest is to provide the source of information about medical science to confine the needs of the law.
Forensic medicine is mostly an exercise of common sense combined with the application of knowledge and experience acquired in other branches of medicine.
Forensic medicine involves:
1. Observation of facts,
2. Collection of evidence,
3. Interpretation of the scene of crime and
4. Reconstruction of the events based on medicolegal examination.
In all cases of crime involving human body, e.g., homicide, suicide, assault, sexual offences, criminal abortion, traffic accidents, poisoning, etc., the help of the medical officer is sought by the investigative agency. In all such cases, the doctor will be required to appear in the court as an expert witness and depose evidence.
In some cases, as in cases of sudden death, the authorities will have to depend completely on the medical witness in establishing the cause of death.
A properly prepared physician often finds his court room experience educative. The physician must bear testimony within the limits of science. The attitude of the scientific witness should be the same whether he is called by the prosecution or by the defense.
The sole obligation of the medical witness is to present the truth as he sees it, adding nothing, withholding nothing and distorting nothing. The doctor must be honest, unbiased and truthful, for the confidence is inspired by honesty and success depends on confidence.

WHAT ARE THE CIRCUMSTANCES A DOCTOR MAY BE CALLED TO THE COURT?

A doctor may be called to the court to testify:
1. As an ordinary witness who saw something happen.
2. As a medical practitioner who treated the patient.
3. As an expert witness to give opinion on matters of science.

MULTIPLE CHOICE QUESTIONS

1. Medical jurisprudence means:

Knowledge of medicine required for lawyers
Knowledge of law required for doctors for medical practice
Knowledge of medicine required for doctors
Knowledge of law required for legal practice

2. “Medical etiquette” deals with:

The conventional laws of the courtesy observed between members of the medical profession
Legal responsibilities of the physician
The study and application of the effects of violence or unnatural disease in its various forms
The moral principles which should guide members of the medical profession in their dealings

ANSWERS

1. b

2. a

Chapter Notes

Introduction and Scope of Forensic MedicineCHAPTER 1

KEY WORDS

FM1.1	Demonstrate knowledge of basics of forensic medicine like definitions of forensic medicine, clinical forensic medicine, forensic pathology, state medicine, legal medicine and medical jurisprudence.
FM1.2	Describe history of forensic medicine.