Forensic Medicine and Medical Ethics

Forensic Medicine & Toxicology

• Forensic medicine applies medical knowledge to legal issues, particularly in law enforcement.
• Medical jurisprudence involves the role of law in medicine.
• Medical ethics are self-imposed codes of conduct.
• Medical etiquette are conventional rules of courtesy.
• Codes of medical ethics are established by the National Medical Commission and are used to guide actions.
• Warning notices are issued by the NMC for violations of medical ethics.
• Acts covered in warning notices may involve infidelity, association with unqualified individuals, advertisement violations, alcohol issues, addiction, unlawful abortions (x-mtp act), issuing false certificates or fee splitting.
• Maintaining professional secrecy is an important aspect.
• Violations of medical ethics are serious professional misconduct or ethical negligence, leading to consequences in a legal context, such as warnings, fines or professional sanctions.
• Penal Erasure is a measure taken to resolve or mitigate the consequences due to offenses in the medical field.
• Punishment may take the form of warnings, fines, and in severe cases, professional sanctions.

Legal Procedures

• Inquest is an inquiry into a cause of death, often conducted by a magistrate, which, may involve death in custody (police inquest, 194).
• Magistrate inquest involves death in custody (judicial magistrate).
• A Judicial Magistrate may also conduct an inquiry in cases of rape in custody and dowry death.
• An Executive magistrate examines cases of dowry death.
• Exhumation is the digging up of a body from a grave which is done only by magistrate.
• Post-mortem examination procedures are carried out in the process of exhumation
• An inquiry into the cause of death is conducted by a magistrate
• The lowest court authorised to pass a death sentence is the sessions court.

Dying Declaration

• Oath administered during a dying declaration, which is assessed as true or false.
• Doctor's certification is required to check mental stability of the individual.
• Record of dying declaration is the responsibility of anyone and can be documented.
• A dying declaration is considered a true statement.
• If the person survives the declaration, it has no legal effect

Offences and Laws

• Offences include causing harm to a person's body, reputation, or property.
• The legal standards are outlined in laws like the McNaughton's rule.
• The mental state of the person committing the crime can affect judgments in a court of law in determining any criminal responsibility.
• Laws of insanity include the Durhams rule, Cumens Rule, and the American Law Institute test.

Identification

• Precipitin test aids in species identification.
• The medullary index is measured in hair to distinguish between humans and animals.
• The cephalic index is calculated to determine a person's race (human skulls).
• Pelvic bone characteristics are critical factors in determining biological sex.
• Dental records are used to determine age.
• Secondary sexual characteristics and bone ossification patterns assist in age determination.
• Tooth eruption timeline is used to determine age.

Dactylography

• Prints are commonly used in fingerprint analysis by the Henry Galton system.
• Fingerprint development occurs between 12-16 weeks in utero.
• Criminal identification often relies on a minimum of 8 unique points from fingerprints.
• Fingerprints are unique to an individual.

Thanatology

• Thanatology is the study of death in all its aspects (manner and cause).
• Immediate post-mortem changes involve the cessation of respiration and circulation.
• Early post-mortem changes include pallor, loss of skin elasticity, changes in eye, Algor mortis, Livor mortis, Rigor mortis.
• Late post-mortem changes include putrefaction, adipocere, and mummification.

Identification Methods

• Methods used in identification procedures include bloodstain analysis, examination of skeletal remains, analyzing wounds, and using fingerprints to distinguish between different species or races.
• The study of bones and tissues is conducted for identification of organisms or races.

Mechanical Injuries

• Injuries from blunt weapons can result in abrasions, contusions, or lacerations.
• Injuries from sharp weapons can create incised or stab wounds.
• Various factors such as the depth, length, or width of the wound are considered to determine the cause of the injury.
• The classification of wounds depends on the severity of injury and the presence or absence of bleeding.

Thermal Injuries

• Thermal injuries are caused by high temperatures.
• Flame burns involve the presence of soot in the trachea, carboxyhemoglobin may be present in the victims blood, with signs of healing.
• Cause of death in these injuries may be neurogenic shock, carbon monoxide poisoning, hypovolemic shock, or septic shock.
• Scalds/moist burns are typically caused by the contact of boiling water or steam with the skin.
• Electrocution and lightning strikes can also cause burns.

Asphyxia

• Asphyxia results from the lack of oxygen supply to the body.
• Hanging occurs due to the constriction of the neck.
• Strangulation occurs when the neck is compressed.
• Suffocation occurs when the nose and mouth are blocked.
• Drowning is caused by immersion in water.

Autopsy

• Autopsy is a method of examination of the body for diagnostics purposes.
• The time of death is estimated based on the presence of specific changes.
• Blood flow and other biological changes are examined by forensic pathologists.

Toxicology

• Arsenic poisoning exhibits symptoms such as intense pain, vomiting, and purging.
• Mercury poisoning, known as hydrargyrism, shows symptoms such as tremors, gingivostomatitis, acrodynia, and nephrotoxicity.
• Lead poisoning (plumbism) causes anemia, basophilic stippling of RBCs, encephalopathy, etc.
• Iron poisoning may lead to mild to severe forms of complications depending on the dose.
• Phosphorous poisoning can cause whitening, and oral diseases such as phossy jaw.

Specific Poisons and Toxins

• Poisons and toxins like phenol and carbolic acid, have various toxic effects on the body.

Other Topics

• Medical Termination of Pregnancy (MTP) Act, 2021: Legal rules in abortions.
• Excessive sexual desire (terms).
• Toxicity of cobra venom and other issues.
• Medical tests, examination procedures and legal issues.