2. The task of Doctors now a days has become very sensitive in
society as we are coming across various news in respect of
negligence in treatment, allegations and violent attacks by the
family members on hospitals and speculative litigations filed
against Doctors.
Thus role of Doctors has not become restricted only to Medico–
Legal Cases or to act as an Witnesses in various courts, but due
to introduction of Consumer Protection Act, alertness of
patients in society, accessibility of modern techniques viz. C.Ds,
films etc. the said responsibility is increased and hence one
should be aware about the various provisions of law, protections
under the law, and changed focus of legislature.
3. There are various laws wherein role of doctors,
their certificates and reports helps to decide the
controversy or unnatural acts. These laws are
Indian Penal Code, Consumer Protection Act and
claims under Motor Vehicle Act. In view of this it is
necessary to know various courts established under
the law, certain provisions and their implications.
4. The person who receives summons is normally under
some psychological pressure or stress. Therefore following
provisions will be helpful.
Section 88 act not intended to cause death done by
consent in good faith for persons benefit
Section 89 act done in good faith for benefit of child or
insane person or by consent of guardian
Section 90 consent known to be given under fear or
misconception
Section 91 exclusion of acts which are offences
independently of harm caused
Section 92 act done in good faith for benefit of person
without consent
5. 279 IPC – Offences affecting Public health & safety
Sec.302 IPC- Punishment for the offence of murder
304A IPC – Causing death by Negligence
Sec.304 B IPC- Dowry Death
Sec.307 IPC- Attempt to Murder
337 IPC – Rash & negligent driving & normally
injuries arising out of accident. Causing hurt or injury
to endanger human life or personal safety
338 IPC – Causing grievous hurt endangering human
life or personal safety
319 IPC -Hurt (Simple Injury)
320 IPC – Grievous hurt (Grave Injury)
6. DETAILS OF INJURY CERTIFICATE SHOULD INCLUDE,
There are cases wherein this certificate is very crucial piece of
evidence. The said certificate is mostly useful in the cases referred
above.The following details will help to meet the ends of justice.
AGE- This helps to calculate the day of incidence and date of
examination.
COLOUR- This helps to determine when patient was examined and
same and above.
CAUSE OF INJURY ( DETAILS OF WEAPON)-
NATURE OF INJURY ( SIMPLE/GRIEVIOUS)-
SHORT HISTORY, GENERAL & SYSTEMIC EXAMINATION
PLACE OF INCIDENCE-
TIME OF INCIDENCE -
DATE OF INCIDENCE-
REMARKS-
7. The medical officer normally has to state in the
medical certificate whether the injuries are simple
or grievous.
In one of the case there was use of Chilly Powder
while e committing an offence, however in total
medical papers there was no whisper about the
availability of the particles of chilly powder or
itching aspect in the eyes was not noted.
Regarding direction of injuries- Horizontal, vertical,
circular, etc.
Depth of injuries-
Regarding thumb impressions and identification of
patients-
8. REGARDING SEXUAL OFFENCES
The relevant section under Indian Penal Code
Section 375- Rape
Section 376- Punishment for Rape
Section 376 A to E–There are certain classifications viz.
commission of rape and due to injuries it causes death or
persistent vegative state, intercourse by a man with his
wife during separation, by public servant with woman in
his custody, intercourse by superintendent of jail, remand
home, Gang rape, etc.
These offences are very sensitive and nature of
punishments is also severe.
9. Age ofVictim.
Age of accused.
Position of sexual penetration i.e. standing / lying
Height/weight.
Physical Injuries.
Genital Organs-
Injuries to Genitals
Labia Majoria
Labia Manoria
Hymen
Fourchette
Perineum
Cervix
10. The observation regarding injury to these
parts are very crucial, vital and of great
significance. These injuries decide the fate of
the matter and hence a doctor should take
care to write in detail all the injuries noticed
by him.
Regarding concluding part of examination
i.e. Final Opinion. This opinion should not be
vague, ambiguous and incomplete as this
opinion decides fate of the case and accused.
The opinion should be specific so as it should
be helpful to draw inference regarding the
commission or non commission of offence.
11. 2013 CRI. L. J. 2446
(SUPREME COURT)
Lillu alias Rajesh and anotherV/s. State of Haryana.
Penal Code (45 of 1860), S. 376 – Rape – Presumption to consent – Medical evidence –
Two fingers test and its interpretation – Violates right of rape survivors to privacy,
physical and mental integrity and dignity – Even if report is affirmative, cannot ipso
facto give rise to presumption of consent.
Evidence Act (1 of 1872), S. c.
In rape cases so far as two finger test is concerned, it requires a serious
consideration by the court as there is a demand for sound standard of condonation
and interpreting forensic examination of rape survivors. (Para 7)
In view of international Covenant on Economic, Social and Cultural Rights 1966;
United Nations Declaration of Basic Principles of Justice for Victims of Crime and
Abuse of Power 1985, rape survivors are entitled to legal recourse that does not
retraumatize them or violate their physical or mental integrity and dignity. They are
also entitled to medical procedures conducted in a manner that respects their right to
consent. Medical procedures should not be carried out in a manner that constitutes
cruel, inhuman, or degrading treatment and health should be of paramount
consideration while dealing with gender-based violence. The State is under an
obligation to make such services available to survivors of sexual violence. Proper
measures should be taken to ensure their safety and there should be no arbitrary or
unlawful interference with his privacy.
Thus, undoubtedly, the two finger test and its interpretation violate the right of
rape survivors to privacy. Physical and mental integrity and dignity. Thus, this test,
even if the report is affirmative, cannot ipso facto, give rise to presumption of
consent.
12. Section 328 of Indian Penal Code causing hurt by
means of poison etc. with intent to commit an
offence.
WHAT ARETHE GENERAL PRINCIPLES
OFTREATMENT OF POISONING-
Removal of poison
Administration of antidotes
Elimination of poison
Symptomatic treatment
Collection of toxical samples for chemical analysis
Timely sending the toxicological samples to C.A.
13. UNCONCIOUS PATIENTS-
There are incidences wherein patients are
admitted in unconscious state of mind and in
such situations for immediate diagnosis
following aspects are important.
Who brought the patient?
Spot where the patient find ?
What were the clothes of patient?
Doctor should obtain blood and urine sample
14. ALCOHOL-
Doctor should examine whether the patient was intoxicated
or not?
The judgment of Bacchubai Karyani is the landmark
judgment on this point wherein it is observed that blood and
urine test are the conclusive test for the same.
OFFENCES RELATED IN RESPECT OF ALCOHOL-
The relevant sections are -
185 of MotorVehicle Act i.e. Driving by a drunken person or by
person under the influence of drugs
85 Bombay Prohibition Act – Penalty for being drunk and
disorderly behaviour
The percentage of Alcohol contemplated is above 50 mg.%
15. The death certificate is crucial piece of evidence,
however it is appearing that if the patient is treated
by the doctor in that event entire medical notes,
treatment given to the patient all these aspects
needs to be mentioned on the case paper, notes of
treatment needs to be noted so as one can draw
the conclusion of the line of treatment and
secondly the patients, relatives will also be aware
about the span of treatment and cause of death.
16. The post mortem is required for knowing the cause
of death. The cause of death may be due to
accidental, suicidal or homicidal. The doctor is not
supposed to advise anything but to treat the patient.
In MLC cases if the death is occurred and cause of
death is known then the certificate of cause of death
is to be handed over to the police authorities with all
relevant case papers, clinical notes. The said
compilation is to be forwarded to the police
authorities and then police will take a call if he is not
satisfied with the cause of death, investigation made
from attending circumstances.
17. (1993) ACC 308 Baburao Kotgire vs.Venkatai
Thote
(2013) 1TAC 122 Madras New India Assurance vs.
Santhi
18. SEC.175 OF IPC-
OMMISSION TO PRODUCE DOCUMENT OR ELECTRONIC RECORD TO
PUBLIC SERVANT BY PERSON LEGALLY BOUNDTO PRODUCE IT-
PUNISHMENT-SIMPLE IMPRISONMENT FOR A TERM WHICH MAY
EXTEND TO ONE MONTH OR WITH FINE WHICH MAY EXTEND TO RS.500/-
OR BOTH
SEC.176 OF IPC-
OMISSION TO GIVE NOTICE OR INFORMATION TO PUBLIC SERVANT BY
PERSON LEGALLY BOUNDTO GIVE IT-
PUNISHMENT- SIMPLE IMPRISONMENT FOR A TERM WHICH MAY
EXTEND TO ONE MONTH OR WITH FINE WHICH MAY EXTEND TO RS.500/-
OR BOTH
AND IF SUCH NOTICE IS REQUIRED TO BE GIVEN IN RESPECT OF
COMMISSION OF OFFENCE OR FOR PREVENTING COMMISSION OF
OFFENCE,THEN
PUNISHMENT- SIMPLE IMPRISONMENT FOR A TERM WHICH MAY
EXTEND TO SIX MONTH OR WITH FINE WHICH MAY EXTEND TO RS.1000/-
OR BOTH
19. SEC.177 OF IPC-
FURNISHING FALSE INFORMATION ON ANY SUBJECT TO PUBLIC
SERVANT-
PUNISHMENT- SIMPLE IMPRISONMENT FOR A TERM WHICH MAY
EXTEND TO SIX MONTH OR WITH FINE WHICH MAY EXTEND TO
RS.1000/-OR BOTH
SEC. 179 OF IPC-
REFUSING TO ANSWER TO PUBLIC SERVANT AUTHORISED TO
QUESTION ANY QUESTION DEMANDED BY HIM IN THE EXERCISE OF
LEGAL POWERS-
PUNISHMENT-
SIMPLE IMPRISONMENT FOR A TERM WHICH MAY EXTEND TO SIX
MONTH ORWITH FINE WHICH MAY EXTENDTO RS.1000/-OR BOTH
SEC.186 OF IPC-
OBSTRUCTING PUBLIC SERVANT IN DISCHARGE OF PUBLIC
FUNCTIONS-
PUNISHMENT- IMPRISONMENT FOR A TERM WHICH MAY EXTEND
TO THREE MONTH OR WITH FINE WHICH MAY EXTEND TO RS.500/-OR
BOTH
20. SEC.187 OF IPC-
OMISSION TO ASSIST PUBLIC SERVANT WHEN BOUND BY
LAWTO GIVE ASSISTANCE-
PUNISHMENT- IMPRISONMENT FOR A TERM WHICH MAY
EXTEND TO ONE MONTH OR WITH FINE WHICH MAY
EXTENDTO RS.200/-OR BOTH
SEC.189 OF IPC-
THREAT OF INJURYTO PUBLIC SERVANT –
PUNISHMENT- IMPRISONMENT FOR A TERM WHICH MAY
EXTENDTOTWOYEARS ORWITH FINE OR BOTH
21. SEC.202 OF IPC-
INTENTIONAL OMISSION TO GIVE INFORMATION OF
OFFENCE BY PERSON BOUNDTO INFORM-
PUNISHMENT- IMPRISONMENT FOR A TERM WHICH
MAY EXTEND TO SIX MONTH OR WITH FINE OR
BOTH
SEC.204 OF IPC-
DESTRUCTION OF DOCUMENT OR ELECTRONIC
RECORD TO PREVENT ITS PRODUCTION AS
EVIDENCE-
PUNISHMENT- IMPRISONMENT FOR A TERM WHICH
MAY EXTEND TO TWO YEARS OR WITH FINE OR
BOTH
22. Medical evidence is hardly conclusive and decisive,
because primarily it is evidence of opinion and not of
fact.
Medical Practitioner is a expert witness and he should
act as an expert irrespective of side.
To rely upon the finding of the medical person who
conducted the post mortem. The court considers not
merely medical evidence but also the other evidences
and circumstances appearing developed in the case.
It is normally observed that the opinion is not
supported by comments, observations, details, notes
during course of investigations/treatment.
Medical opinion pointing out two alternative
possibilities cannot be accepted as conclusive.
24. 1. Examine the patients thorough and completely & give first
preference to emergency patients and then to routine patients
2. Avoid unnecessary investigation
3. Facts observed while examination should be clearly and completely
and well preserved documentation.
4. Proper counseling with patients relatives about the disease & risk
factors
5. Explain the patients relative cost of management & prognosis of the
disease clearly
6. Give appropriate opinion of decease based on facts observed and
which can be explained scientifically
7. Awareness of legal provisions & MLC protocols
8. Timely collect of Toxicological, Psychological, Ballistic to respective
Analysis Dept.
9. Call for Medico legalist in case of expert opinion whenever require
10. Precise opinion & certificate to police dept.
11. Timely submission of document whenever asked from police Dept.
& Medico legalist in MLC cases.
