detail knowledge of medico-legal cases, introduction,types, reports, consent,death certificate, patient right. it will help you to understand the concept of medico-legal cases
introduction to MLC
Laws related to MLC
General guidelines
Evidence
Legal Requirements of MLC
Preservation of MLC documents
Precautions
Examples of MLC
In the presentation efforts have been made to guide the medical professionals how to deal with a MLC case in a step by step manner and certain issues relating to medical case records.
Biomedical waste
‘Bio-medical waste’ means any solid and/or liquid waste including its container and any intermediate product, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research pertaining thereto or in the production or testing thereof.
introduction to MLC
Laws related to MLC
General guidelines
Evidence
Legal Requirements of MLC
Preservation of MLC documents
Precautions
Examples of MLC
In the presentation efforts have been made to guide the medical professionals how to deal with a MLC case in a step by step manner and certain issues relating to medical case records.
Biomedical waste
‘Bio-medical waste’ means any solid and/or liquid waste including its container and any intermediate product, which is generated during the diagnosis, treatment or immunization of human beings or animals or in research pertaining thereto or in the production or testing thereof.
The objective of this presentation is to make you aware of issues which are generally confronted during medical practice.
SOURCES OF LAWS:
PRIMARY SOURCES
Laws passed by the Parliament or the State Legislative
Ordinances passed by the President and the Governor
Subordinate legislation: Rules and regulations made by the executive through the power delegated to them by the Acts.
SECONDARY SOURCES:
Judgments of the Supreme Court, High Court and Tribunals (The ratio decedendi is a binding precedent)
Judicial legislation
Judgment of Foreign Courts
International Treaty
Surgical Hand Washing
By Josfeena Bashir
Lecturer, BGSBU, Jammu
Introduction
During the 19th century, surgical hand preparation consisted of washing the hands with antimicrobial soap and warm water, frequently with the use of a brush.
Definition
Hand washing is important in every setting, including hospital. It is an effective infection control measures, as it prevent spread of micro organisms. For routine client care, the CDC recommends a vigorous hand washing under a stream of water for at least 10 seconds using soap.
Purpose
To remove transient and resident bacteria from fingers, hand and forearms.
To prevent the risk of transmission of infection to patients.
To reduce the risk of transmission of infection organisms to oneself.
To prevent cross infection among clients.
Equipments/ Articles Used For Hand Washing
Soap in a soap dish
Bacteriocidal or antimicrobial soap.
Surgical scrub brush
Running water
Towel/ sterile towels
Surgical hand washingSteps of procedure
Done mask, hair cover and booties, if required
Perform 5 to 10 minute surgical scrub using counted brush stroke method.
Remove rings, chipped nail polish and watch.
Contd….
Wet hands and arm from elbows to fingerprints under flowing water (use sink with side or foot pedal).
Place soap, preferably antimicrobial/ bacteriostatic, on hands and rub vigorously for 15 to 30 seconds; use scrub brush gently
Contd….
Using circular motion, scrub all skin areas, joints, fingernails, between finger and so forth (on all sides and 2 inches above elbows); slide ring, if present, up and down while rubbing fingers.
Continue scrub for 5 to 10 min or per agency policy.
Contd…
Rinse hands from fingers to elbow under flow of water.
Repeat soaping, rubbing and rinsing until hands and arms are clean.
Pat hands dry with sterile towel, moving from fingers to wrist.
"whenever any medico-legal case comes to the hospital, the medical officer on duty should inform the Duty Constable, giving the name, age, sex of the patient and the place of occurrence of the incident and should start the treatment of the patient.
It will be the duty of the said Constable to inform the nearest concerned police station or higher police functionaries for further action.
The objective of this presentation is to make you aware of issues which are generally confronted during medical practice.
SOURCES OF LAWS:
PRIMARY SOURCES
Laws passed by the Parliament or the State Legislative
Ordinances passed by the President and the Governor
Subordinate legislation: Rules and regulations made by the executive through the power delegated to them by the Acts.
SECONDARY SOURCES:
Judgments of the Supreme Court, High Court and Tribunals (The ratio decedendi is a binding precedent)
Judicial legislation
Judgment of Foreign Courts
International Treaty
Surgical Hand Washing
By Josfeena Bashir
Lecturer, BGSBU, Jammu
Introduction
During the 19th century, surgical hand preparation consisted of washing the hands with antimicrobial soap and warm water, frequently with the use of a brush.
Definition
Hand washing is important in every setting, including hospital. It is an effective infection control measures, as it prevent spread of micro organisms. For routine client care, the CDC recommends a vigorous hand washing under a stream of water for at least 10 seconds using soap.
Purpose
To remove transient and resident bacteria from fingers, hand and forearms.
To prevent the risk of transmission of infection to patients.
To reduce the risk of transmission of infection organisms to oneself.
To prevent cross infection among clients.
Equipments/ Articles Used For Hand Washing
Soap in a soap dish
Bacteriocidal or antimicrobial soap.
Surgical scrub brush
Running water
Towel/ sterile towels
Surgical hand washingSteps of procedure
Done mask, hair cover and booties, if required
Perform 5 to 10 minute surgical scrub using counted brush stroke method.
Remove rings, chipped nail polish and watch.
Contd….
Wet hands and arm from elbows to fingerprints under flowing water (use sink with side or foot pedal).
Place soap, preferably antimicrobial/ bacteriostatic, on hands and rub vigorously for 15 to 30 seconds; use scrub brush gently
Contd….
Using circular motion, scrub all skin areas, joints, fingernails, between finger and so forth (on all sides and 2 inches above elbows); slide ring, if present, up and down while rubbing fingers.
Continue scrub for 5 to 10 min or per agency policy.
Contd…
Rinse hands from fingers to elbow under flow of water.
Repeat soaping, rubbing and rinsing until hands and arms are clean.
Pat hands dry with sterile towel, moving from fingers to wrist.
"whenever any medico-legal case comes to the hospital, the medical officer on duty should inform the Duty Constable, giving the name, age, sex of the patient and the place of occurrence of the incident and should start the treatment of the patient.
It will be the duty of the said Constable to inform the nearest concerned police station or higher police functionaries for further action.
“Juris”- Law “Prudentia”- Knowledge . Therefore, Knowledge of Law
-In relation to practice of Medicine
-In relation with legal consequences
Medical Jurisprudence is also known as legal medicine.
Medical jurisprudence or legal medicine is the branch of science and medicine involving the study and application of scientific and medical knowledge to legal problems, such as inquests and in the field of law.
medical
judisprudence
legal medicine
dentistry
mbbs doctors
ethics
rules in medicine
medical practise
consents
autopsy
doctor patient state relation
medical negligence
biomedical
medical devices
malpractice
medico legal cases
dental course
dr. swostik devkota
bright line dental care
Medical records means and includes the record pertaining to the admission, diagnosis, treatment, investigation, daily progress, operations, consultations
Is health information always admissible as evidence in court Explai.pdfjeeteshmalani1
Is health information always admissible as evidence in court? Explain your answer and provide
APA references.
Solution
What is one of the most important non-clinical uses of the medical redcord?
It serves as the legal document recording a particular episode of a patient\'s care. (of the facility
and treatment)
When can a patient\'s information be disclosed?
With the written consent or authorization of the patient.
pursuant to statutory requirements or on proper legal process.
Define Evidence
Testimony, writings, material objects, or other things presented to prove or disprove a fact.
Define ADMISSIBLE EVIDENCE
Info. or things that may be admitted as evidence in a trial if the applicable rules establish that the
info. is BOTH PERTINENT and PROPER (timely, accurate, complete records) for the the judge
or jury to consider when deciding issues involved in the lawsuit.
What is HEARSAY?
Out-of-court statements that are offered to prove the truth of the matter asserted. Not signed
under oath.
Why are medical records considered hearsay evidence?
Because the health-care providers making the statements, (entries into the record) do not do so
under oath in a court of law. Therefore under the Hearsay rule they are not admissible as
evidence in court.
So, if Hearsay evidence is not addmisible in court, how can medical records be an exception to
the rule? There ARE exceptions to the rule...
BUSINESS RECORD EXCEPTION to the HEARSAY EXEMPTION RULE specifically allows
medical records to be used as evidence. if the person offering the records can successfully
convince the judge the records are kept in the ordinary course of business and not in preparation
for litigation.
BUSINESS RECORD EXCEPTION to the HEARSAY EXEMPTION RULE
HIM Mgr. / Custodian must establish in court the FOUNDATION and TRUSTWORTHINESS
of their record-keeping.
The three elements of a FOUNDATION REQUIREMENT to the hearsay exemption?
Person submitting the evidence must extablish that the record was;
1. Made and kept in the ordinary course of business
2. recorded at or near the time the event
3. By a person with knowledge of the facts, events, conditions, opinions, or diagnoses appearing
in it.
How is TRUSTWORTHINESS REQUIREMENT to the hearsay exception established?
One of the requirements of the Business Record Exemption to the hearsay rule. HIM/custodian
must testify to:
- Internal policies/procedures governing access to meddical record
- quality control techniques (i.e. corrections & abbreviations of the record)
How does the party wishing to introduce a medical record as evidence establish the accuracy and
trustworthiness of the medical record?
They will bring in the custodian of medical records to testify to the accuracy and trustworthiness
of the records.
How does the Medical Records Custodian testify as to both the foundation and trustworthiness
requirements of the business record exception?
The custodian, the HIM professional, testifies in a trial or deposition:
- To FOUNDATION - testifi.
The legal duties of a doctor. 1. Emergency medical services 2. Disclosure of 3. What are MLC? What is the duty of the doctor in MLC, medical records preservation, proper documentation, valid is very important for saving the doctors consent from legal actions under IPC and actions for negligence.
For info log on to www.healthlibrary.com. "Rights and Duties of Doctors - Part 2" By Dr. Ghazala Shaikh held on 3 Nov 2015.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
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2. DEFINITION
Medico legal cases can be defined as a case of injury or ailment, etc. in
which investigations by the law-enforcing agencies are essential to fix the
responsibility regarding the causation of the said injury or ailment.
In simple language it is a medical case with legal implications for the
attending doctor where the attending doctor, after eliciting history and
examining the patient, thinks that some investigation by law enforcement
agencies is essential.
3. DOCTOR AND MLC
Every doctor under law bound by a contract to serve its patient and cannot
refuse treatment.
Every doctor has to fulfill certain legal requirements in service by
compulsion or voluntarily as defined under law.
Medico-legal case (MLC) examination and reporting is one of the legal
responsibility of all doctors working in hospital.
4. RECEIVING A MLC
o It can be received in four situations by the doctor/hospital:
1. A case brought by the police for examination and reporting or order of
the court for medico-legal examination.
2. The person in question was already attended by doctor and MLC was
already registered in a previous hospital and the person is now referred
for the expert management/advice.
3. By the doctor himself after eliciting history and examining the patient, if
he feels so that the case in accordance with the law of the land.
5. 4. When the patient himself expresses his intention to register a case against
the alleged accused.
6. DOCTORS WORKING IN A HOSPITAL
REPORT HOMICIDAL POISONING TO THE POLICE(U/S 39 CRPC)
FAILURE TO DO SO IS PUNISHABLE U/S 176 IPC
7.
8. TYPES OF MLC
o All road traffic accident
o All rail traffic accident
o Burns
o Scalds
o Hanging
o Electrocutions
o Poisoning
o Drowning
o Bomb blasts and explosions vitriolage
9. o All air and sea accidents
o Any other cases having legal implications
o Assault- known, unknown
o Legal investigations
o Natural disasters- earthquake, flood,
o Molestations- rape, kidnapping, husband wife beating, child abuse
o Inhalation of gas vapors
o Fall from height
o Brought dead
10. o Industrial accidents
o Bull gore/animal bite/snake bite
o Bullet injury
o Hijacking
o Hostage taking
o Anything related to smuggling
12. FORMALITIES IN MLC:
o Entry like Name / Age / Sex / Date / Time / I.P. No. /Hosp. No. / Type of M.
L. C. is done in the main Emergency Register.
o All M. L. C‘s are registered / admitted.
o Case is examined and case sheet written by the duty Casualty Medical
Officer.
o Accident Register (A. R.) two copies and Police Intimation (P.I) three copies
are written.
o The original P. I. from should be dispatched to the assigned Police Station
as quick as possible (not later than 24 hours) and the signature of the
receiving Police Officer should be obtained.
13. o In most of the Government hospitals, police stations are inside the hospital
premises.
o In private hospitals - dispatch the accident register and police intimation to
nearby police station.
14.
15.
16. Writing a Medico Legal Case :
o 1. Road Traffic Accident -
o Write the following details in the case file :
o Mode of Accident
o Time of Accident
o Place of Accident
o Brought by Name is a must Brought in time
o Condition of the patient after accident
o Condition of the patient at the time of admission
o Injuries
o 3 I.D. Marks Preferable (2 I.D. Marks must)
17. o 2. Rape -
o Write as Alleged by rape by known / unknown /single person / group
o Patient should be examined by the Gynecologist.
o 3. Kidnapping -
o Write as Alleged to have kidnapped by known / unknown / single person /
group.
o 4.Wife / Husband Beating -
o Medico Legal is registered, provided one of them insists on it.
o Write as Alleged to have beaten up by husband /wife
18. Medical Record
Definition and function
o 1. The medical record is a document which contains statements by trained
observers of conditions found and results of treatment.
o 2.Hospital records shall contain data to permit a basis for a complete audit
of professional service given and for gathering statistical information.
o 3.Proper recording methods and procedures shall be maintained to assure
compilation of data for proper administration of services.
19. Medico-legal purposes :
o Any MR may become evidence in accordance with Indian evidence Act.
o Insurance and other claims settlements.
o Medical certificates such as fitness for employment sickness certificate etc.
o Workmen‘s compensation Act : The clinical data recorded by medical
practitioner to indicate the extent of injury and the degree of disability of the
individual is taken as documentary evidence to settle the claims for payment
by certain classes of employees to give their workmen, some compensation
for by certain arising out of and in the course of his employment under the
Workmen‘sCompensation Act.
20. Filling of Records / Preservation of Medical
Records :
o There are two common methods of numbering and filling records.
o One is the assignment of a new register number to each patient at time of
admission. This is known as serial numbering and chart may be filed either
separately under numbers as assigned to together under the most recent
number.
o The second methods, called ―unit numbering, is the assignment of one
number to a patient on first admission, using that same number of
subsequent admissions.
21. How long to preserve the case papers :
o Limitation period for filing a case is maximum up to 3 years under the
Limitation Act (2 years according to Consumer Protection Act). This
limitation period starts only after the patient comes to know the effect of
the alleged negligence on part of the doctor.
o Maharashtra government has issued a resolution (G.R. No. JJH-29
66/49733) which states that OPD paper should be kept for 3 years, indoor
for 5 years, and papers of Medico Legal Cases for 30 years.
22. Dying Declaration :
o Dying declaration is provided by section 32 , sub- section 1 , of the Indian
Evidence Act .
o According to this section , dying declaration is the declaration of a dying
person as to the cause of his death or as to any of the circumstances of the
transaction which resulted in his death when the cause of his death is in
question .
o If the declarant survives after making the dying declaration, the statement
is inadmissible as dying declaration but the statement can be used under
section 158 of the Indian evidence Act , in order to contradict or confirm
the credit of the person by whom it was made.
25. PATIENTS RIGHTS IN LEGAL ASPECTS
o Patients rights in healthcare are those rights a person owes when he/she is
in hospital.
o If any of patients rights are violated in hospital, patients can go for legal
actions against the hospital or healthcare professionals
o Patients rights are legal interests of persons
26. DIFFERENT RIGHTS OF PATIENTS ARE:
1. Right to appropriate medical care and human treatment
2. Right to informed consent
3. Right to privacy and confidentiality
4. Right to information
5. Right to choose healthcare provider and facility
6. Right to self determination
7. Right to medical records
8. Right to religious beliefs
9. Right to leave
10. Right to refuse participation in medical research
11. Right to correspondence and to receive visitors
12. Right to express grievances
13. Right to be informed of his rights and obligation as a patients.
27. Discussing patients rights in details:
1. Right to appropriate medical care and human treatment: Every person
has a right to health and medical care corresponding to his state of health,
without any discrimination. Ex: triage in emergency
2. Right to informed consent: The patients has the right to a clear, truthful,
and sustainable explanation, in a manner of language understandable to
the patients, of all proposed procedure whether diagnostic, preventive
curative, rehabilitative or threaupeutic. There are some exception in this
right.
3. Right to privacy and confidentiality: The patients has the right to
demand that all information, communication and records pertaining to his
care be treated as confidential. Some exception are their.
4. Right to information: In the course of his/her treatment and hospital
care, the patients or his/her legal gurdian has a right of evaluation of
his/her disease, any other additional medical treatment and procedure.
5. Right to choose healthcare provider and facility: patients is free to
choose healthcare provider to serve him as well as the facilities.
28. 6. Right to self determination: Patients has the right to avail
himself/herself of any recommended diagnostic and treatment
procedures
7. Right to religious beliefs: The patient has the right to refuse
medical treatment or procedures which may be against to his
religious beliefs.
8. Right to medical records: The patients has entitled to a summary
of his medical history and conditions.
9. Right to leave: The patients has the right to leave hospitals or any
healthcare institution regardless of his/her physical condition.
10. Right to be informed of his/her rights and obligation as
patients: every person has the right to be informed about his
rights and obligation as a patient.
30. CONSENT
o Consent is-permission granted in full knowledge of the possible
consequences, typically that which is given by a patient to a doctor for
treatment with knowledge of the possible risks and benefits.
o Informed consent is the process in which a health care provider educates
a patient about the risks, benefits, and alternatives of a given procedure or
intervention
31. CONT..
o . The patient must be competent to make a voluntary decision about
whether to undergo the procedure or intervention. Informed consent is
both an ethical and legal obligation of medical practitioners and originates
from the patient's right to direct what happens to their body.
32. ELEMENTS OF INFORMED CONSENT
o The following are the required elements for informed consent
discussion:
o (1) describing the proposed intervention,
o (2) emphasizing the patient's role in decision-making,
o (3) discussing alternatives to the proposed intervention,
o (4) discussing the risks of the proposed intervention and
o (5) eliciting the patient's preference (usually by signature).
33. EXCEPTIONS TO INFORMED CONSENT
o Several exceptions to the requirement for informed consent include
o (1) the patient is incapacitated,
o (2) life-threatening emergencies with inadequate time to obtain
consent, and
o If the patient's ability to make decisions is questioned or unclear, an
evaluation by a psychiatrist to determine competency may be
requested.
34. CHILDREN AND INFORMED CONSENT
o Children (typically under 18) cannot provide informed consent. As
such, parents must permit treatments or interventions. In this case, it
not termed "informed consent" but "informed permission."
35. Clinical Significance
o Informed consent is required for many aspects of health care. These
include consent for:
o Treatment,
o dissemination of patient information,
o specific procedures,
o surgery,
o blood transfusions, and
o anesthesia.
36. CONSENT IN CASE OF MEDICOLEGAL CASES
o In emergencies, resuscitation and stabilization of the patient will be
carried out first and medico-legal formalities may be completed
subsequently. The consent for treatment is implied in all
emergencies.
37.
38. THE LEGAL BASIS OF CONSENT
o Consent is perhaps the only principle that runs through all aspects
of health care provisions today.
o It also represents the legal and ethical expression of the basic right
to have one's autonomy and self-determination.
o If a medical practitioner attempts to treat a person without valid
consent, then he will be liable under both tort and criminal law.
o Tort is a civil wrong for which the aggrieved party may seek
compensation from the wrong doer.
o The consequences would be payment of compensation (in civil) and
imprisonment (in criminal).
39. Examples of MLC related to consent
o In one case, a 44-year-old unmarried female consulted her doctor
and was advised to undergo a laparoscopy. A few consent forms
were taken from her of which one was for admission and another
one was for the surgery. The relevant one among such consent
forms gave the doctor an allowance to carry out a “diagnostic and
operative laparoscopy” and there was an additional endorsement
that a “laparotomy may be needed”. When the patient was in the
operation theater (and was unconscious), another proxy consent was
taken from her attending mother for a hysterectomy. Her uterus,
ovaries, and fallopian tubes were removed. Subsequently, when an
action was brought, it was held that the operation was conducted
without real consent and the doctors were held liable.
40. Cont…
o A patient was operated on for sterilization. While giving consent he
deposed that he is married and has two baby girls. In fact, he was
undergoing an operation only for getting the money as incentive. After the
operation, his father contended that the patient was of unstable mind and
was not competent to give consent.
o The court held that if there are no circumstances for a doctor to sense foul
play or doubt about the capacity of the patient, he is protected. The case
demonstrates that a doctor acting reasonably under normal circumstances
is always protected and he is never expected to play the role of an
investigative agency.
41. Medical Certification of Cause of Death
o Medical Certificate of Cause of Death, commonly called Death
Certificate, is the most frequently issued certificate, at least by a
government employed medical officer, if not by a private
practitioner. It is common knowledge that many medical officers,
even some of those with incomparable medical knowledge and
expertise, do not fill up this document of immense medical and legal
importance correctly. The reasons may be many, ranging from
ignorance to indifference.
42. REGISTRATION OF DEATH
o For registering a death, identity of the
deceased, date and time of death and
cause of death are to be provided to
the registering authorities. If any of
these details are not available death
can not be registered. Providing these
details is not a difficult task for a
medical officer when the death is of
one of his patients suffering from a
known disease, who dies attended by
the doctor.
43. CONT..
o The situation may not be so simple in medico-legal cases.
o Most of these deaths are unattended, hence, exact time and date is not
known and since terminal symptomatology is not available, cause of death
can not be decided.
o Many times the identity of the deceased is also not known. Hence, a
medico-legal postmortem is carried out, as a part of the inquest, to
establish the cause of death, time of death and identity of the deceased.
44. DEATH CERTIFICATE IN MEDICOLEGAL CASES
o If the death is not clearly of natural category i.e.other than natural or
cause not known/doubtful, the medical officer having carried out
first task i.e. declaration of death, informs the police of occurrence of
the death for further course of action. He will not issue a medical
certificate of cause of death. Since the bottom portion of the
medical certificate of cause of death is required to be produced by
the relatives at the cremation ground/the municipality office giving
permission for cremation, non-issuance of the same will
automatically ensure that the body can not be cremated.
45. CONT..
o The medical certificate of cause of death is filled up either by the medical
officer who carries out the medico legal autopsy or by the hospital
administrative authorities immediately on conclusion of the autopsy.
o Since the medico legal postmortem is carried out on orders of the
investigating police officer/coroner/magistrate, the medical certificate of
cause of death is forwarded to these authorities only, by the certifier, and
not directly handed over to the relatives of the deceased.
46.
47. POINTS TO BE KEPT IN MIND BY THE MEDICAL
OFFICER CONCERNING THE ISSUANCE OF
MEDICAL CERTIFICATE OF CAUSE OF DEATH:
o He should not delay, for any reason, issuing the medical certificate of
cause of death, once he is sure of the cause of death.
o He can not charge any fees for issuing this certificate.
o He should not withhold issuance of medical certificate of cause of death
even if his dues have not been cleared by the relatives.
o No medical officer should sign medical certificate of cause of death in
advance (i.e. before the individual has died) or without viewing and
examining the dead body personally.