A few short notes in forensic medicine


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judicial hanging
brain stem death
section 84 IPC
live births

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A few short notes in forensic medicine

  1. 1. A few short notes in forensic medicine M. Harini Priyadharshini II MBBS
  3. 3. Judicial hanging  Hanging is the suspension of a person by a ligature.  Hanging has been a common method of capital punishment since medieval times, and is the official execution method in many countries and regions today.
  4. 4.  In India legal death sentence is carried out by hanging the criminal.  A rope to allow a drop of 5 to 7 meters (according to the person’s build and age) is looped around the neck.  The placement of the knot in the sub- mental position is said to be more effective  Death is usually by a fracture dislocation noramlly at the leve of C2 and C3 or C3 and C4 vertebrae.
  5. 5. Contd.,  With proper judicial hanging there is a rupture of brainstem between Pons and medulla.  This results : 1. Instantaneous and irreversible loss of consciousness 2. Irreversible apnea.  Heart beats and respiratory movements may continue for 15 min approx.  The victim is found to have a epileptic attack due to a sudden and
  6. 6. Classification of hanging Complete • When the whole body hangs off the ground and the entire weight of the victim is suspended at the neck, the hanging is said to be complete Incomplete • Incomplete hangings imply that some part of the body is touching the ground and that the weight of the victim is not fully supported by the neck
  7. 7. Methods of judicial hanging Suspension Short drop Standard drop Long drop
  8. 8. Suspension  Suspension, like the short drop, causes death by using the weight of the body to tighten the trachea with the noose.
  9. 9. Short drop  The short drop is performed by placing the condemned prisoner on the back of a cart, horse, or other vehicle, with the noose around the neck.  The object is then moved away, leaving the person dangling from the rope
  10. 10. Death by hanging - Mechanisms  Closure of carotid arteries causing cerebral ischemia  Closure of the jugular veins  Induction of carotid sinus reflex death, which reduces heartbeat when the pressure in the carotid arteries is high, causing cardiac arrest  Breaking of the neck (cervical fracture) causing traumatic spinal cord injury or even decapitation  Closure of the airway
  12. 12. Brain stem death ?  Brain stem death is a clinical syndrome defined by the absence of reflexes with pathways through the brain stem in a deeply comatose, ventilator-dependent, patient.
  13. 13. The concept of brain stem death legally accepted in India  permits the diagnosis and certification of death on the premise that a person is dead when consciousness and the ability to breathe are permanently lost, regardless of continuing life in the body and parts of the brain, and that death of the brain stem alone is sufficient to produce this state
  14. 14. Transplantation of Human Organ Act of 1994  to make a diagnosis of brainstem death requires a panel of four doctors consisting of: 1. the doctor in charge of the patient, 2. the doctor in charge of the hospital where the patient was treated 3. independent specialist of unspecified specialty 4. neurologist or a neurosurgeon  The burden of proof rests with the specialist of the neurosciences, with the other members confirming the diagnosis
  15. 15. Tests done to document absence of brainstem function  pupillary reflex  doll’s head eye movement  corneal reflex (both sides)  gag reflex  cough (tracheal)  eye movements on caloric testing bilaterally  absence of motor response in any cranial nerve distribution  apnea test.
  16. 16. SECTION 84 IPC
  17. 17. Section 84 IPC  Act of a person of unsound mind.-- Nothing is an offence which is done by a person who, at the time of doing it, by reason of unsoundness of mind, is incapable of knowing the nature of the act, or that he is doing what is either wrong or contrary to law.
  19. 19. Live birth ?  In human reproduction, a live birth occurs when a fetus, whatever its gestational age, exits the maternal body and subsequently shows any sign of life, such as voluntary movement, heartbeat, or pulsation of the umbilical cord, for however brief a time and regardless of whether the umbilical cord or placenta are intact.
  20. 20. Tests for live birth  Shape of chest : before respiration the chest is flat, after respiration the chest becomes arched of drum shaped  Position of the diaphragm 4th or 5th rib – before respiration 6th or 7th rib after respiration
  21. 21.  Lungs:  Volume: unrespired lungs appear smaller  Margin: before respiration margins are sharp  Consistency: before respiration lungs are dense and firm  Colour and expansion of air vesicles  Gas  Blood in the lung beds  Weight
  22. 22.  Changes in the stomach and intestine: they float in water if respiration has taken place.  Changes in the middle ear: before birth the middle ear contains gelatinous embryonic connective tissue
  23. 23.  Other signs: Blood: nucleated RBC usually disappear within 24 hrs Meconium: completely excreted within 24 to 48 hrs Caput succedaneum: gradually disappears within a week after birth Skin: skin becomes darker on 2nd or 3rd day Umbilical cord: blood clots in the cut end 2hrs after birth Circulation: contraction of umbilical arteries starts in 10 hours and are completely closed by 3rd day.
  24. 24. Live birth is probable when  All lobes of lung are fully expanded  There is edema of lung especially gross  An alveolar duct membrane is present and has widespread distribution in the lungs.  Contusions of the lung are present