2. TRIALS AND TRAVAILS OF MEDICAL WITNESS by Dr.D.R.Kothari Prof. & Head of Forensic Medicine, Kesar Sal Medical College, Ahmedabad. and Ex-Prof. And Head, Dept. Forensic Medicine, NHL Municipal Medical College, Ahmedabad.

3. A Dialogue from: Alice ’ s Adventures from Wonderland by Lewis Carrol A case is gong on in the court of the King of Hearts---- The white rabbit asks the king, “ Where shall I begin,please,your Majesty? “ Begin at the beginning, ” the King said,gravely, “ and go on till you come to the end: then stop. ”

4. As a, our duty is to help the cause of Justice justice Helping attitude towards Justice Objective,effective Presentation Objective,Accurate collection Of Data Objective and Thorough analysis Of Data

5. However: There are Obstacles Miscarriage of Justice Obstacles are: 1. Lack of Knowledge 2. Casual approach 3. Personal,e.g.,Enmity, Ego 4. Susceptibility to Pressure 5. Lack of Integrity

6. THREE CASES TO EMPHASISE 1.POLICE IN THE DOCK 2.POLICE AS FUGITIVE 3. DIFFERENCE OF OPINIONS,THEN?

7. CASE 1: POLICE IN THE DOCK A man was arrested by the Police on charge of Drunkenness. Blood Report: Ethyl Alcohol ---155mg% Methyl Alcohol ---275mg% The Man also complained of Dimmed Vision. He died in Police Custody. Magistrate inquest does not show any marks of Injury.

8. CASE-1 Cause of Death recorded after the 1 st PM: Cardiac Failure. Relatives demanded a second PM Second PM at a bigger center with Histopathological facilities done after 24hrs

9. Salient points of difference between the 1 st and 2 nd PM First PM: PM on 6-2-88 at 10-30am, 8hrs after death. Inquest “Hanumanji’ tattoed on right forearm.Identification mentioned. Only abrasion on left elbow Second PM: PM on 7-2-88at 11.30am,25hrs after first PM No inqest. No identiry mentioned. This plus 9 others.Bruises reddish blue with swelling lower back and buttocks.

10. Differences in two PMs … (contd.) No Injuries Heart: Dilated. Left Coronary thicker and lumen narrower.Atheroma patches present. Liver. Cirrhosis +ve. Injuries on Head and Chest. No incision mark on heart.Atheromatous thickening of left coronary. Cirrhosis +ve

11. Differences between two PMs Blood conc.before death: Ethyl Alc.:155mg% Methyl Alc:275mg% Blood conc.after 2 nd PM: 31.92mg% 107.00mg%

12. Important Points on Blood Conc. 1. Significant fall in blood conc. of both Ethyl and Methyl Alcohol in 2 nd reading compared to the 1 st. Possibly due to metabolism. 2. Methyl Alc.conc.before death was 275mg% with associated dimness of vision. The conc.is not taken as serious because one book said the fatal conc.is 8oomg%. Later the author confessed it as misprint. 3. Other books mention correct fatal levels. Taylor: 80mg%; Modi: 60to 200ml. Important Points on Blood Conc. 1. Significant fall in blood conc. of both Ethyl and Methyl Alcohol in 2 nd reading compared to the 1 st. Possibly due to metabolism. 2. Methyl Alc.conc.before death was 275mg% with associated dimness of vision. The conc.is not taken as serious because one book said the fatal conc.is 8oomg%. Later the author confessed it as misprint. 3. Other books mention correct fatal levels. Taylor: 80mg%; Modi: 60to 200ml.

13. Important points from case 1 1.Histopathological report not asked for. 2.Injuries AM/PM not ascertained. 3.Can it be Methyl alcohol poisoning? Could the person have been saved if it were recognised and proper treatment had started? 4.It is wise to refer to more than one book for important information.

14. CAUSE OF DEATH GIVEN ‘ INJURIES ’. A police constable held responsible and given 3 years RI. Casual approach? Malafide intent? Someone trying to fix someone?

15. CASE-2: POLICE, THE FUGITIVE? A man arrested for some petty crime,dies in custody.( 3 rd Degree Interrogation?) Incidence took place in a smaller center 300 km away. The body was brought to a non- governmental hospital against set norms.Objection by medical personnel not acceded to.

16. CASE-2 The police version: 1. The man complained of Chest pain. 2. He was being taken to a hospital. 3. He died on the way. CASE-2 The police version: 1. The man complained of Chest pain. 2. He was being taken to a hospital. 3. He died on the way.

17. CASE-2(contd.,) Casualty Report: Brought dead with Rigor Mortis. PM Report: - Multiple injuries on the body - Heart normal,histo-pathologically Cause of Death given: Multiple Injuries Result: Police found guilty and penalized

18. Case-3:Difference of Opinion.Then? Upper middle class,educated,well connected family A daughter in law(DIL) with an infant and old mother in law living in a mansion in a posh area of the city Husband, an orthopedic Surgeon, out of the country One night the mother in law was stabbed and murdered: the carotid being severed The wife tried to intervene and got injured in the scuffle

19. The Daughter in law ’ s law ’ s injuries. Two incised wounds of 2”x 1” on scalp, one on occipital region Injury to the left eye with Sub-conjunctival haemorrage DIL arrested on charge of Murder

20. Were the injuries of DIL self- inflicted? In the court, the verdict of GUILTY or NOT GUILTY depended on this question. If self -inflicted—Murder—Guilty If not---- Innocent--- Not Guilty The medical Witness said they could have been self -inflicted.

21. So, The session ’ s court found DIL guilty. High Court: Two judge bench had different verdicts. Third Judge appointed.Verdict of lower court was upheld. Case went to the Supreme Court.

22. WHAT IS YOUR JUDGEMENT? Self inflicted? Not Self Inflicted?

23. A Medical Witness Requires: 1. 1) KNOWLEDGE: There is no substitute or short cut for knowledge. Knowledge leads to good. Ignorance leads to evil.

24. A Medical Witness Requires: 2. An Eye and Insight for small details. From ‘Adventures of Sherlock Holmes’ by Sir.Arthur Conan Doyle: “ My dear Watson, the little things are of immense importance.” From Poet Auden: “We are required to hear the ones who have no voice, And see the things That do not exist”

25. A Medical Witness Requires: 3) Objectivity and Scientific Temper: Freedom from: 1.Bias 2. Prejudice. 3. Personal Feelings.

26. A Medical Witness Requires: 4) Integrity. Will and Courage to resist authorities: 1.Institutional. 2. Police. 3. Politicians. Determination to resist temptations of : 1. Money 2. Power

27. THANK YOU!