INTRODUCTION OF FORENSIC MEDICINE
Introduction
Forensic , Legal or State Medicine can simply be defined as the branch of medical science which deals with the application of other branches of medical knowledge for the purpose of justice and law. The word Forensic is a Latin word , forensis which means “of the forum.” Hence , it is the science which deals with application of medical wisdom to aid establishment of justice through the law. It is a connection between medicine and legislation.
History Hippocrates discussed the lethality of wounds in his era.Evidence of examining injuries with rules and regulations were found from China approximately 220 BC during Qin Dynasty on bamboos inscriptions .Similarly , legal medicine has been found in various other civilizations like Egypt , Sumer , Babylon , India dating 4000-3000BC.
First legal autopsy was conducted on Julius Caesar after his assassination in 44 BC by Antistius.
The first book on Forensic Medicine was published in 1620 by an Italian physician , Fortunato Fedele. Later on Paul Zacchias wrote " QUESTIONES MEDICOLEGALES " who is also considered as the father of Legal Medicine.
First Autopsy in Nepal is believed to be started from Bir Hospital.
TERMINOLOGIESMedical Jurisprudence ; ( Juris – law , Prudentia- knowledge ) deals with legal responsibilities of the physician with particular reference to those arising from doctor -patient relationship like medical negligence ,consent ,medical ethics.
Medical etiquette are conventional laws and customs of courtesy followed between members of medical professions.
Forensic Pathology deals with the knowledge of medicine to find the cause of the death of an individual.
Medical ethics deals with the moral principles which guide members of the medical profession in their dealings with each other, their patients .
Corpus Delciti means the body of offense or the body of crime.
PUBLIC HEALTH
The cause of death becomes important when casualties rises unnaturally or from new diseases . Example: carbon monoxide poisoning is commonly seen in our country during winter . People dead on bed mysteriously has been reported which becomes a public health concerns. After knowing the cause, one can aware others and such incidents may be declined eventually.Hence , it aids public health as well.
USES
It plays an important role in helping the administrations of justice of correlating and applying it to the purposes of law. It helps to find evidences regarding homicide ,suicide ,assault , sexual offenses ,traffic accident , poisoning , identification of unrecognizable dead bodies , estimation of age etc. It helps to distinguish false claims and aid justice to the innocent.
The extraordinary scientific innovations and advancements in forensic science have allowed it to become a highly developed science involving a number of disciplines and thousands of forensic scientists specializing from DNA and botany to dentistry and tool marks.The investigation of human deaths requires the cooperative interaction of different disciplines. Police investigation and medical investigation are equally important.
DIFFERENT SYSTEMS
The coronel system
Coronel is an official empowered to conduct, order an inquest into the manner or cause of death to investigate or confirm the identity of an unknown person who was dead. He/she may be a doctor, lawyer or layperson. Formerly , election system was there which later was replaced by appointee system which minimal qualifications of 5 years medical practice in 1926 AD.
The medical examiner system
Medical examiner is an official trained in pathology that investigates death that occur under unsual or suspicious circumstances , perform post mortem , and is well awared of toxicology , DNA technology, Forensic serology.
Some other systems are sherrif-coronel , medical examiner-coronel system.
Medicolegal Services status in Nepal
In Nepal, autopsy is believed initiated in Bir Hospital, but is still doubtful. Bir Hospital continued to be the center for death investigation, until 2057 B.S. when it was shifted to Institute of Medicine (IOM). Besides IOM ,BP Koirala Institute of Health Sciences is the only other medical college performing autopsy routinely.
It has been long since the practices of autopsies began in Nepal yet there hasn't been a significant hike in development of medicolegal Services and adequate freedom of practice to medical professionals in Nepal. There are still few mortuaries which doesn't have proper facilities and aren't well equipped to run smoothly.
Talking about the toxicology laboratory in Nepal ,it is performed only by central police forensic science laboratory.
Medicolegal education has been included in undergraduate program of medicine which would have been more effective if every institution would have been allowed to perform autopsies under supervision of trained professionals . Sadly , it's only practiced in government college and the students from private colleges get only few glimpses of autopsy which might not be sufficient to study every aspects of Forensic science.
It can be mastered only by an extensive practical experience acquires by an application and study of medicolegal problems.Giving such a sensitive issue to a naive person lacking sufficient practice and case handling is surely an injustice to an individual and the law itself.
Social stigmas and conservative mentality of the people has also contributed for lagging of medico-legal practice in Nepal. There is a belief among people that the dead won’t go to heaven if autopsy is performed on their bodies. So, People usually want their relatives’ body to be cremated as soon as possible so they don’t want the legal procedure to be performed on dead bodies due to which less number of dead bodies end to mortuary.