Forensics: exact science or dramatised fiction? #2
Post mortems (or autopsies) in India are usually done by government doctors of various irrelevant specialities or no specialities at all by rotation. They are neither trained nor qualified in forensic medicine. Even in government medical colleges, forensic medicine experts might not be found as it is not a popular branch.
To put it in simple words, doctors conducting post mortems Have been actually making a fool of the public, police and the Courts for decades.
How post mortems are really done in India?
Be prepared for the shocker now. The doctors find the task so disgusting that they hardly ever perform the dissection and examination of the dead bodies by themselves. For them, it is simply a forced duty that only needs their signature. The actual dissection is done by the safai karmchari of the mortuary. His sensibilities are suitably numbed by cheap liquor supplied to him by the police personnel accompanying the dead bodies as they want to be done with the unpleasant task as quickly as possible. This illiterate or barely literate man cuts up the dead body with a few rusted knives and shouts what he thinks he sees to the doctor waiting outside. The doctor laces it with just a bit of jargon and voila the post mortem report is ready!
I am serious and I am not talking through my hat! Although I do know the reality from my personal service experience also, it is better to convince readers with something already published in the public domain. Rudraneil Sengupta for the Mint has furnished an eye-opening account of real-life post mortems in India at Barabanki, UP, an hour’s drive from the state’s capital, Lucknow and the Sabzi Mandi mortuary at India’s capital Delhi.
Why post mortems are doomed to remain a farce forever?
What can be expected out of a post mortem report when the doctor has not even seen the body himself? However, the ugly reality does not end here. Even if he would have seen the body, there is little he could have inferred because of sheer ignorance. MBBS graduates and non-forensic medicine specialists entrusted with doing post-mortems in India have never done an autopsy during their training. In the MBBS course, forensic post mortem is the only clinical discipline that does not have a prescribed practical teaching schedule or internship.
For doctors graduating from many a government medical college, the only requirement is to simply observe 10 autopsies being done. In practice, most of them either do not get or choose not to attend, even those 10 autopsies during their course. In most of the private medical colleges, which are not authorized to conduct autopsies in any state except Karnataka and Puducherry, even this basic minimum is missing.
If readers are wondering why those who are not specialists in forensic medicine are officially made to conduct post mortems, the answer lies in the Criminal Procedure Code (CrPC). In 1861, when the speciality of forensic medicine did not even exist, Section 174 of the CrPC provided that the examination of the body be done by a ‘qualified medical man’. Taking advantage of this, state governments have authorized all doctors in government service—general practitioners, paediatricians, gynaecologists, ophthalmologists, whoever—to perform autopsies.
Dr Indrajit Khandekar, professor of forensic medicine at the Mahatma Gandhi Institute of Medical Sciences in Sewagram, Maharashtra says, “So, a person who has never done a single autopsy in training, and in many cases, have never even witnessed one, is expected to do it. The only thing mandatory in forensic studies is that you write a theoretical exam.” Dr Adarsh Kumar, professor of forensic medicine at AIIMS, agrees with this broadly.
Justice Kannan Krishnamoorthy, formerly with the Punjab and Haryana High Court says, “Not only is there no doubt that most doctors doing post mortem work have no training in it, but because the system forces them to do it, and at a volume that no one can handle, they do a terrible job of it.”
How post mortem reports are fudged under police pressure?
It is extremely common for government doctors to oblige the police by writing whatever they want in the post mortem reports—truth and professional integrity be damned. Even as there are many judgments to this effect, we will illustrate the sort of ‘sinful’ mischiefs, which the police and the doctors commit, through the judgment (2017) in the Aarushi Murder Case. As most readers would be aware, in this case, a 14-year old girl Aarushi and the family’s 45-year old domestic help Hemraj were found murdered inside their house. The police had charged Aarushi’s parents for murder. Acquitting them, the Allahabad High Court castigated the CBI and the trial judge in unprecedentedly harsh terms.
They hauled Drs Sunil Kumar Dohre and Naresh Raj over coals for the manner in which they were trying to interpret Aarushi’s and Hemraj’s post mortem reports. The Court concluded, “It is proved beyond all reasonable doubts that Dr Naresh Raj like Dr Sunil Kumar Dohre too committed medical blasphemy in supporting the prosecution case of sexual intercourse and consequent grave and sudden provocation theory.”
Dr Dahiya implicated himself by his theory of a golf club being the murder weapon. He himself admitted that the theory was based wholly upon the information made available to him in the questionnaire supplied to him by A.G.L. Kaul, the IO, which has no legal sanctity. Moreover, as the Court noted, neither the post mortem of Aarushi nor that of Hemraj had mentioned any injury of triangular shape.
There are a large number of cases in which two or more post mortems have arrived at diametrically opposite conclusions. Notable cases of this type include the Shopian (Kashmir) rape-cum-murder case (2009) and Bhandara (Maharashtra) rape-cum-murder case (2013).
The simple fact is that both sets of doctors who simultaneously gave diametrically opposite views could not be correct. Whosoever was wrong should have been punished severely so that the conscience of the criminal justice system remained clear and the possibility of the recurrence of such situations was reduced. But this is India and nobody gets punished for professional incompetence.
This implicates the investigating agencies too because they cannot explain on what basis they accepted one report and rejected the other. Either they must give their own scientific arguments for or against one report or admit that they merely go by the rank or reputation of the doctors or some other extraneous consideration. But there is no guarantee that senior doctors cannot be wrong ever. Science does not go by ranks or positions.
Due to such bungling, in the end, justice is denied to the people.
The consequences of horrible professional ignorance
Essentially, in the post mortem reports in India, prepared under the able guidance of the illiterate cleaner/safai karmachari of the mortuary, all that the Indian doctors do is to write a description of the external appearance of the dead body (that is, external injuries, etc.) and the external appearance of the internal organs as they appear to the cleaner. Their opinion on the cause of death is little more than pure guesswork, which is window-dressed in a little jargon to confuse the courts.
The scientific fact is, except in most obvious cases, it is extremely difficult and often impossible to give a definite opinion on the cause of death. Prof. Stephen M. Cordner says that the pathological evidence of injury or disease is often obliterated by advanced post mortem changes. Other confusing factors include a substantial delay between injury and death, non-fatal injury precipitating death in a relatively short time from natural causes, and some peculiarity of the victim rendering a survivable injury fatal. M. S. Pollanen notes that there are often instances with multiple competing potential causes of death.
Still, Indian doctors, in their blissful ignorance or complicity with the police, have been writing the ‘cause of death’ with an air of finality, a scientific impossibility. Since it is generally quietly accepted in the courts, it results in grave miscarriage of justice. If justice is to be delivered to the people, the fraternity of the lawyers and the judges will have to strike at this nexus of the doctors and the police. For this, the lawyers will have to educate themselves, especially about forensic medicine. As for the courts, it is imperative that they must use their own reasoning to infer the cause of death from the totality of the case and not accept the doctors’ opinion as infallible.
(To be continued)