Course on Scientific Investigation Level-I Module-VII: (3 days) Medical Jurisprudence Module Title: Medical Jurisprudence Duration: 3 days Training Faculty: CDTS offices/guest Group: SI/ASI. faculty Aim: To improve the knowledge and skills of trainees in Medical Jurisprudence and enable them to make a fair assessment of nature and cause of injuries, nature and likely cause of death and time since death. Time Table Day 1 st Period 9.30 to 10.30 1 Injuries (LP-1) 2 Importance of Postmortem examinatio n (LP-6) 2 nd Period 10.30 to 11.30 3 rd Period 11.40 to 12.40 Changes after Death (LP-2) Death due to alleged medical negligence (LP-7) 3 Observing a Post-mortem examination (LP-11) 4 th Period 12.40 to1.40 Death due to poisoning Medicolegal (LP-3) Medicolegal of custodial deaths (LP-8) B R E A K 5 th Period 3.00 to 4.00 Death due to burning (LP-4) Transport ation deaths and mass disasters (LP-9) Compariso n of notes on PM examinatio n (LP-12) 6 th Period 4.10 to 5.30 Death due to Asphyxia Medicolegal (LP-5) Sexual offences Medicolegal (LP-10) Module Test 1
Title: Injuries LESSON PLAN-1 Duration: 120 Aim: To improve knowledge of trainees in Medical Jurisprudence 1. Describe various kinds of injuries 2. Describe weapons that cause such injuries (Blunt, Sharp, Fire Arms, Explosives, Burns and Physical Force) 3. Identify all types of injuries and match weapons that caused the injuries 4. Describe how to recognise anti-mortem and post-mortem injuries 5. Describe how to decide whether the injuries are suicidal, homicidal or accidental. TIME Content Methods and 0 to 10 11 to 20 21 to 30 31 to 40 41 to 50 61 to 90 91 to 110 111 to 120 Types of Injuries Weapons & Objects Causing injuries Weapon & Injury Correlation Lecture/Slides/Photogr aphs Photos & Slides Lecture with slides Differentiating Ante-Mortem from Post-mortem Explanation with injuries photos Medico-Legal of Injuries Lecture & Clarifications Break for 10 Practice on describing injuries Practice on identifying weapons that cause such injuries Clarifying doubts, if any. 2
LESSON PLAN-2 Title: Changes after Death (May be covered Duration: 60 during post-mortem examination) Aim: To improve knowledge & skills of trainees in Medical Jurisprudence 1. List out changes after death according to time space 2. List out criteria by which time of death could be assessed 3. Describe the steps to be taken to identify unidentified dead body TIME Content Methods and 0 to 10 Diagnosis of death Post-Mortem changes: Lecture & Board Immediate, Early, Delayed 11 to 30 Criteria of assessing time since death Lecture & Board 31 to 40 41 to 50 Steps regarding identification of unidentified bodies Fingerprints; photographs, superimposition; DNA Fingerprinting Lecture & slides Operative & anaesthetic deaths Lecture & Board Feedback and removal of doubts. 3
LESSON PLAN-3 Title: Death due to poisoning Medico Legal Duration: 60 Aim: To improve knowledge & skills of trainees in Medical Jurisprudence 1. List out various poisons and method of administering them on human body. 2. List out symptoms of poisoning 3. Describe probable injuries that may cause in poisoning cases 4. Precautions to be taken while deciding about suicide, accident or homicide in poisoning cases. 0 to 10 Listing out poisons Classification Lecture & Board 11 to 20 Methods of administration Routes Lecture & Board 21 to 30 Signs & symptoms of poisoning Lecture 31 to 40 Injuries in poisoning Preservation of material Lecture & Board 41 to 50 Nature of Poisoning Accidental, suicidal & Homicidal Feedback and removal of doubts Lecture & Board 4
Title: Death due to Burning LESSON PLAN-4 Duration: 60 Aim: To improve knowledge & skills of trainees in Medical Jurisprudence 1. List out external symptoms of burning, degree of burns 2. Precautions to be taken while noting down external injuries 3. List out precautions to be taken to preserve dead body without losing vital clues 4. Describe how to decide whether it is suicide, accident or homicide 0 to 10 Degree of burns Signs & symptoms & Burns Lecture & Board 11 to 20 Precautions to be taken to preserve clues at scene Lecture & Board 21 to 30 Ante-mortem & post-mortem Burns Lecture 31 to 40 Causes of death in burns Lecture & Board 41 to 50 Discussion regarding the nature of burns Group Discussion Feedback and removal of doubts 5
LESSON PLAN-5 Title: Death due to Asphyxia Medico Legal Duration: 60 Aim: To improve knowledge & skills of trainees in Medical Jurisprudence 1. List out various ways of death due to asphyxia 2. List out symptoms of asphyxia 3. Describe probable injuries that may cause in asphyxia cases 4. Precautions to be taken while deciding about suicide, accident or homicide in asphyxia cases. 0 to 10 Definition of Asphyxia Types of asphyxial deaths Lecture with Photographs 11 to 25 Sings of asphyxia Description of cyanosiz, Lecture & Board congestion and petechial haemorrhages 26 to 40 Injuries occurring in Asphyxial deaths Lecture 41 to 50 Precautions in deciding about the nature of Asphyxia Lecture & Board 50 to 60 Accidental, Homicidal & Suicidal Discussion & Doubts Group discussion 6
LESSON PLAN-6 Title: Importance of Post-mortem Duration: 60 Examination Aim: To improve knowledge & skills of trainees in Medical Jurisprudence 1. State precautions to be taken while noting external injuries 2. Describe the importance of post-mortem 3. List out precautions to be taken to preserve dead body without losing vital clues 0 to 10 Precautions to be taken while describing injuries Lecture & Board 11 to 20 Various methods of dead body preservation Lecture & Board 21 to 35 Aims & Objectives of post-mortem examination Lecture & slides 36 to 50 Knowledge check Objective type questions Clarification of doubts, if any. 7
LESSON PLAN-7 Title: Deaths due to alleged medical Duration: 120 negligence Aim: To improve knowledge and skills in medical jurisprudence. 1. Describe what constitutes medical negligence, difference due to criminal and civil negligence. 2. Describe the procedure to investigate cases of deaths due to medical negligence. 0 to 20 21 to 40 41 to 60 71 to 100 101 to 120 Introduction to medical negligence Definition, ingredients:- 1) Duty (2) Dereliction (3) Damage and (4) Direct causation (4 Ds) Case discussion on civil and criminal medical negligence Differences between civil and criminal negligence. 1. Test of Negligence 2. Proof of medical negligence 3. Burden of proof Transparency-1 Transparencies 2 & 3 Transparencies 4, 5 & 6 Investigative procedures in medical negligence Transparencies 7, 8 & 9 Group Discussion and clarification of doubts Interaction 8
LESSON PLAN-8 Title: Medico-Legal of custodial Duration: 60 deaths Aim: To impart knowledge on Medico-Legal of custodial deaths. 1. Define Custodial Deaths 2. Classify custodial deaths into different categories (natural, accidental, suicidal, homicidal, etc.) 3. List out the common causes of unnatural deaths in custody (death by hanging, poisoning, beating, injuries self-inflicted or otherwise) 4. List out precautions to be taken to avoid custodial death 5. Describe the investigation to be followed in custodial deaths. 0 to 10 Introduction, definition of custodial deaths Transparencies 1 & 2 11 to 20 Classification of custodial deaths Transparency 3 21 to 30 Common causes of deaths in custody Transparency-4 31 to 40 Precautions to be taken to avoid custodial death (Do s Transparency-5 & Don ts) 41 to 50 Investigation procedure to be followed in custodial Transparency-6 death cases (Do s & Don ts) Feedback and removal of doubts 9
LESSON PLAN-9 Title: Transportation deaths and mass Duration: 60 disasters Aim: To improve knowledge and skills in medical jurisprudence. 21 to 30 31 to 40 41 to 50 1. Identify deaths due to transportation mishaps and type and pattern of injuries sustained. 2. To reconstruct the incident from the crime scene and pattern of injuries 3. What constitutes mass disasters, problems encountered, procedure of investigation. 0 to 10 Transportation deaths Common factors responsible Causes. Transparencies 1 & 2 11 to 20 Patterns of injuries sustained: Pedestrian; two wheeler- Transparencies 3 & rider/pillion, 4 wheeler occupants. Rail and Air accidents Patterns of injuries 4 (Charts) Transparencies 5 & 6 (Photographs & slides) Mass disaster: What constitutes? Classification Transparencies 7, 8 & 9 Procedure of investigation Crime Scene, Steps to be Transparencies taken 10, 11 & 12 Problems Discussion Removal of doubts Interaction. 10
LESSON PLAN-10 Title: Sexual Offences Medico-Legal Duration: 60 Aim: To improve knowledge of trainees in Medical Jurisprudence 1. Describe probable injuries that may cause in sexual offences. 2. Describe how a death could occur without external injuries in sexual offences. 3. List out precautions to be taken while noting down injuries in sexual offences and be able to analyse the medical findings on which opinions are based. 0 to 10 Classification Types of sexual offences Lecture/Slides 11 to 15 Injuries occurring in sexual offences Lecture & Board 16 to 25 Causes of death in sexual offences Lecture 26 to 30 Precautions while describing injuries Lecture & Board 31 to 50 Do s & Don ts for IOs. Examination of accused victim Material to be preserved for FSL - Interpretation of Medical Reports Feedback and removal of doubts Lecture & Group Discussion 11
LESSON PLAN-11 Title: Observing a Post-mortem examination Duration: 4 hours Aim: To explore the trainees to actual conduct of a post-mortem examination 4 hours The trainees will be taken to a mortuary, by prior arrangement, to observe a post-mortem examination. They will take notes during the examination and will be briefed by the autopsy surgeon at the end of the post-mortem examination. 12
LESSON PLAN-12 Title: Comparison of notes on post-mortem Duration: 60 examination Aim: To enable the trainees to refresh their knowledge of inputs given during the module and to assess the accuracy of their own observations noted during the PM examination. 60 Comparison of notes under trainer s guidance and group discussion. 13