duty o fdoctors -medicolegal aspect doc pov

8/20/2019 Duty o fDoctors -Medicolegal Aspect Doc POV

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Duty of Doctors-Duty of Doctors-

Medicolegal AspectMedicolegal Aspect Prof. S. Batabyal

Head, Dept of FSM

Medical College, Kolkata


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Duty of Doctors- MedicolegalDuty of Doctors- Medicolegal

Aspect Aspect

IntroductionIntroduction

Obtaining consentObtaining consent

Different consenting ageDifferent consenting age Duty of M.O. in case of suspectedDuty of M.O. in case of suspected

poisoningpoisoning

Duty of M.O. in case of criminal abortionDuty of M.O. in case of criminal abortion Civil and Criminal negligenceCivil and Criminal negligence

Cases for medicolegal postmortemCases for medicolegal postmortem


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Aspect co!td. Aspect co!td.

"egal proble#s faced by M.$."a%s related to"egal proble#s faced by M.$."a%s related to#edical practices#edical practices

Ci&il la%' "a% of co!tract, "a% of (ort,Ci&il la%' "a% of co!tract, "a% of (ort,Co!su#er Protectio! ActCo!su#er Protectio! Act

Medical Cou!cilMedical Cou!cil $t)er la%s$t)er la%s Co!clusio!Co!clusio!

Protocol for police cases * +apeSeual assault'Protocol for police cases * +apeSeual assault'!troductio! to +apeSeual assault!troductio! to +apeSeual assault

!ter&ie%i!g t)e patie!t!ter&ie%i!g t)e patie!t


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Aspect co!td. Aspect co!td.

!ter&e!tio!' Prepari!g t)e patie!t for!ter&e!tio!' Prepari!g t)e patie!t forea#i!atio!ea#i!atio!

P)ysical ea#i!atio!P)ysical ea#i!atio!

Pro&idi!g follo% up ser&icesPro&idi!g follo% up ser&ices $btai!i!g laboratory Speci#e!$btai!i!g laboratory Speci#e! /a#i!atio! of t)e 0icti#/a#i!atio! of t)e 0icti#

Profor#a for ea#i!atio! of t)e accused i! aProfor#a for ea#i!atio! of t)e accused i! arape case' Medicolegal Certificate for Malerape case' Medicolegal Certificate for Male

Medicolegal Certificate for Fe#aleMedicolegal Certificate for Fe#ale


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!troductio!!troductio!

Every registered medical practitioner has toEvery registered medical practitioner has toperform some medicolegal duty during dischargeperform some medicolegal duty during dischargeof his/her dutyof his/her duty

In the emergency room they have to ma!eIn the emergency room they have to ma!ein"ury report in all unnatural casesin

"ury report in all unnatural cases #ut if the patient is moribund arrangement of#ut if the patient is moribund arrangement of

treatment is to be made first. In case the patienttreatment is to be made first. In case the patientis not admitted only $C %police case& is done. #utis not admitted only $C %police case& is done. #utif the police case is admitted I$C %indoor policeif the police case is admitted I$C %indoor police

case& is to be done.case& is to be done. In both the cases government prescribed form isIn both the cases government prescribed form is

there. If the form is not available it may be donethere. If the form is not available it may be donein plain paper under seal and signature of thein plain paper under seal and signature of themedical officer.medical officer.


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'ere brief history of the case is necessary. (he'ere brief history of the case is necessary. (hein"uries are to be mentioned one by one )ith theirin

"uries are to be mentioned one by one )ith theirposition

position appro*imate measurement and type ofappro*imate measurement and type ofthe in"uries ie abrasion bruise lacerationthe in"uries ie abrasion bruise laceration

in"uries etcin"uries etc +astly the provisional diagnosis of the case and+astly the provisional diagnosis of the case and

the prognosis of the case are to be mentioned. Itthe prognosis of the case are to be mentioned. Itis a very important duty for EMO %emergencyis a very important duty for EMO %emergencymedical officer&.medical officer&.

If he fails to discharge this duty he may beIf he fails to discha

rge this duty he may becharged under ,ec. I$Cchar

ged under ,ec. I$C and the punishmentand the punishmentmay be 0 months of imprisonment or fine uptomay be 0 months of imprisonment or fine upto1s.2. or both1s.2. or both


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In addition during e*amination of the case aIn addition during e*amination of the case amale/female attendant should be present for amale/female attendant should be present for amale patient and a female for a female patient.male patient and a female for a female patient.Other)ise the doctor may be charged )ithOther)ise the doctor may be charged )ith

indecent assaultindecent assault under ,ec.023 I$C and theunder ,ec.023 I$C and thepunishment may be imprisonment upto yearspunishment may be imprisonment upto years)ith and/or fine)ith and/or fine

4e*t4e*t in the )ardin the )ard the doctor is to e*amine the the doctor is to e*amine thecase very carefully and treat the patient )ith acase very carefully and treat the patient )ith a

reasonable degree of s!ill care and !no)ledge toreasonable degree of s!ill care and !no)ledge toavoid charge of negligence.avoid charge of negligence.

#'( %bed head tic!et'( %bed head tic!et& is to be maintainedis to be maintainedproperly )ith care and s!ill. (he doctor shouldproperly )ith care and s!ill. (he doctor shouldgive proper and suitable prescription. 'e shouldgive proper and suitable prescription. 'e should

mention the e*act 5uantities and precise timingmention the e*act 5uantities and precise timingfor ta!ing medicinesfor ta!ing medicines


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Here, #ay )a&e to #akeHere, #ay )a&e to #ake 1dyi!g Declaratio! 1dyi!g Declaratio!2. t2. tis a state#e!t of a perso!, %ritte! or oral, %)ois a state#e!t of a perso!, %ritte! or oral, %)ois dyi!g as a result of so#e u!la%ful act.is dyi!g as a result of so#e u!la%ful act.

()e doctor is to assess t)at t)e patie!t is i!()e doctor is to assess t)at t)e patie!t is i!good #e!tal co!ditio! before t)e declaratio! isgood #e!tal co!ditio! before t)e declaratio! isrecorded. ()e declaratio! is #ade i! 3uestio!recorded. ()e declaratio! is #ade i! 3uestio!a!d a!s%er for#.a!d a!s%er for#.

()e declaratio! s)ould be !oted do%! i!()e declaratio! s)ould be !oted do%! i!&erbati# or t)e patie!t i! prese!ce of t%o&erbati# or t)e patie!t i! prese!ce of t%oreaspo!sible %it!esses. t s)ould be sig!ed byreaspo!sible %it!esses. t s)ould be sig!ed byt)e doctor, t)e patie!t a!d t)e %it!esses.t)e doctor, t)e patie!t a!d t)e %it!esses.


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A!ot)er i#porta!t #edicolegal duty of t)e A!ot)er i#porta!t #edicolegal duty of t)edoctors i! t)e %ard, is to )elp i! t)e preparatio!doctors i! t)e %ard, is to )elp i! t)e preparatio!

ofof 1Dyi!g Depositio! 1Dyi!g Depositio!2.2. t is t)e state#e!t of a dyi!g #a!, before at is t)e state#e!t of a dyi!g #a!, before aMagistrate a!d t)e accused or )is Cou!sel, o!Magistrate a!d t)e accused or )is Cou!sel, o!

$at). ! a %ard, it is a bed side court.$at). ! a %ard, it is a bed side court.

Here, t)e doctor )as to certify t)e #e!tal a!dHere, t)e doctor )as to certify t)e #e!tal a!dp)ysical fit!ess of t)e patie!t to #ake suc) ap)ysical fit!ess of t)e patie!t to #ake suc) a

state#e!t.state#e!t.


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4o%, i! t)e operatio! t)eatre,4o%, i! t)e operatio! t)eatre, t)e doctor i!t)e doctor i!c)arge of t)e operatio! s)ould be &ery carefulc)arge of t)e operatio! s)ould be &ery carefulbefore goi!g to operatio! properbefore goi!g to operatio! proper..

He s)ould !ote t)at all t)e for#alities )a&eHe s)ould !ote t)at all t)e for#alities )a&ebee! co#pleted. ()ebee! co#pleted. ()e %ritte! co!se!t%ritte! co!se!t of t)eof t)epatie!t a!d t)e guardia! s)ould be take! beforepatie!t a!d t)e guardia! s)ould be take! beforegoi!g for operatio!.goi!g for operatio!.

Before closi!g t)e operatio!, t)eBefore closi!g t)e operatio!, t)e s%ab cou!ts%ab cou!t a!d t)e i!stru#e!t cou!t s)ould be #ade soa!d t)e i!stru#e!t cou!t s)ould be #ade sot)at !o!e of t)e# re#ai!s i! t)e operatio!t)at !o!e of t)e# re#ai!s i! t)e operatio!field.field.


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IntroductionIntroduction

If any one of them remains in side the operationIf any one of them remains in side the operationarea the doctor may be charged )ith criminalarea the doctor may be charged )ith criminalnegligence undernegligence under 61es Ipsa +o5uitur 61es Ipsa +o5uitur7 )hich7 )hichmeans 6(he thing spea!s of itself7.means 6(he thing spea!s of itself7.

(he doctor may be charged )ith criminal(he doctor may be charged )ith criminalnegligence undernegligence under ,ec.03A I$C,ec.03A I$C causing the deathcausing the deathof any person by doing rash and negligent act notof any person by doing rash and negligent act notamounting to culpable homicide and theamounting to culpable homicide and thepunishment is imprisonment upto years or )ithpunishment is imprisonment upto years or )ith

fine or )ith both.fine or )ith both. In addition administrative proceedings )ill startIn addition administrative proceedings )ill start

against the doctor and he may be dismissed fromagainst the doctor and he may be dismissed fromthe service and his name may be erased from thethe service and his name may be erased from the,tate Medical Council.,tate Medical Council.


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Duty to ta!e consent inDuty to ta!e consent in

medical practice8 -medical practice8 -

Consent meansConsent means voluntary agreementvoluntary agreement compliance complianceor permission )hen a patient is coming to aor permission )hen a patient is coming to adoctor for treatment the consent is implied.doctor for treatment the consent is implied.(here is no need of ta!ing )ritten consent.(here is no need of ta!ing )ritten consent.

#ut in some#ut in some special cases )ritten consentspecial cases )ritten consent isisre5uired. In criminal cases the victim and there5uired. In criminal cases the victim and theaccused can not be e*amined )ithout his/heraccused can not be e*amined )ithout his/her)ritten consent. (he court also can not compel a)ritten consent. (he court also can not compel aperson to get medically e*amined against his/herperson to get medically e*amined against his/her

)ill.)ill. A& A& In case of rapeIn case of rape the victim should not be the victim should not be

e*amined )ithout her )ritten consent.e*amined )ithout her )ritten consent.

#& In medicolegal cases of#& In medicolegal cases of pregnancy deliverypregnancy deliveryand abortionand abortion the )oman should not be e*amined the )oman should not be e*amined

)ithout her )ritten consent.)ithout her )ritten consent.


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Co!se!tCo!se!t

#ut the#ut the convicted person can be e*aminedconvicted person can be e*amined)ithout his/her consent by applying)ithout his/her consent by applyingreasonable forcereasonable force. #ecause the convicted. #ecause the convicted

person has no civil right.person has no civil right. Different consenting age8 -Different consenting age8 - 9or medicolegal e*amination9or medicolegal e*amination years and years and

above.above.

9or se*ual intercourse9or se*ual intercourse :: years and above. years and above. 9or operation to suffer any bodily harm9or operation to suffer any bodily harm ;;

years and above. years and above.

A child A child under yearsunder years of age and anof age and an insaneinsane person can not give valid consent.person can not give valid consent.


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1e5uirement of consent1e5uirement of consent '-'-

! &arious field of #edical practice %ritte!! &arious field of #edical practice %ritte!co!se!t is re3uired. $!ly so#e ea#ple areco!se!t is re3uired. $!ly so#e ea#ple aregi&e! )ere '-gi&e! )ere '-

ForFor co!tracepti&e sterili5atio!co!tracepti&e sterili5atio! %ritte! co!se!t of%ritte! co!se!t ofbot) t)e )usba!d a!d %ife s)ould be obtai!ed.bot) t)e )usba!d a!d %ife s)ould be obtai!ed. ForFor artificial i!se#i!atio!artificial i!se#i!atio! %ritte! co!se!t of bot)%ritte! co!se!t of bot)

t)e do!or a!d t)e recipie!t side s)ould bet)e do!or a!d t)e recipie!t side s)ould be

obtai!ed.obtai!ed. ForFor #edical ter#i!atio! of preg!a!cy#edical ter#i!atio! of preg!a!cy t)e %ritte!t)e %ritte!co!se!t s)ould be obtai!ed fro# t)e %o#a! asco!se!t s)ould be obtai!ed fro# t)e %o#a! as%ell as fro# t)e guardia!.%ell as fro# t)e guardia!.


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9or9or organ transplantationorgan transplantation the organ of the dead the organ of the deadperson should not be removed )ithout theperson should not be removed )ithout theconsent of the person having la)ful possessionconsent of the person having la)ful possession

of the body.of the body. $athological autopsy$athological autopsy should not be conductedshould not be conducted

)ithout the consent of the guardian or legal)ithout the consent of the guardian or legalheirs of the deceased. #ut for medicolegalheirs of the deceased. #ut for medicolegalautopsy no consent is re5uired. Only in5uest isautopsy no consent is re5uired. Only in5uest is

sufficient to hold this autopsy.sufficient to hold this autopsy. In case ofIn case of emergencyemergency no consent is re5uired to no consent is re5uired tosave the life of the patient in good faith.save the life of the patient in good faith.

If the doctor fails to follo) these rules ofIf the doctor fails to follo) these rules ofconsent he may be charged )ith professionalconsent he may be charged )ith professional

negligence %malpractice& both civil and criminalnegligence %malpractice& both civil and criminalnegligence. (he punishment may be issuing ofnegligence. (he punishment may be issuing of)arning notice)arning notice for infamous conduct erasure offor infamous conduct erasure ofnames civil negligence and criminal negligencenames civil negligence and criminal negligence)here the patient dies after operation and the)here the patient dies after operation and theconsent has not been ta!en.consent has not been ta!en.


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Suspected Poiso!i!gSuspected Poiso!i!g

In case ofIn case of homicidal poisoninghomicidal poisoning the doctor is duty the doctor is dutybound to inform the police officer or thebound to inform the police officer or theMagistrate. #ut the doctor should confirm hisMagistrate. #ut the doctor should confirm hissuspicion before e*pressing an opinion. 9or thissuspicion before e*pressing an opinion. 9or this

he must 8he must 8 %a&%a& CollectCollect urine vomit and faeces and submit forurine vomit and faeces and submit for

analysis.analysis.

%b& Carefully observe and record the%b& Carefully observe and record the symptomss ymptoms ininrelation to food.relation to food.

%c& Consult in strict confidence )ith%c& Consult in strict confidence )ith seniorseniorpractitioner.practitioner.

%d& Either remove the patient to hospital or%d& Either remove the patient to hospital orengage nurses of his confidence.engage nurses of his confidence.

%e& Any%e& Any suspected articlessuspected articles of good e*creta andof good e*creta andstomach )ash samples should be preserved.stomach )ash samples should be preserved.


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4on-compliance is punishable under ,ec. I$C4on-compliance is punishable under ,ec. I$Cif it is proved that the doctor did it )ith theif it is proved that the doctor did it )ith theintention of protecting the accusedintention of protecting the accused. If the doctor. If the doctoris sure that the patient is suffering from suicidalis sure that the patient is suffering from suicidal

poisoning he is not bound to inform the police.poisoning he is not bound to inform the police. If the doctor is summoned by the investigatingIf the doctor is summoned by the investigating

police officer he is bound to give all informationpolice officer he is bound to give all informationregarding the case that has come to his notice.regarding the case that has come to his notice.

If heIf he conceals the information he is liable to beconceals the information he is liable to beprosecuted under ,ec. I$Cprosecuted under ,ec. I$C if he gives falseif he gives falseinformation he is liable to be charged )ith theinformation he is liable to be charged )ith theoffence of giving false information under ,ec.


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A go&er!#e!t #edical officer is re3uired to A go&er!#e!t #edical officer is re3uired toreport to police all t)e cases of suspectedreport to police all t)e cases of suspected

poiso!i!g, %)et)er accide!tal suicidal orpoiso!i!g, %)et)er accide!tal suicidal or

)o#icidal i! !ature.)o#icidal i! !ature.

f a case of suspected poiso!i!g dies, deat)f a case of suspected poiso!i!g dies, deat)certificate s)ould !ot be issued but deat)certificate s)ould !ot be issued but deat)

declaratio! s)ould be #ade a!d it s)ould bedeclaratio! s)ould be #ade a!d it s)ould beco##u!icated to t)e !earest police statio!.co##u!icated to t)e !earest police statio!.


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Duty of a doctor in a case ofDuty of a doctor in a case of

criminal abortion 8-criminal abortion 8-

A criminal abortion is the induced destruction and A criminal abortion is the induced destruction ande*pulsion of the foetus from the )omb of thee*pulsion of the foetus from the )omb of themother unla)fully )hen there ismother unla)fully )hen there is no therapeuticno therapeuticindication for the operation.indication for the operation.

(he doctor=s duty in this case is to guard all the(he doctor=s duty in this case is to guard all theinformations obtained by him as ainformations obtained by him as a professionalprofessionalsecrecysecrec y. 'e must urge the patient to ma!e a. 'e must urge the patient to ma!e astatement about the induction of criminalstatement about the induction of criminalmiscarriage.miscarriage.

If she refuses to ma!e a statement he shouldIf she refuses to ma!e a statement he shouldnot pursue the matter. 'e must treat her to thenot pursue the matter. 'e must treat her to thebest of his ability. 'e must consult a professionalbest of his ability. 'e must consult a professionalcolleague.colleague.


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f t)ef t)e %o#a! dies%o#a! dies,, )e s)ould !ot issue a deat))e s)ould !ot issue a deat)certificatecertificate, but s)ould i!for# t)e police for, but s)ould i!for# t)e police for#aki!g arra!ge#e!t for post#orte##aki!g arra!ge#e!t for post#orte#

ea#i!atio!.ea#i!atio!. 6!der sec. 789 PC %)oe&er6!der sec. 789 PC %)oe&er &olu!tarily causes&olu!tarily causescri#i!al #iscarriagecri#i!al #iscarriage is liable for i#priso!#e!tis liable for i#priso!#e!tupto 7 years a!d or fi!e a!d if t)e %o#a! isupto 7 years a!d or fi!e a!d if t)e %o#a! is3uick %it) t)e c)ild t)e i#priso!#e!t #ay3uick %it) t)e c)ild t)e i#priso!#e!t #ayete!ded upto : years.ete!ded upto : years.

! t)is case,! t)is case, bot)bot) t)e perso! procuri!g t)et)e perso! procuri!g t)e#iscarriage a!d t)e %o#a! are#iscarriage a!d t)e %o#a! are liableliable forforpu!is)#e!t. f t)is case, bot) t)e perso!pu!is)#e!t. f t)is case, bot) t)e perso!

procuri!g t)e #iscarriage a!d t)e %o#a! areprocuri!g t)e #iscarriage a!d t)e %o#a! areliable for u!is)#e!t.liable for u!is)#e!t.


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If the miscarriage is causedIf the miscarriage is caused )ithout the)ithout theconsentconsent of the )oman the imprisonmentof the )oman the imprisonmentmay be upto years under ,ec.00 I$C.may be upto years under ,ec.00 I$C.

If the )oman diesIf the )oman dies from the act of criminalfrom the act of criminalabortions the punishment is upto yearsabortions the punishment is upto yearsunder sec.03 I$C under sec.0: I$Cunder sec.03 I$C under sec.0: I$Ccausing death of 5uic! unborn child bycausing death of 5uic! unborn child by

any act amounts to culpable homicide andany act amounts to culpable homicide andthe punishment may e*tend upto yearsthe punishment may e*tend upto yearsof imprisonment.of imprisonment.


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(he civil and criminal(he civil and criminal

negligencenegligence

$rofessional negligence$rofessional negligence is absence of reasonableis absence of reasonabledegree of care and s!ill or )illful negligence of adegree of care and s!ill or )illful negligence of amedical practitioner in the statement of a patientmedical practitioner in the statement of a patientso as to lead bodily in"ury of death of the patient.so as to lead bodily in"ury of death of the patient.

(he 5uestion of(he 5uestion of civil negligencecivil negligence )ill come)ill come)hen a patient in case of death any relative bring)hen a patient in case of death any relative bringsuit in a civil court for reali>ation of compensationsuit in a civil court for reali>ation of compensationfrom his doctor if he has suffered in"ury due tofrom his doctor if he has suffered in"ury due tonegligence.negligence.

,imilarly the doctor can bring a civil suit for,imilarly the doctor can bring a civil suit forreali>ation of his fees from the patient or hisreali>ation of his fees from the patient or hisrelatives )ho refused to pay the same on therelatives )ho refused to pay the same on theground of professional negligence.ground of professional negligence.


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/a#ples of ci&il !eglige!ce/a#ples of ci&il !eglige!ce

"oss of ear!i!g of t)e patie!t due to !eglige!t act of t)e"oss of ear!i!g of t)e patie!t due to !eglige!t act of t)eatte!di!g doctor.atte!di!g doctor.

/pe!ses i!curred eg. Hospital epe!ses, special/pe!ses i!curred eg. Hospital epe!ses, speciali!&estigatio!, special diet, etc.i!&estigatio!, special diet, etc. +eductio! of epectatio! of life of t)e patie!t due to+eductio! of epectatio! of life of t)e patie!t due to

%ro!g treat#e!t.%ro!g treat#e!t.

+educed e!;oy#e!t of life of t)e patie!t.+educed e!;oy#e!t of life of t)e patie!t.

Pai! a!d sufferi!g, eit)er p)ysical or #e!tal.Pai! a!d sufferi!g, eit)er p)ysical or #e!tal. "oss of pote!cy"oss of pote!cy Deat) of t)e patie!t.Deat) of t)e patie!t.


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A doctor is !ot liable for a! error of A doctor is !ot liable for a! error of ;udge#e!t or of diag!osis, if )e )as ;udge#e!t or of diag!osis, if )e )as

secured all !ecessary data i! %)ic) tosecured all !ecessary data i! %)ic) tobase abase a sou!d ;udge#e!tsou!d ;udge#e!t..

Co!tributory !eglige!ceCo!tributory !eglige!ce o! t)e part of ao! t)e part of a

patie!t is &ery good defe!ce forpatie!t is &ery good defe!ce for!eglige!ce.!eglige!ce.


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Cri#i!al !eglige!ceCri#i!al !eglige!ce

Cri#i!al !eglige!ce occurs %)e! t)e p)ysicia!Cri#i!al !eglige!ce occurs %)e! t)e p)ysicia!e)ibits gross lack of co#pete!cy, grosse)ibits gross lack of co#pete!cy, grossi!atte!tio!, cri#i!al i!differe!ce to t)e patie!t


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Cri#i!al !eglige!ceCri#i!al !eglige!ce

Ad#i!istratio! of a %ro!g #edici!e i! to Ad#i!istratio! of a %ro!g #edici!e i! tot)e eye causi!g loss of &isio!.t)e eye causi!g loss of &isio!.

A#putatio! of %ro!g fi!ger or operatio! A#putatio! of %ro!g fi!ger or operatio!o! a %ro!g li#b.o! a %ro!g li#b.

"ea&i!g i!stru#e!ts, tubes, spo!ges or"ea&i!g i!stru#e!ts, tubes, spo!ges or

s%ab i! abdo#e!.s%ab i! abdo#e!. Perfor#i!g cri#i!al abortio!Perfor#i!g cri#i!al abortio!


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A si!gle professio!al act by a p)ysicia! #ay A si!gle professio!al act by a p)ysicia! #aysub;ect )i# tosub;ect )i# to bot) ci&il a!d cri#i!al liabilitybot) ci&il a!d cri#i!al liability, eg,, eg,if a p)ysicia! perfor#s a! u!aut)ori5edif a p)ysicia! perfor#s a! u!aut)ori5ed

operatio! o! a patie!t, )e #ay be sued ci&illy foroperatio! o! a patie!t, )e #ay be sued ci&illy forda#ages a!d prosecuted cri#i!ally for assault.da#ages a!d prosecuted cri#i!ally for assault.

()e doctor #ay )a&e to pay da#ages i! ter#s()e doctor #ay )a&e to pay da#ages i! ter#sof #o!etary fi!e as %ell as co!&icted forof #o!etary fi!e as %ell as co!&icted forcri#i!al !eglige!ce u!dercri#i!al !eglige!ce u!der Sec.7>?A PCSec.7>?A PC %it)%it)

i#priso!#e!t upto 9 years or %it) fi!e or %it)i#priso!#e!t upto 9 years or %it) fi!e or %it)bot).bot).


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"astly, a!ot)er &ery i#porta!t #edicolegal duty"astly, a!ot)er &ery i#porta!t #edicolegal dutyof t)e doctors is to )old #edicolegalof t)e doctors is to )old #edicolegalpost#orte# ea#i!atio! a!d to ea#i!e t)epost#orte# ea#i!atio! a!d to ea#i!e t)e

&icti# girl a!d t)e accused&icti# girl a!d t)e accused perso!.perso!. /&ery doctor %)o )as per#a!e!t registratio!/&ery doctor %)o )as per#a!e!t registratio!!u#ber of State Medical Cou!cil is e!titled to do!u#ber of State Medical Cou!cil is e!titled to dot)is ;ob.t)is ;ob.

Alt)oug), it is t)e ;ob of ser&ice doctor, t)e Alt)oug), it is t)e ;ob of ser&ice doctor, t)epri&ate practitio!er #ay be asked to do t)is ;obpri&ate practitio!er #ay be asked to do t)is ;obduri!g 4atio!al /#erge!cyduri!g 4atio!al /#erge!cy. He!ce, )ere is so#e. He!ce, )ere is so#eidea about it.idea about it.


29/59

Cases for medico legalCases for medico legal

postmortem e*aminationpostmortem e*amination

All u!!atural deat) cases. All u!!atural deat) cases. Sudde! deat), %)ere cause of deat) isSudde! deat), %)ere cause of deat) is

!ot k!o%!.!ot k!o%!. All cases of deat) due to poiso!i!g. All cases of deat) due to poiso!i!g. (raffic accide!ts deat) cases.(raffic accide!ts deat) cases.

(raffic accide!ts deat) cases.(raffic accide!ts deat) cases. Deat) occurri!g duri!g operatio! orDeat) occurri!g duri!g operatio! oru!der a!aest)esia.u!der a!aest)esia.


30/59

Cases for medico legalCases for medico legal

postmortem e*aminationpostmortem e*amination

Death occurring inDeath occurring in prisonprison police custody "ail police custody "ailcustody asylum #orstal school etc. 'erecustody asylum #orstal school etc. 'erepostmortem e*amination is to be done underpostmortem e*amination is to be done under

?ideo $hotography as per directive of 'uman ?ideo $hotography as per directive of 'uman1ights Commission.1ights Commission.

In case ofIn case of do)ry deathsdo)ry deaths. 'ere postmortem. 'ere postmorteme*amination is preferably to be conducted ate*amination is preferably to be conducted atleast by t)o doctors.least by t)o doctors.

Death certified as due toDeath certified as due to postoperativepostoperative shoc! orshoc! orhaemorrhage.haemorrhage.

InIn e*humatione*humation cases.cases. #efore holding medicolegal autopsy in5uest is#efore holding medicolegal autopsy in5uest is

re5uired from the police authority or Magistratere5uired from the police authority or Magistrate


31/59

+E@A+ $1O#+EM, 9ACED #+E@A+ $1O#+EM, 9ACED #

('E DOC(O1, .('E DOC(O1, .

! t)e past, litigatio!s %ere less i! !dia,! t)e past, litigatio!s %ere less i! !dia,because people %ere !ot a%are of t)eir rig)ts.because people %ere !ot a%are of t)eir rig)ts.! de&eloped cou!tries like 6.S.A. , 6.K., Ca!ada! de&eloped cou!tries like 6.S.A. , 6.K., Ca!ada

etc., t)ere is Medical "a% specially for #edicaletc., t)ere is Medical "a% specially for #edicalprofessio!.professio!.

6!fortu!ately, t)ere is !ot)i!g like Medical "a%6!fortu!ately, t)ere is !ot)i!g like Medical "a%i! !dia@ so litigatio!s are based o! cri#i!al "a%,i! !dia@ so litigatio!s are based o! cri#i!al "a%,"a% of (orts, "a% of Co!tracts, Co!su#ers


32/59

+E@A+ $1O#+EM, 9ACED #+E@A+ $1O#+EM, 9ACED #

('E DOC(O1,('E DOC(O1,

)e! a doctor is s)o%i!g abse!ce of)e! a doctor is s)o%i!g abse!ce ofreaso!able degree of care a!d skill i!reaso!able degree of care a!d skill i!treati!g )is patie!t, )e #ay be c)argedtreati!g )is patie!t, )e #ay be c)arged

%it) Ci&il !eglige!ce.%it) Ci&il !eglige!ce. )e! a doctor is s)o%i!g gross lack of)e! a doctor is s)o%i!g gross lack of

co#pete!cy a!d gross i! atte!tio!, )eco#pete!cy a!d gross i! atte!tio!, )e#ay be c)arged %it) Cri#i!al !eglige!ce.#ay be c)arged %it) Cri#i!al !eglige!ce.So t)e doctors s)ould possess so#e legalSo t)e doctors s)ould possess so#e legalk!o%ledge to protect t)e#sel&es fro#k!o%ledge to protect t)e#sel&es fro#!eglige!ce.!eglige!ce.


33/59

,OME +AB, I4 1E+A(IO4 (O,OME +AB, I4 1E+A(IO4 (O

MEDICA+ $1AC(ICEMEDICA+ $1AC(ICE

Cri#i!al "a%.Cri#i!al "a%.

Ci&il "a%.Ci&il "a%. Co!su#er Protectio! Act.Co!su#er Protectio! Act.

Medical Cou!cilsMedical Cou!cils

$t)er "a%s.$t)er "a%s.


34/59

C1IMI4A+ +ABC1IMI4A+ +AB

SECTIONSECTION OFFENCESOFFENCES PUNISHMENTSPUNISHMENTS

193 IPC193 IPC PerjuryPerjury Imprisonment upto 7Imprisonment upto 7

rs.+! Fine.yrs.+! Fine.

197 IPC197 IPC Issuin" F#$seIssuin" F#$se

%erti&i%#te%erti&i%#te

!'o!!'o!

191 IPC191 IPC Hosti$e (itnessHosti$e (itness !'o!!'o!

3)* IPC3)* IPC In'e%ent #ss#u$tIn'e%ent #ss#u$t Imprisonment upto Imprisonment upto

,rs. +! Fine.,rs. +! Fine.


35/59

SECTIONSSECTIONS OFFENCESOFFENCES PUNISHMENTSPUNISHMENTS

31 IPC31 IPC Crimin#$ -ortionCrimin#$ -ortion Imprisonment &romImprisonment &rom

3 ,rs. To 1/ yrs.3 ,rs. To 1/ yrs.

+! Fine.+! Fine.TOTO

310 IPC310 IPC

370 IPC370 IPC #pe#pe Imprisonment upto 7Imprisonment upto 7

yrs. M#y e 1/yrs. M#y e 1/

yrs2 m#y e $i&eyrs2 m#y e $i&eimprisonment +!imprisonment +!

&ine.&ine.


36/59

SECTIONSSECTIONS OFFENCESOFFENCES PUNISHMENTSPUNISHMENTS

31 IPC31 IPC Crimin#$ -ortionCrimin#$ -ortion Imprisonment &romImprisonment &rom

3 ,rs. To 1/ yrs.3 ,rs. To 1/ yrs.

+! Fine.+! Fine.TOTO

310 IPC310 IPC

370 IPC370 IPC #pe#pe Imprisonment upto 7Imprisonment upto 7

yrs. M#y e 1/yrs. M#y e 1/

yrs2 m#y e $i&eyrs2 m#y e $i&e

imprisonment +!imprisonment +!

&ine.&ine.

*97 IPC*97 IPC -'u$tery-'u$tery Imprisonment upto )Imprisonment upto )

,rs. +! Fine,rs. +! Fine


37/59

()e legal protectio! for Doctors()e legal protectio! for Doctors

Sec. to 7 PCSec. to 7 PC

(o follo% t)e rules of co!se!t.(o follo% t)e rules of co!se!t. CI?I+ +ABCI?I+ +AB '-'-

()is ca! be di&ided i!to ($ groups'-()is ca! be di&ided i!to ($ groups'-

"a% of Co!tract"a% of Co!tract

"a% of (ort."a% of (ort.


38/59

AEAE +AB O9 CO4(1AC(+AB O9 CO4(1AC(

'ere there is a specific contract bet)een a'ere there is a specific contract bet)een apatient and a doctor )hich may be O1A+patient and a doctor )hich may be O1A+B1I((E4 or IM$+IED one under )hich theB1I((E4 or IM$+IED one under )hich the

doctor is supposed to treat the patient and thedoctor is supposed to treat the patient and thepatient is liable to pay the specific or reasonablepatient is liable to pay the specific or reasonablefees to the doctor.fees to the doctor.

In operative cases usually the contract isIn operative cases usually the contract isbet)een surgeon and patient O4+ andbet)een surgeon and patient O4+ and

anaesthesists cardiologists paediatricians andanaesthesists cardiologists paediatricians andother doctors may 4O( be a party.other doctors may 4O( be a party.

(hey have an implied contract )ith the surgeon(hey have an implied contract )ith the surgeononly. 'ence the surgeon may be vicariously liableonly. 'ence the surgeon may be vicariously liablefor his negligencefor his negligence


39/59

+AB O9 (O1(+AB O9 (O1(..

Certai! duties are i#posed o! e&ery perso!Certai! duties are i#posed o! e&ery perso!i! t)e society irrespecti&e of #o!etaryi! t)e society irrespecti&e of #o!etaryco!sideratio!. ()us a doctor is also )a&i!gco!sideratio!. ()us a doctor is also )a&i!g

certai! specific duties to%ards )is patie!t,certai! specific duties to%ards )is patie!t,payi!g or co#pli#e!tary.payi!g or co#pli#e!tary.

1 1 f a doctor co##its a! act, %)ic) ot)erf a doctor co##its a! act, %)ic) ot)erreaso!able doctor of )is sta!dard %ould !otreaso!able doctor of )is sta!dard %ould !otco##it@ or a doctor $M(S to do so#et)i!gco##it@ or a doctor $M(S to do so#et)i!g

%)ic) ot)er doctor %ould certai!ly do is a%)ic) ot)er doctor %ould certai!ly do is a4/="=/4( AC(2 . ()e doctor is liable for t)at4/="=/4( AC(2 . ()e doctor is liable for t)atu!der "a% of (ort.u!der "a% of (ort.


40/59

CO4,ME1 $1O(EC(IO4 AC(CO4,ME1 $1O(EC(IO4 AC( ''

(his act is most hot sub"ect in the medical(his act is most hot sub"ect in the medical)orld today. (his act is enacted in


41/59

At any centre mention belo) )ith/)ithout At any centre mention belo) )ith/)ithoutengaging a +a)yer and paying a nominal fees.engaging a +a)yer and paying a nominal fees.

At At District levelDistrict level District Consumer Dispute District Consumer Dispute1edressal 9orum - to be chaired by a District1edressal 9orum - to be chaired by a DistrictFudge and t)o other members. CompensationFudge and t)o other members. Compensationto)ards damagesto)ards damages upto 1s. la!hsupto 1s. la!hs

At At ,tate level,tate level ,tate Consumer Dispute ,tate Consumer Dispute1edressal Commission chaired by a 'igh court1edressal Commission chaired by a 'igh courtFudge and t)o other members. CompensationFudge and t)o other members. Compensationaboveabove 1s. la!hs to Crore1s. la!hs to Crore..

At At 4ational +evel4ational +evel 4ational consumer Dispute 4ational consumer Dispute

1edressal Commission chaired by a Fudge of1edressal Commission chaired by a Fudge of,upreme Court and four other members.,upreme Court and four other members.CompensationCompensation more than 1s. Croremore than 1s. Crore..


42/59

Apprehensions 8- Apprehensions 8-

Bad doctor-patie!t relatio!s)ip.Bad doctor-patie!t relatio!s)ip.

(e!de!cy for ete!si&e laboratory i!&estigatio!.(e!de!cy for ete!si&e laboratory i!&estigatio!. (e!de!cy to #ake differe!t(e!de!cy to #ake differe!t

!de#!ity!sura!ce policy for payi!g!de#!ity!sura!ce policy for payi!g

co#pe!satio!.co#pe!satio!.

()e treati!g P)ysicia! %ill c)arge #ore fro# t)e()e treati!g P)ysicia! %ill c)arge #ore fro# t)ege!eral patie!ts.ge!eral patie!ts.


43/59

MEDICA+ CO4CI+MEDICA+ CO4CI+..

A patient can file a complaint )ith the A patient can file a complaint )ith therespective council for doctor=s negligence.respective council for doctor=s negligence.nfortunately the council has po)er to punishnfortunately the council has po)er to punish

the doctor but does not have the po)er to orderthe doctor but does not have the po)er to ordercompensation even if the negligence is proved.compensation even if the negligence is proved.

(he punishment )hich can be given to the(he punishment )hich can be given to thedoctor by the Medical Council/state Medicaldoctor by the Medical Council/state Medical

Council Council Issuing a )arning notice.Issuing a )arning notice. (emporary erasure of name from Medical(emporary erasure of name from Medical

1egistrar.1egistrar.

$ermanent erasure of name from Medical$ermanent erasure of name from Medical1egistrar.1egistrar.


44/59

O('E1 +AB, 8O('E1 +AB, 8

6!der M.(.P. Act, Drug Act, Bo#bay6!der M.(.P. Act, Drug Act, Bo#bay4ursi!g Ho#e act etc. patie!t ca! file a4ursi!g Ho#e act etc. patie!t ca! file a

co#plai!t to t)e respecti&e aut)ority. Hereco#plai!t to t)e respecti&e aut)ority. Herealso t)ey do !ot )a&e po%er to orderalso t)ey do !ot )a&e po%er to order

co#pe!satio!co#pe!satio!


45/59

CO4C+,IO4CO4C+,IO4 '-'-

(O A?OID A++ ('E MEDICO+E@A+(O A?OID A++ ('E MEDICO+E@A+$1O#+EM, CE1(AI4 $1ECA(IO4, (O #E$1O#+EM, CE1(AI4 $1ECA(IO4, (O #E

(AGE4(AGE4 '-'- Keep full a!d accurate Medical +ecords.Keep full a!d accurate Medical +ecords. /#ploy sta!dard care a!d skill/#ploy sta!dard care a!d skill Do !ot fail to get %ritte! i!for#ed co!se!t.Do !ot fail to get %ritte! i!for#ed co!se!t.

Diag!osis to be co!fir#ed by laboratory tests.Diag!osis to be co!fir#ed by laboratory tests. Proper i!&estigatio! to be ad&ised.Proper i!&estigatio! to be ad&ised. Proper i##u!i5atio! sc)edule to be follo%ed.Proper i##u!i5atio! sc)edule to be follo%ed.


46/59

Se!siti&ity tests to be do!e %)ere applicable.Se!siti&ity tests to be do!e %)ere applicable. )e! diag!osis is obscure co!sult a!ot)er)e! diag!osis is obscure co!sult a!ot)er

se!iorspecialists.se!iorspecialists. Do !ot critici5e a!ot)er practitio!er.Do !ot critici5e a!ot)er practitio!er. (o c)eck t)e co!ditio! of t)e e3uip#e!t(o c)eck t)e co!ditio! of t)e e3uip#e!t

fre3ue!tly.fre3ue!tly.

()e drug to be ide!tified %it) epiry date()e drug to be ide!tified %it) epiry datebefore i!troductio!.before i!troductio!.

()e patie!t #ust !ot be aba!do!ed.()e patie!t #ust !ot be aba!do!ed. 4o fe#ale patie!t s)ould be ea#i!ed4o fe#ale patie!t s)ould be ea#i!ed

%it)out a!y fe#ale atte!da!t.%it)out a!y fe#ale atte!da!t. A!aest)esia s)ould be gi&e! by a 3ualified A!aest)esia s)ould be gi&e! by a 3ualified

perso!.perso!.

4/0/+ =6A+A4(// A C6+/.4/0/+ =6A+A4(// A C6+/.


47/59

$1O(OCO+ 9O1 $O+ICE CA,E, H$1O(OCO+ 9O1 $O+ICE CA,E, H

1A$E/,EA+ A,,A+(.1A$E/,EA+ A,,A+(.

A patient )hen comes to E1/O$D of @ovt. A patient )hen comes to E1/O$D of @ovt.'ospital C/O any in"ury/Accidental/,elf-'ospital C/O any in"ury/Accidental/,elf-Infected/'omicidal/$oisoning/,e* assault/#urnInfected/'omicidal/$oisoning/,e* assault/#urnin"ury etc. proper reporting in papers suppliedin"ury etc. proper reporting in papers suppliedfrom $olice Dept. the named as indoor $olicefrom $olice Dept. the named as indoor $olice

cases/outdoor police cases )here history ta!encases/outdoor police cases )here history ta!enand other points are )ritten.and other points are )ritten.

(he form should be properly filled up )ith(he form should be properly filled up )ithsignature of patient/patient party and )itnesssignature of patient/patient party and )itnessshould be ta!en mar!s of identification of patientshould be ta!en mar!s of identification of patientshould be noted.should be noted.

(he si>e of in"ury in )hich part of the body the(he si>e of in"ury in )hich part of the body thein"ury is present. Age of in"ury type of )eaponin"ury is present. Age of in"ury type of )eaponused should be noted.used should be noted.

If there are minor in"ury patient should beIf there are minor in"ury patient should betreated properly at E1 )ith advice to attendtreated properly at E1 )ith advice to attend,O$D/O$D ne*t morning and or to attend E1 in,O$D/O$D ne*t morning and or to attend E1 in


48/59

f patie!t is u!co!scious a!df patie!t is u!co!scious a!d

u!k!o%! t)e!u!k!o%! t)e!

4a#e of perso!s broug)t t)e patie!t4a#e of perso!s broug)t t)e patie!ts)ould be !oted %it) full address a!d t)eirs)ould be !oted %it) full address a!d t)eir

sig!ature s)ould be take!.sig!ature s)ould be take!. ()e &aluable #aterials %it) t)e patie!t()e &aluable #aterials %it) t)e patie!t

s)ould be sei5ed. ()ese s)ould bes)ould be sei5ed. ()ese s)ould be

properly packed labeled a!d )a!ded o&erproperly packed labeled a!d )a!ded o&erto ard Master %it) records kept i! t)eto ard Master %it) records kept i! t)e

%ard.%ard.

$t)er special poi!ts %)ic) s)ould$t)er s

pecial poi!ts %)ic) s)ould


49/59

$t)er special poi!ts %)ic) s)ould$t)er special poi!ts %)ic) s)ould

be do!e i! t)e %ard.be do!e i! t)e %ard.

After recei&i!g t)e patie!t i! t)e %ard t)e doctor After recei&i!g t)e patie!t i! t)e %ard t)e doctora!d 4urse s)ould !ote for a!d 4urse s)ould !ote for Air%ay if obstructio!, proper #a!age#e!t Air%ay if obstructio!, proper #a!age#e!t

Bleedi!g if prese!t, proper #a!age#e!tBleedi!g if prese!t, proper #a!age#e!t Cardiac co!ditio! of t)e )eart s)ould be !oted %it)Cardiac co!ditio! of t)e )eart s)ould be !oted %it)B.P.Pulse.B.P.Pulse.

()e %eapo! s)ould be sei5ed. t s)ould be()e %eapo! s)ould be sei5ed. t s)ould be!oted t)at %)et)er t)e patie!t co#e alo!e or!oted t)at %)et)er t)e patie!t co#e alo!e or

%it) so#e perso!s.%it) so#e perso!s. f police perso!!el broug)t t)e patie!t t)e! )isf police perso!!el broug)t t)e patie!t t)e! )is

!a#e s)ould be %ritte! i! t)e for#.!a#e s)ould be %ritte! i! t)e for#.


50/59

1A$E/,EA+ A,,A+(1A$E/,EA+ A,,A+(

()e &icti#s a!d accused s)ould be ea#i!ed as per()e &icti#s a!d accused s)ould be ea#i!ed as per%ritte! prayer ora!d order fro# Ho!orable Magistrate%ritte! prayer ora!d order fro# Ho!orable MagistrateS.D.G.M.E.S.D.G.M.E.

()e %ritte! co!se!t of &icti# a!d accused #ust be()e %ritte! co!se!t of &icti# a!d accused #ust betake! i! for#.take! i! for#.

Accordi!g to t)e Bureau of Police researc) a!d Accordi!g to t)e Bureau of Police researc) a!dDe&elop#e!t t)e !u#ber of rape cases per lak)De&elop#e!t t)e !u#ber of rape cases per lak)populatio! )as rise! co!ti!uously i! !dia o&er t)e year,populatio! )as rise! co!ti!uously i! !dia o&er t)e year,

t)e )ig)est &olu#e of rape cases %as registered i! Sikki#t)e )ig)est &olu#e of rape cases %as registered i! Sikki#follo%ed by Ga##u a!d Kas)#ir, Mad)ya Prades), Assa#follo%ed by Ga##u a!d Kas)#ir, Mad)ya Prades), Assa#a!d est Be!gal.a!d est Be!gal.

A#o!g t)e #a;or cities i! !dia Del)i )as s)o%! t)e A#o!g t)e #a;or cities i! !dia Del)i )as s)o%! t)e)ig)est !u#ber of rape cases i! o!e year follo%ed by)ig)est !u#ber of rape cases i! o!e year follo%ed byBo#bay co#pared to ot)er #etropolita! cities i! t)eBo#bay co#pared to ot)er #etropolita! cities i! t)e%orld.%orld.


51/59

)at is +ape)at is +ape

+ape is defi!ed as a! u!la%ful car!al k!o%ledge+ape is defi!ed as a! u!la%ful car!al k!o%ledgeof a fe#ale for a!d agai!st )er %ill.of a fe#ale for a!d agai!st )er %ill.

Car!al k!o%ledge is defi!ed as pe!etratio! ofCar!al k!o%ledge is defi!ed as pe!etratio! ofge!italia !o #atter )o% slig)t by t)e pe!isge!italia !o #atter )o% slig)t by t)e pe!isoccurs %)ile t)e fe#ale is sleepi!g u!co!sciousoccurs %)ile t)e fe#ale is sleepi!g u!co!scious

or u!der t)e i!flue!ce of alco)ol or drugs.or u!der t)e i!flue!ce of alco)ol or drugs.

A #ale %)o is seually assaulted is sodo#i5ed. A #ale %)o is seually assaulted is sodo#i5ed. Sodo#y is oral or a!al pe!etratio!.Sodo#y is oral or a!al pe!etratio!.


52/59

4ursing Alert4ursing Alert '-'-

()e #a!age#e!t of t)e seual assault is()e #a!age#e!t of t)e seual assault isi#porta!t but i##ediate p)ysical )ealt) s)ouldi#porta!t but i##ediate p)ysical )ealt) s)ouldbe e!sured first.be e!sured first.

A co#plete pri#ary a!d focused assess#e!t A co#plete pri#ary a!d focused assess#e!t

s)ould take place bei!g alert for sig!s of i!ter!als)ould take place bei!g alert for sig!s of i!ter!al)ae#orr)age, s)ock or respiratory distress but)ae#orr)age, s)ock or respiratory distress but&icti# is sufferi!g fro# trau#a i! t)e for# of&icti# is sufferi!g fro# trau#a i! t)e for# ofp)ysical assault t)e trau#a s)ould be #a!agedp)ysical assault t)e trau#a s)ould be #a!agedi! t)e order of establis)ed priorities.i! t)e order of establis)ed priorities.

Most e#erge!cy depart#e!t )a&e co##erciallyMost e#erge!cy depart#e!t )a&e co##erciallyprepared rape e&ide!ce collectio! kits as %ell asprepared rape e&ide!ce collectio! kits as %ell as%ritte! protocols for t)e treat#e!t of i!;uries,%ritte! protocols for t)e treat#e!t of i!;uries,legal docu#e!tatio! a!d seually tra!s#ittedlegal docu#e!tatio! a!d seually tra!s#itted

disease a!d preg!a!cy pre&e!tio!.disease a!d preg!a!cy pre&e!tio!.


53/59

Intervie)ing the patient 8-Intervie)ing the patient 8-

Co!se!t s)ould be obtai!ed for t)e ea#i!atio!Co!se!t s)ould be obtai!ed for t)e ea#i!atio!of collecti!g of s%abe&ide!ce for release ofof collecti!g of s%abe&ide!ce for release of

i!for#atio! to la% e!force#e!t age!cies.i!for#atio! to la% e!force#e!t age!cies. +ecord )istory of e&e!t i! t)e patie!t


54/59

Intervie)ing the patient 8-Intervie)ing the patient 8-

+ecord ti#e of ad#issio!, ti#e of ea#i!atio!,+ecord ti#e of ad#issio!, ti#e of ea#i!atio!,date a!d ti#e of seual assault a!d t)edate a!d ti#e of seual assault a!d t)eappeara!ce of t)e patie!t.appeara!ce of t)e patie!t.

Docu#e!t a!y e&ide!ce of trau#a Docu#e!t a!y e&ide!ce of trau#a dislocatio!, bruises, laceratio!, secretio!, tor!dislocatio!, bruises, laceratio!, secretio!, tor!a!d bloody clot)i!g.a!d bloody clot)i!g.

+ecord e#otio!al state.+ecord e#otio!al state. All collected sa#ples * records to be All collected sa#ples * records to be

e!&eloped by sealed.e!&eloped by sealed.


55/59

Intervention 8 $reparing forIntervention 8 $reparing for

physical e*aminationphysical e*amination

Assist t)e patie!t to u!dress o&er a s)eet large piece Assist t)e patie!t to u!dress o&er a s)eet large pieceof paper to obtai! debris.of paper to obtai! debris.

Protect patie!t agai!st seually tra!s#itted diseasesProtect patie!t agai!st seually tra!s#itted diseases

suc) as go!orr)oea, H..0. etc.suc) as go!orr)oea, H..0. etc. ##ediately obtai!ed positi&e s%ab take! i! t)e##ediately obtai!ed positi&e s%ab take! i! t)e

i##ediate post rate period %ill o!ly reflect eisti!gi##ediate post rate period %ill o!ly reflect eisti!gdiseaseE.diseaseE.

Place eac) ite# of clot)i!g i! a separate paper bagPlace eac) ite# of clot)i!g i! a separate paper bag

plastic bags pro#ote #oisture rete!tio! %)ic) #ayplastic bags pro#ote #oisture rete!tio! %)ic) #aylead to for#atio! of #old a!d #ilde% %)ic) ca!lead to for#atio! of #old a!d #ilde% %)ic) ca!destroy e&ide!ceE.destroy e&ide!ceE.

"abel bags appropriately ' gi&e to appropriate la%"abel bags appropriately ' gi&e to appropriate la%e!force#e!t aut)orities a!d )as to be sealede!force#e!t aut)orities a!d )as to be sealed


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$hysical E*amination$h ysical E*amination..

/a#i!e t)e patie!t fro# )ead to toeE for i!;ury/a#i!e t)e patie!t fro# )ead to toeE for i!;uryespecially to t)e )ead, !eck, breasts, t)ig), back a!despecially to t)e )ead, !eck, breasts, t)ig), back a!dbuttocks.buttocks.

Assess for eter!al e&ide!ce of trau#a bruises, Assess for eter!al e&ide!ce of trau#a bruises,laceratio!, stab %ou!dsE.laceratio!, stab %ou!dsE. !spect fi!gers for broke! !ails a!d tissue a!d foreig!!spect fi!gers for broke! !ails a!d tissue a!d foreig!

#aterials u!der !ails.#aterials u!der !ails.

Docu#e!t e&ide!ce of trau#a %it) body diagra#s orDocu#e!t e&ide!ce of trau#a %it) body diagra#s orp)otograp)s.p)otograp)s.

Assist i! co!ducti!g oral ea#i!atio! to deter#i!e Assist i! co!ducti!g oral ea#i!atio! to deter#i!esecretio! status of patie!t co#pared %it) t)at ofsecretio! status of patie!t co#pared %it) t)at ofassaila!t.assaila!t.

obtai! a sali&a speci#e!obtai! a sali&a speci#e!

take prescribed cultures of gu# a!d toot) areas.take prescribed cultures of gu# a!d toot) areas.


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$roviding follo)-up services.$roviding follo)-up services.

Make a! appoi!t#e!t for follo% up sur&eilla!ceMake a! appoi!t#e!t for follo% up sur&eilla!cefor preg!a!cy, seually tra!s#itted disease a!dfor preg!a!cy, seually tra!s#itted disease a!dH0 cou!seli!g.H0 cou!seli!g.

()e patie!t s)ould be acco#pa!ied by fa#ily()e patie!t s)ould be acco#pa!ied by fa#ily#e#ber or frie!d %)e! lea&i!g t)e )ealt) care#e#ber or frie!d %)e! lea&i!g t)e )ealt) carefacility.facility.

!for# t)e patie!t for cou!seli!g ser&ices to!for# t)e patie!t for cou!seli!g ser&ices topre&e!t lo!g ter# psyc)ological effects.pre&e!t lo!g ter# psyc)ological effects.Cou!seli!g ser&ices s)ould be #ade a&ailable toCou!seli!g ser&ices s)ould be #ade a&ailable tot)e fa#ily.t)e fa#ily.

Obtaining +aboratoryObtaini

ng +aboratory


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Obtaining +aboratoryObtaining +aboratory

,pecimen,pecimen

Collect &agi!al aspiratio! %)ic) is ea#i!e forCollect &agi!al aspiratio! %)ic) is ea#i!e forprese!ce or abse!ce #otile!o!-#otile sper#.prese!ce or abse!ce #otile!o!-#otile sper#.

6se sterile s%ab to dra% fro# &agi!al pool for6se sterile s%ab to dra% fro# &agi!al pool for

acid p)osp)atase, blood group, a!tige! ofacid p)osp)atase, blood group, a!tige! ofse#e! a!d precipitatio! test agai!st )u#a!se#e! a!d precipitatio! test agai!st )u#a!sper# a!d blood.sper# a!d blood.

label all speci#e!s %it) !a#e of patie!t, date,label all speci#e!s %it) !a#e of patie!t, date,ti#e of collectio!, body area fro# %)ic)ti#e of collectio!, body area fro# %)ic)speci#e! %as obtai!ed a!d !a#es of perso!!elspeci#e! %as obtai!ed a!d !a#es of perso!!elcollecti!g speci#e!s to preser&e c)ai! ofcollecti!g speci#e!s to preser&e c)ai! ofe&ide!ce, gi&e to desig!ated perso! cri#ee&ide!ce, gi&e to desig!ated perso! cri#elaboratoryE etc. a!d obtai! a! ite#i5ed receipt.laboratoryE etc. a!d obtai! a! ite#i5ed receipt.


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E*amination of the ?ictimE*amination of the ?ictim '' t #ust be re#e#bered t)at t)e police or courtt #ust be re#e#bered t)at t)e police or court)as !o po%er of co#pelli!g a %o#e! to s)o%)as !o po%er of co#pelli!g a %o#e! to s)o%t)e pri&ate parts of )er perso! for ea#i!atio!t)e pri&ate parts of )er perso! for ea#i!atio!

of #edical practitio!er, #ale or fe#ale.of #edical practitio!er, #ale or fe#ale. Conclusion 8Conclusion 8 +ape )as bee! described as '-+ape )as bee! described as '- 1 1 !ot a! act of se but a! act of &iole!ce %it)!ot a! act of se but a! act of &iole!ce %it)

se as t)e pri#ary %eapo!2. t #ay lead to ase as t)e pri#ary %eapo!2. t #ay lead to a%ide &ariety of p)ysical a!d psyc)ological%ide &ariety of p)ysical a!d psyc)ologicalreactio!s.reactio!s.

duty o fdoctors -medicolegal aspect doc pov

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