Puneet Setia

Filicide-suicide: An unusual variant of dyadic death

Dyadic suicides may be committed simultaneously or one after another by two or more people who may or may not have made a prior pact. The perpetrator is usually male and their victims female, and generally their intimate partners, with children less commonly involved. Another distinct type of homicide-suicide is the killing of children by a parent (filicide-suicide). The terms ‘maternal filicide’ or ‘paternal filicide’ are used respectively when the perpetrator is the mother or the father of the victim. We report a rare case of maternal filicide, where the mother drowned her three children and then herself in the same water tank. The case highlights the extreme stress put on a mother of girls in a patriarchal society where there is an overriding expectation and wish for sons. The resulting pressure on this mother for her ‘failure’ caused her to take her own and her childrens lives.

Estimation of stature from sternum – Exploring the quadratic models

Identification of the dead is significant in examination of unknown, decomposed and mutilated human remains. Establishing the biological profile is the central issue in such a scenario, and stature estimation remains one of the important criteria in this regard. The present study was undertaken to estimate stature from different parts of the sternum. A sample of 100 sterna was obtained from individuals during the medicolegal autopsies. Length of the deceased and various measurements of the sternum were measured. Students t-test was performed to find the sex differences in stature and sternal measurements included in the study. Correlation between stature and sternal measurements were analysed using Karl Pearsons correlation, and linear and quadratic regression models were derived. All the measurements were found to be significantly larger in males than females. Stature correlated best with the combined length of sternum, among males (R = 0.894), females (R = 0.859), and for the total sample (R = 0.891). The study showed that the models derived for stature estimation from combined length of sternum are likely to give the most accurate estimates of stature in forensic case work when compared to manubrium and mesosternum. Accuracy of stature estimation further increased with quadratic models derived for the mesosternum among males and combined length of sternum among males and females when compared to linear regression models. Future studies in different geographical locations and a larger sample size are proposed to confirm the study observations.

Euthanasia: Global Scenario and Its Status in India

The legal and moral validity of euthanasia has been questioned in different situations. In India, the status of euthanasia is no different. It was the Aruna Ramachandra Shanbaug case that got significant public attention and led the Supreme Court of India to initiate detailed deliberations on the long ignored issue of euthanasia. Realising the importance of this issue and considering the ongoing and pending litigation before the different courts in this regard, the Ministry of Health and Family Welfare, Government of India issued a public notice on May 2016 that invited opinions from the citizens and the concerned stakeholders on the proposed draft bill entitled The Medical Treatment of Terminally Ill Patients (Protection of Patients and Medical Practitioners) Bill. Globally, only a few countries have legislation with discreet and unambiguous guidelines on euthanasia. The ongoing developments have raised a hope of India getting a discreet law on euthanasia in the future.

A rare fatality due to calcified stylohyoid ligament (Eagle syndrome)

The elongation or calcification of the stylohyoid ligament that leads to pressure symptoms, or entrapment of nearby glossopharyngeal nerve or carotid artery, is known as Eagle syndrome. A PubMed search leads to finding of rare fatality among the 49 reported cases. In the present case, the deceased was a 40-year-old male who choked on his food. We hypothesise that the impaction of food in the upper respiratory tract, as well as the inability to intubate the person, were both the result of the calcified stylohyoid ligament.

Photography in Forensic Medicine: Guidelines and Recommendations in the Indian Perspectiv

Photography has been an integral part of Forensic Medicine since time immemorial. Since these photographs are predominantly used for legal purposes, they should be as accurate and informative as possible. Photographs are not only important to document injuries, but also to document absence of injuries (negative photographs). The major factor with photography in Forensic Medicine is that the photographs are not repeatable and also that one copy has to be submitted to the courts. Therefore utmost care is required when the photographs are taken and preserved. A good photograph not only gives detailed information of the incident but also assists the court in administration of justice. The present paper not only addresses common problems faced by the Forensic Medicine experts while taking photographs, but also provides guidelines and technical suggestions for better photography. Along with that new concepts in medical photography are also discussed.

Can a Child Above 12 years Give Consent for Routine, Elective Surgery? Yes, Says the Indian Penal Code

To the Editor: The role of consent in legal matters, specially with respect to consent in medical practice, has been described in sections 87 to 90 of the Indian Penal Code (IPC) [1]. Section 87 : Act not intended and not known to be likely to cause death or grievous hurt, done by consent .—Nothing which is not intended to cause death, or grievous hurt, and which is not known by the doer to be likely to cause death or grievous hurt, is an offence by reason of any harm which it may cause, or be intended by the doer to cause, to any person, above eighteen years of age, who has given consent, to take the risk of that harm. Section 88 : Act not intended to cause death, done by consent in good faith for person’s benefit .—Nothing, which is not intended to cause death, is an offence by reason of any harm which it may cause, or be intended by the doer to cause, or be known by the doer to be likely to cause, to any person for whose benefit it is done in good faith, and who has given a consent, whether express or implied to suffer that harm, or to take the risk of that harm. Section 89 : Act done in good faith for benefit of child or insane person, by or by consent of guardian .—Nothing which is done in good faith for the benefit of a person under twelve years of age, or ......., is an offence by reason of any harm which it may cause, or be intended by the doer to cause or be known by the doer to be likely to cause to that person. Section 90 : Consent known to be given under fear or misconception.—A consent is not such a consent as is intended by any section of this Code Consent of child ..-unless the contrary appears from the context, if the consent is given by a person who is under twelve years of age . The age of consent as per Section 87 of IPC is eighteen years, but it is applicable in only those cases where the act is not known to cause death. Any operative procedure has the potential to cause grievous hurt and death to the individual. Therefore, by corollary, any act, that can cause death, will not fall under the purview of this section. This shows that medical profession is out of the gambit of section 87 of IPC. In section 88 of IPC the words “not known to be likely to cause death or grievous hurt” are missing , as compared to section 87 of IPC. This shows that in section 87 IPC, the condition is “not known to cause grievous hurt or death”, while in section 88, “there is no intention to cause death or grievous hurt, but it can happen”. Another major difference is that in section 88, there is mention of the term “done by consent in good faith for person’s benefit”, which is missing in section 87. Any medical procedure, that is done on a human being, is intended to be done for the benefit of that person. This shows that section 87 IPC, where age of consent is 18 y, is not applicable on medical professionals. In both sections 89 and 90, the child has been described as a personwho is less than 12 y of age, and that consent is not valid only if the child is less than 12 y of age , and not 18 y of age. Since these sections succeed section 88, the age of consent as given in these two sections is valid and not in section 87, which precedes section 88, this is the general rule of law. Therefore we can say that the age of consent for any procedure, in India, is 12 y and not 18 y.