A few short notes in forensic medicineM. Harini PriyadharshiniII MBBS

JUDICIAL HANGING

Judicial hangingHanging is the suspension of a

person by a ligature.Hanging has been a common

method of capital punishment since medieval times, and is the official execution method in many countries and regions today.

In India legal death sentence is carried out by hanging the criminal.

A rope to allow a drop of 5 to 7 meters (according to the person’s build and age) is looped around the neck.

The placement of the knot in the sub-mental position is said to be more effective

Death is usually by a fracture dislocation noramlly at the leve of C2 and C3 or C3 and C4 vertebrae.

Contd., With proper judicial hanging there is a

rupture of brainstem between Pons and medulla.

This results : 1. Instantaneous and irreversible loss of

consciousness2. Irreversible apnea.

Heart beats and respiratory movements may continue for 15 min approx.

The victim is found to have a epileptic attack due to a sudden and complete loss of oxygen to the brain.

Classification of hanging

Complete •When the whole body hangs off the ground and the entire weight of the victim is suspended at the neck, the hanging is said to be complete

Incomplete •Incomplete hangings imply that some part of the body is touching the ground and that the weight of the victim is not fully supported by the neck

Methods of judicial hanging

Suspension

Short drop

Standard drop

Long drop

Suspension Suspension, like the short drop,

causes death by using the weight of the body to tighten the trachea with the noose.

Short dropThe short drop is performed by

placing the condemned prisoner on the back of a cart, horse, or other vehicle, with the noose around the neck.

The object is then moved away, leaving the person dangling from the rope

Death by hanging - MechanismsClosure of carotid arteries causing

cerebral ischemiaClosure of the jugular veinsInduction of carotid sinus reflex death,

which reduces heartbeat when the pressure in the carotid arteries is high, causing cardiac arrest

Breaking of the neck (cervical fracture) causing traumatic spinal cord injury or even decapitation

Closure of the airway

BRAIN STEM DEATH

Brain stem death ?Brain stem death is a clinical

syndrome defined by the absence of reflexes with pathways through the brain stem in a deeply comatose, ventilator-dependent, patient.

The concept of brain stem death legally accepted in India

permits the diagnosis and certification of death on the premise that a person is dead when consciousness and the ability to breathe are permanently lost, regardless of continuing life in the body and parts of the brain, and that death of the brain stem alone is sufficient to produce this state

Transplantation of Human Organ Act of 1994to make a diagnosis of brainstem death

requires a panel of four doctors consisting of:

1. the doctor in charge of the patient, 2. the doctor in charge of the hospital where the

patient was treated3. independent specialist of unspecified specialty 4. neurologist or a neurosurgeon

The burden of proof rests with the specialist of the neurosciences, with the other members confirming the diagnosis

Tests done to document absence of brainstem functionpupillary reflex doll’s head eye movementcorneal reflex (both sides) gag reflexcough (tracheal)eye movements on caloric testing

bilaterallyabsence of motor response in any

cranial nerve distribution apnea test.

SECTION 84 IPC

Section 84 IPCAct of a person of unsound

mind.-- Nothing is an offence which is done by a person who, at the time of doing it, by reason of unsoundness of mind, is incapable of knowing the nature of the act, or that he is doing what is either wrong or contrary to law.

TEST FOR LIVE BIRTH

Live birth ?In human reproduction, a live

birth occurs when a fetus, whatever its gestational age, exits the maternal body and subsequently shows any sign of life, such as voluntary movement, heartbeat, or pulsation of the umbilical cord, for however brief a time and regardless of whether the umbilical cord or placenta are intact.

Tests for live birthShape of chest : before respiration the chest

is flat, after respiration the chest becomes arched of drum shaped

Position of the diaphragm 4th or 5th rib – before

respiration 6th or 7th rib after respiration

Lungs: Volume: unrespired lungs appear

smaller Margin: before respiration margins are

sharp Consistency: before respiration lungs

are dense and firm Colour and expansion of air vesicles Gas Blood in the lung beds Weight

Changes in the stomach and intestine: they float in water if respiration has taken place.

Changes in the middle ear: before birth the middle ear

contains gelatinous embryonic connective tissue

Other signs:Blood: nucleated RBC usually

disappear within 24 hrsMeconium: completely excreted within

24 to 48 hrsCaput succedaneum: gradually

disappears within a week after birthSkin: skin becomes darker on 2nd or 3rd

dayUmbilical cord: blood clots in the cut

end 2hrs after birthCirculation: contraction of umbilical

arteries starts in 10 hours and are completely closed by 3rd day.

Live birth is probable when All lobes of lung are fully

expandedThere is edema of lung especially

grossAn alveolar duct membrane is

present and has widespread distribution in the lungs.

Contusions of the lung are present

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