Virtually
every case of poisoning, whether acute or chronic, has medicolegal overtones.
Basically there are three categories of medicolegal cases: accidental, suicidal, and homicidal.
The vast majority constitute either accidental or suicidal poisoning, while
homicidal cases are quite rare. Whatever the nature, every hospital (Government
run or privately owned) is under a legal obligation to treat to the best
possible extent, and no case can be turned away on the pretext that the
hospital concerned is not “authorised” to handle medicolegal cases.* If
adequate facilities do not exist for proper treatment, the victim should be
administered first-aid and such other medical or surgical help that is possible
under the circumstances before referring him to the nearest hospital where
required facilities exist.
·
If a case of poisoning is
indubitably accidental or suicidal in nature, the attending doctor is under no
legal obligation to notify the police in case he is working in a private
hospital. But if the patient dies, the police has to be informed. Death
certificate must not be issued.
·
Doctors working in government
hospitals are required to report every case of poisoning regardless of the
nature, to the police.
·
All cases of homicidal poisoning
(definite or suspected) must be compulsorily reported to the police as per
section 39 of the Criminal Procedure Code (CrPC).
Failure todo so will make him culpable under section 176 of the Indian Penal Code
(IPC).
·
If the police require information on
any case of poisoning which is either suicidal or homicidal in nature, the
attending doctor has to divulge it. There is no scope for professional secrecy
in such matters (175 CrPC). If
information is witheld or wrong information is provided, the doctor becomes
culpable under section 202 and 193IPC respectively.
·
Every effort must be made by the
attending doctor to collect and preserve evidence suggestive of poisoning.
·
Deliberate omission to do so can
attract punishment under section 201 IPC.
·
Collect vomitus, faeces, stomach
washings, contami-nated food, incriminating substance, etc., and despatch the
same for chemical analysis to the nearest ForensicScience
Laboratory.
·
If a poisoned patient is conscious
but on the verge of death, record a dying declaration relating to the
circum-stances. It is preferable to call a magistrate for this purpose, but if
death appears imminent, or if there is likelihood of delay in the arrival of the
magistrate, the attending doctor must himself record the declaration as per
section 32, clause 1, of the Indian Evidence Act(IEA). Even when a declaration is taken down by
amagistrate, the presence of a doctor is desirable to certify that the dying
victim was in possession of his senses, and there was no clouding of judgement
or coherence which is sometimes encountered in the final moments before death.
·
If a patient dies before the exact
diagnosis could be made out, or he was brought dead to the hospital, the duty
doctor must notify the police who will in all probability order an autopsy to
be done. Death certificate must not be issued.
·
Detailed written records should be
made with respect to every case of poisoning and kept in safe custody.
·
If a doctor comes across a case of
food poisoning from a public eatery (canteen, café, restaurant, etc.), he must
notify the public health authority
concerned.
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