Bridging the Forensic Divide: Empowering Private Medical Colleges to Conduct Autopsies

Need for Autopsy in every death –

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The Forensic Medicine fraternity in India stands majestically caparisoned with false dichotomy fallacy. It is praise-worthy that medico-legal autopsies are often indispensable towards getting justice in the criminal justice system. But unfortunately, reporting the final opinion after medico-legal autopsies is often plagued by undue delays. And in such scenarios, the legal maxim “Justice delayed is justice denied” is woefully evident. These inordinate delays often stem from overburdening of facilities in Government Medical Colleges and the perceived lack of Forensic Medicine experts in the country.

But that is simply not the case. There is abundant untapped manpower which, if utilised, will reduce the burden on the overworked Forensic Medicine experts in Government Medical colleges; Yes! it is the Forensic Medicine Experts in Private Medical Colleges.

Allowing Forensic Experts from Private Medical Colleges to perform autopsies is not a new or radical thought. In 2014, the Madras High Court had suggested the State Government to explore the feasibility of permitting private medical colleges to perform autopsies. They made this suggestion with the aim of relieving the congestion and workload in the mortuaries of Government hospitals.

At present, there are 25 private medical colleges in the State of Tamil Nadu only. In the year 2023, there were approximately more than 70,000 autopsies conducted in Tamil Nadu, of which 99% were done in Government centres. On an average, almost 10 + autopsies were performed per day in a Government Medical college in Tamil Nadu. Considering the faculty strength in these centres, this causes an unreasonable burden to be placed on these already overworked Forensic Medicine experts. Now, if the Government had permitted private medical colleges to conduct autopsies, the burden would have been shared by private medical colleges with qualified experts literally halving the burden on the Government experts. The same policy could easily be extrapolated to all the States of the country as well. Similarly, in the State of Kerala, there are 10 medical colleges in the Government sector, and 21 in the private sector. It is understandably demonstrating that distributing the burden of autopsies among 31 colleges rather than 10, would tremendously decrease the bottleneck experienced in obtaining autopsy reports.

Moreover, permission being granted to private medical colleges to conduct autopsies would also be extremely beneficial to the undergraduate medical students as well. As per the Graduate Medical Education Regulations (GMER) 2019 curriculum, each medical student is expected to observe at least 15 medico-legal autopsies as part of their training & the National Medical Commission (Compulsory Rotating Medical Internship) Regulations recommend that an intern should observe or preferably assist in a medico-legal autopsy. These measures are required since any registered medical practitioner (RMP), especially in rural India, may be called upon to perform a medico-legal autopsy and furnish a detailed report. This is only possible if all undergraduate medical students, especially those in private medical colleges are also given sufficient opportunities to witness autopsies.

Since in many states, medico-legal autopsies are conducted exclusively in Government medical colleges, the undergraduate medical students in private medical colleges are robbed of this opportunity to observe and learn. Considering the number of doctors graduating from private medical colleges which do not conduct autopsies, obviously would not have any knowledge regarding conducting autopsies. This is not an ideal situation.

Another unfortunate result of this disparity between Government and private medical colleges with respect to conducting autopsies is that very few medical graduates show an inclination to specialise in Forensic Medicine. With progressively fewer postgraduate students specializing in Forensic Medicine, the burden on existing Forensic experts is constantly increasing overworked Forensic Medicine experts performing autopsies with the assistance of unskilled workers creates a situation that is rife with the potential errors, which can lead to miscarriage of justice.

While insisting on performing autopsies in Government centres alone, the humanitarian aspect is often overlooked. Even when a private medical college with all the facilities and trained faculty for conducting the autopsy is present closer to the location of the deceased, the relatives are often forced to transport the body of their loved one to a government centre. The Government centre may be quite far away and/or understaffed. This leads to the added burden of expense to the family and delay in releasing the body to the family for funeral rites. The private medical colleges would be able to cater to these needs of the community around them, keeping in mind their social and religious customs.

Under the cadaver donor program in Tamil Nadu, if a private hospital has a brain-dead donor reported as a medico-legal case, they are authorized to perform the autopsy after retrieval of organs. This autopsy can be performed by any Forensic Medicine expert, or by a pathologist posted in Forensic Medicine department, or by any Government medical officer experienced in conducting post-mortem examinations.

Since such a practice is permitted by the state on humanitarian grounds, private medical colleges and hospitals with the requisite infrastructure and expertise should also be allowed to perform all autopsies and assist the state in administering justice. These are areas which need to be explored further in order to strengthen medico-legal work in India.

The Judiciary’s Perspective:

On 01^st. November, 2014 – a division bench of the Madras High Court comprising Justices S. Rajeswaran and P. N. Prakash gave the suggestion to the state government to explore the feasibility of permitting private medical college hospitals to perform autopsies on unidentified bodies; which will relieve the congestion in mortuaries in government hospitals; while issuing a set of directions to authorities relating to man missing cases and unidentified bodies.

Why did the Madras high court suggest allowing private medical college hospitals to perform autopsies on unidentified bodies?

To provide training opportunities for students in private medical colleges.

To relieve congestion in mortuaries in government hospitals.

To ensure immediate post-mortem examinations for all unidentified bodies.

To prevent private doctors from issuing bogus post-mortem certificates.

“Will not these private doctors become amenable to influence and issue bogus post-mortem certificates?” But the situation seems no better in the government hospitals either. “If videography of all post-mortems, whether done in government hospital or private hospital is made compulsory, such misadventures can be curtailed”, the bench added.

The bench said an apprehension was voiced that the state will not be able to take any action against a doctor of a private medical college, if the post-mortem certificate given by him was found to be bogus. It cited various sections under the Indian Penal Code dealing with furnishing false information and causing disappearance of evidence, among others that are to prosecute the doctor. The legislature can also bring in an amendment to the definition of “public servant” found in section 21 of IPC and in section 2 of the Prevention of Corruption Act, by including “The doctors who perform autopsy at the request of a police officer” so that the doctor can be prosecuted even under the Prevention of Corruption Act, the bench added.

To be continued…………………

Writer Suvro Sanyal

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