Part I
Introduction and Evolution
Medicine and Law were wedded from the earliest times, perhaps from the perceived necessity of protecting the community from the irresponsible acts of unqualified medical practitioners and quacks. Religion and superstition were intimately entangled with the medical art for time immemorial and this has also rubbed on to the dealings between those practicing medicine and those practicing law. From this interaction between these two professions of medicine and of law, emerged the specialist discipline and later the academic subject, forensic medicine.
DEFINITION
Forensic medicine is defined as that branch of medicine, which deals with the application of medical and paramedical scientific knowledge to the knowledge of both civil and criminal law in order to aid administration of justice.1–10
The word forensic is derived from the Latin word forensis, which implies something pertaining to the forum. In ancient Rome, the ‘forum’ was the communal meeting or market place where those with public responsibility discussed civic and legal matters, and where justice was dispensed and indeed seen by the public to be dispensed.2,4,7–10
In ancient India also, settlement of disputes was done by Panchayat where a group of panchas or five village elders were authorized to settle the dispute.6,8 Thus, the word forensic essentially conveys any issue related to the debate in relation to medical matters that can occur in a court of law.
FORMER TERMINOLOGIES
Forensic medicine was earlier known as Medical Jurisprudence (Juris meaning Law and prudentia meaning knowledge). Indeed the first university chairs in this subject also bear the additional title of Medical Police.3 The specialist in this discipline was supposed to be knowledgeable in matters of public health and hygiene, industrial health, epidemics of disease and other matters, which nowadays pertain together to the specialty of Public Health Medicine. For this reason also Social Medicine (Medicina Socialis) was thought to fall within the remit of the same specialist and this is still the case in the continent of Europe, e.g. France, Portugal and Italy.1–3
Social medicine pertains to medical matters related to employment and includes such other, matters as disease and injuries acquired at work, compensation for such, through insurance companies, and so on. In the Anglo-Saxon scheme of things and in those other systems derived from it, the specialist in forensic medicine does not have this additional clinical and community-related remit.
This discipline has also been termed as State Medicine, which was the code of medical ethics and practice developed to regulate the code of conduct for registered medical practitioners, to guide and regulate the professional activities of the doctors and to standardize and supervise the medical profession. In the continent of Europe, the term Legal Medicine is often preferred and accepted to explain the interaction of professions of medicine and law.3–5
This range in terminology should direct the reader to the nuances of practice that exist worldwide in this specialty. It is, perhaps more important that the specialty is not taken to include forensic science as an integral and essential part of it. Although in a number of countries scientists and medical practitioners rub shoulders with each other and often work in the same department, there should not be a conscious or subconscious trend to mix the two specialists: Doctors may be scientists, but are not necessarily so. Doctors offer opinions based on their observations. In the same vein scientists are rarely medical men, but they measure accurately the characteristics of physics, chemistry, biology, etc. in which they are involved. To ensure that the best advice is given to lawyers, it is essential that our legal colleagues and the courts are made well aware of such a distinction and the reasons and situations in which it should be made.
The two main aspects of legal medicine are pathology and clinical work. Forensic Pathology is practised by those who are able to carry out autopsies and who have the appropriate level of knowledge and expertise to distinguish the various pathological processes which may occur in the human body as a consequence of aging, natural processes, disease and injuries of various types.7–10 The Clinical Forensic Medicine deals with those who are still alive and on whom a medicolegal opinion is required. This includes those who have been traumatised physically and/or sexually, but who have not succumbed to their injuries, those who are under the influence of alcohol and/or drugs in relation to such matters as driving, human rights abuses, etc.7–10 The latter medical practitioners have been referred to as police surgeons, casualty surgeons, forensic medical examiners, and this branch of legal medicine is often specifically referrd to as forensic medicine.1–10
Thus, although medical practitioners have given evidence in the courts and professional opinions of their findings over 2the years since the dawn of history, the academic and specialised status of this specialty and its development as a single specialised discipline with its own teaching programmes, diplomas and certificates, and curriculum of postgraduate specialisation is of only recent origin. In most countries this subject appropriately now constitutes an integral part of undergraduate and postgraduate medical curricula, and it is furthermore fully integrated into the training of police officers, lawyers, the judiciary and others.
REFERENCES
- Britain RP. Origins of Legal Medicine. Leges Barbarorum. Medicolegal Journal, 2003.
- Cameron JW. The medicolegal expert. Med Sci Law 1980;20(1):3–13.
- Camps, Francis E (Eds). Gradwohl's Legal Medicine (3rd edn). Year Book Medical Publishing Company, Chicago: 1994.
- Curran WJ. History and Development. In Modern Legal Medicine, Psychiatry and Forensic Medicine, WJ Curran, AL McCarry, LS Patty (Eds). Philadelphia, FA Davis: 1982.
- Edinburgh A. and C. Black Encyclopaedia Britannica, 1886, Vol XXI (9th edn). Article: Salic Law, 214.
- Mathiharan K, Patnaik AK. Modi's Medical Jurisprudenc and Toxicology. 23rd edn. Lexis Nexis Butterworths 2005.
- Mukharji JB. Forensic Medicine and Toxicology, Vol I, 2nd edn, Arnold Association, Kolkata, 2000.
- Rao NG. Forensic Medicine: Historical Perspectives (3rd edn), HR Publication Aid: Manipal, 2002.
- Rao NG. Forensic Pathology, 6th edn, HR Publication Aid, Manipal, 2002.
- Parikh CK. Parikh's Textbook of Medical Jurisprudence and Toxicology (6th edn) CBS, Mumbai, 2000.