Kumar Binay, Singh Nilabh P, Singh Nawal, Goel Nikhil
Forensic Medicine & Toxicology, All India Institute of Medical Sciences, Patna, Patna, IND.
Cureus. 2022 Jul 12;14(7):e26775. doi: 10.7759/cureus.26775. eCollection 2022 Jul.
Background This study is intended to compare the Indian system of inquests, which is conducted by nonscientific people like police and magistrate (who are compulsorily neither qualified in science nor in law), and the medical examiner system of the USA which is done by doctors specialized in forensic medicine/pathology. Aims The goal of this study was to see if bringing in a medical examiner system makes a difference in determining the cause, manner, and time of death as compared to the current system of conducting inquests and autopsies by two different agencies, namely, the police and forensic medicine experts. Material and methods In the present study, a peculiar case (in which the police were clueless and the autopsy surgeon was confused during the autopsy) was chosen for getting an expert opinion from 50 forensic medicine experts from different parts of the country in which police were not clear regarding cause, manner and time of death, but later after a crime scene visit by forensic medicine experts who had conducted the autopsy, it was clarified. Opinion regarding the cause, manner, and time since death was taken from 50 medico-legal experts in two steps. In the first step, only the autopsy finding and history obtained from police were provided and in the second step, additional information obtained from the crime scene visit by forensic medicine experts was provided. The sampling method was purposive sampling. Result In the cause of death, Cohen's Kappa coefficient was 0.30% (z-statistic = 3.87, p-value = 0.0001), indicating a significantly low agreement between the first and second steps by the experts, as their decision changed after getting the evidence of the crime scene visit. In the manner of death, Cohen's Kappa coefficient was 0.06% (z-statistic = 0.66, p-value = 0.2540) indicating a very low agreement between the first and second opinions by the experts as their decision regarding the suspected manner of death changed drastically after getting the evidence of crime scene. In the time since death, Cohen's Kappa coefficient was 0.5531% (z-statistic = 7.25, p-value = 0.0001), which also indicates significant difference. Conclusion Therefore, in this study, the usefulness of the medical examiner system in the Indian setting has been proved beyond doubt expecting drastic improvement in criminal investigation by introducing the medical examiner system in India.
背景 本研究旨在比较印度的死因调查系统，该系统由警察和治安法官等非专业人员进行（他们既没有科学资质也没有法律资质），以及美国的法医系统，该系统由法医/病理学专业医生进行。目的 本研究的目的是探讨引入法医系统与目前由警察和法医专家这两个不同机构进行死因调查和尸检的系统相比，在确定死亡原因、方式和时间方面是否有差异。材料和方法 在本研究中，选择了一个特殊案例（在该案例中，警察毫无头绪，尸检外科医生在尸检过程中感到困惑），以征求来自该国不同地区的50位法医专家的意见，在该案例中，警察对死亡原因、方式和时间不清楚，但在进行尸检的法医专家对犯罪现场进行勘查后，情况得以澄清。分两步从50位法医学专家那里获取关于死亡原因、方式和死亡时间的意见。第一步，仅提供尸检结果和从警方获得的病史，第二步，提供从法医专家对犯罪现场勘查中获得的额外信息。抽样方法为目的抽样。结果 在死亡原因方面，科恩kappa系数为0.30%（z统计量=3.87，p值=0.0001），表明专家在第一步和第二步之间的一致性显著较低，因为他们在获得犯罪现场勘查证据后改变了决定。在死亡方式方面，科恩kappa系数为0.06%（z统计量=0.66，p值=0.2540），表明专家在第一种和第二种意见之间的一致性非常低，因为他们对可疑死亡方式的决定在获得犯罪现场证据后发生了巨大变化。在死亡时间方面，科恩kappa系数为0.5531%（z统计量=7.25，p值=0.0001），这也表明存在显著差异。结论 因此，在本研究中，法医系统在印度背景下的有用性已得到毫无疑问的证明，预计通过在印度引入法医系统，刑事调查将有大幅改善。
