Social Aspects of Medico-Legal Cases

Social aspects of medico-legal
cases
Dr. Nirmal Krishnan M
Assistant Professor
Department of Forensic Medicine and Toxicology
Kasturba Medical College, MAHE, Manipal
Victimology
• It is a social science regarded as the study of the
victim.
• The current dominant view in victimology of a

bad offender and a good victim, of an innocent
victim and a guilty criminal, will slowly give way
to the more realistic and defensible view of two
humans being caught in a web of intricate social
relationship and human emotions. – Fattah 2000
Victimology and fraud
• Victims are often entitled to counterbalance
for the loss or harm they suffer.
• Its often in the form of monetary or other

forms of incentives which can be used as a
chance of abuse and can be used as a easy
ground for fraud.
Reinforcements
• Expectation of the society from victim is often
less.
• Often removal of the barriers of everyday
challenges
• Hence, establishing oneself as a victim is one

of the ways that someone can account for
personal failures
Some examples of reinforcements
• Students – illness, loss of a close relative,
personal tragedy, are allowed to retake exams,
submit assignments for making up attendance,
may get a sympathy in their grades often.
• The same is extended to the workplace when
they become employee. – Holstein and miller
1990
• Financial, caste, gender, religion based
reservations are other examples.
A doctor should know about
• Social aspects
• Ethical aspects
• Humanitarian aspects
• Legal aspects
• In victimisation for handling a victim.

Victims approaching a doctor can be of
• Physical assault
• Rape
• Attempted suicide
• Attempted homicide
• Domestic violence
• Dowry
Intimate Partner Violence (IPV)
• Jhonson’s typology of IPV
• Intimate terrorism : Mostly females are

victims
• Situational couple violence : equally males and
females
• Violent resistance : Mostly females are victims
Types of intimate partner abuse
• Rejection
• Degradation
• Terrorisation
• Social isolation
• Exploitation
• Emotional unresponsiveness
• Close confinement
Expected victim profile
• Confused, fearful, frustrated and angry
• Why this happened, and why it happened to them
• No knowledge of who or where to turn in the aftermath
of crime.
• Insecure and do not know who to trust or rely on for
support, understanding, and help
• Suffer physically, emotionally, psychologically and
financially from their victimization
• Burdened by the complexity of the criminal justice
system
Challenges faced by a doctor and law
enforcement agencies
• Victim profile is never straight forward.
• Victimization is never a matter happening to a
completely innocent, honest and law abiding person.
• A victim may claim innocence from his/her side but
in reality it is a complex interaction between two
human beings.
• It is about real people facing real life problem the
circumstances are often convoluted and never like a
laboratory condition.
Social Injuries
• Caused by society in the aftermath of the
crime.
• Treated insensitively or not receiving the
services and/or information that a victim
requires.
• A family member, a friend, a law enforcement
officer, prosecutor, a crisis counselor or a
victim services worker.
Secondary victimisation
• Victimization which occurs, not as a direct result of the criminal act,
but through the response of institutions and individuals to the victim.
• Example:
– refusal to recognize their experience as criminal victimization.
– intrusive or inappropriate conduct by police or other criminal justice
personnel
– the whole process of criminal investigation and trial (decisions about
whether or not to prosecute, the trial itself, the sentencing of the offender,
and his or her eventual release)
– victim perceives difficulties in balancing their rights with those of the
accused or the offender.
– criminal justice processes and procedures do not take the perspective of the
victim into account.
– relatives may have restricted access to the body of a
loved one due to hospital policies and procedures
– hurried schedule of the emergency room may affect a
sexual assault victim's privacy or sense of dignity
– School personnel may discount child disclosure of
abuse
– Doctors may not acknowledge signs of spouse abuse
– Spiritual leaders may attempt to guide victims into
paths of forgiveness or accommodation before they
are ready or against their wishes
– Intrusive or inappropriate investigation and filming,
photographing, and reporting by the media.
– Even agencies may have some policies and procedures
that lead to secondary victimization.
Attitude of the near and dear ones
• may wish to distance themselves from the
distress of the crime - blaming the victim for
what has occurred
• Victim's behaviour as having contributed to
• Deny the impact of the crime on the victim by
urging them to forget about the crime and “get
on with their lives''
• Families can be a particularly powerful influence
What do victims need after a crime is
committed?
• Need to feel safe as crime
• feelings of self-blame, anger, shame, sadness, or denial - emotional distress
• Victims should be able to express their emotions
• Have their feelings accepted and have their story heard by a non-judgmental
listener
• Victims may need to know “what comes next”
• Have concerns about their role in the investigation of the crime and in the legal
proceedings.
• Concerned about issues such as media attention
• Payment for health care or property damage
• Knowing what to expect in the aftermath of crime can help relieve anxiety
• Police, court and community based services

Recovering from Victimization
• Last for years following a crime
• Normal responses for people who have survived a
traumatic event
– Memories of the crime can trigger the long-term crisis reactions.
– Sensing (seeing, hearing, smelling, touching, tasting) something
similar to what the victim sensed during the crime.
– Media coverage of the crime or similar crimes.
– Anniversaries of the crime.
– Holidays or significant life events.
– Going through the criminal justice process.
– Going through civil proceedings.
Crimes and their impacts
• Physical assault
• Rape
• Attempted suicide
• Attempted homicide
• Domestic violence
• Dowry
• Apart from social impacts

– Impacts of physical injuries
– Psychological impact
– Economic impact
• Children at home
What can be done..
• Treated with compassion and respect for their
dignity
• Entitled to access to the mechanisms of justice and
to prompt redress
• Judicial and administrative mechanisms should be
established and strengthened - expeditious, fair,
inexpensive and accessible
• Informed of their rights in seeking redress
• Offenders or third parties - make fair restitution to
victims/their families/dependants
• Governments should review their practices, regulations and
laws
• States should endeavour to provide financial compensation
to:
(a) Victims who have sustained significant bodily injury or impairment
of physical or mental health as a result of serious crimes;
(b) The family, in particular dependants of persons who have died or
become physically or mentally incapacitated as a result of such
victimization.
• States should periodically review existing legislation and
practices.
False victimisation in the criminal trial
• False victimisation and fraud must be identified
and enhanced punishments must be advised.
• Judges must be trained in exclusionary rules of
the evidence
• Probative value of the evidence should be
considered and unfair prejudice towards the
victim owing to the public outcry or political
pressures should be avoided.
Role of the doctor/health care professionals
• Doctors and all health professionals play a

dual role
– providing medical treatment and psychological
support
– assisting survivors in medico-legal proceedings
• First point of reference

Role of the doctor/health care
professionals
i. Having an in-depth understanding of sexual victimization
ii. Obtaining a medical history of the child’s experience in a

facilitating, non-judgmental and empathetic manner
iii. Meticulously documenting historical details
iv. Conducting a detailed examination to diagnose acute and

chronic residual trauma and STDs, and to collect forensic
evidence
v) Considering a differential diagnosis of behavioural complaints
and physical signs that may mimic sexual abuse
vi) Obtaining photographic/video documentation of all

diagnostic findings that appear to be residual to abuse
vii) Formulating a complete and thorough medical report with

diagnosis and recommendations for treatment
viii) Testifying in court when required

References
• https://www.livemint.com/Home-Page/
Vp6lyyANSMnNujEVuWSTTM/The-social-factors-that-
shackle-victims-of-domestic-violence.html
• https://www.crcvc.ca/docs/victimization.pdf
• https://www.aic.gov.au/publications/tandi/tandi496
• https://
aifs.gov.au/publications/impacts-sexual-assault-wome
n
• https://www.ohchr.org/en/professionalinterest/
pages/victimsofcrimeandabuseofpower.aspx
Thank you

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Social aspects of medico-legal

• The current dominant view in victimology of a

• Its often in the form of monetary or other

• Hence, establishing oneself as a victim is one

• In victimisation for handling a victim.

• Intimate terrorism : Mostly females are

• Police, court and community based services

• Apart from social impacts

• Doctors and all health professionals play a

• First point of reference

ii. Obtaining a medical history of the child’s experience in a

iii. Meticulously documenting historical details

iv. Conducting a detailed examination to diagnose acute and

vi) Obtaining photographic/video documentation of all

vii) Formulating a complete and thorough medical report with

viii) Testifying in court when required

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