23.1: IPC Sections Relevant to Trauma

• Injury — defined as any harm whatsoever illegally caused to any person in body, mind, reputation, or property.

  • In the legal sense, it is clear that injury can be caused without touching the body.

  • Causing mental agony, damaging the reputation of the person by making false allegations, or causing damage/loss of property belonging to another person, etc. are also considered injuries in law.

• Hurt — defined as causing bodily pain, disease, or infirmity to a person.

  • Example: Pulling the hairs of another person to cause pain, transmitting syphilis to the sex partner, or mixing some deleterious substance with food, leading to infirmity (ill health) to the person consuming it, etc. are all examples of hurt.

• Grievous Hurt — a more serious kind of hurt and is a specific hurt, inflicted voluntarily to another person and comprise any of the eight kinds (clauses) enumerated below:

  • Clause 1: Emasculation — depriving a male, of masculine vigor.

  • Clause 2: Permanent privation of the sight of either eye

  • Clause 3: Permanent privation of the hearing of either ear.

  • Clause 4: Privation of any member or joint.

  • Clause 5: Destruction or permanent impairment of powers of any member or joint.

  • Clause 6: Permanent disfigurement of head or face.

  • Clause 7: Fracture or dislocation of bone or tooth.

  • Clause 8: Any hurt which endangers life or which causes the sufferer to be, during the period of 20 days, in severe bodily pain or unable to follow his or her ordinary pursuits.

Punishment for Hurt and Grievous Hurt

• Section 323 of IPC — Punishment for voluntarily causing hurt – imprisonment up to one year or with a fine up to Rs. 1000 or both.

• Section 324 of IPC — Punishment for voluntarily causing hurt by dangerous weapons or means–imprisonment up to three years or a fine or with both.

• Section 325 of IPC — Punishment for voluntarily causing grievous hurt –imprisonment up to seven years and fine.

• Section 326 of IPC — Punishment for voluntarily causing grievous hurt by dangerous weapons or means—life imprisonment or imprisonment up to for ten years and fine.

  • Dangerous Weapon

    • Instruments used for shooting, stabbing, or cutting or any other instrument which is used as a weapon of offense is likely to cause death, and constitute dangerous weapons.

  • Means Causing Hurt or Grievous Hurt

    • Fire, heated substances, a poison or corrosives, or explosives, or any substance deleterious to the body to inhale, swallow, or received into the blood or by means of animal constitute means causing hurt or grievous hurt.

23.2: Homicide

• Homicide — causing the death of one person, by the act of another.

• Homicide is punishable under certain circumstances (culpable homicide) and not punishable under other circumstances (excusable or justifiable).

Lawful Homicide

• These homicides which are not punishable and are also known as simple homicides are enumerated as follows:

  • Homicide did by a person of unsound mind.

  • Homicide by a child below the age of 7 years.

  • Homicide due to an accident/misfortune.

  • Homicide during the private defense of body or property, e.g.: personal defense in order to prevent death or rape, or private defense of property.

  • Homicide did as per the order of the court.

Unlawful Homicide

• Culpable or Unlawful Homicide is defined as causing death by doing an act:

  • With an intention of causing death or

  • With the intention of causing such bodily injury as is likely to cause death or

  • With the knowledge that he is likely to cause death by such act.

Punishment for Culpable Homicide Not Amounting to Murder

• Life imprisonment or imprisonment up to 10 years and fine if the act by which death is caused is done with the intention of causing death or such bodily injury as is likely to cause death.

• Imprisonment up to 10 years or a fine, or both if the Act is done with the knowledge that it is likely to cause death.

Culpable Homicide Amounting to Murder

• With the intention of causing death/kill.

• With the intention of causing such bodily injury as the offender knows to be likely to cause death.

• With the intention of causing such bodily injury, as is sufficient to cause death in the ordinary course of nature.

• With the knowledge that the act is so imminently dangerous that it must in all probability cause death or such bodily injury as is likely to cause death.

Five exceptions are given in Section 300 IPC

• Causing death by grave and sudden provocation.

• Causing death by exceeding the right of private defense.

• Public servant exceeds the powers given by law and causes death.

• Death caused without premeditation in sudden flight, in the heat of passion.

• A person aged above eighteen years suffers death or takes the risk of death with his own consent.

Differences between Grievous Hurt, Culpable Homicide, and Murder

1. Culpable homicide of first degree – the gravest form of culpable homicide also called ‘murder’.

2. Culpable homicide of the second degree – punishable under the first part of Section 304, IPC.

3. Culpable homicide of the third degree – the lowest form of culpable homicide punishable under the second part of Section 304, IPC.

Rash or Negligent Homicide

• If the death of a person is caused by any rash or negligent act, not amounting to culpable homicide, the punishment is imprisonment up to 2 years, or fine, or both.

• The person doing the act is conscious that a dangerous consequence may follow; however, he hopes that it may not result in that particular case e.g.: A penicillin injection given without a test dose.

• But since the doctor had no intention to cause death, it is not considered as culpable homicide.

Abetment of Suicide

• Punishment for abetment of suicide: The person abetting the suicide of another person shall be punished with imprisonment for up to 10 years and shall also be liable to a fine.

• Attempt to commit suicide: If any act towards the commission of suicide is done, the punishment is imprisonment for up to one year, or fine, or both.

Dowry Death

• When the death of a woman is caused within seven years of her marriage and it is shown that soon before her death she was subjected to cruelty or harassment by her husband or any relatives of the husband for, or in connection with any demand for dowry such husband/ relative shall be deemed to have caused her death.

• The punishment for such dowry-related death is imprisonment for not less than seven years, but may be extended to life imprisonment.

23.3: Medical Management

Medicolegal Management

1. Specific Measures

   • Consent for the examination of the injured

   • Informing the police

   • Confidentiality of medical examination findings of the patient.

   • If the patient is conscious, ask him how the injury was

   • caused. Record it in the patient’s own words. If the patient dies later, it will be accepted as a dying declaration by the court.

2. General Measures

   • Prepare, preserve and maintain the following documentary requirements.

     1. Accident register/wound register

     2. Case sheet, date, time of examination, and observations noted

     3. Special reports or other laboratory test reports

     4. Hospital discharge certificate

     5. Dying declaration – whenever death is likely to occur.

     6. Death certificate – is not issued unless postmortem, examination is completed.

   • In doubtful circumstances

     1. Consult a professional colleague available nearby

     2. Refer standard textbook

     3. Refer the case to another hospital with better facilities

     4. Perform the clinical and other essential medical investigation procedures as available to confirm the diagnosis.