By Aires Rodrigues
It seems that a very erroneous practice is being followed at the Goa Medical College (GMC). Patients shifted there from any private hospital are being admitted as a medico-legal case. As a result of this, if the patient dies at GMC, the hospital will not certify the death unless a post-mortem is done.
We recently had a young Ribandar lady diagnosed with cancer who had to be shifted from GMC to Manipal Hospital at Dona Paula as there was no ventilator available. The young lady who continued in a state of coma was arranged to be shifted back to GMC when a ventilator was made available. On being brought back to GMC she was re-admitted as a medico-legal case. After a few days at GMC she lost her battle against cancer. But the already much traumatized parents were in for further dose of horror and anguish when told by the doctors that a post mortem would have to be done on their departed daughter.
It can be a medico legal case only if 1. A patient is brought by the police for examination and reporting, or by an order of the court for medical examination. 2. The patient was already attended to by a doctor and a medico-legal case was registered in the previous hospital, and the person is now referred for expert management/ advice. 3. When the patient himself expresses intention to register a case against an alleged accused.4. If after eliciting the history and examining the patient, the attending doctor feels that some investigation by law enforcement agencies is essential to establish and fix responsibility for the case in accordance with the law of the land.
I had an opportunity to speak to various doctors in the know who were all of the opinion that the case in question should never have been considered as a medico-legal case.
The word autopsy (also known as a post-mortem) is derived from the Greek word autopsia "to see with one's own eyes”. After having seen the young lady succumb to cancer what else was left to be ascertained through an unnecessary post-mortem?
Terry Tempest Williams had said “An individual doesn't get cancer, a family does”. This is what the family must have felt when told that the young departed lady would have to undergo a post-mortem after having already bravely endured so much pain.
Let us hope that the Dean of Goa Medical College Dr V.N.Jindal will discuss this issue thread bare with the Heads of his various departments so that in future the cases where the cause of death is well established, an unnecessary post mortem is avoided. A well laid out protocol may have to be in place and uniformly followed by all doctors.
