Forensic Medicine in South Asia: Comparison to the Developed Countries

Abstract

This study attempted to discuss the historical context and current practice of forensic medicine in South Asia. Comparisons within and between countries in South Asia, and between South Asia and the developed countries (represented by Japan and the USA) have been made to provide an insight into their distinct practice of forensic medicine. Though the formal establishment of forensic medicine in South Asia commenced at a comparable period to the developed countries, their pace of development has been considerably slow. Moreover, their ways of practice as well have evolved differently. In effect, South Asian countries follow an 'integrated service' system, whilst Japan and the USA practice 'divided service' systems to provide forensic medical services. Similarly, regarding the death investigations, most South Asian countries follow a Police-led death investigation system, whereas Japan and the USA follow a hybrid model and the Medical examiner's system of death investigation, respectively. Indeed, forensic medicine in South Asia is undeniably underdeveloped. In this paper, by highlighting the issues and challenges confronted in South Asia, key actions for prompt redressal are discussed to improve the standard of forensic medical services in South Asia.

Keywords: South Asia; death investigation system; forensic medicine; medicolegal system.

Fig. 1.

Medicolegal services provided by the Department of Forensic and Toxicology at JDWNRH, Bhutan from 2005 to 2020. Clinical forensic medicine services include examination of victims/perpetrators of physical/sexual assaults, rape, etc. Embalming and postmortem external body examinations constitute forensic pathology services. Source: Department of Forensic and Toxicology, JDWNRH. JDWNRH, Jigme Dorji Wangchuk National Referral Hospital.

Fig. 2.

Death investigation system of Bhutan. When unnatural deaths (Accidental deaths, sudden deaths, custodial deaths, suicides, homicides and suspicious deaths) are reported to the Police, a death investigation (Inquest) is initiated. A medical doctor performs external body examinations and assists the Police in determining the medical cause of death. In doing so, two types of deaths are determined: Criminal and non-criminal deaths. A preliminary report is compiled in an ‘Inquest form’ after which the body is released for cremation. No full-body autopsy is performed in Bhutan.