A serious debate has erupted following a postmortem examination conducted on the body of Ranga Rajapakshe, who was found dead in his garden.
The controversy has arisen as Rajapakshe, an Assistant Director in the Finance Ministry, had been suspended over the diversion of 2.5 million dollars to a fraudulent account. Although the cause of death (COD) is obviously cardiorespiratory failure due to severe haemorrhage (loss of blood), whether the two cut wounds on his legs and on his left wrist were self-inflicted or caused by an external agency is what has led to this raging controversy.
A four-member ‘regional’ expert forensic panel (EFP) was appointed supposedly by the Secretary, Ministry of Health. The Judicial post mortem report was submitted within 24 hours. Many questions have risen as a result. Whether the expert forensic panel looked into all aspects of the death – and not only the injuries in the body of the deceased — has become a moot point.
Was the death due to self-inflicted cut injuries, i. e. suicide? Or, were they inflicted by another or others? If so, it becomes homicide or murder. If there have been any deficiencies in the procedure adopted by the expert forensic panel, whether they are errors, negligence or deliberate is what is reverberating on the social media and the public spaces.
One important point has to be mentioned at the outset. The JPM Report is still not in the public domain. Whether it would remain a privileged communication limited to the judiciary remains to be seen. Hence, none can come to definitive conclusions on the JPM findings – except judicious, informed speculation.
Judicial Post Mortem Examinations: Are they prone to error, negligence or deliberate falsification?
History tells us that all three of the above are possible. The fourth possibility is that it is none of the three above, but a legitimate, academically defensible difference of opinion. Neither medicine, nor forensics is an exact science.
Error
A cursory glance at information on the Internet gives us a reasonable overview of the issue of error. Of them, I quote only those that may be relevant to the issue at hand.
(1) Errors in post-mortem examinations can arise from procedural oversights, misinterpretation of findings, or lack of expertise, with major diagnostic error rates ranging from 8% to 24%.
(2) Common mistakes include misinterpreting postmortem changes as injuries, missing findings due to incomplete examination, and failing to secure the chain of custody.
(3) Incomplete Examination: Failing to examine all necessary body cavities or failing to perform histology/toxicology.
(4) Misclassification of Death Manner: Incorrectly labelling a death as natural vs. unnatural (e.g., suicide vs. homicide) due to overlooking evidence or biased interpretation.
Causes of Errors
(1) Systemic Issues: Heavy workloads, lack of specialised training, inadequate equipment, or poor communication between investigators and pathologists.
(2) External Pressure: Influences from law enforcement, media, or families that can bias the investigation.
(3) Inefficient Techniques: Relying on delegated assistants for vital dissections or conducting superficial examinations.
The above would suffice to give us an idea about lacunae and deficiency in JPM examinations that could lead to error. Those interested could go into the plethora of academic articles on this subject of error in JPMs.
Did any of the above lead to an outcome of error in the conclusions of the JMP Report by the expert panel?
Negligence
Negligence involves critical and serious errors that are inexcusable. These include inadequate body examination, failed scene investigations, missed evidence and speculative, premature reporting. These shortcomings can hinder legal proceedings, obscure causes of death, and lead to wrongful conclusions, with studies identifying major procedural errors, including failure to identify injuries or misinterpreting pathological findings.
We have no information whether the EFP had done a detailed site visit.
Deliberate falsification
Deliberate falsification or fraudulent autopsy reporting involves the intentional alteration of findings, documentation, or conclusions to misrepresent the cause or manner of death.
This misconduct can take many forms, including covering up homicide, misrepresenting police actions, or protecting influential individuals.
Forms of Deliberate Falsification include modification of Conclusions due to Forensic pathologists facing coercion from police, politicians, or families to change a homicide to an accidental death or natural causes. Intentional Neglect of Evidence: Failing to document injuries like strangulation marks or bruises to support a fabricated narrative of natural death. Issuing misleading or untrue post-mortem reports constitutes “serious” professional misconduct that is punishable by law.
There is absolutely no evidence that deliberate falsification has occurred in this case. But what I have attempted to inform the readers of is that such situations are well known.
The celebrated Sathasivam case illustrates the earliest instance in Sri Lanka, in which there was conflicting forensic evidence from two highly eminent forensic professors. Professor GSW de Saram, the first professor of forensic medicine, faculty of medicine, of the then University of Ceylon and JMO, Colombo was the most pre-eminent forensic expert in Ceylon who gave evidence for the prosecution and Sir (Prof.) Sydney Smith, world renowned professor of forensic medicine, University of Edinburgh who gave contrary forensic evidence on behalf of the defence. This conflict in the forensic evidence was a key factor that resulted in Sathasivam’s acquittal
I list below, a few JPM discrepancies and conflicting JPM reports that are now in the public domain in the recent past in Sri Lanka:
1. The death of a student at the University of Ruhuna raped and killed on the Matara beach, considered a suicide when circumstantial evidence indicated thugs of a well-known politician were involved in the incident. I was on the academic staff of the faculty of Medicine, University of Ruhuna at that time and came to know several details that had not come into the public domain.
2. The conflicting PM reports on the “disappearance” of the kidneys of a child at LRH, which was originally given as a medical death and later judgement given as a homicide. The child’s good kidney had been removed when the nephrectomy had to be done on the damaged kidney.
3. The infamous JPM report first given on Wasim Thajudeen’s killing. This falsification was done by a very senior JMO.
4. Lasantha Wickrematunga’s death, which was originally attributed to shooting but subsequently found to be due to stabbing with a sharp implement.
5. The RTA death of a policeman on a motorcycle (his wife and children were also seriously injured) in Boralesgamuwa due to the drunk driving by a female specialist doctor. The first JMO report stated that the doctor had not been under the influence of alcohol until CCTV evidence was presented to the Court that showed her drinking in a club that night. The police informed Court that the breathalyser test had confirmed that the doctor was under the influence of alcohol.
These are some of the well-known instances that there had been conflicting JMO reports. Furthermore, there have been several JMO reports where death in police custody was falsely documented in the JPM or JMO reports to safeguard the police involved in torture.
I know of one case personally, where a doctor from Nagoda Hospital, Kalutara was hauled up by the Sri Lanka Medical Council (of which I was a member for 10 years) for falsifying his JPM report of a death of a young man in police custody to safeguard the policemen concerned.
Why do JMOs falsify JMO reports?
Based on reports and studies, primarily focusing on the context of Sri Lanka, allegations of false or misleading judicial medical reports by Judicial Medical Officers (JMOs) arise from a combination of systemic, ethical, and external pressures rather than a single cause.
Reports indicate that instances of faulty reporting often stem from several factors. The main factor being political and external influence. These are likely in high-profile cases; JMOs may face pressure to tailor reports to suit the interests of powerful individuals or to minimize the culpability of suspects.
It has been seen that some reports are deemed erroneous or contradictory due to negligence, improper reporting procedures, or a lack of understanding of the ethical responsibilities of their role as JMOs. The police sometimes exert influence to speed up investigations, leading to “shortcuts”, where evidence is not properly scrutinised, or reports are tailored to support a premeditated narrative rather than scientific findings.
To be fair by JMOs, it must be said that false history or narratives given by victims and or perpetrators mislead the JMO. Victims or suspects may provide false history during the medical examination to protect themselves or to misdirect investigations.
The dearth of experienced forensic specialists can lead to inexperienced officers handling complex forensic cases. It has been the practice in many instances that Magistrates make specific requests that the PM examination be transferred to an experienced and senior forensic expert.
The subversion of justice is not limited to our part of the world. It happens everywhere. The judiciary, the legal and medical professions can work together to deliver justice to the impoverished and unempowered masses.
by Prof. Susirith Mendis
susmend2610@gmail.com
from The Island https://ift.tt/wyxs4zD
No comments:
Post a Comment