Describe judicial hanging and distinguish it from suicidal hanging.

Method and Purpose

• Judicial hanging is execution by hanging carried out under sentence of a court. It is the method of execution in INDIA for civilians, reserved for the "rarest OF rare" cases following Bachan Singh v State of Punjab (1980); the Army Act also permits shooting
• The object is instantaneous and painless death by fracture-dislocation of the upper cervical spine with transection of the cord — not by asphyxia, which is the mechanism in suicidal hanging and which would be slow and distressing
• The mechanism depends entirely on the drop, which converts the fall into a sudden distraction force on the neck. The knot is placed submentally or beneath the angle of the left jaw, so that at the end of the drop it forces the head into violent hyperextension and rotation
• The length of the drop is calculated from the body weight by the standard formula drop (in feet) = 1260 ÷ body weight (in pounds), giving a drop of roughly 5 to 7 feet for an average adult. Heavier prisoners receive a shorter drop and lighter prisoners a longer one
• The calculation matters absolutely: a drop that is too short fails to fracture the spine and the prisoner dies slowly by asphyxia, which may take many minutes; a drop that is too long causes decapitation. Both have occurred and both are regarded as a failure of the process

Findings and Procedure

• The classical lesion is fracture-dislocation at C2–C3 with bilateral fracture of the pars interarticularis of the axis — the "hangman'S fracture" — and transection or severe contusion of the spinal cord at that level. Death is essentially instantaneous, though the heart may continue to beat for some minutes
• Other findings — the ligature mark is high, oblique and deep; there is rupture of the anterior longitudinal ligament and of the intervertebral disc; and there may be tearing of the carotid intima (Amussat's sign) and even complete rupture of the carotids. Asphyxial signs are absent or minimal, since death was not asphyxial — which is the diagnostic contrast with suicidal hanging
• Procedure in India — execution is carried out before sunrise; the prisoner is weighed and the drop calculated in advance; the rope is tested with a sandbag of the prisoner's weight; a doctor and a magistrate attend; and the body is suspended for at least 30 minutes after the drop, or until the doctor certifies death, before being lowered
• The doctor's role is to certify death after the prescribed period and to conduct the subsequent postmortem examination. The doctor does not participate in the execution, and under the Declaration of Tokyo should not certify a person "fit for execution" or otherwise facilitate it — a distinction of real ethical importance and one that is not always observed

Comparison and Applied Aspects

• The distinction is examinable and clinically real — a cervical fracture in a hanging is very unusual outside judicial execution, and its presence in an ordinary case suggests a fall with the ligature, an unusual mechanism, or an elderly person with a degenerate spine
• Perform the postmortem carefully and completely, since a judicial execution attracts scrutiny and the report may be examined by courts and human rights bodies
• Do not certify fitness for execution; the Declaration of Tokyo prohibits a doctor from facilitating punishment, and the role is confined to certifying death afterwards
• Examine the cervical spine specifically by the posterior approach, since the fracture is the whole point and will be missed on a routine anterior dissection
• Note the absence of asphyxial signs and state it; their presence would indicate that the drop failed and the prisoner died slowly, which is a matter of legitimate public concern
• A cervical fracture in an ordinary hanging is very unusual, and suggests a fall with the ligature, an elderly degenerate spine, or a judicial execution