Define inquest. Describe the types of inquest in India with their indications and procedure.

Definition and Purpose

• The inquest establishes the manner of death — natural, accidental, suicidal or homicidal — whereas the autopsy establishes the cause. The two are complementary and neither replaces the other
• Two types are recognised in India — the police inquest and the magistrate'S inquest. The coroner's inquest was abolished in Mumbai in 1999 and the coroner system no longer operates anywhere in India; the jury system was abolished in 1959

• A magistrate'S inquest is mandatory in — death IN police custody or in the course of police action; death IN prison; death in a psychiatric establishment, a remand home or a protective home; dowry death and the death of a woman within seven years of marriage in circumstances raising reasonable suspicion; and death from police firing
• The reason is the appearance of impartiality — where the police themselves may be implicated, or where the family may be, an inquiry by the police would not command confidence
• In custodial deaths the autopsy must be videographed and is conducted by a board of doctors, on the directions of the National Human Rights Commission; the report is sent to the Commission within 24 hours

The Doctor and the Inquest

• The doctor does not conduct the inquest in India; this is a common misconception. The doctor conducts the autopsy, which is a separate exercise, and provides the medical opinion on which the inquest authority relies
• The autopsy is performed only on a written requisition from the police or magistrate, accompanied by the inquest report, and the body is brought and identified by a police constable or a relative — the identity of the body is not the doctor's to establish
• The doctor should read the inquest papers before starting, since the circumstances direct the examination; but must not be bound by them, and should record findings independently even where they contradict the police account
• The doctor may be summoned as a witness at the inquest and later at the trial

Other Systems and Deaths Requiring Report

• The coroner — formerly a magistrate holding inquests in Kolkata and Mumbai, empowered to hold an inquiry with a jury, issue summonses and commit an accused for trial. The office was abolished in Mumbai in 1999 and does not now exist in India, though it operates in England and parts of the United States. It remains an examination topic
• The medical examiner system — used in many parts of the United States, in which a qualified forensic pathologist (not a lawyer or a layman) is appointed and has authority both to investigate the circumstances and to perform the autopsy. It is generally regarded as the superior system, since medical questions are decided by a doctor from the outset

The Panchanama and its Contents

• The panchanama is the written report of a police inquest, drawn up in the presence of the panchas — two or more respectable inhabitants of the locality who witness the proceedings and sign the document. The requirement of independent witnesses exists to prevent the police account being the only account
• It records — the place, date and time; the identity of the deceased and who identified them; the position and posture of the body and its surroundings; the condition and disposition of the clothing; the postmortem changes present; a description of visible wounds and marks; any weapon, ligature, poison container, note or other article found; and the apparent cause and manner of death
• It is signed by the investigating officer and by the panchas, and accompanies the body to the mortuary with the requisition for autopsy
• Its limitations must be understood by the doctor — it is prepared by a person without medical training, the descriptions of injuries are frequently inaccurate, and the "apparent cause" stated in it has no medical authority. It informs the autopsy; it does not constrain it
• Discrepancies between the panchanama and the autopsy findings are common and expected, and the doctor records what they find without attempting to reconcile the two; the reconciliation is for the investigating and judicial authorities

Applied Aspects

• Do not issue a death certificate where the death is unnatural, sudden or suspicious; inform the police and let the medicolegal process take its course. Issuing a certificate in such a case may amount to abetting the concealment of an offence, and is a common source of serious trouble for young doctors
• Do not delay reporting to consult the family's wishes; the obligation to inform the police is statutory and does not depend on the family's consent or convenience
• Preserve everything in a case going for inquest — clothing, tubes, catheters, drains, the endotracheal tube, ligatures and residual fluids — and do not wash the body or remove therapeutic devices, which will otherwise be mistaken for injuries or their absence assumed
• Record resuscitation injuries explicitly; rib fractures from cardiac massage and lip or dental injury from intubation are regularly and wrongly attributed to assault
• A hospital death does not exempt a case from inquest; a patient who dies weeks after a road accident still dies an unnatural death, and the injury remains the cause however remote
• The autopsy is done on requisition, not on request; a doctor should not begin a medicolegal postmortem without the written requisition and inquest papers, and should record their receipt
• Read the inquest papers but do not be led by them; the police account is a hypothesis, and findings that contradict it must be recorded exactly as found
• The doctor does not conduct the inquest in India — a persistent misconception. The doctor performs the autopsy and gives the medical opinion on which the inquest authority relies
• The medical examiner system is generally regarded as superior, because a qualified forensic pathologist investigates the circumstances as well as performing the autopsy, so medical questions are decided medically from the outset
• Videograph a custodial autopsy and constitute a board; departure from this attracts the inference that the process was not transparent, whatever the findings
• Consent of relatives is irrelevant to a medicolegal autopsy, and their objection does not stop it; explaining this kindly at the outset prevents a great deal of distress and confrontation
• The panchanama is not a medical document, and the "apparent cause" it states carries no authority; discrepancies with the autopsy are expected and are not the doctor’s to reconcile
• A magistrate’s inquest is required for a woman dying within 7 years of marriage in suspicious circumstances, and a doctor should ask about the duration of marriage in every such death rather than assume
• The coroner system no longer exists in India — abolished in Mumbai in 1999 — but it remains examinable and is still in use in England and parts of the United States
• Preserve viscera in any death sent for inquest where poisoning is conceivable; they can always be discarded later, whereas they cannot be obtained after the body is released
• Record the inquest number and the requisitioning officer in the autopsy report; the linkage between the two documents is what a court will follow