---

LONG ANSWER QUESTION (15 Marks)

Q1. 14-Year-Old Girl - Sexual Assault Medical Examination

---

(a) Applicable Sections of BNS, BNSS, and BSA [1+1+1]

• Section 63, BNS (old S.375 IPC) - Definition of Rape
• Section 64, BNS (old S.376 IPC) - Punishment for rape (min. 10 years; since victim is under 16, min. 20 years rigorous imprisonment, up to life)
• Section 65, BNS (old S.376-AB IPC) - Rape on woman under 12 years - life imprisonment or death
• Section 66, BNS (old S.376-A IPC) - Rape causing death or persistent vegetative state
• Section 67, BNS (old S.376-B IPC) - Sexual intercourse by husband upon separation
• Section 70, BNS (old S.376-D IPC) - Gang rape
• Section 72, BNS (old S.228-A IPC) - Prohibition on printing/publishing identity of victim (imprisonment up to 2 years)
• Section 74, BNS (old S.354 IPC) - Assault/criminal force to outrage modesty
• Section 75, BNS (old S.354-A IPC) - Sexual harassment

• Section 183, BNSS - Medical examination of rape victim to be conducted by registered medical practitioner; examination of victim within 24 hours; report to be forwarded to court (formerly S.164-A CrPC)
• Section 196, BNSS - If rape alleged in custody of police, inquest by judicial magistrate (formerly S.176(1A) CrPC)

• Section 120, BSA (old S.114-A IEA) - Presumption of absence of consent in custodial rape and gang rape when victim states she did not consent (burden of proof shifts to accused)

---

(b) Classification of Sexual Offences and Definition of Rape

1. Rape (S.63 BNS)
2. Forced/non-consensual insertion
3. Sexual acts with animals (bestiality)
4. Paraphilias and paraphilic disorders
5. Sex-linked disorders

1. Normal men who behave abnormally under alcohol (most common)
2. Sexually deviated but psychologically non-deviated offenders
3. Sexually and psychologically deviated offenders (compulsive, emotionally disturbed)
4. Sexually non-deviated but psychotic/defective/brain-damaged

• (a) Penetrates his penis, to any extent, into the vagina, mouth, urethra or anus of a woman, or makes her do so with him or any other person
• (b) Inserts any object or part of the body (not being penis) into the vagina, urethra or anus of a woman
• (c) Manipulates any part of the body so as to cause penetration into vagina, urethra, anus, or any body part
• (d) Applies his mouth to the vagina, anus, urethra of a woman

---

(c) Procedure for Medical Examination [2]

• Examination is a medical procedure under S.183, BNSS - requires consent of victim (she is a minor, so guardian/police authorization is also needed)
• Examination only by a registered medical practitioner; female doctor preferred
• Record date, time, place of examination; name/designation of examining doctor
• Police should be asked to advise victim NOT to change clothes, bathe, or douche before examination
• Victim may go directly to a doctor; the doctor informs the police station afterward

• General history (name, age, address)
• History of the alleged assault (time, place, nature, assailants)
• Menstrual history (last menstrual period), obstetric history
• Recent consensual sexual activity
• Bathing, douching, or change of clothes since assault

• General physical condition: height, weight, built, nutrition, signs of intoxication or stupor
• Emotional state: distressed, calm, tearful
• Injuries on body: note site, shape, size, color of all bruises, abrasions, lacerations (especially on arms, thighs, chest, neck - indicating struggle)
• Nail clippings collected for assailant's epithelial cells/blood
• Clothing: note tears, stains, soil - collect in separate paper bags

• Patient placed in lithotomy position in good light
• Pubic hair: note matting, dried secretions; comb and collect loose hairs
• Thighs: bruising, seminal staining
• Vulva: redness, bruising, abrasions, tears
• Hymen: carefully examined - note shape, elasticity, tears (fresh vs old), bleeding; new tears bleed and have raw edges; in prepubertal girls, hymen is delicate
• Vagina: introital lacerations, frenulum tears, posterior fourchette tears
• Cervix: bruising, lacerations
• Per rectum examination if anal penetration alleged
• Swabs taken before digital examination

---

(d) Findings of Recent Forceful Penetrative Sexual Intercourse [3]

• Torn or stained clothing
• Bite marks, nail scratches, bruises on neck, breasts, thighs, wrists (signs of struggle)
• Sand/mud/soil on clothes or body
• Evidence of a struggle: disheveled appearance
• Signs of drugs/alcohol if victim was stupefied

• Fresh tears with raw, bleeding edges (most important finding)
• Tears most commonly at 6 o'clock and 3 o'clock positions
• In a 14-year-old, the hymen is relatively elastic; tears with effusion of blood
• Bruising and swelling around hymenal margins

• Redness (erythema) and swelling of labia
• Abrasions and bruising on labia majora and minora
• Tears of posterior fourchette and frenulum (common finding)
• Bruising or laceration of vaginal walls

• Lacerations of vaginal walls; may extend to posterior fornix in severe cases
• Evidence of seminal fluid on high vaginal swab
• Motile spermatozoa (within 6-8 hours in vagina; up to 24 hours)
• Non-motile spermatozoa (up to 48-72 hours in vagina; up to 7 days in cervix)
• Acid phosphatase positive

• Seminal fluid: presence of spermatozoa is proof of sexual connection (but not alone proof of rape)
• Venereal disease signs: gonorrhoeal discharge (2-4 days), syphilitic ulcer (3 weeks)
• Pregnancy (longer term)

• Injuries are more severe due to smaller anatomical dimensions
• Complete disruption of vaginal canal possible
• Vaginal injuries may extend into the abdominal cavity through posterior fornix

---

(e) Samples to be Collected for Medico-Legal Purpose [3]

• Samples preserved in sealed containers, labeled, sent to forensic science laboratory via police
• UV lamp examination: seminal stains fluoresce
• Y-chromosome STR markers (DNA fingerprinting) to determine number of semen donors

---

(f) POCSO Act, 2012 with Recent Amendments [3]

• S.19 - Mandatory Reporting: Any person aware of sexual offence against child MUST report to police/SJPU; failure is punishable under S.21
• S.24 - Child-friendly investigation: statement in non-threatening environment; in-camera trial
• S.29 & 30 - Presumption of guilt: accused presumed guilty unless proven innocent (reverse burden of proof)
• S.35 - Compensation to victims for medical treatment and rehabilitation

1. Gender-neutral: protects both boys and girls
2. Child-friendly procedures: special courts, in-camera trials, video-recorded statements
3. Mandatory reporting by all professionals (doctors, teachers)
4. Identity protection: media cannot disclose child's name
5. Time-bound trials: must be resolved within 1 year
6. Strict punishments including death penalty

• Introduced death penalty for aggravated penetrative sexual assault (S.4)
• Increased minimum punishments across offences
• Criminalized storage of child pornographic material

• Directed states to set up POCSO fast-track special courts

• Digital Monitoring: Cyber cells track online Child Sexual Abuse Material (CSAM)
• Awareness campaigns: "Cyber Safe" and similar government initiatives
• Continued enforcement of digital pornography provisions

• Child: any person below 18 years
• Sexual assault: penetrative or non-penetrative sexual acts against a child
• Aggravated sexual assault: in certain aggravating circumstances
• Sexual harassment: non-physical acts like stalking, exhibitionism, showing pornography
• Child pornography: any visual depiction of sexually explicit conduct involving a child

---

(g) Medical Findings in a Victim of Sodomy [2]

1. Anal region: Redness, swelling, bruising, abrasions around anal verge
2. Anal sphincter: Bruising, laceration; tears of anal mucosa (3 and 9 o'clock positions are common)
3. Bleeding: Fresh bleeding from anal tears/fissures
4. Semen: Spermatozoa can be demonstrated on rectal/anal swab (motile spermatozoa up to 6-8 hours; non-motile up to 24-48 hours)
5. Contusions on buttocks
6. Fundus of rectum: Spermatozoa may be demonstrated on rectal swab

1. Funnel-shaped anus (inverted funnel appearance) - classical sign
2. Loss of anal tone - gaping anus, patulous (widely open) anus
3. Thickening/induration of anal mucosa
4. Rugae obliterated - smooth, shiny perianal skin
5. Multiple healed fissures and scarring
6. Fecal incontinence in severe cases
7. Absence of anal reflex (anal wink abolished)

• Venereal disease: gonorrhoeal proctitis, anal chancre (syphilis)
• HIV, herpes simplex in anal region
• Human papilloma virus (anal warts/condylomata)

• Anal swab (high and low)
• Rectal washings
• Smear slides
• Clothing

---

---

SHORT ESSAYS (5 Marks each)

---

Q2. Causes of Impotency in Males and Medico-Legal Importance

Causes of Impotence in Males:

• Impotence may occur before puberty (poor penile development)
• In advanced age, power of erection may diminish or disappear
• No specific age for loss of power; boys of 9 years and men of 94 years have fathered children

• Absence or non-development of penis
• Partial amputation (coitus may still be possible)
• Phimosis (tight foreskin) - may prevent erection; curable
• Hypospadias / epispadias - difficulty depositing semen in vagina (AI may be needed)
• Priapism (persistent painful erection) - causes fibrosis and secondary impotence
• Testicular underdevelopment (cryptorchidism)

• Urethral stricture (painful erection)
• Gonorrhoeal urethritis
• Peyronie's disease (fibrosis causing curved, painful erection)
• Epididymo-orchitis (causes sterility, not usually impotence)

• Diabetes mellitus (autonomic neuropathy, vascular disease) - most common organic cause
• Cardiovascular disease, hypertension
• Obesity
• Multiple sclerosis, spinal cord injury
• Liver failure (estrogen excess), renal failure
• Hormonal: testosterone deficiency, elevated LH/prolactin, hypothyroidism, Cushing's syndrome

• Prostatectomy
• Pelvic fractures (injury to pudendal nerve or vessels)
• Orchidectomy

• Alcohol (acute - "brewers droop"; chronic - permanent)
• Antihypertensives, antidepressants, antipsychotics
• Opioids, cannabis

• Performance anxiety, depression, relationship problems
• Psychogenic impotence (most common overall cause in young men)
• Psychological testing: early response with papaverine injection = psychogenic; very high dose required = organic

Medico-Legal Importance:

1. Divorce proceedings: Impotence at time of marriage is a ground for nullity of marriage
2. Rape cases: Accused may plead impotence as defense; court decides from evidence (even old/disabled men can commit rape)
3. Workmen's compensation: If impotence results from industrial accident or injury
4. Life insurance: Impotence after accident may be basis for claim
5. Criminal law: Impotence affects ability to physically commit rape but legal opinion must be guarded (erection and penetration are separate functions)
6. Marriage law: Impotence renders a marriage voidable; a marriage that has not been consummated due to impotence is null and void under personal law

---

Q3(a). Artificial Insemination - Legal and Medico-Legal Aspects

• AIH (Artificial Insemination - Husband): Semen from husband
• AID (Artificial Insemination - Donor): Semen from a donor (anonymous)

1. Husband is impotent
2. Husband cannot deposit semen in vagina (hypospadias, epispadias)
3. Husband is sterile (azoospermia)
4. Rh incompatibility between husband and wife
5. Husband suffering from hereditary disease

• Ovulation timing important; insemination on successive days increases success
• Success rate: 30-40% pregnancy within 3-4 months
• Frozen semen used increasingly (stored at -196°C with glycerol cryoprotectant)

1. Written consent of donor and his wife essential
2. Identity of donor must remain secret
3. Donor should not know recipient or result
4. Donor must be mentally and physically healthy; screened for genetic defects, chromosomal studies
5. Donor must not be a relative; should have fathered children
6. Race/characteristics of donor should match husband's
7. Same blood group as husband; no Rh incompatibility
8. Couple must be psychologically stable
9. Written consent from both husband and wife
10. Witness must be present during insemination
11. A single donor's semen should not produce more than 10 children
12. Physician performing AI should ideally not deliver the child (to avoid disclosure)

• No specific statutory law for AI (until Surrogacy Act 2021 and ART Act 2021)
• AIH is justifiable and unobjectionable - legal
• AID without husband's consent = considered adultery historically (though not true biological adultery)
• Child born of AID: legitimate if husband consented in writing; child has right to inherit from husband
• If husband did not consent: child is technically illegitimate
• Blood group testing cannot definitively prove AID
• The Delhi Artificial Insemination (Human) Act, 1995 provides some legal framework in Delhi

1. Legitimacy of child - depends on husband's consent
2. Adultery allegation - if done without husband's knowledge/consent
3. Inheritance rights of AID child
4. Identity of donor - legal protection of anonymity vs. child's right to know biological father
5. Liability of physician if child born with genetic disease

---

Q3(b). Surrogate Motherhood and Medico-Legal Aspects

1. Traditional surrogacy: Surrogate's own egg fertilized with donor/husband's sperm (genetic mother and birth mother are same)
2. Gestational surrogacy: Embryo from commissioning couple implanted in surrogate (surrogate has no genetic link to child) - more common legally

• Only altruistic surrogacy is permitted (no commercial surrogacy)
• Eligible intending couples: Married Indian couples (wife: 23-50 years; husband: 26-55 years); also single women (widows/divorcees: 35-45 years)
• Eligible surrogate: Close relative of intending couple; married with at least one child; 25-35 years; can be surrogate only once
• Surrogacy Board: National Surrogacy Board and State Surrogacy Boards regulate and oversee
• Commercial surrogacy - prohibited and criminal offence
• Insurance: Intending couple must provide 36-month insurance for surrogate

1. Maternity: Surrogate who delivers child is traditionally the legal mother; gestational surrogacy complicates this
2. Parentage and custody disputes: If surrogate refuses to hand over child
3. Commercial exploitation of poor women - exploitative arrangements criminalised
4. Citizenship and nationality of child (international surrogacy disputes)
5. Medical risks to surrogate: IVF ovarian hyperstimulation, pregnancy complications
6. Right of child to know genetic origin
7. Consent: Full informed consent of surrogate is mandatory
8. Rights of surrogate: Cannot be forced to abort; retains bodily autonomy

---

Q4. Forensic Psychiatry Terms

Illusion

Impulse and Its Types

1. Homicidal impulse: Sudden uncontrollable urge to kill; seen in epilepsy, mania, melancholia
2. Suicidal impulse: Sudden urge to end own life
3. Kleptomania: Irresistible impulse to steal (not for financial gain)
4. Pyromania: Irresistible impulse to set fire to things
5. Dipsomania: Uncontrollable craving for alcohol at intervals
6. Erotomania: Irresistible sexual impulse
7. Dromomania: Irresistible impulse to wander/travel
8. Trichotillomania: Impulse to pull out own hair
9. Oniomania: Impulse to buy things

Delusion

Hallucination

• Auditory hallucination: Most common in schizophrenia (hearing voices)
• Visual hallucination: Alcohol withdrawal (DTs), cocaine
• Tactile/haptic: Formication (cocaine, delirium)
• Olfactory/gustatory: Temporal lobe epilepsy, depression

Voyeurism

Somnambulism (Sleepwalking)

Bobbit Syndrome

---

Q5. Criminal Responsibility of Mentally Ill Persons

Q5(a) - Case: 25-year-old man stabs neighbour, claims "I have killed the president of India," was on treatment for mental illness. Will he be punished?

• Section 22, BNS (old Section 84, IPC): "Nothing is an offence which is done by a person who, at the time of doing it, by reason of unsoundness of mind, is incapable of knowing the nature of the act, or that he is doing what is either wrong or contrary to law."

• He was receiving treatment for mental illness (documented)
• He stabbed without provocation (irrational behavior)
• He shouted a delusional statement ("I killed the president of India") - demonstrating he was grossly out of touch with reality (grandiose/persecutory delusion)
• His act + delusional statement indicates he did NOT understand the nature or wrongfulness of his act
• Therefore, Section 22, BNS provides a complete defense - he cannot be convicted of murder

• He will be examined by forensic psychiatrists
• If found to be of unsound mind during trial: Section 368-375, BNSS (old Ss.328-339 CrPC) - trial suspended; person kept in safe custody/mental institution

---

Q5(b) - Civil and Criminal Responsibility of Mentally Ill Persons / Legal Tests

• A person is not criminally responsible if, at the time of the act, they could not understand the nature of the act, or know it was wrong/contrary to law due to unsoundness of mind (S.22, BNS)
• The mental disease must have existed at the time of the act - not before or after
• Temporary insanity, delirium, epileptic automatism can also provide defense
• Diminished responsibility: partial defense reducing murder to culpable homicide

• A mental health patient retains civil rights unless specifically removed by court
• Can make contracts during lucid intervals; contracts made during mental illness are voidable
• Testamentary capacity: Can make a will during a lucid interval (see Q5d)
• Marriage: Marriage during insanity is voidable (Hindu Marriage Act, Dissolution of Muslim Marriages Act)
• Lunacy inquisition: Court may take over management of the person's property via a guardian

---

Q5(c) - M'Naghten's Rule and Comparison with Durham's Test

1. Those who did not know the nature or quality of the act
2. Those who knew the nature but did not know it was wrong
3. Those who operated under a specific delusion (but only if the imagined facts would have provided a legal defense had they been true)

---

Q5(d) - Testamentary Capacity of the Insane

1. Must know the nature of the act of making a will
2. Must know the extent of property being distributed
3. Must know the natural objects of bounty (relatives/heirs)
4. Must understand the effect of the will on beneficiaries
5. Must be free from undue influence or delusions that affect disposition

• A mentally ill person CAN make a valid will during a lucid interval
• Even a person previously certified insane, if examined and found lucid, can validly execute a will
• A will made during actual mental illness (not lucid interval) is void
• Medical certificate from examining physician at time of will-making is important evidence
• A delusion that directly influences the will (e.g., testator believes son is persecuting him and disinherits him due to delusion) can invalidate the will

---

Q6(a) - Difference Between Feigned Insanity and True Insanity

• Criminals to evade death sentence or long imprisonment
• Soldiers/policemen to leave service
• Businessmen to avoid contractual obligations

---

Q6(b) - Restraint of Mentally Ill Persons

• Use of physical devices (straps, handcuffs, straitjacket, chair)
• Justified only when patient is violent and danger to self or others, and when other methods have failed
• Must be minimal and temporary

• Use of sedatives or antipsychotics (haloperidol, lorazepam) to control violent behavior
• Preferred over mechanical restraint in modern practice

• Physically held by attendants

• Placing patient in a room alone; used to reduce stimulation

• Restraint is permitted only when necessary to prevent harm to the patient or others
• Must be documented in patient records
• Should be for the minimum time necessary
• Patient must be monitored continuously during restraint
• Relatives/guardians must be informed
• Routine or punitive use of restraint is prohibited and constitutes abuse
• The right to treatment with dignity includes freedom from cruel restraint

• To prevent immediate harm to self (suicidal behavior)
• To prevent harm to others (violent/homicidal behavior)
• During administration of emergency treatment
• During transport to mental health establishment

---