Answer (KSN Reddy - Essentials of Forensic Medicine and Toxicology, 36th Ed.)

(a) Examination, Report Preparation & Preservation/Despatch of Trace Evidence (8 marks)

Objectives of Medical Examination

1. Search for physical signs (injuries) corroborating the victim's history
2. Search, collect, and preserve all physical (trace) evidence for laboratory examination
3. Treat the victim for injuries, prevent venereal disease or pregnancy, and minimize psychological damage

General Procedure

• Examine when there is a written requisition from the investigating police officer or Magistrate
• The Court or police cannot force a woman for medical examination against her will
• Written, witnessed consent is mandatory - for collection of specimens, photographs, treatment, and release of information to police
• Since she is a minor (17 years), consent of her parent/guardian must also be taken in writing
• She has been brought in altered sensorium - her condition must be stabilized first; medical care takes priority

• Victim identified by the escorting police constable (name and number recorded)
• Identification marks noted
• Record: name, parent's name, marital status, residence, occupation, date and time, place of examination, and who gave the requisition
• Date and time are important - the interval between the alleged incident and examination is material

• Taken in privacy, in a child-friendly environment
• Record her own words as far as possible
• History includes: date, time, place of assault; nature of assault; whether she bathed, changed clothes, douched; whether she has been sexually active before; last menstrual period

• Assess her mental and physical state - since she is in altered sensorium, assess for intoxication, head injury, or drug influence
• Ask to undress completely; examine under ultraviolet light to detect seminal stains
• Note all soiling areas, swab with plain cotton swabs
• Collect any loose hair or foreign substances on skin surface
• Take large and close-up photographs of injuries, especially the sexual area
• Examine entire body for marks of violence: scratches, bruises, lacerations, tenderness
  • About mouth and throat (forcible silencing)
  • About wrists and arms (seizure marks)
  • On back, shoulders, buttocks
  • Inner and outer thighs (especially inner aspect of upper thigh)
  • Breasts - bite marks, suction lesions
  • Petechiae on face/conjunctivae suggest partial asphyxia

• Examine pubic area: any matted area should be cut close to skin and combed; loose pubic hairs retained
• Inspect tops of thighs, labia, and perineum; note injuries
• Take swabs from introitus and perineum
• Examine hymen: separate labia majora and minora by gentle traction
  • Take low vaginal swab before speculum insertion
  • Tears most commonly occur posteriorly, at 5-7 o'clock position
  • Hymenal tears from penile penetration extend to the margin
• Vaginal speculum examination: take high vaginal swab and cervical os swab under direct vision
• Note abrasions, bruising, lacerations of vaginal walls
• Two-finger test is banned by the Supreme Court (2013) - it violates the right to privacy
• Note: "Rape can occur without causing any injury; negative evidence does not exclude rape"

• For evidence of buggery (anal intercourse)
• Examine for fissures, bruises, lacerations

Preparation of Report and Framing the Opinion

• Personal details: name, age, identification marks
• Requisition number, date/time of examination
• History as given by the victim (in her own words)
• General condition: pulse, BP, consciousness level, signs of intoxication
• Findings of general examination and injuries (described systematically)
• Findings of genital examination - hymen, vagina, cervix
• Laboratory results when available (semen, blood group, DNA)

• Whether signs of recent sexual intercourse are present
• Whether signs of forcible intercourse are present
• Whether injuries are consistent with the history given
• Age estimation
• The doctor should mention only the negative facts, but should NOT give an opinion that rape has not been committed, as rape can occur without injury

Preservation and Despatch of Trace Evidence

• Examine for tears, loss of buttons, seminal stains, blood
• Dry the clothes, store in a clean paper bag (not plastic - prevents decomposition of evidence)
• Send to the Forensic Science Laboratory

• Sealed, labelled with date, time of collection, name of victim
• Chain of custody maintained - signed by examining doctor

• Lose motility within 1-6 hours in vagina
• May be recovered up to 24 hours from vagina

(b) Medicolegal Issues (Amendments) Related to this Scenario (5 marks)

1. POCSO Act, 2012 (Protection of Children from Sexual Offences)

• This girl is 17 years - a minor - so POCSO applies
• Section 3: Penetrative Sexual Assault - insertion of penis/object into vagina, anus, etc. - Punishment: 20 years to life imprisonment + fine
• Section 4: Aggravated Penetrative Sexual Assault - Life imprisonment or death penalty + fine
• Section 19: Mandatory reporting - any person (including doctors) aware of sexual offence against a child MUST report to police or Special Juvenile Police Unit (SJPU); failure to report is punishable
• Section 24: Child-friendly investigation and trial - in-camera proceedings, child's statement in non-threatening environment
• Section 29 & 30: Reverse burden of proof - accused is presumed guilty unless proven innocent
• Section 35: Compensation to victims for medical treatment and rehabilitation

2. POCSO Amendment, 2019

• Introduced death penalty for aggravated penetrative sexual assault (Section 6)
• Increased fines and imprisonment terms
• Criminalized storage of child pornography

3. BNS 2023 (Bharatiya Nyaya Sanhita) - Replaced IPC

• Section 64 BNS (formerly Section 376 IPC) - Rape: Imprisonment minimum 10 years, extendable to life
• Consent of a woman below 18 years is not valid (since she is 17, consent is immaterial)

4. BNSS 2023 (Bharatiya Nagarik Suraksha Sanhita) - Replaced CrPC

• Statement of victim of sexual assault recorded by female police officer
• Examination of victim by female doctor only (or in presence of female attendant)
• Medical examination must be done within 24 hours

5. MTP Act relevance

• If pregnancy results from rape, MTP is permitted up to 24 weeks (MTP Amendment Act, 2021)
• For rape victims, only one RMP's opinion needed (up to 20 weeks); two RMPs required up to 24 weeks
• For minor rape victims, guardian consent is required

6. Child Line involvement

• Child Line (1098) is a national emergency phone service for children in distress
• The doctor must cooperate with Child Line and the SJPU for proper legal process

7. Two-Finger Test

• Banned by Supreme Court in 2013 - violation of right to privacy of rape survivors

8. Section 120 BSA (formerly S. 114-A IEA)

• If victim states in evidence she did not consent, the court shall presume she did not consent (corroborated by 120 BSA)

(c) One Stop Centre (2 marks)

• Recent guidelines from the Ministry of Women and Child Welfare have created ONE STOP CENTRES at all District Hospitals across the country
• The Union Health Ministry has asked all hospitals to set up a designated room for forensic and medical examination of rape victims

1. Medical assistance - emergency treatment, forensic examination, collection of evidence
2. Legal aid - assistance in filing FIR, legal counseling
3. Psychological support - counseling, crisis intervention
4. Social support - shelter, rehabilitation
5. Police facilitation - to register the complaint

• Available 24 hours, 7 days a week
• Staffed by trained professionals including female doctors, nurses, counselors, legal aid workers, and police
• Maintains confidentiality and dignity of the victim
• Child-friendly environment as mandated under POCSO
• Funded under the Nirbhaya Fund (Government of India)
• One-stop service so the victim does not have to run from department to department