Death Mess
It was late evening when i got a call from the clinic that a body has been brought in dead due to an apparent snake bite. Initial findings by the medical assistant is that there were 3 puncture marks on his cheek. Otherwise no other injuries were noted. This was a 56 year old gentleman with no prior history of medical illnesses. The event occured approximately at 6 pm and he was brought in at 9 pm. There was no information regarding the type of snake that it was.
Due to the sudden nature of the death, a post mortem report is requested. Unfortunately the family members refused. The Police officer in attendance, urged me to write the cause of death and settle the issue. I refused as i insisted on a proper post mortem examination in hospital.
This was not the only case. In another, a lady in his 50s was brought in dead due to alleged electrocution. She was previously healthy. I wrote a letter informing the police regarding the circumstances of her death as relayed by her family members. There were no external injuries noted. A burial permit was issued. Later in the afternoon, the police requested for a post mortem report. The body had been released and i could only mention "alleged electrocution" as the cause of death.
The point is, the system in Malaysia leaves much to be desired. There is no flow and even the police can sometimes appear lost. Asking them about procedures will only get a reply that "you are the doctor. you tell me". Knowing such incompetencies and inconsistencies in procedures of determining death, murder could easily be missed.
Even though i am a doctor at a clinic, without clear causes of death, i can only rely on information provided in the history. In an ideal situation, a post mortem (eg a simple blood sample) should be performed by qualified personnel. Even doctors may not be experienced enough to detect foul play.
Calls that post mortem is unIslamic and thus family members refusal for one should not be entertained. If not , it leaves the system vulnerable to abuses. A murderer could easily escape.
Take this scenario. Poison someone with cyanide. He dies. You bring him to a clinic. You say he suddenly died afer complaining of chest pains. Doctor requests post mortem. You refuse. Police request doctor to issue a report so a burial permit can be given. Doctor agrees to write a cause of death (eg acute coronary syndrome). Police issues burial permit. You bring body home and bury. You get good chunk of insurance money. Everybody is happy!
Trust me ... it could probably already have happened with our current system.
links..
how about reading a log of a medical examiner intern. Interesting stuff.
Due to the sudden nature of the death, a post mortem report is requested. Unfortunately the family members refused. The Police officer in attendance, urged me to write the cause of death and settle the issue. I refused as i insisted on a proper post mortem examination in hospital.
This was not the only case. In another, a lady in his 50s was brought in dead due to alleged electrocution. She was previously healthy. I wrote a letter informing the police regarding the circumstances of her death as relayed by her family members. There were no external injuries noted. A burial permit was issued. Later in the afternoon, the police requested for a post mortem report. The body had been released and i could only mention "alleged electrocution" as the cause of death.
The point is, the system in Malaysia leaves much to be desired. There is no flow and even the police can sometimes appear lost. Asking them about procedures will only get a reply that "you are the doctor. you tell me". Knowing such incompetencies and inconsistencies in procedures of determining death, murder could easily be missed.
Even though i am a doctor at a clinic, without clear causes of death, i can only rely on information provided in the history. In an ideal situation, a post mortem (eg a simple blood sample) should be performed by qualified personnel. Even doctors may not be experienced enough to detect foul play.
Calls that post mortem is unIslamic and thus family members refusal for one should not be entertained. If not , it leaves the system vulnerable to abuses. A murderer could easily escape.
Take this scenario. Poison someone with cyanide. He dies. You bring him to a clinic. You say he suddenly died afer complaining of chest pains. Doctor requests post mortem. You refuse. Police request doctor to issue a report so a burial permit can be given. Doctor agrees to write a cause of death (eg acute coronary syndrome). Police issues burial permit. You bring body home and bury. You get good chunk of insurance money. Everybody is happy!
Trust me ... it could probably already have happened with our current system.
links..
how about reading a log of a medical examiner intern. Interesting stuff.
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