Sexuality, Sexual Offences and infanticide Flashcards
Impotence
Inability of man to achieve erection or orgasm
M/C cause in India: psychogenic
M/C in world: vasculogenic
Quoad hoc
Frigid
Quoad hoc:
A male being impotent only to a particular female
Frigid:
Inability to initiate/maintain sexual arousal in a female
M/C of sterility
Lead intoxication
Supposititious child
Fictitious child
A female may feign pregnancy 🤰 and claim the child 👶 to be her own to extort money by blackmailing
Fecundation ab extra
Conception by deposition of semen in vulva/thigh
Superfetation
Superfecundation
Fertilisation of 2 separate ova by 2 acts of coitus in 2 different menstrual cycles ➡️ twin pregnancy
Fertilisation of 2 separate ova by 2 acts of coitus within one menstrual cycle ➡️ twin pregnancy
Sterilisation in India
Compulsory sterilisation is not practiced in India
Voluntary sterilisation is practiced in India. It requires written consent from husband and wife.
After vasectomy, abstinence is required for 3 months
Artificial insemination
Artificial introduction of semen (1ml) into female genital tract to result in pregnancy
1 donor can produce 10 children max.
Race of donor should be similar to recipient
Written consent of both husband and wife
Confidentiality
Child should be adopted
Indications for artificial insemination
Use of donor specimens in cases of:
- Impotent husband
- Sterile husband
- Rh incompatibility
- Hereditary disease
Methods of artificial insemination
- Artificial insemination of husband AIH
- Artificial insemination by donor AID
- Artificial insemination by husband + donor ➡️ pooled semen
Artificial insemination and legality of marriage
In case of insemination due to impotency of the husband ➡️ wife can file for divorce
But not for sterility
Types of surrogacy
1. Commercial: Not practiced in India Surrogate mother paid for caring child 2. Altruistic: Practiced in India Only medical expenses are covered Close relative with at least 1 child The intending couple should be married for at least 5 years
Punishment for intending couple of surrogacy for breaking the law
- 10 lakhs penalty
2. 10 years punishment minimum
Adultery
Extra marital affair
Was punishable under 497 IPC
Decriminalised since 27th September 2018
Indications for MTP
S. Social indication (contraceptive failure)
E. Eugenic indication and environmental indication
T. Therapeutic indication
H. Humanitarian
Criminal abortion laws related IPC
312 IPC: with mother’s consent 313 IPC: without mother’s consent 314 IPC: death of the mother 315 IPC: killing a foetus >28 weeks 316 IPC: killing the foetus on an attempt to kill mother
MTP amendment Bill
In 2014
Homeopathic and Ayurvedic doctors were allowed to conduct MTP
MTP register should be maintained for 5 years
Data should be confidential
Changes in criteria of MTP
Criteria for MTP
- Consent for MTP should be given only by mother
- Age for consent >18 years
- MTP < 12 weeks, requires 1 doctor
- MTP 12-20 weeks, requires 2 doctor
Abortifacients
Substances that induce abortion 1. Ecbolics: eg., ergot uterus contraction 2. Emmenagogues: increased blood flow to pelvis/menstrual blood flow 3. Diachylon and utus paste 4. Abortion stick: vaginal irritation
Emmenagogues
Abortifacient Mechanism: increased pelvic / menstrual blood flow Eg., B. Borax O. Oestrogen S. Sanguinarine S. Senecio Rue, Labrunum
Diachylon, utus paste
uses as abortifacients
Diachylon: lead product
Utus paste: combination of iodide + iodine
Abortion stick
Length 12-18 cm Causes vaginal irritation ➡️ abortion 🌱 used: P. Plumbago E. Ergot E. Ecbolics C. Calotropis (M/C) O. Oleander L. Lead A. Arsenic, aconite, Abrus precatorius S. Strychnine
Defloration
Loss of virginity
1. Hymen may be torn
2. Fourchette/posterior commissure is torn
3. Fossa Navicularis: disappeared, not intact
Vagina is dilated
Its rugosity is lost
Hymen
Does not decide virginity
M/C site of rupture: posterolateral (5’-7’o clock position)
Semilunar/crescentic in 70% of women
In children hymen is not ruptured easily because it is deep-seated
Caruncula myrtiformis- healed tag of hymen
Features of fimbriated hymen (natural notches of vagina) that differentiate it from vaginal tear
- Present anteriorly
- Symmetrical
- Fold of mucous membrane
- Do not extend to vaginal wall
Causes of rupture of hymen
- Sex
- Surgery
- Infection
- Masturbation
- Sanitary tampons
- Trauma
- Shola pith
Aptae viris
Shola pith is a spongy plant stem used to dilate the vagina
It is used in young girls (aptae viris) to make them fit for sexually intercourse
False virgin
A female who participated in sexual intercourse but with hymen intact (elastic hymen)
Differences between nulliparous and parous female
1. Uterine cavity: Triangular 🆚 circular 2. Wall of uterus: Convex 🆚 concave 3. External os: Circular 🆚 transverse slit
Sexual offence
- Natural:
Penovaginal sexual route
Rape is both natural and unnatural sexual offence - Unnatural:
Any offence where this route is not used.
Punishable under 377 IPC (10 years)
• Incest is not a crime in India
• Adultery is only a civil case ➡️ divorce
Incest complex
- Electra complex:
Sexual relationship between daughter and father - Oedipus complex:
Sexual relationships between son and mother - Pharaon complex:
Sexual relationship between brother and sister
Lesbianism
The active sexual partner is Dyke/ Butch
Passive sexual partner is Femme in 2018, change in 377 IPC.
Homosexuality in adults with consent is decriminalised
Sodomy
differences b/w habitual and non-habitual
1. Non habitual passive agents: Tear, injury, rigidity of anal canal 2. Habitual passive agent: Funnel shaped anal canal No tear, rugosity Shaved perineal hair Positive lateral buttock traction test Manual reaction of buttocks - paradoxical dilation of anal canal
Rape
definition
375 IPC - defines rape
Rape is insertion of penis/penis like objects into vagina/oral/ anal/urethral parts of female
Natural or unnatural
Rape and consent/ will
Rape includes: 1. Against will 2. Without consent 3. With consent: • out of fear 😨 • fraud • intoxication • <18 years - statutory rape
Medical definition of rape
Slightest penetration of vulva - defines rape
Hymen rupture, semen discharge or complete penetration is not necessary
No age limit for committing rape
Only with females in India
Impotency is not a defence for rape
In France rape - both male and female
Punishment for rape
Under 376 IPC A. Coma or any vegetative state: LI-☠️ B. Both 👫🏻 legally separated/divorced: 2-7 yrs C. Custodial rape: 5-10 years D. Gang rape: 20 yrs-LI E. Excessively heinous or rarest of rare crime/related gang rape: LI-☠️
Examination of victim
formalities
164 CrPC
Minimum rank - Sub Inspector
Female SI and doctor required
Examination done with consent 53(2) CrPC
Examination of victim
medical tools used
- Toluidine blue dye:
detect injuries in vaginal and perianal region - Glaister keen Rod:
detect hymen rupture 5-7’o clock - Four swabs from different region collected
Examination of accused of rape
53 CrPC
Consent not required
Minimum rank sub inspector level
Smegma present around glans penis ➡️ no sexual intercourse in last 24 hours
Penile swabs collected: detect vagina cells by Lugol’s iodine stain or Papanicolaou stain
Legal implications in rape
Disclosure of identity of rape victim: punishable under 228 IPC
For rape trial in court: camera trial or secret trial ➡️ public not allowed 327 CrPC
357 CrPC : it is mandatory for any hospital to examine/treat rape victim without any delay
166 A and B IPC
166 A IPC:
If police fails to report/file FIR its punishable under 166 A IPC
166 B IPC:
If hospital fails to provide treatment to rape victim, its punishable under 166 B IPC
Acts which impose burden of proof of a rape case on male
114 A IEA: Presumption of absence of consent
113 A IEA: Presumption of abetment of suicide
113 B IEA: presumption of dowry death
146 IEA: immortal character of rape victim is not questionable
Marital rape in India
Old law: wife <15 years even with consent is punishable
Supreme Court changed it to 18 years
Above 18 years - no marital rape
Juvenile rape
POSCO act: protection of child against sexual offences
It is for children below 18 years - both male and female
Implemented in 2012
Amendment Bill passed on 2019
Infanticide Neonaticide Filicide Xenocide Uxoricide
Infanticide: Killing a child < 1 years Neonaticide: Killing a child within 24 hours of birth (not 28 days) Filicide: Killing a child by parents Xenocide: Killing of a whole race Uxoricide: Killing of romantic partner
Fetus deaths
1. Dead born: Within uterus 2. Still born: In birth canal during delivery 3. Live born: Gets delivered and respires at least once
Features seen for a viable baby i.e, >28 weeks out 7 months
Length: 35 cm Weight: 900-1200 gm Eyelid: open at 7 months 👁 Pupillary membrane: disappears Bony centers of sternum and talus appears 🦴
Features in a dead born
R. Rigor mortis, Robert sign A. Aseptic autolysis M. Mummification S. Spalding sign Hyper flexion off spine + crowding of ribs Deuel’s Halo sign
Robert sign
Maceration
Robert sign: • air or gas in aorta • earliest sign - within 12 hours Maceration/aseptic autolysis : • Fetus becomes soft and flaccid • fetus surrounded by aseptic amniotic fluid • skin - red and peeled off • sweet smell
Mummified fetus
Seen when the amniotic fluid, air and blood supply to the fetus is compromised
Fetus is dehydrated and sunken
Seen in dead born
Spalding sign
Deuel’s halo sign
Both are seen in dead born Spalding sign: Seen because of liquefaction of 🧠 Leads to overlapping of bones 🦴 Deuel’s halo sign: skull table show Deuel’s Halo because of 🔼 subcutaneous fat
Findings in live born
- Respiratory signs are present
- 🫁: voluminous, inflated, soft, 🔼 weight, rounded margins and light red 🟥
- Position of diagram: 6-7 ribs (before 4-5 ribs)
Tests for live born
- Wreden test: air in👂
- Breslau 2nd life test: air in stomach/intestine
- Fodere test: 🫁 weight ✖️2
30 gm ➡️ 60 gm - Plouquet’s test: 🫁:👤 in weight
1:70 ➡️ 1:35 - Hydrostatic test
Hydrostatic test
Breslau 1st life test
Raygat test
Unused 🫁 : Sp. gravity: 0.94 Does not sink Respired 🫁: Sinks in water Sp. gravity 1
False positive for tests for live born
Non-respired lung showing positive test 1. Decomposition: Gas in lungs Liver is taken as control 2. Artificial respiration
False negative for tests for live born
Fetus respired but test is negative
- Pulmonary edema
- Alveolar duct membrane
- Feeble respiratory effort
- Pneumonia
- Air absorbed by 🫁
Umbilical structures and foramen ovale
forensics
1. Umbilical artery: • Closes by 3rd day • forms medial umbilical fold 2. Umbilical vein: • closes by 4th day • forms ligamentum teres 3. Umbilical cord; • closes by 5-6 days • falls off 4. Ductus venosus: • closes by 3-5 days 5. Ductus arteriosus: • closes by 7-10 days 6. Foramen ovale: • closes by 2-3 months
Vagitus uterinus
Vagitus vaginalis
- Vagitus uterinus:
Crying of baby intra-uterine - Vagitus vaginalis:
Crying of baby in vaginal canal
Cephalohematoma
infant injuries
Injuries due to instrument
Present in b/w periosteum and skull
M/C in right parietal bones
It never crosses the suture lines
Caput succedaneum
Edema and congestion of scalp because of pressure produced by vaginal ring
SIDS sudden infant death syndrome
Crib death
Cot death
Seen as negative autopsy: no cause can be ascertained
M/C sleep apnea
IPCs relevant to infanticide
312-316: criminal abortion
317: abandoning child < 12 years
318: concealment of birth (punishment of 2 years + fine)
Battered baby syndrome
Caffey syndrome
Baby is abused physically by guardian or parent repeatedly
History given by parents and physical findings in the baby’s body are inconsistent
Multiple injuries of various duration are seen:
1. Multiple rib fractures:
String of beads appearance
2. Metaphyseal fractures of long bones:
Bucket 🪣 handle fracture/ Corner fracture
3. Skull fracture: Egg shell🥚 fracture
Shaken baby syndrome
Infantile whiplash injury
- Repeated shaking ➡️ forced hyperextension ➡️ hyperextension injury of neck
- Intraocular bleed ➡️ Dot blot hemorrhage
- Periorbital hemorrhage
- Subdural hemorrhage
- Six penny bruise or 🪙 shaped bruise may be present
- Butterfly bruise: may be present
Steps in examination of accused in a sexual assault
- Brought by 👮♂️ and signed request
- Consent
- Preliminary data
- Physical & mental status
- Signs of struggle on clothes or body
- General & local examination
- Preservation of samples
- Lab report and opinion
- Potency certificate
- Age estimation
