Opinion Writing- An Art or Science?

DR. SHRABANA KUMAR NAIK

Professor, Forensic Medicine,
Lady Hardinge Medical College,
New Delhi-110001
Ph: 9891224143
Email: naikshrabana@yahoo.co.in
Abstract:
Opinion is the most vital part of any medico-legal report. It must be dedicated to fulfill aim of laborious
medico-legal examination and report writing to bring out the truth for administration of justice. The
investigating police agency as well as the court of law are more concerned with the opinion than detailed
medico-legal findings. An opinion can halt the entire police investigation or can boost it in any direction. It
can convict or acquit an alleged accused in the court of law.
Opinion cannot be readymade. It varies with type of medico-legal report, medico-legal findings, demand
and situation of the particular case and experience of the forensic medicine expert.
Unnecessary reservation of opinion serves no useful purpose to further police investigation. It can provide
ample time for accused to flee from the site or for destruction of valuable evidence. Too short opinion may
not solve all the medico-legal questions arising in the case, forcing the investigating agency to seek
subsequent opinion again and again. On the other hand, due to overconfidence, unwanted proactive opinion
before submission of all the relevant fact can sometimes land the forensic medicine expert in embarrassing
situation at later stage. Thus there must be balance in the opinion.
It should not be coined with unusual or difficult medical terms that cannot be interpreted easily by
investigating agency or judiciary system. It cannot be mere beautiful arrangement of words or just
presentation of scientific fact. Therefore, opinion writing in medico-legal report is an art or science??
Key Words: Medico-legal report; Opinion; Art of writing; Scientific fact;
Investigating agency; Administration of justice
Way of Medico-legal Report Writing

Cutting, overwriting raises suspicion- hence, pre-

thought required about complete sentence or
paragraph before writing.
Cutting, overwriting must be marked with initial, in
case multiple, it is always better to change the entire
page with fresh one.
Once submitted to the investigating agency, no recall
is made to modify the medico-legal report.
Way of Medico-legal Report Writing

If not typed, handwriting should be readable to

others.
It should be grammatically correct.
There should be always improvement from one
report to another.
Whenever required, helps should be obtained from
senior colleague or forensic medicine expert.
Medico-legal findings mentioned in the books
should not just be fitted into the case.
Way of Medico-legal Report Writing

All the columns and rows must properly be filled-in.

No abbreviation should be used.
E.g., CLW
Writing NA/ NAD should be avoided.
There is no ready made opinion.
Mentioning negative findings are sometimes more
useful than positive findings. Hence, one should
aware when to mention those.
Way of Medico-legal Report Writing
One should not feel ashamed of writing findings and
opinion in obscure and negative autopsy.
Nothing should be treated as impossible in forensic
medicine.
Medico-legal reports archieved in the department are
very good source of learning.
Case reports presented in the older version of Modis
Jurisprudence were also good source of learning.
Mistake due to ignorance or inadvertent mistakes must
be admitted with due apology, rather than argument.
Way of Medico-legal Report Writing

No difficult medical terminology should be used to

show the superiority or uniqueness.
Opinion should be simple as far as possible so that
it can be understood by both investigating agency
and court of law.
It should not be too ornamental.
It should not be too short missing important
component of interpretation or explanation.
Way of Medico-legal Report Writing

It should not be too lengthy, that is more than

required.
What the mind does not know, the eyes cannot see.
Hence, during initial learning stage, have a pre-
reading of medico-legal findings of the particular
type of case for better observation during
examination.
Way of Medico-legal Report Writing

Also have a post-reading of pathology of organs

based upon the medico-legal findings.
The dead always tells the truth, not the relatives or
police. Hence, do not rely too heavily upon the
history of the case.
Investigating agency or culprit implanting story or
weapon of offence are not uncommon. Hence, it
must be kept in mind.
Way of Medico-legal Report Writing
Always use of complete sentence. Description must be
complete one.
E.g., Abrasion, red, 5X 2 cm, on the face.
Abrasion red in colour of size 5cm X 2 cm situated
horizontally on the left side face, 2cm in front of left tragus.
Location of the injuries must be well defined.
Specific sequence of bodily injuries must be followed.
There must be use of only standard international units.
Additional pictorial diagrams are helpful but wrong
depictation of side can land into trouble.
Way of Medico-legal Report Writing

No space should be left behind to avoid any kind

of alteration.
E.g.,Addition of No can reverse the whole meaning
of findings or opinion.
Entire medico-legal report must be thoroughly read
to cross check any mistake, before submission to the
office or concerned investigating agency.
Way of Medico-legal Report Writing

Opinion should able to stand test of the time, even

after years.
No innocent should be incarcerated for any reason
at any cost.
Too much deviation must be avoided during
subsequent opinion.
Advantages of Computerization of
Medico-legal Reports
Can easily be read by everyone.
Less chance of spelling error.
Cutting and overwriting will be nil.
Can be easily modified before submission.
Softcopy can be transferred to any part of the
world within no time.
Advantages of Computerization of
Medico-legal Reports
Softcopy can be stored within hard disk for years
without occupying much office space.
Can be retrieved within seconds.
Softcopy can minimize the time required in the court
of law for dictation and typing the whole medico-
legal report.
Disadvantages of Computerization of
Medico-legal Reports
Auto correction of word by the computer for
typographical error if overlooked can change the
whole meaning of the sentence.
Copy paste from old reports can left undesirable
remnants (findings) that are not part of present
case.
Chance of crashing of computer with loss of all the
medico-legal reports stored inside, even after using
best anti-virus.
Disadvantages of Computerization of
Medico-legal Reports
Chance of hacking of medico-legal report.
Chance of loss of confidentiality of medico-legal
report, unless stored with strong pass words.
Chance of editing by someone at any stage cannot
be denied.
Types of Opinion
Complete opinion
Incomplete opinion
Silent opinion- Bomb blast victim
Pro-active opinion- Tihar jail death
Opinion based upon exclusion Drowning death with
no typical froth
Pending opinion
Malafide opinion
Reversed opinion- Strangulation to hanging
Controversial opinion- Sudden unnatural death
Types of Opinion
Over-confident opinion
Doubtful opinion
Opinion of possibility- Murder- Two weapons for same
pattern injuries
Opinion out of ignorance- Not well trained M.O.
Time buying Ignorant
Helping opinion- RTA leading to drowning
Deciding opinion- Court direction, only one to choose
Informative opinion- Atypical decomposition
Opinion based upon obsolete tests- Hydrostatic or Diatom
test
Types of Opinion
Signature opinion- Sustained
Pleasing opinion
Sound opinion
Medical opinion
Legal opinion- Rape
Needy (privileged) opinion- Starvation instead of PEM
Double edged opinion- Constriction of the neck
Pre-mediated opinion- Throttling
Guarded opinion- Keeping option to either sides
Types of Opinion
Fixed opinion
Fluctuating opinion- Murder to suicide to accident
Conclusive opinion
Inconclusive opinion- insufficient findings
Explained/ substantiated opinion
Lost opinion- Decomposition
Wrist cutting opinion- committing manner in burn
cases
Problems associated with Medico-legal Opinion

No scope in PHC/ CHC and private medical

colleges to learn the art of medico-legal opinion
writing.
In medical colleges- learning depends upon
knowledge, experience and attitude of senior
teachers.
Quality improves with experience of medico-legal
works.
Quality improves with experience of cross-
examination in the courts of law.
Problems associated with Medico-legal Opinion

Learning from past mistakes.

E.g., Mixture of modes of death- coma and shock;
shock and suffocation.
Quality improves with continuous exposure to
practical works- Seniors hardly visit morgue-
thereby rusting of knowledge.
One should have desire to learn- Without it, there
cannot be further improvement, but can be
degradation.
Problems associated with Medico-legal Opinion

Medico-legal languages are not easy at all! Even

the best English teacher cannot understand it
properly. Only experienced seniors can teach the
art.
Cause of Non-availability of Seniors for Medico-
legal works and their supervision

Busy with UG teaching and administrative works.

No appetite to learn further.
Reluctant to attend the courts of law:
Hectic journey for distant courts of law.
Inadequate compensation for travelling expenses.
Undue delay in payment of TA/ DA bill by the
administration.
Cause of Non-availability of Seniors for Medico-
legal works and their supervision

No Post-mortem allowance.
Fear of attending the courts of law long years after
retirement from job.
Disrespectful attitude of courts of law- Even not a
single seat is meant for sitting of the forensic
medicine expert.
Problems associated with Medico-legal Opinion

Opinion must confer with law of the land.

E.g., Hanging is a form of ligature strangulation.
Seniors may reluctant to pass his medico-legal
knowledge to juniors if;
Not obedient
Disinterested- Only for degree, not for knowledge
Fear of misuse in future

No standardized proforma for medico-legal reporting

across the country- Without mentioning all the findings,
hard to form a sound opinion.
Problems associated with Medico-legal Opinion

Virtual cause of death- Physiological death-Ventricular

arrhythmia, Atrial fibrillation- Without appreciable findings-
difficult to conclude.
Without performing complete autopsy, confidence
regarding opinion cannot be absolute.
While opinion is provided on the basis of photographs-
Photographs are not truly scientific.
E.g., Incomplete course of ligature mark
Observation and interpretation may vary from expert to expert.
Again chance of edited photographs submitted for examination
cannot be denied.
Problems associated with Medico-legal Opinion

Expert opinion based upon observation made by others.

All the observations made during examination may not be reflected in
the medico-legal report.
Hence, chance of erroneous expert opinion which may even lead to
suspension/ dismissal of the colleague.
Expert opinion based upon video graphs at NHRC.
Quality of video graph may be very poor.
Video graphs may have missed important findings.
Superiority of direct naked eye examination cannot be compared with
observation upon video graphs.
Editing of video graphs cannot be denied.
Doctors who conducted the real medico-legal examination are not
available to explain any doubt.
Problems associated with Medico-legal Opinion

Seniors have the duty to check the kind of opinion furnished by

juniors- rather than just forwarding it.
Junior may be too adamant, thus not rectifying any mistake pointed out
by the senior.
On the other hand, juniors may be forced unethically to write the
wrong opinion because of various reasons including:
Political pressure.
Request from other professional colleague.
Biased by the investigating agency.
Biased by the media trial.
Lack of knowledge and experience in themselves.
Low confidence over juniors
To avoid unnecessary harassment including career progress.
Problems associated with Medico-legal Opinion

No uniform distribution of medico-legal works. Quality can decrease

with heavy medico-legal work loads per expert.
Medico-legal report writing is felt like a burden- not integral part
of duty.
Power of observation- power of interpretation- power in opinion.
Without honesty, no use of medico-legal knowledge and experience.
Only honesty without knowledge, then again chance of injustice and
incarceration of innocent.
Hence, overall improvement in quality of opinion- improvement in
conviction rate in courts of law- better law and order situation in the
society.
Why Opinion Writing is a Science?

Opinion is based upon findings which are pure

medical science.
Most of the words coined in the opinion are medical
terms.
Opinion is based upon scientific evidences; there is
no scope for imagination.
As it is a science, same medical findings- same
interpretation and same conclusion by any forensic
medicine expert across world.
Why Opinion Writing is a Science?

As it is science, it is able to stand against the test of

time.
When the finding are based upon medical science,
derivation out of it cannot be other than science.
That is why forensic expert are rightly called as
man of science.
Why Opinion Writing is An Art?
Scientific findings need a systemic arrangement,
those cannot be thrown haphazardly.
Opinion is not necessarily medical language, but
medico-legal language contrast to findings based
upon medical science.
Even there is same medical findings, forensic expert
can reflect the interpretation or conclusion in many
ways.
Why Opinion Writing is An Art?
Besides meant for administration of justice, it may
also meant for many other purposes.
Science of possibility, probability cannot be called
as pure science.
Medical science has its own limitations, beyond
that.
Writing positive findings in double negative form is
nothing but an art.
Even insertion of negative findings is nothing but an
art.
 Hence, I wonder whether Opinion writing is an art
or science!!

Conclusion:
Opinion writing is an art of reflecting interpretation
of scientific evidences to the demand of the case.
Thank
You.