Notes

2009 July - Note 9

Precautions in dealing with suicide cases

Suicide cases pose a very unusual problem to doctors especially if the patient or those who have brought him or her pretend as if nothing has happened or when history supplied is doubtful or conflicting. In such cases, first inform the police. It may be on telephone or by a simple letter. Then treatment must be started immediately without waiting for police to come.

In some cases when the family is known to the doctor and a fervent request is made not to disclose this fact as it is a matter of family honor the usual course followed is not to make any record, treat the patient and then discharge or transfer the patient. Legally speaking, attempt to suicide does not fall within the mandatory provisions prescribed in Section 39 of Criminal Procedure Code where the consequences of not disclosing the incident of a crime to the police is very harsh.

Clinically you must preserve the returning fluid of stomach wash in sealed containers in poisoning cases.

Do not issue normal death certificate under any circumstances a wrong that is often done.\

Intimating police
Intimation to police must be in —

• writing and
• duplicate

Obtain police officer’s signature as acknowledgment of receipt. Retain and preserve your copy for records.

Medical records in suicide cases
In cases of attempted suicide, the following must be specifically noted in the medical records of the patient:

1. Name of the patient (if known)
2. At least two identification marks over exposed parts
3. Person accompanying the patient (in case of a policeman, write name, number, rank and police station)
4. From where the patient is brought (stated by the patient or the person accompanying)
5. Clinical condition
6. Injury (nature, extent, location)
7. Consciousness and orientation status
8. Vital signs
9. Time and date
10. Time, date and copy of the intimation given to the police, if any