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Deaths that occur in the custody of police even in jails or during their arrest are considered very contentious and difficult deaths for the forensic medical specialists to be investigated. Usually, each death results in a coroner's inquest, an expensive inquiry, together with stress and anxiety amongst those who were actually involved in detainee care. A number of questions are raised when any death occurred in the custody of police, which show a conflicting point within an authority that encloses the states' coercive apparatus. Eventually, these deaths should be explained for the unraveling prevention of hegemony as well as the loss of legitimacy of apparatus (Pemberton 2008). There is no available statistics in a number of countries and there is also a lack of investigative bodies for the reviewing of evidence and make sure that there is no wrong doing by the state bodies, states, or by the individuals (Payne-James,Â SmockÂ & Busuttil 2003).
There are a number of analyses and reviews available of the custody deaths around the globe. Pretschel and Gall (2000) revealed the deaths in custody in Australia. Death in the custody was described for the study purpose as the death, which happened when the person was in the custody or care of police, the psychiatric service, and corrections service. This death includes in the custody or care of police, being conducted by the police, under non-custodial improvements, and any detainee in the prison (Payne-James, Smock & Busuttil 2003).
2. Causes of death
If any death occurs in the custody of police then it does not mean that the death has occurred because of the bad treatment or police assault. However, still you should keep in mind the existence of police suffering, excesses, or any other forms of vicious or humiliating treatment (Jacobsen & Smidt-Nielsel 1996). Sometime prisoners are also involved in committing suicide but there are always some hidden reasons behind these acts. Actually, it is the responsibility of agency, which preserves these detainees to ensure that they are protected physically, to take and to be aware of the precautionary measures, if they supposed that a prisoner might go for confiding suicide. One more issue involved the fitness to arrest in the custody. Nevertheless, most of the time, no serious consideration is given to this aspect in some of the countries. Police of some countries are not trained properly on such issues and the suspects are held in custody who may suffer from the medical conditions that require regular treatment or medical attention.
If anything annoying occurred to the prisoner who already feels some natural disease, by the asset of denied approach to the proper medical treatment may leave the police in any vulnerable circumstance. Often the death in the custody of police is caused by the ignorance. Sometimes those people who suffer from some infection or are drug addicts are put in bars with other prisoners. Consequently, other prisoners are then exposed to risk of getting infection and thus police become liable for this event (Nadesan, Ong & Nambiar 2003).
The statistics of death causes in the custody of police differ from one country to the other and even from one area to the other (Leigh, Johnson & Ingram 1998; Norfolk 1998; Wobeser, Datema, Bechard & Ford 2002; Curnow & Joudo 2009). Those individuals who are held in the custody of police are suffered from different mental disorders, physical health problems, and those conditions that are linked with the drug and alcohol use (McKinnon & Grubin 2010). Deaths in the police custody include those prisoners who involved use of alcohol, self-harm and illicit drugs (Best, Havis, Payne-James & Stark 2006), killed Unlawfully, misadventure, self neglect/ lack of care, or suicide.
2.1 Torture victims
Torture is considered one the serious problems in different developing and developed countries. Torture is defined, according to the Declaration of Tokyo 1975, as 'the systematic, wanton infliction of mental or physical sufferings by the people that act alone or on someone's authority orders, to coerce some other person to have the desired information, to make confession, or for some other reason' (International declarations & conventions, 1996). Torture is considered a prevented form of the extreme degradation, dehumanization, human interaction, and humiliation. There is psychological suffering or extreme pain experienced by victims. Victims are captured in the double blind circumstance where they are dispossessed of different rights and are forced to select between the impossible options (Gurr & Quiroga 2001). There are different forms of physical torture and from this torture many victims survive but many of them die. In death event there will be a distracted attempt for covering up any crime. In case of such deaths, there must be an independent judicial investigation (Adhikari 1993).
2.2 Drunken prisoners in police custody
Drunken prisoners are biggest problem for police and it is also one of the common groups of detainees to die in the police custody (Johnson 1982). In 2004, Best & Kefas explored police associated death rates between 2000 and 2001 due to consumptiom of alcohol by prisons. They investigated that 40% of detainee out of 58 deaths were also involved in 19% of alcohol-intoxicated cases.
2.3 Excited disorientation
Excited delirium syndrome has been associated with deaths in custody which include the use of ECDs electronic control devices on subjects (Jauchem 2011). This is a hyper psychological activity state that is found in unexplained under arrest deaths (Conner 2006). In some circles, it is also known as 'Sudden in-custody death syndrome' (Robinson & Hunt 2005). Generally, police received a call to subjects who show unusual behavior as the person may have partial clothed, nude, or sweating profusely. These conclude in those officers that are forced to use force for bringing the circumstances under their control. With the quick emergency medical treatment, suspects recover rarely. Leaving officers asking questions about why and what happened (Benner 1996).
2.4 Misconduct of officer
This category is supposed to more often than some other is. This group involves torturing, officers beating, or abusing a detainee physically. This does not involve any justifiable force to be used for affecting any control or arrest some combative prisoner. This occurs when the officers abuse prisoners by using some physical force when detainee is non combative and compliant. This also includes officers who deliberately use force on suspect in the custody. If officers refuse medical aids to suspect who is in real distress then it will fill in such category. Mainly, this category includes an officer, with malice or his actions is involved in the death of prisoner (Taylor 2007).
2.5 Autopsy for diagnosis
Post mortem is the term that is applied to the examination of any body after the death. Necropsy (to look at dead) and autopsy (to see for oneself) are usually considered as synonyms for post mortem, but it is the only autopsy that correctly relates to the aims of procedure: to directly observe and study the body relative to the rely on the disease indicators, like clinical symptoms and signs (Burton & Underwood 2007).
3. Death investigations-procedure and policy
In the Los Angeles, following procedures and policy were established for the investigations of such deaths (Sathyavagiswaran, Rogers & Noguchi 2007).
3.1 Investigative aspect
In custody, deaths occur during the apprehension by the police, and the deaths while subjects are incarcerated or detained in public institution. When any such death occurs then the Medical Examiner Coroner staff is responsible to respond the scene, investigating situations, and taking charge of body. Such circumstances often activate emotional outbursts by community activists and family members that can also direct to litigation. Investigations of these deaths require timely thorough processing and sensitivity. Team approach is used to handle such cases in Los Angeles. Such type of deaths raised question related to the use of force, illegal or risky procedures, therefore inquiry is extended into illegal possibility of acts of omission or commission of police department.
Police department is concerned about excessive lawsuits against criminal prosecution and department of involved police officers. The role of Medical Examiner in such case is to hold them with thorough investigation, sound, or by systematic process of gathering, recording, observing, and preserving information and evidence and by the data analyses with rendering goal of cause and manner, and to provide the information for preventing such types of deaths in future (Sathyavagiswaran, Rogers & Noguchi 2007).
3.2 Standard procedure of Autopsy
These autopsies are conducted by well qualified forensic pathologists as external examination needs care. It is required to note even faint abrasions and bruises. This may help in investigating the time of injuries and the abrasion force direction may become crucial issue. Same importance should be given to any type of injury that is found on any part of body on either upper extremities or lower extremities and even genitals. It is important to look properly at neck for petechial hemorrhages and buccal mucosa. It should keep in mind that any existing injury could contribute to death cause. Thorough and complete detail of all investigations is important as basis of assigning proximal death cause (Sathyavagiswaran, Rogers & Noguchi 2007). It is important to follow special procedures for minimizing the chance of missing some important findings:
It is needed to have multiple photographs of injury with ruler.
Photographs include all aspects.
Photographs should be in vertical angels.
It is better to use fine grain negative film with enough lighting so that photographs can be enlarged when needed.
It is better to have sample of fingernail, hair, and clothing related to death and these items should be placed in aerated containers to avoid decomposition.
Neck X-ray is required, even if negative. Post-mortem vertebral artery perfusion is suggested for detailed study.
Conduct toxicology studies and save the adequate sample.
Existing diseases should be assessed by carrying microscopic studies on lung, heart, kidneys, and liver.
Attention should be given to injurious areas to investigation injury time.
CNS should be examined for the assessment of fine neuropathological changes (Sathyavagiswaran, Rogers & Noguchi 2007).
3.3 Gang activity and Prison riots
To better understand the death in jail, it is necessary to gather information from inmates or custodian. Gang activities or prison riots may result in prison custody death and this can also serve important factors to draw conclusion (Sathyavagiswaran, Rogers & Noguchi 2007).
Deciding the death cause in an unclear death is one of the difficult tasks in forensic medicine. Two processes are important to decide the death causes that are causation understanding and adequate autopsy. Corner has investigated that a proper post mortem is essential rather sufficient condition to investigate cause of death. A causation understanding can actually help pathologists to decide death cause in unclear cases. Notably, deciding the death causes is an important part of criminal justice system. Providing well argued and logical opinion will increase the credibility of pathologists in courts and help to ensure fair judicial outcome (Gee 1995).