India's morbid obsession with post-mortems needs to be exposed

Dr Indrajit Khandekar is a man with a mission. Doctors (the good ones) are always people with a purpose. But Dr Khandekar is different. He is a forensic physician as well as a lawyer. That gives him an extra tool to investigate, research and expose medico-legal wrongs.

I first interacted with him in 2013. The nation was in a state of shock at that time: in the wake of the Delhi gang rape case, "rape survivors" were appearing in silhouette on TV and talking about their trauma at the hands of doctors - the Two-Finger Test. Although banned across the world for being archaic, unscientific and massively invasive of privacy and dignity, it was still being done in India. To check the elasticity of a victim's vagina, whether a victim was "habituated to sex" or not (although such questions have no bearing on a case of sexual assault). Dr Khandekar was determined to expose that there was no "scientific basis to this test".

He had prepared a list of, what he called, "improper, irrelevant and absurd" questions put to doctors by the police, when examining a victim of sexual assault. His study report, "Pitiable and Horrendous Quality of Forensic Medical Examination of Sexual Assault Cases" prompted a PIL, with the Bombay High Court asking Maharashtra government to frame new guidelines based on Dr Khandekar's suggestions. With the Union health ministry taking up the issue, Two-Finger Tests were banned in India last year.

But Dr Khandekar has not stopped being forensic medicine's face of courage. Recently, he told me that he is now on to yet another cause: unnecessary autopsies. Apparently, lakhs of unnecessary, and even illegal, autopsy examinations are being carried out in India. India spends a huge amount of time and money on these, even when an external examination is all that's needed to figure out the cause of death: "In the name of investigation, the police forward dead bodies for medical examination routinely and constantly."

According to 174 CrPC, he said, the police should go for dissections, only if there is:

1) An unnatural suspicious death of a woman, within seven years of marriage.

2) Any doubt regarding the cause of a death.

According to Dr Khandekar, unnecessary post-mortems are turning mortuaries into "production-line abattoirs". Apart from the wastage of manpower, money and time, they lower criminal investigation standards and cause unnecessary harassment and pain to the relatives of the dead.

Of course, India does not keep straight records of the total number of autopsies a year, the cost of conducting those or what sort of procedures are followed. (I still remember how shocked I was to read about the post-mortem procedure followed in the most famous murder case in recent times: the Aarushi Talwar murder case. The court documents showed that Aarushi's body was taken away for post-mortem at 9am on May 16, 2008. Strangely, the autopsy was done by a "public health specialist", Dr Sunil Dohre of Noida, and not a forensic physician. And who helped him? He did the job along with a "pharmacist and two sweepers." What I have found so far (and I need to verify this) is that in most countries around the world the rate of post-mortem is less than 20 per cent. It is over 95 per cent in India.

Dr Khandekar's team put forward a model to Maharashtra CM Devendra Fadnavis, on how the state could stop about 47,500 unnecessary autopsies a year. "That would save 142,500 hours a year of the police, 95,000 hours of doctors and 28,500 hours of relatives," he said.

A week back, he informed me that the Maharashtra government has taken it up in earnest. The government is now studying the report. It's one step at a time for Dr Khandekar, but never missing a step.