PRETENDED ASSAULT

How may wounds, alleged to have been the result of an assault, be shown to have been self-inflicted? This has to be done by considering:

(1) The character of the wounds: in these cases they are generally slight, and may consist in a series of small, superficial wounds.

(2) The parts of the body where they are, and those from which they are absent. They are never found on vital parts, but always where there is little danger of doing harm. They are present on parts accessible to the individual. The hands are seldom wounded, and if they be, not severely.

(3) The clothing may not be cut, and if it be, the cuts may not go right through, and if they do, they may not coincide with the position of the wounds. The person should be clothed in order to determine this. Blood-stains on the cuts in the clothing may be erratic in distribution, some being on the inner layer only, some on the outer, and rarely soaking through all, pointing to the probability of its having been artificially applied.

Such self-inflicted wounds are usually produced for the purpose of bringing a fictitious charge of assault, feigning self-defence or provocation on the part of the assailant when accused; and in order to divert suspicion, as in the case of a person who alleges he has received the injuries by an assailant who was committing robbery while he himself is guilty of it.

THE CAUSES OF DEATH
FROM WOUNDS

Wounds may prove fatal from results which are (1) directly due to injury—hæmorrhage, shock, or mechanical injury to some vital organ, e.g. the heart or lung; or (2) indirectly from complications which may supervene such as infective processes—erysipelas, tetanus, septic infections, gangrene,—exhaustion, or the effects of surgical operations; or (3) malum regimen (a) on the part of the patient, (b) on the part of the medical attendant.

1. Direct

Hæmorrhage.—Hæmorrhage may be profuse and cause rapid death if a large blood-vessel, more especially an artery, has been injured. The hæmorrhage may take place internally, in which case it need not necessarily be profuse; it will depend upon the position; a small hæmorrhage into the pericardium or in the brain may prove rapidly fatal.

Shock.—Death from shock is generally associated with severe injury, either a single one, or from several smaller injuries, any of which alone would not be expected to prove fatal. Death may occur from shock when the visible injury may be slight, as in blows over the heart and abdomen, the latter causing fatal syncope from dilatation of the splanchnic vessels. Repeated lesser injuries as in flogging may cause death through shock; and fatal psychical shock may be caused by mental excitement, as, for instance, in an encounter when no physical injuries have been received.

Mechanical Injury to Viscera.—This causes rapid death, more especially when the viscus injured, as the heart or medulla, is necessary for the immediate functions of life; injuries to other organs may not be followed by immediate death unless very severe and with great shock. A wound of the lung may not be followed by death for some time.

In a healthy person the violence necessary to prove fatal ought to be greater than in one diseased, and pathological conditions may be found post-mortem, which were pre-existent to the injury, e.g. degeneration of blood-vessels, aneurysm, valvular disease of the heart, phthisical cavities which may have bled, gastric ulcer which may have ruptured. Such conditions might influence the findings of a jury, as, for example, it is not always possible to form the opinion that death has been directly due to violence when signs of injury are slight; a man may receive a blow on the head while in the act of falling in a fight, and post-mortem a cerebral hæmorrhage be found with diseased vessels, when it would be difficult to say with certainty that the hæmorrhage was directly caused by the blow or preceded it.

2. Indirect

Fatal Complications.—In English law if death follow injury inflicted by a person within a year and a day, the assailant may be tried and punished; beyond that time the person is not held responsible for the death. The infective processes mentioned above may supervene at any time during the course of wounds with fatal result. Further, as a result of altered conditions left by injuries which in themselves have not proved fatal, and from the immediate effects of which the person has recovered, fatal complications may follow, e.g. a person may have received an abdominal wound which after healing may become the seat of hernia which may strangulate; or an injury to the spinal cord, which may cause death at a late date from bedsores and exhaustion.

Septic Processes.—These may cause death at an early date according to their nature and virulence and the power of resistance of the person. In such cases the original injury need not have been dangerous to life. In other cases the infection may persist after the wound has healed, as infective endocarditis might conceivably do.

Surgical Operations.—Should a surgical operation be considered necessary for the treatment of the injury or in order to save life, and the person dies after it, the prisoner will be held responsible for the death. This holds good if the operation has been done in good faith and performed with reasonable skill and care. If, however, it can be shown that the operation was unnecessary, or performed unskilfully and death resulted, the prisoner would not be held responsible unless it can be proved that the injury apart from the operation could have caused death, when the jury might convict.

Where from improper treatment of an injury an operation is called for because of the improper treatment and the person dies, the prisoner would not be held responsible. The main points to be considered in reference to surgical operations for criminal injuries are:

3. Malum regimen

(a) On the part of the Person Injured.—If the wound is not in itself sufficient to cause death, but by negligence in the care of it by the injured person, complications arise which cause death, then the punishment would probably be mitigated; but in law a person accused of criminally injuring another is held responsible for the immediate and remote results. “No man is authorised to place another in such a predicament as to make the preservation of his life depend merely on his own prudence.” If, however, it can be proved that death was largely due to the imprudence or recklessness of the deceased, it is probable that this would lessen the punishment.

(b) On the part of the Doctor.—A person accused of criminally injuring another being held responsible for the results immediate and remote, may plead that the latter, i.e. complications, or the death itself are not due to the injury directly, and endeavour to throw the responsibility on someone else, either the injured person through negligence, or on the doctor for unskilful treatment. In reference to the complications, the medical witness may be asked for his opinion as to the cause and effect of the complication, and how it might have been avoided. Having considered all the facts laid before him and made his deductions, he must give his opinion fairly, and leave it to the Court to decide in what way his opinion may influence its judgment and the amount of punishment for the offence.

When there is an allegation that the treatment has been unskilful or negligent, and contributory to complications and death, and a defence raised accordingly, the prisoner has to prove this to the satisfaction of the Court in order to mitigate the offence and punishment. The medical man is expected to have exercised reasonable skill. If the person treating the injury is a registered medical practitioner, and has applied his treatment in good faith and for cure, even if the treatment were improper, the assailant would be held responsible.

The care which the medical man ought to exercise is that which everyone ought to exercise who has received the statutory education and passed the statutory examinations.