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Dr K K Aggarwal

National IMA (membership 2.2 lacs) and eMedinewS (readership 1 lac) recommendations to Justice Verma

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1. The word penis should not be used (use male sex organs) anywhere in the law

2. The work vagina, labia majora should not be used anywhere in the law (Female sex organs)

3. Under the influence of alcohol and drugs the punishment should be different and treatment added. For rarest of the rare case death sentence can be added. People with abnormal sexual urges should be treated.  

4. We must sensitize the parents, teachers and schools to identify red flag signals of an abnormal personality trait in children (present in up to 10% of children) so that they do not indulge in sexual offences later

5. Chemical castration is not acceptable to medical profession, is not safe, not health friendly is temporary and lead to corruption

6. Medical profession should help training all policemen in CPR and first aid

7. Every PCR van should be a mini ambulance also. One can post a paramedic in it for RTA and assault cases

8. Private hospital should be allowed to examine rape victims and guidelines should be pasted in every Emergency room

9. We need to define, issuing of medical bulletin, guidelines

10. Transfer to other country there should be a clear cut national policy and decide by a panel of treating doctors in consultation with Govt. health officials

 11. Sick RTA or assaulted patients should b shifted to a nearby hospital (govt. or private) so that medical services are available within ten minutes and stabilized within one hour.

12. Forensic examination lab should be strengthened and should give results in time bound manner.

13. Most sexual assault cases occur in slum areas. Efforts should be made to create awareness in these areas

14. All accused should be compulsorily be tested for sexually transmissible illnesses and victims be considered for STI, HIV and pregnancy prevention treatments

15. All health care professionals to have compulsorily short term training in counselling, empathy, communication, etiquette as part of medical education.

Drafted by Dr KK Aggarwal for National IMA and eMedinews based on proceedings of a seminar organised by IMA and inaugurated by National President IMA, Dr K Vijaykumar.

 

 

 

Inaugurating the seminar on ‘Psyche Behind Rape: Treatment-cum-punishment’, Dr. K Vijaykumar, National President, IMA said that on one hand, IMA supports stringent punishment to the rape accused, on the other hand, IMA is for providing correct sex-education in the school at the right age and also educating the society, especially, the youth so that they do not end up in psyche, which provokes rape in the society.

Addressing the seminar, Dr. Narender Saini, Secretary General, IMA said that the IMA will come out with guidelines on “How a medical doctor should tackle a patient with suspected rape?”

Moderating the session, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, National Vice President (Elect.), IMA said that it is crucial for the doctor to examine both the rapist and the rape victim for HIV-AIDS, Hepatitis B and Hepatitis C, all which can be transmitted through sexual route. The rape victim as well as of the accused should be checked for these infections at baseline, then again at 6 weeks to 3 months. Post exposure HIV prophylaxis should be given to all rape victims.

The other faculty in the seminar included Dr Vinay Aggarwal Past President IMA;  Dr. D.R. Rai, Senior Vice President, IMA;  Mr. Ajay Kumar, Aaj Tak;  Dr. S K Pal and Dr Anil Goel (Andrologists); Ms Indu Malhotra (Senior Advocate); Dr. BB Rewari (NACO);  Dr. Jitender Nagpal (Psychiatrist); Dr Anita Kant (Gynecologist);  Dr. Ajay Gambhir (Pediatric and Finance Secretary, IMA), Ms Kalpana Kapoor (Educationist) and Dr Sarvesh Tandon (Finance Secretary IMA East Delhi Branch).

Following were the salient points of the seminar:

  • Right sex education should be started in school age. IMA will come out with suggestions regarding curriculum.
  • All doctors dealing with rape victims should ensure total confidentiality of the victim and examine them properly.
  • All rapists are also brought to medical doctors for examination which includes tests for their sexual potency. They should also be checked for presence of sexually transmitted diseases.
    • There has a suggestion from the Government that chemical castration can be one of the punishments to the rapist. The same cannot be done without involving the medical fraternity. The oral tablet for chemical castration given daily cannot be the punishment for rapist. One can only give injections which reduce testosterone levels but the same injection has to be given every 3-6 months and the effects are reversible.
    • Chemical castration injections are not safe and health-friendly. In the long run, they can cause thinning of bones and cardiovascular diseases.
    • Chemical castration injections will also promote corruption since influential people will force or bribe the police and the doctors to give a water injection and write anti-testosterone injection has been given.
    • A paraphiliac rapist has been differentiated from a non-paraphiliac rapist.
    • Sexual contact with a girl who is less than 16 years of age is a rape even if the sexual contact is with mutual consent.
    • The percentage of rapes is not reported. Majority of the rapes are reported from JJ Cluster areas.
    • False allegations may be made in the following situations:
  • Consensual live-in relationship where one refused to marry.
  • One is caught in an extramarital affair.
  • As a part of revenge
  • Under the influence of alcohol and drugs
  • In an atmosphere of pornographic movie
  • Date rapes and under the influence of date rape drugs
  • Presence of stepfather and stepbrother in the house.
  • Blackmailing a rich person after consensual relationship
  • Showing your supremacy of raping a girl in the society so that nobody speaks against the Dada.
  • To show off amongst your friends that you can do it and you did it.
  • Politically motivated
  • You plant a girl to somebody.
  • Examination of a rape victim
  • First and foremost make the woman/girl/child comfortable – she has been through physical and emotional trauma.
  • Take her to a room or corner with adequate privacy
  • A short recount of her trauma is necessary so that the doctor knows where all she has been violated.
  • All the surfaces – cheeks, ears, nose, breasts, arms, legs, thigh (inner parts), abdomen, locally the private parts, even anal opening should be examined for scratches, cuts,  bite marks, blood, dried white patches etc.
  • Examine the hair over vulva for blood or white discharge
  • Check the hymen for fresh/ old injuries
  • Examine the clothes of the victim e.g. underclothes or other clothes depending on how the victim has been violated; they should be collected in transparent bags and sealed to be sent for lab examination
  • After that swabs are taken from vagina (and other areas if relevant) to be tested in lab for sperms, PSA, DNA testing. Sometimes, blood or hair of the rapist can be picked up for DNA matching.
  • Medical treatment of the victim requires prevention of the following:
    Pregnancy – give i-pill; Sexually transmitted diseases (STDs) – fungal vaginitis, syphilis, HIV prophylaxis; The wound, if any, need to be cleaned, stitched, antibiotics, tetanus toxoid etc. to be given.; Psychological support is very important; preliminary blood test for HIV after consent and counseling, and subsequent follow up test is necessary

Types of rapes

Rape generally encompasses nonconsensual vaginal, anal, or oral penetration that involves force or threat of force (physical or psychological), lack of consent, or inability to provide consent because of age, intoxication, or mental status. Rape is categorized according to the relationship between the perpetrator and the victim.

  • Stranger rape describes nonconsensual sexual penetration between individuals who do not know each other before the sexual act
  • Acquaintance rape describes nonconsensual sexual penetration between individuals who know each other in some capacity before the sexual act
  • Date rape is a subset of acquaintance rape in which nonconsensual sexual penetration occurs between two people who are in a romantic relationship. Date rape can occur when the victim is alert and rational or irrational, semiconscious, or unable to respond due to alcohol or other drug use. Verbal coercion, threats or use of physical force, or the use of alcohol or illicit drugs may occur as precipitating events.
  • Pendency of Gang Rape Cases and Rape Cases in Delhi Alone: No. of cases file in court last year 568.
S. No. District Gang Rape Cases Rape Cases Total
1. Central 4 51 55
2. North 8 26 34
3. West 14 105 119
4. New Delhi 5 5
5. South 11 106 117
6. South-East 18 107 125
7. East 13 62 75
8. North-East 15 137 152
9. North-West 23 131 154
10. Outer 23 79 102
11. South-West 21 75 96
  Grand Total 150 884 1034