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Alcohol also contributes to accidents during custody, especially head
injuries. Falls onto a hard surface are often on the occiput and the
frequent inding of frontal and temporal contre-coup brain damage
at autopsy is good evidence of a deceleration injury rather than an
assault with a weapon.
• Some falls may occur during custody or in transit from the site of
arrest to the police station – others have happened before arrest, but
the ill-effects and death may become manifest during the stay in the
police cell, when the police are often blamed either for allowing or
causing the injury – or for not summoning or providing urgent
medical attention.
• Drugs overdose or hypersensitivity deaths are occasionally seen
amongst offenders.
• Death may be from purely natural causes, usually cardiovascular in
origin, which happened to have occurred during detention. It must
be admitted, though it is almost impossible to provide objective
proof, that the emotional and sometimes physical upset of being
arrested and con ined may have affected the blood pressure and
heart rate suf iciently, by an adrenaline response, to have
precipitated an acute cardiac crisis in the presence of severe preexisting disease (diabetes, epilepsy, asthma or other diseases).
89. What do we mean by deliberate self-harm (DSH) & suicidal
attempt? How to identify the signs suggestive of DHS?
Deliberate self-harm and suicidal attempt which are considered high
risk behaviors and the negative outcomes of which could be fatal,
grievous injury or person may frequently come in con lict with law as
in this case non-compliance with the jail rules. The cause of deliberate
self-harm could be mental illness, substance abuse, personality
problem or manipulative behaviour. Most commonly noted deliberate
self-harm could be
1. Super icial cuts
2. Head banging
3. Swallowing non-edible materials
4. Scratching
5. Opening old wounds
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