Medico-Legal Journal

Cancer diagnosis, medicine, prevention and care is changing – all for the better. As opposed to the “old days” of luck, trial and error and toxicity, we are now entering a new dawn due to advances in genomics and our understanding of biology. Personalised medicine or PM (aspects of which may also be referred to as precision medicine) is a medical model that proposes the customisation of healthcare – with medical decisions, practices, and/or products being tailored to the individual patient. This talk examines how this has evolved in the field of oncology, to maximise benefits to our patients and minimise toxicity, being able to predict in advance who our therapies will work for.

The principle of personal autonomy means that patients are free not to attend scheduled medical appointments and to risk the complications that may occur as a consequence of their non-attendance. But the situation may be more complicated if the patient’s doctor recognises that the patient may be vulnerable to a particular risk. What are the limits of the doctor's obligation to follow-up or recall the patient for a further consultation? Some recent cases cast light upon this issue.

Castration is an anthropogenic procedure by which the person loses the functions of the testicles or ovaries; it can be performed by surgery or by administering chemicals. The motivation was primarily eugenic, to weed out the “unfit” from the human gene pool. In 1996, California first introduced chemical castration under s 645 of the California Penal Code for child molestation and this legal template has spread globally to counter sexual offences. The anti-androgenic pharmacotherapy used for chemical castration includes cyproterone acetate or medroxy-progesterone acetate (Depo-Provera), which reduces testosterone levels and reduces male sexual urge and fantasies. However, the associated health hazards with anti-libido drugs put a question mark on such State sponsored penal response. Castration destroys human dignity, breaches the right of privacy and procreation and attracts the cruel and unusual punishment clause. The failed Oregon castration experiment and Moldova Court verdict in July 2013 indicate that the stage is set to right this wrong.

Rapid advancements of information and communication technology in the form of electronic mails, mobile phones, social networking sites, etc have an increasing impact on people's day to day life. It has been observed that these readily available applications are used frequently to express suicidal intentions. There are many studies on conventional handwritten suicide notes but suicide note in electronic format is an emerging issue and an under-researched phenomena. The authors have termed it as “E-suicide note” and discuss its medico-legal implications in India with examples from their observations.