H.A. Lediard
1890 The Lancet  
THE titl'e is not far distant when the question of the present method of dealing with criminals will be thoroughly discussed, but until the necessity for such discussion is demonstrated there is but little hope of the matter being dealt with in the only Chamber that can deal with alterations in law-I mean the House of Commons. As a prison medical officer of a few years' standing, I have been necessarily experienced ip the rules and regulations put in force by the Prison Commissioners for the
more » ... ssioners for the safety of those committed to their charge. No one could fail to appreciate the care which has been taken to divide the responsibility in the duties of the different officials, whether visiting, resident, or inspecting. The chaplain, the governor, the doctor, the warder, the inspector, and lastly the commissioner, have each duties of his own, for which he is responsible, and the outcome is the safety of the prisoner. Safety, as far as escape is concerned, is not the meaning, but safe keeping in its widest sense. This being so, the general body of the public is content, and it is only when political offenders are classed with criminals that we hear anything of the interior management of our prisons. It is almost impossible for any grave injustice to befall any prisoner without the beads of the department becoming aware of a breach in the rules, and visiting the offender with a censure, a suspension, or dismissal. The general body of the public can rest assured, if it is needful, that at all events a convicted prisoner has British fair play. At the present moment no Howard is required, and he who seeks for abuses and reform must work outside prisons. A few years' work as a prison medical officer teaches much, and I can look back wich some satisfaction upon the time spent upon the duties I am disposed to think that familiarity does not here breed contempt. It will be found that the older officials, so far from being hardened by the routine, become enlarged in their understanding, and make a certain allowance for the caged bird beating its wings against the bars in its futile attempts to escape the thraldom of prison regulations. There arises a quickened intelligence as an outcome of experience, and much real kindness of heart is exhibited in various ways in sickness and trouble, and all this within the bounds of standing orders. For example, we have from time to time criminals whose morbid state of mind has led to crime or the appearance of crime; these unfortunates are "well and truly tried" before Mr. Justice Stareleigh, but are subsequently transferred to their proper place on the recommendation of the medical officer. In such a case much discrimination and, indeed, gentleness is called for, and my experience has been of a favourable kind. Far otherwise is the state of mind in which is to be regarded the occa-sionaUy haphazard method of dealing with persons on their trial. No new fact is stated; no one's experience is transcended when it is said that there is much to be done in order to place an unconvicted prisoner upon a platform of equality with the convict. The question is ripening, and is open to be taken up by any enthusiastic member of the House of Commons who has the welfare of the general body of the public at heart, as well as the dignity of our law courts in his mind. Let me admit at once that I am incompetent to do more than point out a glaring defect, and let me ask some one who is capable to suggest a remedy. It has already been urged, and there are strong arguments for it, that a court of appeal for criminal cases would do much to meet the case of a prisoner who has been convicted upon either false or insufficient evidence, or whose sentence was hastily pronounced, and a too severe term of imprisonment inflicted. It has been pointed out that such a court would act like a two-bladed sword, and cut both waysthat is, where a sentence was too light, the court of appeal might increase the punishment. No doubt the hands of such a court should be free to bind or to loosen, to increase or diminish, and to award credit or to censure. I believe that a court of appeal would do much, and it is within the rights of the general body of the public that such a safeguard should exist; on the other hand, prevention of error is preferable to its cure when mistakes have been made, and the contention is that a healthier method of criminal pro-cedure would be a strong argument against the necessity for constituting a fresh court of j justice. At the present moment there is a pseudo-court of appeal at the Home Office, and there, I believe, much patience, care, and thought are given to all representations made on behalf of convicted prisoners, with, in some cases, the happiest results. For instance, how many more victims would the hangman claim were the court of appeal non-existent ? It is not, in my opinion, that sort of court of appeal which is wanted, and nothing short of a public review of a case, with all the witnesses, fresh facts, and a réchauffé of the old ones will satisfy those who ask for a court ot appeal. I know that such a court of appeal would be inaccessible to a poor man, and therefore were such a thing established he would be as far off as ever from obtaining a rehearing of his case. The costliness of the law which hampers the prisoner whose circumstances are humble would hamper him still more at his second tribunal. If he be unable to engage the full services of a lawyer whilst he awaits his trial, and unable to collect sufficient to properly reward a proper counsel to defend him, how can he provide the means to obtain a rehearing of his case unless he throws himself upon the benevolence of a sympathising public ?-an impossible arrangement, especially should he chance to be convicted of a disgusting offence, the very nature of which forbids public controversy. To the wealthy a court of appeal would do much ; for the poor man it would be like caviare to the general public. Scientific igiiperfections.-The chief direction where lies wrong to be put right is in the position of the medical profession in the witness-box in criminal cases. I say nothing as to civil cases, as these do not concern the personal liberty of the subject, and they are beyond the scope of my present observations. Before going further, let us see how a medical man becomes mixed up in criminal work, which leads up to his subsequent appearance in a witness-box. Violence of some kind is inflicted upon someone, a dead body is found, or an assault or outrage is suspected, and the policeman is informed. It is possible that in the mind of the informer, and possibly in the mind of the policeman as well, a first impression is made, which, finding its way into a note-book, is handed on to the authorities in the next rank. The inspector or chief constable now comes upon the scene, his mind is brought to bear upon the subject, and an order is sent to the police doctor to examine a body in either a living or dead state; in the latter case the order would come from the coroner, and a post-mortem examination and report are the result. So far all seems orderly enough ; the doctor pockets his instruments, and with assistance makes his examination in a cellar, a shed, or a bedroom, with more or less assistance from daylight. Prior to this he has been made acquainted with the nature of the case from the person from whom the post-mortem order came ; indeed, he has kept his ears open for all information which might enable him to direct his attention to one or more points of suspicion. Already his mind is a little biased, but he may or may not end with adopting the view first presented to him by an unscientific person. The report is drawn up, the evidence given, the trial gone through, the jury retire, the judge pronounces the sentence, and perhaps an innocent person is within an ace of the gallows, or perhaps actually hanged. No imaginary case is raised, and nothing is suggested that is not already known and written in works on medical jurisprudence. As a general rule, medical men make bad witnesses, whether before the coroner or in the assize court ; this is admitted on all sides, and it is well to inquire wliy such a slur has been cast upon our profession. During an undergraduate's or student's career medical jurisprudence is a popular subject. In the class-room a good lecturer has an enthusiastic audience of medical and legal students, eager to apply scientific knowledge to common sense; the diagrams shown, the highly flavoured stories related, all tend to interest the student to a high degree, and he takes to medical jurisprudence naturally. The house surgeon finds his medico legal work profitable, he is often in the witness-box, and soon gets over his first dislike to the wig and gown in front of him. Hence it follows that a young medical man, turning his back upon his alma mater, is often at his best as far as medico-legal knowledge goes. Does he improve himself? Does he remain stationary, or does he deteriorate in his subsequent career ? The answer to this lies much in where he is placed. If he becomes attached to a hospital he may become a lecturer in medical jurisprudence, and lay the foundation for an expert's reputation. He may be constantly employed
doi:10.1016/s0140-6736(01)90467-2 fatcat:axzuqd3ozjgnvm4qrlarws4gge