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LEGAL MEDICINE

LEGAL MEDICINE is a branch of

medicine which deals with the

application of medical knowledge to the

purpose of law and justice. It is the

application of the basic and clinical,

medical and paramedical sciences to

elucidate legal matters.

Legal Medicine and Forensic Medicine

are synonymous and in common practice

are used interchangeably, although legal

medicine strictly speaking means

medicine applied to legal cases, while

forensic medicine science to elucidate

legal problems.

MEDICAL JURISPRUDENCE is that

branch of law which deals with the

organization and regulation of the

medical profession, with the contractual

obligation existing between practitioner

and his patient and with the duties

imposed on the practitioner by the state.

DISTINCTION BETWEEN LEGAL

MEDICINE AND

MEDICAL

JURISPRUDENCE

1. Legal medicine is a branch ofmedical science, while medical

jurisprudence is a branch of law.

2. Legal medicine is a medicineapplied to law and

administration of justice, whilemedical jurisprudence is law

applied to the practice of

medicine.

3. Legal medicine basically originatefrom the development of medical

science, it being a branch of

medicine, while medical

jurisprudence emanates from acts

of Congress, executive orders,administrative circulars, custom

and usage and decisions of

tribunal which have relation to

the practice of medicine.

4. Legal medicine is based on theprinciples of coordination, that

legal medicines coordinate

medicine to law and justice. On

the other hand, medical

jurisprudence is based on the

principles of subordinations, that

it is the duty of a physician to

obey the laws in as much as our

government is established on the

principle of government of laws

and not of men and that no one is

considered above the law.

PURPOSE OF THE STUDY

1. To give the students andpractitioners of medicine a

theoretical and practical

knowledge of the subject in his

relation to law.

2. To give information to physiciansof his rights and duties and the

manner in which the law expect

him to act under certain

circumstances.

3. To enable a lawyer find theprinciples which apply, and the

laws and decisions which may

govern, in any case involving

medical questions, as well as the

points upon which medical

experts should be examined.4. To acquaint medical and law

students and practitioners of the

recent advances of forensic

medicine and the medico legal

system and procedure adapted in

different countries.

5. Students of criminology and policesciences must be acquainted with

the medical aspect of criminalinvestigation, their significance,

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LEGAL MEDICINE

interpretation and probative value

in court.

SCOPE OF LEGAL MEDICINE

The scope of legal medicine is

quite broad. It is the application of all

branches of medicine and other allied

sciences to law and administration of

justice. The knowledge of wounds has

been acquire in surgery, abortion in

gynecology, sudden death in medicine,

effects of trauma in pathology, etc.

although viewed in a different angle.

NATURE OF LEGAL MEDICINE

Knowledge of legal medicine

means the ability to acquire facts, the

power to arrange those facts in the

logical order, and the application for the

purposes of law the conclusion which

they lead.

A physician should be an

impartial observer, intent only or

seeking the truth of a case in relation its

circumstances, the conscience with

which he discharges his duties is but a

corollary to his putting into practice the

medico legal knowledge he has acquired.

It is not only necessary that aphysician should have an impartial and

accurate observation of the facts but also

must posses the power to impart in words

or in writing all of his observation to

others. He must convey all the facts he

has observed and be able to give is

logical opinion.

Some members of the medicalprofession have been inclined to regard

medico-legal matter with abhorrence.

They consider it as an addition to their

usual duties while other refuse to

handle medico-legal cases because of

fear, and waste of material time when

being summoned in court. But , no

physician in practice can ignore nor

refuse to face the problem of legal

responsibility and his duties to the court.

MEDICAL JURIST- (Medico-legal Expert)

is a physician who specializes in the

science of legal medicine. He must possess

sufficient knowledge pathology, surgery,

toxicology, and other branches of

medicine in the application to law and

justice.

DIFFERENCES BETWEEN ORDINARY

PHYSICIAN AND A

MEDICAL JURIST

1. An ordinary physician sees aninjury or disease on the point of

view of treatment, while a

medical jurist sees injury or

disease as regard to cause.

2. The purpose of an ordinaryphysicians examination of a

patens is to institute remedy or

treatment, while the purpose of a

medical jurist in examining the

patient is for law and to give

justice tone where justice is due.

3. Minor bodily lesions may besignificant to an ordinaryphysician to warrant attention for

they may necessitate treatment

without producing any untoward

effect, but to a medical jurist

physical injury of whatever

nature, size and location must be

appreciated and described.

OTHER DIFINITIONS

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LEGAL MEDICINE

1.Law is a rule of conduct justobligatory laid by legitimate

power for the common

observance and benefit? It is

a science of moral law

founded on the rational

nature of man which

regulates free activity for the

realization of his individual

and social ends under the

aspect of mutual demandable

independence.

2. Medicine is a science and artdealing with prevention, cure

and alleviation of disease? Itis that part of science and art

or restoring and preserving

health.

3. Legal is that which or pertainsto law, arising out of by

virtue of or included in law.

It also refers to anything

conformable to the letters or

rules of law as it is

administered by the court.

4. Jurisprudence it is a practicalscience which investigates

the nature, origin,

development and function of

law. It is a science of giving

a wise interpretation of the

law and making justapplication of them to all

cases as they arise.

PRINCIPLE OF STARE DECISIS

A principle that, when the court

has once laid down a principle of law as

applied to a certain state of facts, it will

adhere to that principle, and apply it toall future cases where the facts

substantially the same.

SOME PRINCIPLE GOVERNiNG

APPLICATION AND EFFECT OF LAWS

1. Ignorance of the law excuses noone from compliance therewith.

2. Law shall have no retroactiveeffect, unless the contrary is

provided.

3. Rights, may be waive unless thewaiver is contrary to law, public

order, public policy, morals, good

customs, or prejudicial to a third

person with a right recognized by

law.

4. Customs which are contrary tolaw, public order or public policy

shall not e countenanced.

BRANCHES OF LAW WHERE LEGAL

MEDICINE IS PRINCIPALLY APPLIED

1. Civil law is a mass precept thatdetermines or regulates the

relations of assistance, authority

and obedience between members

of a family, and those that exist

between members of a society for

the protection of private interest.

2. Criminal law is that branch ordivision of law which defines

crime, treats of their nature, and

provides for their punishment.

3. Remedial law - is that branch oflaw which deals with the rulesconcerning pleadings, practice and

procedure in all courts of the

Philippines.

4. Special lawsMEDICO LEGAL OFFICER

a. Qualifications of a medico-legalofficer

b. How medico-legal officer gets hisoffice

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c. Duties of the medico-legal officerMEDICAL EXAMINER

a. Qualification of medicalexaminer

b. How the medical examiner getshis office

c. Duties of the medical examinerd. Procedure of investigation

CORONER

a. Qualification of coronerb. How the coroner gets his officec. Duties of the coronerd. Procedure of inquest

MEDICAL EVIDENCE

Evidence s the means, sanction by law

of ascertaining in a judicial proceeding

the truth respecting a matter of fact.

Reference: Section 1, 2, 3, 4, -128 rules

of court

Medical Evidence is the means

sanction by law of ascertaining in a

judicial proceeding that truth respecting

a matter of fact wherein scientific

medical knowledge is necessary.

FORMS OF EVIDENCE

1. Real Evidence this form ofevidence is made known or

addressed to the senses of the

court.

Section 1, Rule 130 Rules of Court

View of an Object whenever an object

has such a relation to the fact in disputeas to afford reasonable grounds or belief

respecting it, such object may be exhibit

to or viewed by the court, or its existence,

situation, or character proved by

witnesses, as the court in its discretion

may determine.

a. Indecency and impropriety areexceptions to this rule of evidence,

but when exhibition is necessary

for the end of justice, notions of

decency and delicacy of feeling

will not be allowed to prevail.

b. Repulsive objects and thoseoffensives to sensibilities should

also be excluded if they are not

absolutely necessary for the proper

administration of justice.

2.Testimonial Evidence aphysician may be placed at the

witness stand to answer questions

propounded to him by counsels of

parties or by the presiding officer

of the court. His testimony must be

given orally in open court and

under oath or affirmation.

Qualification of an Ordinary Witness

Section 18, Rule 130, Rules of Court

Except as provided in the next

succeeding section, all persons who,

having organs of sense, can perceive, and

perceiving, can make known their

perception to others, may be witness.

Neither parties nor other personsinterested in the outcome of a case shall

be excluded, nor those who have been

convicted of crime, nor any person on

account of his opinion on matters of

religious belief.

Qualification of an Expert Witness

Section 42, Rule 130, Rules of Court

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The opinion of a witness regarding

a question of science, art or trade, when

he is skilled therein, may be received in

evidence.

3. Experimental Evidence amedical witness may be required

to perform certain experiments to

prove a certain matter of fact.

Again such evidence must not be

offensive to decency, sensibilities,

and propriety. The court, however,

in its discretion may or may not

allow experimental evidence.

4. Documentary Evidence anywritten evidence presented by a

physician in court which is

relevant to the subject matter in

dispute and not excluded by the

rules of court is documentary

evidence.

METHODS OF PRESERVING EVIDENCE

1. Photography and sound recording2. Sketching3. Description4. Testimony of witnesses

KINDS OF EVIDENCE NECESSARY FOR

CONVICTION

1. Direct Evidence that whichproves the fact in dispute without

the aid of any inference or

presumption. The evidence

presented corresponds to precise or

actual point at issue.

2. Circumstances Evidence theproof of facts from which, taken

either singly or collectively, the

existence of a particular fact in

dispute may be inferred as a

necessary or probable consequence.

When is Circumstantial evidence

sufficient to Produce conviction?

a. When there is more than onecircumstance,

b. When the facts from which theinferences are derived are proven,

and

c. When the combination of all thecircumstances is such as to

produce a conviction beyond a

reasonable doubt.

DEGREE OF PROOF REQUIRED IN THE

COURT OF JUSTICE:

1. In civil cases, preponderance ofevidence only is required.

2. In criminal cases, proof beyondreasonable doubt is required.

MEDICAL ASPECTS OF CRIMINAL

INVESTIGATION

I- CRIMINAL INTERROGATION-The principal

psychological, physical and

medical factors to a successful

interrogation are privacy.

Interrogation, it is an inherent

mental process that the suspect or

witness is more apt to divulge his

secret in a private room occupied

by only the subject andinterrogator than in the presence

of other persons.

KINDS OF OFFENDERS

1.Emotional Offenders

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2. Non-emotional OffendersSymptom of Emotional Symptom

1. Sweating2. Color change3. Dry mouth4. Clenching of hands5. Elbows6. Heartbeat7. Breathing8. Fidgeting, general nervous

symptoms

PHYSIOLOGICAL AND PSYCHOLOGICAL

SYMPTOMS OF GUILT OF THE SUBJECT

1. Pulsation of the carotid artery2. Excessive activity of the Adams

apple

3. Dryness of the mouth4. Inability to look at the interrogator

straight in the eye

5. Swinging one leg over the other,tapping the chair etc.

6. The peculiar feeling inside7. Swearing the truthfulness of his

assertion

8. Not that I remember expressionII. DECEPTION DETECTION METHODS

1. USE OF THE LIE DETECTOR ORKEELERS POLYGRAPH

Principles: When a person lies,

there is blushing, dryness of the

throat, change of his blood

pressure, respiration and change

in the activity of the sweat pores.

FACTORS RESPONSIBLE FOR THE 25%

FAILURE OF THE USE OF LIE DETECTOR

1.Nervousness or extreme emotionaltension experienced by a subject

who is nevertheless affected by;

2.Physiological abnormalities3.Mental abnormalities4.Unresponsiveness in a lying or

guilty subject

5.Attempts to beat the machine bycontrolled breathing or by

muscular flexing

6.Unobserved application ofmuscular pressures which produce

ambiguities or misleading

indications in the blood pressure

tracing.

ADMISSIBILITY OF THE RESULT OF LIE

DETECTOR TEST IN COURT.

In a series of decisions of the state

supreme courts in United States,( Fyre vs.

U.S., State vs. Bohner (Wis.), People vs.

Becker (Mich.) People vs. Forte, State vs.

Cole, (Mich), Beech vs. State (Neb.) People

vs Wechnick, (California) etc.

Uniformly ruled non admissibility

of the lie detector test. The common

reason given is that the test has not

gained among physiological and

psychological authorities a degree of

development beyond the experimental

stage. Until it is established that

reasonable certainly follows from such

test, until it is established thatreasonable certainty follows from such

test, it would be an error to admit in

evidence the result. The test is useful in

investigation of crime but it has no in

the courtroom.

CAN A PERSON BE COMPELLED TO BE

SUBJECTED TO LIE DETECTOR TEST?

In as much as the test requires the

subject to answer questions either by yes

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or no, it may infer the use of intelligence

and attention or other mental faculties

which is self-incriminatory, therefore, a

person can not be compelled to be

subjected to the test.

2. ADMINISTRATION OF TRUTHSERUM

Hyoscine hydro bromide is

given hypodermically in repeated

doses until a state of delirium is

induced. When the proper point is

reached, the questioning begins

and the patient has forgetfulness

of any alibi he may have built up

to cover his guilt. Consequentlyunder such circumstances, he is

apt to tell the truth and give

details or may implicate others.

3. INTOXICATIONThe person whose statement

is to be taken is allowed to take

alcohol beverages to intoxication

point. When under the influence

of alcohol, the power control is

diminished and the investigator

begins propounding questions.

4. WORD ASSOCIATION TESTA list stimulus words is

read to the subject who has been

instructed to respond as quickly as

possible. The time interval

between the stimulus word andthe answer is recorded. A person

will not answer quickly questions

containing words which has

relation to the crime committed.

5. NARCOANALYSIS ORNARCOSYNTHESIS

Does not include the use of

the truth serum, but rather aprocess of inducing a state of mind

by the application of a drug

whereby the individuals capacity

to unite thoughts and choose those

to which he de-sides to give

utterance is inhibited. This

method of deception detection

utilizes the administration of

anesthesia or hypnotics and

psychiatry in criminal

interrogation.

6.HYPNOTISMThe subject is made to be

under the influence of hypnosis

by a qualified hypnotist. While

fully hypnotized, questions are

asked relating to the subject-matter of the investigation. This

method of deception detection is

not as dangerous as the use of

truth serum; however, authorities

doubt its value because the

subjects answer is under the

control and suggestion of the

hypnotist.

III- CONFESSION

Confession is an expressed

acknowledgement by the accused in a

criminal case of the truth of his guilt as

to the crime charge, or of some essentials

thereof.

Confession is different from

Admission, although Admission includes

as one of its species of confession.Confession is a statement of guilt, while

Admission is usually a statement of fact

by the accused which do not directly

involve an acknowledgement of guilt of

the accused.

KINDS OF CONFESSION

1.Extrajudicial Confession this isa confession made outside of the

court prior to the trial of the case.

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Extrajudicial confession may be:

a. Voluntary extra-judicialconfession

b. Involuntary extra-judicialconfession- Confession

obtained through force, threat,

intimidation, duress or

anything influencing the

voluntary act of the confessor.

2. Judicial Confession- this is theconfession of an accused in court.

It is conclusive upon the court and

may be considered to be amitigating circumstance to

criminal liability.

MEDICO LEGAL ASPECT OF DEATH

DEATH is defined as the state of

complete and persistent cessation

of respiration, circulation and

other vital function of the body.

LIFE- is the sum total of all the vital

process by which the physical

integrity of the body is

maintained.

KINDS OF DEATH

1. SOMATIC DEATH OR CLINICALDEATH this is the state of thebody in which there is complete

persistent and continuous

cessation of vital function of the

brain, heart and the lungs which

maintain life and health.

2. MOLECULAR OR CELLULARDEATH- after cessation of the

vital function of the body there isstill animal life among

individual cells.

3. APPARENT DEATH - thiscondition is not really death but

merely a transient loss of

consciousness or temporary

cessation of the vital function of

the body on account of disease,

external stimulus or other forms of

influence. It may arise especially

in hysteria, uremia, catalepsy and

electric shock.

LEGAL IMPORTANCE OF DETERMINING

DEATH

1.Civil personality of a naturalperson is extinguished by death,

2.Property of the person istransmitted to his heirs at the

time of death,

3.Criminal liability of a person isextinguished by death,

4.A civil case for claim which doesnot survived is dismissed upon the

death of the defendant.

SIGNS OF DEATH

I- Cessation of the heart action andcirculation

- There must be entireand continous cessation

of the heart action and

flow of blood in the

whole vascular system.Temporary suspension of

the heart action is still

compatible with life.

METHODS OF DETECTING THE

CESSATION OF HEART ACTION AND

CIRCULATION

A.Examination of the heart1. Palpation of the pulse

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2. Auscultation for the heartsound at the pericordial area.

Errors in the method of

determining heart action

a. The heart itself may,like other muscle, be in

a state of apparent and

not real death.

b. The heart sound maynot always be

appreciable to the ear

even with the aid of the

stethoscope.

Difficulties in auscultation

may be encountereda. Stout personb. Fatty degeneration of the

heart

c. Pericardial effusion3. Fluoroscopic examination-

examination of the chest will

the reveal the shadow of the

heart in its rhythmic

contraction and relaxation.

4. By the use of electrocardiograph the heart beat is

accompanied by the passage of

electrical charge through the

impulse conducting system of

the heart which may be

recorded in an

electrocardiograph machine.

B. EXAMINATION OF THEPERIPHERAL CIRCULATION

1. Magnus test a ligature isapplied around the base of a

finger with moderate tightness.

2. Opening of the small artery in the living, the blood escapes

in jerk and at a distance.

3. Icard test this consist of theinjection of a solution of

fluorescein subcutaneously.

4. Pressure on the finger nails ifpressure is applied on the

finger nails intermittently,

there will be zone paleness at

the site of the application of

pressure which becomes livid

on release.

5. Diaphanous test the fingerspread wide and the finger

webs are viewed through a

strong light.

6. Application of the heat on theskin

7. Palpation of the radial pulse8. Dropping of melted wax

melted sealing wax is dropped

on the breast of a person.

II-CESSATION OF THE RESPIRATIONLike heart action, cessation of

respiration in order to be considered as a

sign of death must be continous and

persistent.

In the following condition there

may be suspension