medico-legal aspects of death
TRANSCRIPT
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MEDICO-LEGAL ASPECTSOF DEATH
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IMPORTANCE OF DEATH
DETERMINATION
Civil personality of a natural person is extinguished by
death;
The property of a person is transmitted to his heirs at the
time of death;
The death of a partner is one of the causes of
dissolution;
The death of either the principal or agent is a mode of
extinguishment of agency;
The criminal liability of a person is extinguished by
death; and
The civil case for claims which does not survive is
dismissed upon death of the defendant.
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Legal Presumption of Death:
If absent without explanation from his or her usual or last
place of residence for a long continuous period.
Circumstantial proof of death
- Ex. a passenger on an airplane that crashed isconsidered to have died even if no remains can be
recovered.
Rules of Evidence in Rule 131, section 5 paragraph X,paragraph JJ, and paragraph KK.
In common law the presumption of death does not arise
until the expiration of seven years of continuous
absence.
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Civil Code Provisions
PRESUMPTION OF DEATH
Art. 390. After an absence of seven years, it being
unknown whether or not the absentee still lives, he shall
be presumed dead for all purposes, except for those of
succession.
The absentee shall not be presumed dead for the purpose
of opening his succession till after an absence of ten
years. If he disappeared after the age of seventy-five
years, an absence of five years shall be sufficient inorder that his succession may be opened. (n)
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Civil Code Provisions
Art. 391. The following shall be presumed dead for all
purposes, including the division of the estate among the
heirs:
(1) A person on board a vessel lost during a sea voyage, or
an aeroplane which is missing, who has not been heard
of for four years since the loss of the vessel or
aeroplane;
(2) A person in the armed forces who has taken part in war,
and has been missing for four years;
(3) A person who has been in danger of death under other
circumstances and his existence has not been known for
four years. (n)
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What is DEATH?
Termination of life
Complete cessation of the vital functions withoutpossibility of resuscitation
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Events which produces uncertainty of the
moment of death
The increasing use of mechanical resuscitative devices
There is an increasing demand of organs for
transplantation
Coma following administration of excessive doses ofmodern sedatives and hypnotics
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Death maybe
A. Brain Death occurs when there is a deeply irreversible
coma, and absence of electrical brain activity.
B. Cardio Respiratory Death
occurs when there iscontinuous and persistent cessation of heart action and
respiration.
C. Alternative or eclectic way based on a legislative
enactments where states provide both brain and cardio-
respiratory bases in the determination of the moment of
death.
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BRAIN DEATH
Harvard Criteria of Brain Death (1968)
1. Unreceptivity and unresponsivity.
2. No movements (observe for 1 hour).
3. Apnoea (3 minutes off ventilator).4. No reflexes - fixed dilated pupils
- No brainstem reflexes
- No spinal reflexes
5. Flat EEG (of great confirmatory value) at 5 uv/mm
6. No change after 24 hours
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BRAIN DEATH
Philadelphia Protocol (1969)
1. Lack of responsiveness to internal and external
environment
2. Absence of spontaneous breathing movements for 3minutes
3. No muscular movements
4. No reflexes and responses
5. Falling arterial pressure6. Flat EEG
7. Criteria present in 2 hours and certified by 2 physicians
other than the physician of organ recipient
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Other set of criteria to establish brain deaths
1. The Council of Ministers in France (1968)
2. Mohandas and Chou (1971)
3. Ottawa General Hospital (1979)
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KINDS OF DEATH
1. Clinical or Somatic Death
2. Molecular or Cellular Death
3. Apparent Death or State of Suspended Animations
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Somatic or Clinical Death
The state of the body in which there is a complete,
persistent and continuous cessation of the vital functions
of the brain, heart, and lungs which maintain life and
health.
The clinical death is verifiable only by a physician after
he observes that the patient no longer has a heart beat
no pulse rate, no spontaneous breathing and movement,
with the pupils of the eye widely dilated and not reactive
to light and accommodation.
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Molecular or Cellular Death
The death of the different parts of the body occurs at
different times and stages.
State in which the tissues and their constituent cells are
dead
They no longer have metabolic activity
Is a process, not an event.
This is the reason why such organs as the corneas and
the kidneys can be removed immediately after biologicaldeath and transplanted successfully.
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SIGNS OF DEATH
1. Cessation of heart action and circulation
2. Cessation of respiration
3. Cooling of the body ( Algor Mortis )
- The temperature of 15
20 degrees Fahrenheit isconsidered as a certain sign of death.
4. Loss of motor power
5. Loss of sensory power
6. Changes in the skin7. Changes in and about the eye
- There is loss of corneal reflex
8. Action on the heat of the skin
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End of Presentation