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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 of medical science, while medical jurisprudence is
a branch of law.
2. Legal medicine is a medicine applied to law and administration of justice,
while medical jurisprudence is law applied to the practice of medicine.
3. Legal medicine basically originate from 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 the principles 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 and practitioners of medicine a theoretical and practical
knowledge of the subject in his relation to law.
2. To give information to physicians of his rights and duties and the manner in
which the law expect him to act under certain circumstances.
3. To enable a lawyer find the principles 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 police sciences must be acquainted with the
medical aspect of criminal investigation, their significance, 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 a physician 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 medical profession 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 an injury 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 ordinary physicians 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 be significant to an ordinary physician 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
1. Law is a rule of conduct just obligatory 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 art dealing with prevention, cure and alleviation
of disease? It is that part of science and art or restoring and preserving
health.

3. Legal is that which or pertains to 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 practical science which investigates the nature, origin,
development and function of law. It is a science of giving a wise
interpretation of the law and making just application 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 to all
future cases where the facts substantially the same.
SOME PRINCIPLE GOVERNNG APPLICATION AND EFFECT OF LAWS
1. Ignorance of the law excuses no one from compliance therewith.
2. Law shall have no retroactive effect, unless the contrary is provided.
3. Rights, may be waive unless the waiver 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 to law, 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 that determines 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 or division of law which defines crime, treats of
their nature, and provides for their punishment.
3. Remedial law - is that branch of law which deals with the rules concerning
pleadings, practice and procedure in all courts of the Philippines.
4. Special laws
MEDICO LEGAL OFFICER
a. Qualifications of a medico-legal officer
b. How medico-legal officer gets his office
c. Duties of the medico-legal officer
MEDICAL EXAMINER
a. Qualification of medical examiner
b. How the medical examiner gets his office
c. Duties of the medical examiner
d. Procedure of investigation
CORONER
a.
b.
c.
d.

Qualification of coroner
How the coroner gets his office
Duties of the coroner
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 of evidence is made known or addressed to the
senses of the court. For the court to observe the object itself
Section 1, Rule 130 Rules of Court
View of an Object whenever an object has such a relation to the fact in dispute as
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 are exceptions 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 those offensives to sensibilities should also be excluded
if they are not absolutely necessary for the proper administration of justice.

Expert
witness

2. Testimonial Evidence a physician 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.

Consent from the patient

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 persons interested 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
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 a medical 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 any written 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.
2.
3.
4.

Photography and sound recording


Sketching
Description
Testimony of witnesses

KINDS OF EVIDENCE NECESSARY FOR CONVICTION


1. Direct Evidence that which proves 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 the proof 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 one circumstance,
b. When the facts from which the inferences are derived are proven, and
c. When the combination of all the circumstances is such as to produce a
conviction beyond a reasonable doubt.
DEGREE PF PROOF REQUIRED IN THE COURT OF JUSTICE:
1. In civil cases, preponderance of evidence only is required.
2. In criminal cases, proof beyond reasonable 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 and interrogator than in the
presence of other persons.
KINDS OF OFFENDERS
1. Emotional Offenders
2. Non-emotional Offenders
Symptom of Emotional Symptom
1.
2.
3.
4.
5.
6.
7.
8.

Sweating
Color change
Dry mouth
Clenching of hands
Elbows
Heartbeat
Breathing
Fidgeting, general nervous symptoms

PHYSIOLOGICAL AND PSYCHOLOGICAL SYMPTOMS OF GUILT OF THE SUBJECT

1.
2.
3.
4.
5.
6.
7.
8.

Pulsation of the carotid artery


Excessive activity of the Adams apple
Dryness of the mouth
Inability to look at the interrogator straight in the eye
Swinging one leg over the other, tapping the chair etc.
The peculiar feeling inside
Swearing the truthfulness of his assertion
Not that I remember expression

II. DECEPTION DETECTION METHODS


1. USE OF THE LIE DETECTOR OR KEELERS 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 emotional tension experienced by a subject who is
nevertheless affected by;
2. Physiological abnormalities
3. Mental abnormalities
4. Unresponsiveness in a lying or guilty subject
5. Attempts to beat the machine by controlled breathing or by muscular flexing
6. Unobserved application of muscular 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
that reasonable 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 TOBE SUBJECTED TO LIE DETECTOR TEST?
In as much as the test requires the subject to answer questions either by yes
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 TRUTH SERUM
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. Consequently under such circumstances, he is apt
to tell the truth and give details or may implicate others.

3. INTOXICATION
The 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 TEST
A 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
and the answer is recorded. A person will not answer quickly questions
containing words which has relation to the crime committed.
5. NARCOANALYSIS OR NARCOSYNTHESIS
Does not include the use of the truth serum, but rather a process 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. HYPNOTISM
The subject is made to be under the influence of hypnosis by a qualified
hypnotist. While fully hypnotized, questions are asked relating to the subjectmatter 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 is a confession made outside of the court prior
to the trial of the case.
Extrajudicial confession may be:
a. Voluntary extra-judicial confession
b. Involuntary extra-judicial confession- Confession obtained through force,
threat, intimidation, duress or anything influencing the voluntary act of
the confessor.
2. Judicial Confession- this is the confession of an accused in court. It is
conclusive upon the court and may be considered to be a mitigating
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 CLINICAL DEATH this is the state of the body 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 CELLULAR DEATH- after cessation of the vital function of
the body there is still animal life among individual cells.
3. APPARENT DEATH - this condition 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.
2.
3.
4.

Civil personality of a natural person is extinguished by death,


Property of the person is transmitted to his heirs at the time of death,
Criminal liability of a person is extinguished by death,
A civil case for claim which does not survived is dismissed upon the death of
the defendant.

SIGNS OF DEATH
I- Cessation of the heart action and circulation
- There must be entire and 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 heart
1. Palpation of the pulse
2. Auscultation for the heart sound 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 may not always be appreciable to the ear even with
the aid of the stethoscope.
Difficulties in auscultation may be encountered
a. Stout person
b. Fatty degeneration of the heart
c. Pericardial effusion
3. 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 electro cardiograph 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 THE PERIPHERAL CIRCULATION


1. Magnus test a ligature is applied 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 the injection of a solution of fluorescein
subcutaneously.
4. Pressure on the finger nails if pressure 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 finger spread wide and the finger webs are viewed
through a strong light.
6. Application of the heat on the skin
7. Palpation of the radial pulse
8. Dropping of melted wax melted sealing wax is dropped on the breast of a
person.
II- CESSATION OF THE RESPIRATION
Like 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