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Lecture 1:

General
Considerations

Atty Molly Cr Abiog,


MD, LlB
University of the
Cordilleras
Baguio City

Definition of Terms
Legal Medicine
Branch of Medicine which deals with
the application of medical knowledge
to the purposes of law and in the
administration of justice
Legal Medicine, Forensic Medicine and
Medical Jurisprudence - synonymous
with each other, and in common
practice are used interchangeably

Definitions &
Differences
Strictly speaking
Legal Medicine is primarily the
application of medicine to legal cases
Forensic Medicine concerns with
the application of medical knowledge
to elucidate legal problems.

Differences in Scopes
William J. Curran
a prominent Harvard professor of legal
medicine defines
Legal Medicine as encompassing those
specialty areas of medicine concerned with
relations to substantive law and legal
institutions
Forensic Medicine deals with investigation ,
preparation, preservation and presentation of
evidence and medical opinion in courts and
other legal, correctional and other lawenforcement settings

According to Dr Henry
C. Lee
an eminent U.S. forensic expert who claims
that Forensic Medicine has a broader
definition than Legal Medicine

FM encompasses a variety of fields in forensic


science such as, pathology, anthropology,
odontology, toxicology, entomology, et al
Its application is limited not only to legal issues but
also covers historical, environmental and social
political issues
Legal Medicine refers to substantive law defining
the relationship between and among hospitals,
doctors, patients, whereas Forensic Medicine deals
with activities or acts punishable under our local
laws

Dr. Henry C. Lee,


Medical Jurisprudence denotes the
knowledge of law in relation to the
practice of medicine
It concerns with the study of the
rights, duties and obligations of a
medical practitioner with particular
reference to those arising from a
doctor-patient relationship

Nature of the Study of Legal


Medicine:
Knowledge of legal medicine means:
ability to acquire facts
power to arrange those facts in their
logical order
draw a conclusion from the facts which
may be useful in the administration of
justice
power to impart to others verbally or in
writing all those he has observed.

Facts & Fallacies


Misconceptions among the
public
Medicolegal practitioners must
also be lawyers
One has to be a pathologist to be
involved in this line of work

Who is who?
A physician who specializes or is involved
primarily with medico-legal duties is known
as a Medical Jurist (aka Medical
Examiner, Medico-legal Officer,
Medico-legal Expert)

e.g. Dr V.V. Villasenor (PNP Crime Laboratory)


Dr. Ronaldo Bandonill (NBI)

Atty. Molly Cr. Abiog, M.D. is a doctor and


a lawyer, but not a Medico-legal Officer!

Who are the Medico-Legal


Practitioners?
Can either be in the service of the government
or in private practice.
In government
Connected with law enforcement agencies such as the police
departments
Legitimate investigative bodies such as the PNP Crime
Laboratory
Medicolegal division of the National Bureau of Investigation
Physicians employed by the government as they are
mandated by law to perform autopsies on medicolegal cases
Municipal Health Officer
Provincial Health Officers

Who are the Medico-Legal


Practitioners?
As private practitioners
Consultants in private hospitals to whom
are referred medicolegal patients.
As part of the Hospital Team that monitors the
patients condition while confined at the
Hospital. When the patients case goes to
court, the medicolegal practitioner is called to
testify on the fact of the injury, the treatment
the patient received in the Hospital, his expert
opinion as to the cause of the patienty

Who are authorized by law


to perform autopsies?
Sec. 95, P.D. 856, Code of Sanitation:
Health Officers
Medical Officers of Law enforcement agencies
Members of the Medical Staff of Accredited hospitals

Code of Medical Ethics of the Medical Profession


of the Philippines. Sec. 2. Art. III states:
However, it is the duty of every physician, when
called upon by the judicial authorities, to assist in the
administration of justice on matters which are
medico-legal in character

Distinction between an
ordinary physician and a
medical jurist:

Ordinary Physician

1. Sees an injury or
illness on the point of
view of TREATMENT

Medical Jurist

1. Sees an injury or
illness on the point of
view of CAUSE

2. Purpose in
2. include those
examining patient
bodily lesions in his
is to arrive at a
report and testify
definite Diagnosisbefore the court
Rx Rx
before an
investigation body
result: justice
where justice is

Ordinary Physician
3. Minor or trivial
ignored they do
not require

Medical Jurist
3. Medical jurists must
record all bodily
injuries even if they
are minor because
these injuries may
be proofs to qualify
the crime or to
justify an act

What are these so-called


MEDICOLEGAL CASES?
Injuries or deaths involving persons who have no
means of being identified
Persons pronounced as dead on arrival (DOA)
Deaths under the following circumstances:
Death occurring within 24 hours of admission when the
clinical cause of death is unknown or undeterminable;
Unexpected sudden death especially when the
deceased is in apparent good health;
Death due to natural disease but associated with
physical evidence suspicious of foul play;
Death as a result of violence, accident, suicide or
poisoning;
Death due to improper of negligent act of another
person;

Victims of physical injuries caused by


the following:
Physical violence such as gunshot wound,
stab wound, mauling, etc.;
Vehicular accident
Asphyxia
Electrocution
Chemical or thermal insult
Accident
Attempted Homicide or suicide
Poisoning

Cases of child abuse, domestic violence,


rape, alcoholism and drug addiction;
Cases involving the mental competency
of the patient;
Iatrogenic causes brought about by
negligent acts or omissions of the
hospital staff resulting in violation of
rights of patients or leading to his
physical and mental incapacitation,
physical injury and death.

Under Philippine laws, medico-legal


deaths must undergo mandatory
autopsy
No consent is required for the autopsy
although the next of kin is informed of
this requirement and his signed consent
obtained as a matter of courtesy
Death certificate cannot be completed
without the autopsy.

If the hospital has no authority to conduct


autopsy, it refers the case to a government
body which can do iteither to the PNP or the
NBI or top a Municipal or Provincial Heath
Officer
If the Hospital has the authority to conduct
autopsy but the relatives refuse to cooperate,
the death certificate is merely filled up by
putting as the cause of death undetermined
In effect, it is also as if no death certificate has been
issued because legally the body cannot be buried
without a cause of death

Major capabilities of a
medico-legal officer:
Conducts
autopsy
examination of victims of sexual crimes
examination of victims of Physical injuries
examination of skeletal remains
blood and blood stain, seminal fluid/stainexamination of body fluids
Exhumation of bodies
Histopathological examinations

Branches of Law where Legal


Medicine maybe applied:
Civil Law
Paternity and filiations;
Determination of or change in Civil Personality/Status of
persons;
Adoption, Declaration of Nullity of Marriage, Legal Separation,
etc.

Criminal Law

Circumstances affecting criminal liability


Crimes against persons
Crimes against chastity

Remedial Law

Rules on evidence
Proceedings for hospitalization
Physical/mental examination of a person

Autopsies shall be performed


in the following cases:
Whenever required by special laws
Upon order of a competent court, mayor
and a provincial or city fiscal
Upon written request by police authorities
Whenever the Solicitor General, provincial
or city fiscal deem it necessary to dissenter
and take possession of the remains for
examination to determine cause of death
Whenever the nearest kin shall request in
writing the authorities concerned to
ascertain the cause of death

FORENSIC Science
Disciplines:
Hair Analysis
DNA Analysis
Fiber Analysis Forensic Anthropology
Glass fragments and paint chips
Forensic
Archaeology
analyses Forensic Pathology
Ballistics and Tool marks
Forensic Odontology
Fingerprints
Questioned Document analysis
Footwear Forensic Psychiatry & Psychology
Tire Impressions
Blood Splatter Analysis

ASSIGNMENT:
Bring to class next meeting
Medico-legal certificate
Autopsy Report

Case Discussion:
An 18 year old female, single, came to a medical clinic
complaining that she has been raped.
History of the Present Complaint:

One (1) month PTC, Mr. X by use of force and intimidation had
carnal knowledge with her at Burnham Park @ 2:00 p.m. For fear
of her parents wrath, she kept what happened to herself and
came for medical examination only today.

Examination results:

Recently healed hymeneal lacerations at 4 and 6 oclock;


No signs of recent application of force at the perineal area;
Internal Examination, admits 2 examining fingers with ease;
shallow vaginal rugosities;

Laboratory Examinations: Positive for spermatozoa, no gram


negative cocci.
Conclusions:
-non-virgin state;
-healed lacerations at 4 and 6 oclock
-presence of Spermatozoa,
Conclusion: recent sexual intercourse within the last 24 hrs.

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