Legal Medicine:

An Introduction
Legal Medicine
 Deals with the application of medical knowledge to the purposes of law and in the
administration of justice
Used Synonymously with:
 Forensic Medicine – application of medical science to elucidate legal problems
 Medical Jurisprudence – knowledge of law in relation to the practice of medicine.
Medical Jurist are also known as:
 Medical Examiner
 Medicolegal
 Medicolegal Expert
DIFFERENCES
ORDINARY PHYSICIAN MEDICAL JURIST
Point of view of treatment Point of view of cause
 For the proper treatment of the patient  To determine what happened to cause the
injury

Purpose: Purpose:
Arrives at a definite diagnosis to institute To testify before an investigative body to give
treatment justice to whom it is due

Minor injuries are usually ignored Records all injuries

 Especially those not requiring treatment  For evidentiary purposes
such as scratches and small bruises

Legal medicine
 Concerned particularly with REMEDIAL LAW
 Specifically the Rules of Evidence

Evidence
 Defined as a means of ascertaining in a judicial proceeding the truth regarding a matter of fact
 Important to determine admissibility, materiality and relevance

Types of Evidence
 Autoptic /Real evidence
 Made known or addressed to the senses of the Court
 Limitations:
 Indecency/impropriety
 Repulsive objects / those offensive to sensibilities

 Testimonial evidence
 Ordinary Witness – testifies as to those of their own personal knowledge
  Expert Witness-allowed to testify to matters pertaining to their particular specialty
provided that they be first qualified as experts before the court

 Limitations:
 Privileged Communication such as atty-client, doctor-patient and priest-
confessor
 Hearsay-matters not of the witness personal knowledge

 Spousal Privileged Communication – matters told in confidence to a persons

spouse

 Experimental evidence
 Results of replicable scientific experiments
 Limitations:
 Acceptability of methodology used
 Acceptability of the science used

 Documentary evidence
 An instrument on which is recorded by means of letters, figures or marks intended to be
used for the purpose of recording.
 Limitations:
 Privileged Communication
 Spousal Privileged Communication
 Needs a witness to identify the said documents

Medicolegal Certificate
 A form of documentary evidence
 Is the usual requirement that the prosecutor’s office requires for filing cases of physical injuries,
homicide, and the like
 Should contain:
 NOI (Nature of Incident)
 TOI (Time of Incident)
 POI (Place of Incident)
 DOI ( Date of Incident)
 The list of injuries
 The CONCLUSION

Importance of Legal Medicine

 An ever increasing number of cases require the intervention of forensics and medicolegal
examination
 Forensic Concerns
 Identification
 Determination on the individuality of a person or thing
 Pertains to:
 Victims
 Perpetrators
 Crime Scene
 Murder Weapon
 Causation
 Determination of the cause of the condition/crime

Importance of Proper Identification

 In criminal cases, proof beyond reasonable doubt requires positive identification of both
assailant and victim
 In cases of death, positive identification is needed to facilitate settlement of estates, insurance
claims and the like
 To give closure to the next of kin
 In some commercial transactions such as credit card and check transactions, identification is
necessary to facilitate the transaction

Rules of Identification of Persons

 Law of Multiplicity of Evidence in Identification states:
“The greater the number of points of similarities and dissimilarities of the two persons
compared; the greater the probability of the conclusion to be correct”
 Finds application in fingerprint analysis and DNA analysis

Methods of Identification
 By comparison – comparing evidence with a known sample
 By exclusion – given a set of data such as a population list, if almost all is accounted for then the
ones who are missing must be the unidentified person.
- Prone to error because there is always a level of uncertainty

Identification of Persons
 May be done by a layman
 May be done by a forensic scientist

Methods in Identification
 Description of the characteristics of the unknown
 Applicable to the living
 Characteristics which may easily be changed
 Hair growth, facial hair
 Clothing
  Frequent places visited
 Profession
 Body ornamentation

 Characteristics which may not easily be changed

 Mental Memory
 Speech
 Gait
 Mannerism
 Hands and feet
 Complexion
 Changes in Eye Characterisitcs
 Facies
 Handedness
 Degree of nutrition
 Applicable to both the living and the dead
 Occupational Marks
 Race
 Stature
 Tattoo Marks
 Weight
 Deformity
 Birthmarks
 Injuries
 Scars
 Tribal Marks
 Sexual Organ

Limitations of Physical Descriptions

 Light as a limiting factor
 Clearest moonlight – known person 16-17 yards
 Clearest Starlight – 10-13 yards
 Broad Daylight – 100 yards if person is known
25 yards if person is a stranger
 Flash from a firearm – letters of 2 inches can be seen a distance of 2 feet.

Potrait Parle’
 A verbal, accurate and picturesque description of the person identified.
 This is the end point of a witness desciption
 French term referring to a picture of a suspect in both front and profile views.
 Modernization has led this to be our "mug shot" of a suspect.
Techniques in Identification which require specialized training
 Anthropometry
 Forensic Footwear Analysis
 Fingerprint analysis
 Odontology
 Serology
 DNA Analysis

Anthropometry (Bertillon System)

 Developed the system while holding a position in the police prefecture of Paris
 Developed to address the problem that criminals at the time was adept in the use of disguises
and alibis

Basis of the Bertillon System

 The human skeleton is unchanged after the 20th year
 It is theoretically impossible to find 2 human beings having bones exactly alike
 Measurement can be made with a devise as simple as a tape measure.

Information Included in the System

 Descriptive Data
 Body Marks
 11 Anthropologic measurements
 Body measurements
 Measurement of the head
 Measurement of the limbs

Bertillon System
 Ultimately undone by unequivocal proof that different individuals can have the same
measurement in the parameter of the Bertillon system
 Abandoned in 1901

Forensic Anthropology
 Is the evolution of the old school Bertillon System
 uses a cross-disciplinary approach to identify an individual’s identity, time since death, cause of
death, and the manner of death.
 Determines
 Whether the remains are of human origin
 Whether the remains are of a single person
 Height
 Sex
 Race
 Age
  Time of death
 Forensic Anthropology

Height Determination
 Actual measurement of the skeleton
 1 to 1-1/2in is added to the total length
 Pearson’s Formula
 Stature is obtained by multiplying a factor to a longbone
 Stature Tables – tables of average lengths of each long bone in relation to height

Sex Determination
 Comparison of the following bones which differ from male and female:
 Pelvis
 Skull
 Sternum
 Length of manubrium X 100
 Male 46.2
 Female 54.3
 Femur
 Measures the following:
 Bicondylar width
 Vertical diameter of head
 External condyle oblique length
 Vertical diameter of the neck
 Humerus
 Measures the following:
 Vertical diameter of head
 Transverse diameter of head
 Race Determination
 Difficult to do due to the amalgamation of races
 Utilizes indices for
 Skull
 Pelvis
 Extremities
 Very unreliable and serves only as a general guide.

 Age Determination
 Size of the bones
 Appearance of the Ossification Centers
 Union of Bones and Epiphyses

Importance of Age and Sex Determination

  Certain crimes are determined by age and sex
 Infanticide
 Seduction
 The exercise of legal capacity
 The exercise of the right to marry

Locard’s Principle
 is the cornerstone of forensic science.
 It states that whenever “there is an interaction between the criminal suspect and the victim
in the crime scene, trace evidence will be taken away or be left behind in the crime scene.”
 Trace evidence necessarily includes DNA evidence and serologic evidence

Forensic footwear analysis

 Came about by the study of the human gait
 Forms of Footwear Impression
 3D Impression
 2D Impression
 Traditionally uses plaster of paris as a means of making the impression but currently dental
stone is the reagent of choice in making impressions
 Gives the following information:
 Identification of footwear
 Elimination of footwear
 Determination of the number of suspects
 Rebuttal / Confirmation of Suspects Alibi

Fingerprint Analysis
 Has been used since 2000 years ago in China
 Started to be used in Europe around the 17th and 18th century
 Sir William Hershel – 1st European to recognize the value of fingerprinting in identification
 Had fingerprints and handprints in contracts.

Fingerprint Analysis
 Sir Francis Galton – published the book Fingerprints in 1892
 Encouraged the precursor of Scotland Yard to add fingerprints to Bertillon Cards
 John Vucetich – introduced the use of fingerprints to the Western Hemisphere
 Was first used to solve a crime in 1892 in Argentina.
 Brought to the US in 1903 to prevent impersonations during examinations
 In 1910 was used to identify Thomas Jennings in a case of murder
 Introduced by the Americans into the Philippines in 1910

Other terminology
 Dactylography – Study of recording fingerprint as means of identification
  Dactyloscopy – Study of identification of persons by comparison of fingerprints
 Poroscopy – Study of the pores/friction ridges for purposes of examination

Fingerprints
 Unique to each individual
 Odds of having similar fingerprints are 1:64 billion
 It develops as early as the 4th month in utero
 Does not change throughout life
Fingerprints
 Are friction ridges in the skin characterized by hills and valleys
 Hills –are known as ridges
 Valleys –are known as furrows

Minutiae
 Are features within fingerprint patterns
 Known as Galton’s features ( named for Sir Francis Galton)

Advantages of Using Fingerprints

 Training is simple and widely available
 No expensive instrument is required in the operation
 Easy classification
 Actual prints available for easy comparison

Methods of Producing Fingerprint Impression

 Plain Method
 Rolled Method

Kinds of Impression
 Real Impression – fingerprints intended to be made
 Chance Impression (evidentiary fingerprints)
 Visible /Patent print – visible to the naked eye
 Plastic Print – 3 dimensional print made on a soft surface
 Latent Print – print which is not visible to the naked eye

Development
 Process of rendering a latent print visible
 aka enhancement or visualization

Development of latent prints

 depends upon on the composition of latent print residue
 Primary – eccrine /sweat glands
 Secondary – apocrine residue
Current Fingerprint Analysis Tools
 Physical Methods
 Do not involve any chemical reaction
 Powder dusting
 Magnabrush
 Small Particle Reagent – used for wet surfaces
 Chemical Methods
 Ag NO3 – reacts with the chloride ion of sweat
 Ninhydrin – reacts with the protein in sweat
 PD / Physical Developer – reacts with chloride ion of swear
 Iodine Fuming – reacts with the carbohydrates in sweat
 Cyanoacrylate Ester

 Special Illumination
 Utilises lasers and specialized optics
 Use of oblique lighting and lasers
 Use of special filters

Odontology
 Use of dentition in the identification of individuals
 Allowed for the comparison of dentition with pattern injuries known as bite mark analysis
 Was 1st used as a means of identification in 1st century A.D.
 Gained widespread acceptance as a means of identification in the 19th century
 In 1849, dental identification was used in the U.S. For identification purposes
 In 1849, dentition was 1st used in a mass casualty incident (Vienna Opera House Fire)
Importance
 The number of possible combinations possible with 32 teeth and 5 surfaces make dental records
virtually unique
 Enamel is the hardest substance of the human body and may outlast all other tissues.

Dental Records
 PD 1575 requires dentist to keep dental records of their patients
 If 10 years has passed since the last entry, the dentist is mandated to submit their records to the
NBI
Causes of unreliability:
 Dentist may keep incomplete records
 No uniformity of nomenclature
 No agency is tasked for enforcement
 Lapse of time due to poor dental follow up would make records unreliable.

Forensic Serology
  Involves the examination and analysis of body fluids

Body fluids analysed

 Blood
 Saliva
 Vomitus
 Feces
 Urine
 Semen
 Vaginal Secretions

Identification of Blood Stains

 Careful Visual Examination
 Determine the material and make of the stained material
 Note the color of the stain and the surface
 Note the directionality of the stain
 Directionality
 Tells the direction of the blow as well as the velocity of the wounding instrument

 Application of a presumptive screening test

 Presumptive tests for blood
 Catalytic color test
 Depends of the peroxidase-like activity of the heme group of
haemoglobin
 Includes the following:
 Benzidine Test (Adler Test)
 No longer in use because it is carcinogenic
 Phenophthalein Test ( Kastle Mayer) (specific)
 O-Tolidine
 Tetramethylbenzidine (most sensitive)
 Leucomalachite Green
 Chemiluminescence
 Process by which light is emitted as a product of chemical reaction
 Example is Luminol
 Limitation is it has a cross reaction with bleach
 Flurorescence
 When a chemical substance is exposed to a certain wavelength of light
and light is emitted as a by-product.
 Example is Fluorescein
 Advantages of Chemiluminescence/Fluorescence
 When blood has been cleaned or not clearly visible, both techniques can
still show the blood pattern.
  When the purpose is to show the extent of blood for purposes of
documentation

 Application of a confirmatory test

 Crystal Test
 Teichmann Test
 Takayama Test
 Microscopic Analysis
 Determine the biologic or species origin
 Species Origin Determination
 Serum Protein Analysis
 The following may be used for testing:
 Albumin
 Alpha -1 globulins
 Alpha -2 globulins
 Beta globulins
 Gamma globulins
 The following techniques may be utilized
 Ring Precipitin Tests
 Ouchterlony Double Diffusion Tests
 Crossed over electrophoresis
 Nonserum Protein analysis
 Antihuman hemoglobin antibody

 Characterization of blood using genetic markers

 Genetic Markers in Blood
 Antigen Based Markers
 ABO system
 Most important
 Most useful as a tool for exclusion
 Lewis system
 2 antigens – Lewis a/Lewis b
 Provides insight to secretor status or whether other bodily fluids
have ABO antigens present or not
 Le(a-b+) – ABH secretors – 72% of population
 Le(a+b-) – ABH non secretor – 22%
 Le(a-b-) – 6 % of popu.
 80% secretor
 20% nonsecretor
 Le(a+b+) – very rare.
 Rhesus system
 Wiener (Rh)
  Fisher – Race (C, c, D, E, e)
 Protein Markers
 Hemoglobin
 HbA (Adult haemoglobin)
 HbF (Fetal haemoglobin)
 HbS (haemoglobin found in persons with sickle cell anemia)
 Haptoglobin
 Alpha 2 globulin class
 Enzyme Markers
 Uses flow cytometry
 Rarely utilized nowadays due to the easy access of DNA analysis
Semen
 Semifluid mixture of sperm cells, amino acids, sugar, salts, and organic compounds
 Ejaculate ranges from 2-6 ml
 100-150 million sperm cells / ml.

Sperm Cell
 Approximately 55 um
 Ovoid in shape

Till When Can it be Detected?

 Intact Sperm
 up to 26 hours after intercourse in the vagina
 Up to 5 hours in oral or rectal vaults
 Sperm Heads
 Up to 7 days in vaginal cavity
 2-3 days in the anus and rectum
 24 hours in the oral cavity

Acid Phosphatase
 Used for the presumptive identification of semen
 Uniquely high levels in seminal fluid
 Detected in the vagina up to 72 hours post coitus
 Reagent used: Brentamine Fast Blue test

Confirmatory Tests
 Prostate Specific Antigen (PSA)
 Gamma-seminoprotein
 Secreted by the cells lining the prostate glands
 Visualization of Spermatozoa
 Sperm Cell Identification
 Dye (Christmas tree stain) is applied to the slide
  Sperm cell tail – yellow green
 Midpiece – blue
 Acrosome – pink
 Head – dark red / purple

Importance of Semen Analysis

 Useful in crimes involving sexual assault like
 Rape
 Anti VAWC
 Anti Trafficking Cases
 Stalking

Saliva
 Slightly alkaline secretion
 1 to 1.5 liters of saliva is produced per day
 Amylase (an enzyme used to digest starch) is used to test for it
 Starch-Iodine Test
 Phadibas reagent
 Limitation:
 Amylase is not only present in saliva
 It is also found in secretions of the pancreas

Urine
 Presumptive test uses alternative light sources
 The test relies on urea and creatinine

Feces
 Urobilinogen – most common means utilized for identification
 Limitation:
 Infant < 6 months
 Carnivorous/omnivorous people only
Vomitus
 No specific test for presence of vomitus
 Analysis of stomach contents

Vaginal Secretions
 Important in cases of rape where allegations of foreign body insertion are made
 Tests for glycogenated epithelial cells or the cells lining the vaginal canal
 Uses PAS (Periodic Acid Schiff) reagent
 Limitation:
 Glycogen depends on the stage of the menstrual cycle
DNA
 The genetic material of the body which serves as its blueprint
 DNA stands for deoxyribonucleic acid
 The chain of molecules found in every nucleated cell of the body.
 The totality of an individual's DNA is unique for the individual, except identical twins.
 Definition of Terms (From rules on DNA Evidence)
 Biological sample - any organic material originating from a person's body, even if found
in inanimate objects, that is susceptible to DNA testing.
 Includes :
 Blood
 Saliva and other body fluids
 Tissues
 Hairs and bones
 DNA profile - genetic information derived from DNA testing of a biological sample
obtained from a person, which biological sample is clearly identifiable as originating
from that person
 DNA evidence - the totality of the DNA profiles, results and other genetic information
directly generated from DNA testing of biological samples
 DNA as EVIDENCE
 Allowed expressly by the Rule on DNA Evidence
 DNA testing-verified and credible scientific methods
 Include
 Extraction of DNA from biological samples,
 The generation of DNA profiles
 Comparison of the information obtained from the DNA testing of
biological samples for the purpose of determining, with reasonable
certainty, whether or not the DNA obtained from two or more distinct
biological samples originates from the same person (direct
identification) or if the biological samples originate from related persons
(kinship analysis)
DNA Testing
 Depends on repetitive sequences which are repeated over the chromosome and are
inherited and conserved from familial lines
 Occurs either in tandem or dispersed
 Comprise 50% of the human genome
 Example of sequences
 Pseudogenes
 Alu repeats
 Duplications of large stretches of DNA
 Interspersed repeats occurring in the centromere
  Simple sequence repeats

Simple Sequence Repeats

 Currently the gold standard in DNA fingerprinting
 Utilizes the high variability of the repeating units as basis for comparison
 People have differing numbers of allelic repeat units inherited from their parents.
 Could either be:
 Microsatellites
 Short tandem repeats (STR)
 2-7 bp in each tandem repeat unit
 Minisatellites
 Variable number of tandem repeats (VNTR)
 9-80 bp in each tandem repeat unit

DNA STR Analysis

 Uses multiple loci or areas in the DNA strand
 Limited number of these variations/loci
 13 core microsatellite loci – basis for DNA fingerprinting (US)
 10 core microsatellite loci – basis for DNA fingerprinting (UK)

Steps of DNA Analysis

 Uses Polymerase Chain Reaction (PCR) to mass duplicate a sample DNA
 Results to formation of amplicons which are copies of the original sample
 Electrophoresis
 Technique of separating the sample depending on sample size.
 Capillary Electrophoresis – modern equivalent which uses smaller sample sizes
 Short Tandem Repeat Analysis

Rules in DNA Evidence

Application for DNA Testing Order
 Motu proprio
 On application of any person who has a legal interest in the matter in litigation
 Requires:
 Notice
 Hearing
 Requisites
 A biological sample exists that is relevant to the case
 The biological sample:
(i) was not previously subjected to the type of DNA testing now
requested
 (ii) was previously subjected to DNA testing, but the results may require
confirmation for good reasons

 The DNA testing uses a scientifically valid technique

 The DNA testing has the scientific potential to produce new information that is
relevant to the proper resolution of the case
 The existence of other factors, if any, which the court may consider as
potentially affecting the accuracy or integrity of the DNA testing.

DNA Testing Order

 Order, where appropriate, that biological samples be taken from any person or crime scene
evidence
 Impose reasonable conditions on DNA testing
 Designed to protect the integrity of:
 the biological sample
 the testing process and
 the reliability of the test results, including the condition that the DNA test results shall
be simultaneously disclosed to parties involved in the case
 If the biological sample taken is of such an amount that prevents the conduct of
confirmatory testing by the other or the adverse party and where additional biological
samples of the same kind can no longer be obtained, issue an order requiring all parties
to the case or proceedings to witness the DNA testing to be conducted.
 immediately executory
 shall not be appealable.
 Any petition for certiorari initiated shall not stay the implementation thereof, unless a higher
court issues an injunctive order.
 The grant of a DNA testing application shall not be construed as an automatic admission into
evidence of any component of the DNA evidence that may be obtained

Probative Value of DNA Evidence

 The chain of custody
 Including:
 how the biological samples were collected
 how they were handled
 the possibility of contamination of the samples
 DNA testing methodology
 Including:
 the procedure followed in analyzing the samples
 the advantages and disadvantages of the procedure
 and compliance with the scientifically valid standards in conducting the tests
 Reliability of the Testing Methodology
  The falsifiability of the principles or methods used, that is, whether the theory or
technique can be and has been tested
 The subjection to peer review and publication of the principles or methods
 The general acceptance of the principles or methods by the relevant scientific
community;
 The existence and maintenance of standards and controls to ensure the correctness of
data generated
 The existence of an appropriate reference population database
 The general degree of confidence attributed to mathematical calculations used in
comparing DNA profiles and the significance and limitation of statistical calculations
used in comparing DNA profiles
Probative Value of DNA Evidence
 Forensic DNA laboratory,
 including
 accreditation by any reputable standards-setting institution
 the qualification of the analyst who conducted the tests.
 If the laboratory is not accredited, the relevant experience of the laboratory in forensic
casework and credibility shall be properly established
 The reliability of the testing result.

Reliability of the Testing Result.

 The evaluation of the weight of matching DNA evidence or the relevance of mismatching DNA
evidence;
 The results of the DNA testing in the light of the totality of the other evidence presented in the
case

Medicolegal Applications
 Identification
 Exclusion of Suspects
 Paternity Testing

Paternity Testing
 DNA results that exclude the putative parent from paternity shall be conclusive proof of non-
paternity.
 If the value of the Probability of Paternity is less than 99.9%, the results of the DNA testing shall
be considered as corroborative evidence.
 If the value of the Probability of Paternity is 99.9% or higher, there shall be a disputable
presumption of paternity

Confidentiality of Results
 DNA profiles and all results or other information obtained from DNA testing shall be confidential
  only be released to any of the following, under such terms and conditions as may be set forth by
the court:
 Person from whom the sample was taken;
 Lawyers representing parties in the case or action where the DNA evidence is offered
and presented or sought to be offered and presented
 Lawyers of private complainants in a criminal action
 Duly authorized law enforcement agencies
 Other persons as determined by the court

Preservation of DNA Evidence

 In criminal cases:
 for not less than the period of time that any person is under trial for an offense
 in case the accused is serving sentence, until such time as the accused has served his
sentence
 In all other cases, until such time as the decision in the case where the DNA evidence was
introduced has become final and executory.

Destruction of DNA Evidence

 A court order to that effect has been secured
 The person from whom the DNA sample was obtained has consented in writing to the disposal
of the DNA evidence

Post Conviction DNA Testing

 may be available, without need of prior court order, to the prosecution or any person convicted
by final and executory judgment provided that:
 A biological sample exists,
 Such sample is relevant to the case,
 The testing would probably result in the reversal or modification of the judgment of conviction

Death
 The termination of life
 Complete cessation of all the vital functions without the possibility of resuscitation

Importance of Determination of Death

 Civil Personality is extinguished by death
 Succession
 Business – i.e. agency and partnerships
 Criminal liability is extinguished
 Civil claims for damages are extinguished and are transformed to claims against the estate

Types of death
 Cardio-Respiratory death
  Continuous cessation of heart action
 Method of determination – ECG (asystole or flat line on the ECG)

 Brain Death
 Continuous absence of electrical brain activity
 Deep irreversible coma
 Method of determination – EEG - isoelectric

Kinds of Death
 Somatic Death or Clinical Death
 Patient is pronounced dead but at this stage cells are still functional
 Molecular or Cellular Death
 ATP (or the fuel of the cell) is used up and cell homeostasis is disrupted leading cell
rupture
 Apparent Death or State of Suspended Animation
 Transient loss of consciousness

Signs of Death
 Cessation of heart action and circulation
 General rule: stoppage of heart action for 5 minutes is regarded as certain death
 Ultimen mariens- the stoppage of the auricle which is the last to stop in somatic death
 Methods of Detecting Cessation of Heart Action
 Palpation or feeling for the pulse
 Auscultation or listening for the Heart Sounds
 Fluoroscopic examination
 ECG (gold standard)
 Methods of Detecting Cessation of Circulation
 Magnus Test
 Tying a string around the finger of the person. If the person is alive, the
area near the string becomes pale in color
 Opening of a small artery
 Icard’s Test
 Injection of fluorescein into the skin of the person. If the person still has
circulation , the skin of the person becomes yellowish
 Pressure on the fingernail
 Diaphanous Test
 A light is shined upon the spread hand of the person, if the person is still
alive then the skin is translucent with visible blood vessel
 Heat Application
 Causes the formation of a blister at the point of heat application
 Palpation of the Radial Pulse
 Dropping of melted wax
 Cessation of Respiration
 Must be continuous and persistent
 Instances where there is cessation of respiration but the condition is transient include:
 In free diving (without SCUBA gear)
 In cases of electric shock
 In cases like Obstructive Sleep Apnea (OSA)
 In cases of newborn with poor prognosis
 In cases of near drowning
 Methods of Detecting Cessation of Respiration
 Visual Examination of the Chest and Abdomen
 Auscultation or listening with a stethoscope
 Examination with a mirror
 The mirror should fog due to the breath of a living person
 Examination with a feather or cotton fibers
 The fibers should ruffle due to the breath of the person
 Examination with a glass of water
 The glass is placed upon the chest of the person. If he is still living then
the movement of the chest wall while breathing causes the water to
move.
 Winslow’s Test.
 Similar to the above test but the water is replaced with mercury
 Cooling of the Body (Algor Mortis)
 Progressive fall of the body temperature is one of the most prominent signs of death
 A drop of 15-20°F is a certain sign of death
 Rate of Cooling
 1st 2 hours – (Body temp – Air temp)/2
 Next 2 hours – ½ the value of the previous decrease in temp.
 This rate continues until the body attains room temperature in 12 to 15 hours
after death with an average loss of 1.5°C per hour
 Estimating Time of Death
 The liver temperature is gotten and the temp is subtracted from normal temp
and divided by 1.5 to get approximate time of death
 Factors affecting body temperature
 Factors delaying cooling
 Acute pyrexial illness (post mortem caloricity)
 Apparent good health prior to death
 Obesity
 Death from asphyxia
 Clothing
 Want of access of air to the body
 Small room
 Warm ambient temperature
  Post mortem Caloricity
 A phenomenon wherein the body temperature rises after death due to
rapid and early putrefactive changes usually secondary to an infectious
process.

 Factors accelerating cooling

 Chronic illness
 Advanced age
 Leanness of physique
 Lack of clothing
 Easy access of air to the body
 Large room allowing easy dissipation of heat
 Cold ambient temperature
 Immersion of body to water

 Insensibility of the body and loss of locomotion

 This may be present in living patients suffering from the following thus must be taken in
conjunction with other signs.
 Seizure Disorder
 Coma
 Cerebral Concussion
 Catatonic Schizophrenia
 Changes in the Skin
 Pale and waxy looking skin secondary to loss of circulation
 Loss of elasticity
 i.e. Post mortem contact flattening
 Opacity of the skin under direct illumination
 Application of heat has no inflammatory reaction

 Changes in and about the eye

 Loss of corneal reflex
 Clouding of the cornea
 Flaccidity of the eyeball
 Pupils are fixed and dilated
 Tache noir de la sclorotique
 A spot which may be found in the cornea after death. At the beginning it is
yellowish but later becomes brown or black.

 Changes in the muscle

 Stage of primary flaccidity
 Post mortem muscular irritability
 Stage of post mortem rigidity
  Cadaveric rigidity
 More commonly called Rigor mortis
 Death struggle of muscles
 Stage of secondary flaccidity
 Decay of the muscles

 Stage of Primary Flaccidity

 Complete relaxation and softening of all the muscles of the body
 Pupils are dilated
 Sphincters are relaxed
 Muscles are still susceptible of stimulation by electricity
 Lasts about 3 to 6 hours after death
 Stage of Post mortem rigidity
 Gradual stiffening of the muscles beginning with muscles of the neck and lower
jaw and usually spreading downwards.
 Starts from 3 to 6 hours after death.
 Stiffening is complete after 12 hours
 Lasts approximately 24 to 36 hours
 Medicolegal use is for estimating time of death.
 Factors affecting time of onset
 Internal factors
 State of the muscles
 Age
 State of the nerves
 External factors
 Ambient temperature
 Moisture

 Conditions simulating Rigor Mortis

 Heat Stiffening
 Exposure to temp >75°C
 Caused by coagulation of proteins resulting to shortening of muscle
 Assumes the pugilistic attitude – lower and upper extremities are flexed
and hands are clenched

 Cold Stiffening
 Due to the solidification of fat when the body is exposed to freezing
temperatures
 It is reversible when the body is thawed.

 Cadaveric Spasm
  Instantaneous rigidity of the muscles which occurs at the moment of
death due to extreme nervous tension, exhaustion and injury to the
nervous system.
 Medicolegal use: findings of weapons, hair and other substances may
indicate whether suicide, homicide or murder.

 Stage of Secondary Flaccidity

 Different from primary flaccidity due to the loss of response to electrical stimuli
 Secondary to the dissolution of previously coagulated muscle protein by action
of enzymes

 Changes in the blood

 Clot formation
 Antemortem Clot (clot formed while person is still living)
 Firm
 Surface of the blood vessel is raw after clot removal
 Clot is homogeneous or of single color
 Clot is uniform in color
 Postmortem clot
 Soft
 Smooth blood vessel surface after clot removal
 Can be stripped off in layers
 Clot is layered.
 Post mortem lividity
 Also known as:
 Cadaveric lividity
 Post mortem suggillation
 Post mortem hypostasis
 Livor Mortis
 Blood accumulates in the most dependent portions of the body due to:
 Stoppage age of heart action
 Loss of tone of blood vessels
 Gravity
 Usually begins to be visible 3-6 hours post mortem
 Fully developed in 12 hours post mortem
 Post mortem lividity
 Medicolegal Implications:
 it indicates the position of the body at time of death.
 Shows whether or not the body has been moved from the
original position.
 Color of the lividity is indicative of the cause of death
  In cases of carbon monoxide poisoning, the body becomes
cherry red
 In indicates time of death.
 Characteristics of Postmortem Lividity
 Occurs in the dependent parts of the body
 Involves only the superficial layer of the skin
 Skin is not elevated (unlike in a hematoma)
 Color is uniform
 No injury is present on the skin.

 Putrefaction of the body

 Breaking down of the complex proteins into simpler components
 Associated with the evolution of foul smelling gases
 The action of anaerobic bacteria results in the release of CO2, NH3, H2, H2S and
CH4
 Effect of the Evolution of Gases
 Displacement of blood
 Bloating of the body
 Tete de negri (the body assumes the appearance of an african american)
 Fluid coming out of the Nostrils and Mouth
 Usually in the form of froth
 Extrusion of Fetus in the Gravid Uterus
 Floating of the body.
 Causes bloating of the body
 Tissue changes in Putrefaction
 Changes in the Color of the tissue
 Due to the breakdown of hemoglobin in the tissues
 Liquefaction of the Soft Tissues
 End product of decomposition
 Factors Modifying the Rate of Putrefaction
 Internal Factors
 Age
 Healthy adults decompose faster than infants
 Condition of the Body
 Lean individuals decompose slower.
 Cause of Death
 Due to infection-decompose faster.
 External Factors
 Free Air
 Air (will hasten decomposition)
 Moderate Moisture (will hasten decomposition)
 Condition of the Air
  Temperature (70-100°F)
 Light
 Earth
 Water
 Clothing
 Organs which putrefy early
 Brain
 Lining of the trachea and larynx
 Stomach and Intestines
 Spleen
 Liver
 Gravid Uterus
 Organs which putrefy late
 Esophagus
 Diaphragm
 Heart
 Lungs
 Kidney
 Urinary Bladder

 Special Modification to Putrefaction

 Mummification
 Dehydration of the whole body which results in the shivering and
preservation of the body
 Occurs when the body is buried in a hot arid place
 May occur naturally or artificially
 Artificial Mummification
 Acceleration of the evaporation of the tissue fluid prior to the onset of
decomposition
 This is usually done with the use of salt
 Addition of some body preservative to inhibit decomposition and to
allow evaporation of fluid.
 Formalin, resinous or tarry material
 Saponification or Adipocere formation
 Fatty tissues are transformed to soft brownish white substance
 Adipocere is a waxy material, rancid in odor
 Occurs naturally in the visceral organs
 Is caused by anaerobic bacterial hydrolysis of body fat
 Absence of oxygen in a cold and humid environment
 Maceration
 Softening of the tissue when in a fluid medium in the absence of
putrefactive organism
  Usually observed in fetal death in utero

Physical Injury
 Effect of some form of stimulus on the body
 Becomes apparent only if stimulus applied is SUFFICIENT!
 May be acute or delayed depending on the type of applied stimulus

Causes of Physical Injuries

 Barometric trauma or Dysbarism
 Radiation from Radioactive substances
 Heat or Cold (Thermal Injury)
 Electrical Energy
 Chemical Energy
 Infection
 Physical Violence

Barometric Trauma
 Hyperbarism
 Injuries caused by rapid increase of atmospheric pressure
 Examples:
 SCUBA Diving
 Caisson Mining (mining the seabed or deep riverbed)

 Hypobarism
 Injuries caused by rapid increase of atmospheric pressure
 Example:
 Alpine climbing (High mountain range)
 Rapid Ascent from depth in SCUBA Diving
 Rapid depressurization of cabin pressure in aircraft travelling at more than
30,00 ft.

Radiation Related Injuries

 Type of explosive
 Fission type
 One stage weapons
 Early weapons such as the Hiroshima and Nagasaki bombs
 Fusion type
 Two stage weapons
 Modern thermonuclear devices
 Specialized type of explosive
 Neutron bomb
  Primarily a bomb which releases massive amount of radiation in order kill the
populace without destroying useful structures
 Salted bomb
 Nuclear devices to which salts are added which insure long term radiation
would affect the surrounding area
 Suitcase bomb
 Man portable nuclear devices

 Dirty Bomb
 Not a nuclear bomb per se but a conventional explosive which is mated to
nuclear material

 Other Sources of Radiation

 Natural Sources
 Sun
 From naturally occurring uranium
 Man made Sources
 X-ray and CT Scan
 Clinical nuclear medicine
 Radiotherapy
 Industrial sources (nuclear power plant)

Thermal Injuries
 Caused by appreciable deviation from normal temperature
 either a decrease or an increase
 Cold – frostbite
 Heat – burns or scalds

Death or Injury From Cold

 Unusual in tropical countries
 Frost Bite
 Cause of death
 Decreased ability of the Red Blood Cell to deliver oxygen
 Diminished ability of the tissue to utilize oxygen.
 Vascular effects of cold causes hemostasis and later cell death, necrosis and infection

Death or Injury From Heat

Either:
 Scalds
 Burns

Local Effects
  Burn
 Dry heat (flame, heated solid, radiant heat)
 Occurs at or above the site of contact
 Singeing of the hair is present
 Unclear boundaries
 Severe
 Clothing involved

 Scalds
 Moist heat or steam
 Occurs at or below the site of contact
 Absent
 Distinct boundaries
 Limited
 Clothing usually uninvolved

 Purposes of Intentional Fire or Arson

 To conceal identity and true cause of death
 To commit homicide
 To commit insurance fraud
 To commit suicide
 To perpetuate a cause.

 Proof of burning antemortem or while the victim is still living

 Presence of smoke in the air passage
 Grayish-black to black amorphous material in the mucosa of the larynx, trachea
or bronchii
 Inflammation of the lung and airway
 Smoke Inhalation
 Heat Stiffening
 Exposure to temp >75°C
 Assumes the pugilistic attitude – lower and upper extremities are flexed and
hands are clenched

 Chemical Burns
 Results from the action of strong acids and alkalies and other irritant chemicals
 May cause extensive tissue destruction.

Electrical Energy
 Lightning Strikes
 Electrical Current
Lightning
 Electrical charge in the atmosphere
 May reach 1 Gigavolts and 10,000 to 200,000 amperes
 The distribution is variable and unpredictable
 Lichtenberg Figures – characteristic of lightning strikes

Electrical Current
 Main cause of death is shock
 Principal factor is the intensity of the current or the amperage
 Factors affecting Electrical shock
 Personal idiosyncracy
 Disease
 Heart Disease, presence of pacemakers
 Sleep
 Increases resistance to electrical current
 Amperage
 70-80 in AC
 250 in DC
 Resistance of the body
 Lesser resistance = greater injury
 Nature of the current
 Ac vs DC
 Grounding
 Duration of contact
 Kind of conductor
 Point of entry
 Mechanism of death
 Ventricular fibrillation
 The heart is unable to contract properly leading to loss of cardiac output and
circulation
 Occurs in Low voltage injury
 Respiratory Failure
 Paralysis of the nervous system in charge of breathing
 Occurs in High voltage injury
 Mechanical asphyxia
 Prolonged convulsions often result from electrical injury

 Electrical Burns
 Other names include:
 Electrical necrosis
 Electric marks
 Current markings
  These may be seen at the point of entry and point of exit
 Metallization
 A specific feature of electrical injury
 Metal of the conductor is volatilized or vaporized and the particles are driven
into the epidermis
 Color depends of the conductor
 Iron = yellow brown
 Copper = bluish

Infection
 Caused by a pathogen
 May be:
 Viral
 Bacterial
 Parasitic
 Prions
 Of medicolegal importance:
 Weaponized strains pathogens.
 Historical Implications
 Used since time of antiquity
 Assyrians – Used fungus to poison enemy wells
 Hannibal – Used snakes on enemy ships
 Mongols - animal carcasses to poison enemy wells
 Advent of germ theory
 Weaponization of botulism and brucellosis
 Weaponization
 Increasing resistance to environmental factors
 Means:
 Adding cancer genes to increase the robustness of the pathogen
 Usually studied pathogens
 Small pox
 Ebola
 Lassa
 Anthrax
Chemical Energy
 Causes injury when there is a sudden release of potential energy into kinetic or thermal energy
causing a sudden increase in pressure
 Results in an explosion
 Types of Chemical Explosion
 Diffused Reactant Explosion
 Caused by a mixture of gas and air and initiated by a flame
 Examples include:
  Internal Combustion Engine
 A leaking Gasul
 Fuel Air Bomb
 Condensed Reactant Explosion
 Caused by a large quantity of heat and gas produced as a consequence of a
rapid chemical reaction in a liquid or solid
 Radiating in an outward direction thus maximal damage is sustained nearest the
point of origin
 Subclassified as:
 Low order Explosive (Deflagrating Explosive)
 Relies on burning and confinement to produce explosions
 Gunpowder is the best known low order explosive.
 High Order Explosive
 Type of explosive which detonates
 Detonation is a chemical process which results in the extremely
rapid decomposition of nitrogenous compound releasing heat
and gas as its by-product
 Damage is caused by the shock wave which results from the
sudden release of heat and gas
 Types of High Order Explosive
 Stable
 Stable until detonated by another
explosive such as a blasting cap
 Example: dynamite and plastique such
as C4 or Semtex
 Unstable
 Easily detonates from heat, flame, spark
or percussion
 Example: Picric Acid and Nitroglycerin
 Injury is due to:
 Primary effects of detonation
 Occurs when the body is in contact with the explosive
 Causes complete disruption or fragmentation of the victim’s body
 Compression-decompression effect brought about by sudden rise and
fall of atmospheric pressure
 Secondary to the blast wave
 Body may be thrown some distance and dismembered
 Hollow organs are most heavily damage
 Peppering of shrapnel
 Secondary to the effect of blast wave to small fragments
 May be metallic or not
 Other blast wave effects
  May cause fall related injuries
 Damage to the respiratory organs
 Damage to the ear and the tympanic membrane

Physical Violence
 Wound is a natural disruption of the anatomic integrity of a tissue of the living body.
 Is used synonymously with physical injury however, physical injury does not always result in a
wound.

Classification of Wounds
 Severity
 Mortal
 Non- mortal

 Kind of Instrument Used

 Blunt
 Sharp
 Sharp edged Instrument
 Sharp pointed Instrument
 Sharp edged and sharp pointed
 Tearing force

 Manner of Infliction
 Hit
 Thrust/Stab
 Gunpowder explosion
 Sliding or rubbing

 Depth of the Wound

 Superficial
 Deep
 Penetrating (solid organ)
 Perforating (communication between inner and outer portion of the hollow organs.

 Relation of the Site of Application of Force and the Location of the Injury
 Coup Injury
 Injury same site as the application of force
 Contre-Coup Injury
 Injury opposite site of the application of force
 Coup-Countre Coup Injury
 Both the site as well as the site opposite has injury
 Locus Minoris Resistencia
  The site of the injury is at the point of least resistance
 Extensive

 Special Types of wounds

 Defensive wounds
 Patterned wounds
 Self Inflicted wounds

Legal Classification
 Mutilation (Art 262 RPC)
 Intentionally depriving a person, totally or partially of some of the essential organs of
reproduction
 Intentionally depriving a person, totally or partially of any part other than that of the
essential organs of reproduction
 Serious Physical Injuries (Art 263 RPC)
 Done by:
 Wounding
 Beating
 Assaulting
 Administering Injurious Substances without the intent to kill
 Serious Physical Injuries (Art 263 RPC)
 Graduated penalty
 Prision mayor
 Person shall become insane, imbecile, impotent or blind
 Prision correcional (medium to maximum)
 Loss of the use of speech, power to hear/smell, loss of an eye, hand, foot, arm
and leg
 Loss of use of any such member
 Becomes incapacitated for the work in which he was habitually engaged
 Prision correcional (minimum to medium)
 Person shall become deformed
 Loss of any other member of his body
 Loss the use thereof
 Becomes ill or incapacitated for the performance of work habitually engaged in
for more than 90 days
 Arresto Mayor (maximum) to Prision correcional (minimum)
 Becomes ill or incapacitated for the performance of work habitually engaged in
for more than 30 days

 Administering Injurious Substance or Beverages (Art 264 RPC)

 Infliction upon another of any serious physical injury
  It was done knowing that the substance is injurious or took advantage of the
victims weakness or credulity
 No intent to kill

 Less Serious Physical Injuries (Art 265 RPC)

 Incapacitate the offended party from labor for more than 10 days
 Requires medical attendance for more than 10 days
 Qualified by:
 Manifest intent to insult or offend the injured person
 Circumstance adding Ignominy
 Victim is the offender’s parents, ascendants, guardian, curators or
teachers
 Victim is a person of rank or authority

 Slight Physical Injuries (Art 266 RPC)

 Incapacitate the offended party from labor for 1 to 9 days (arresto menor)
 Causes injury which do not prevent the offended party from working nor require
medical attendance (arresto menor, censure)
 Illtreatment by deed

 Physical Injuries Inflicted in a Tumultuous Affray (Art 252 RPC)

 There is a tumultuous affray
 Participants suffered from serious physical injuries
 Persons who inflicted could not be identified
 All those who appear to have used violence upon the offended party shall be
penalized by arresto from 5 to 15 days

 Type of Wounds
 Closed Wounds
 No breach in the continuity of the skin
 May be:
 Superficial
 Petechiae
 Contusion
 Hematoma
 Deep
 Musculoskeletal Injuries
 Internal Hemorrhage
 Cerebral Concussion
 Open Wounds
 Abrasion
 Incised Wound
  Stab Wound
 Punctured Wound
 Lacerated Wound

 Petechiae
 Circumscribed extravasation of blood into the subcutaneous tissues or beneath the
mucous membrane
 Usually from the capillary systems
 Causes:
 Asphyxia
 Trauma
 Coronary occlusion
 Clotting disorders

 Contusion
 Effusion of blood into the surrounding tissues
 Results from blunt force trauma
 Does not immediately develop after the trauma
 Medicolegal significance:
 May correspond to the shape of the object causing it.
 Extent may suggest the degree of force applied
 Distribution may indicate character and manner of injury
 Age can be estimated by the color
 Red to purple-recent
 Green – 4 to 5 days
 Yellow – 7 to 10 days
 Gradual resumption of skin tone – 14 to 15 days
 Hematoma
 Extravasation or effusion of blood in a newly formed cavity underneath the skin.
 Usually formed if force is applied where the bone is superficially located
 Also known as “bukol”

 Deep Closed Wounds

 Musculoskeletal Injuries
 Sprain
 Partial or complete disruption in the continuity of a muscular or
ligamentous support of a joint.
 Caused by a blow, kick or torsion force
 Dislocation
 Displacement of the articular surface of bones entering into a joint
 Fracture
  Fragmentation of bone resulting loss of continuity
 Strain
 Subluxation
 Internal Hemorrhage
 Rupture of blood vessel which may result in hemorrhage
 Cerebral Concussion
 Concussion is a trauma-induced change in mental status, with confusion and
amnesia, and with or without a brief loss of consciousness.
 Most commonly caused by Vehicular Accidents and Sports Injuries

 Open Wounds
 Abrasion
 An injury characterized by the removal of the superficial epithelial layer
secondary to friction against a hard rough surface.
 Usually develops at the precise point of impact
 May exhibit the pattern of the wounding material
 Also known as “gasgas”
 Incised Wound
 Wound produced by a sharp edged instrument
 May be:
 Impact cut – like that of a jungle bolo
 Slice Cut – like that of a knife
 Stab Wound
 Wound produced by the penetration of a sharp pointed and sharp edged
instrument.
 Punctured Wound
 Injury resulting from the use of a sharp pointed instrument such as an icepick
 Lacerated Wound
 Tear of the skin and underlying tissues due to forcible contact with a blunt
instrument.
 Causes of Injury
 Mauling
 Results from a violent altercation between 2 persons or groups of persons
 Injury may be sustained by:
 The feuding parties
 Bystanders
 Domestic Injury and Industrial Accident
 Usually results from the myriad of combinations of accidents at home or at
work.
 A physician must note whether there is presence of alcohol on the patient.
 Vehicular Accident
 Factors responsible in VAs
 Human Factor
 Human Factor
 Mental Attitude
 Perception Defects
 Delayed or Sluggish Reaction Times
 Disease
 Chemical Factors
 Environmental Factor
 Mechanical Factor
 Social Factor
 Pedestrian

 Factors Responsible for Passenger and Driver Injury

 Impact within structures
 Ejection
 Direct impact with other vehicle occupants.
 Acceleration-Deceleration Injury (Whiplash)
 Pedestrian-Vehicle Collision
 Primary Impact
 Causes injuries such as bumper fractures as well as patterned
wounds of the front grills
 Secondary Impact
 Run Over Injuries
 Usually results to patterned injuries such as tire tread contusion
as well as patterned abrasions
 Motorcycle Injuries
 Is a the leading cause of vehicular accidents
 Reason for increase:
 Increasing number of motorcycles
 Relatively small profile of motorcycles
 Continued failure to use mandated safety equipment
 Very little material in a motorcycle to cushion the impact.
 Sports Injuries
 Boxing
 Wrestling
 Newer sports with attendant risks:
 Mixed Martial Arts
 Extreme Games
 Sky Diving
 Injuries common in combat sports
  Lacerations to the eyebrow and malar region (cheek)
 Hemorrhage secondary to the blood vessel rupture or fracture of the
orbital plate of the frontal bone known as Spectacle Hematoma
 Hematoma of pinna with auricular cartilage necrosis known as
Cauliflower ears
 Cerebral concussion
 Subdural hemorrhage (most common)
 Pontine hemorrhage (known as boxer’s hemorrhage)
 Stabbing Injuries
 Anything with an edge could be used for injuries of this type
 Knives
 Bolo / Machete
 Broken bottles
 Scalpels
 Sharpened instruments such as shanks

 Gunshot Injuries

Firearm
 An instrument used for the propulsion of a projectile using expansive force of gases coming
from the burning of gunpowder
 Includes:
 Rifles
 Muskets
 Shotguns
 Revolvers
 Pistols

Classification of Firearms
 As to wounding power
 Low velocity Firearm (<1,400 fps)
 High power Firearm (>1,400 fps but usually 2,200-2,500 fps)
 As to the Nature of the Bore
 Smooth bore
 Rifled bore
 As to manner of firing
 Pistol - Single handed weapon
 Rifle - Shoulder fired weapon
 As to the Nature of the Magazine
 Cylindrical Revolving Magazine
 Vertical or Horizontal Magazine
 Components of a Weapon
  The Cartridge
 The Firearm
 Cartridge
 The Cartridge Case or Shell
 Cylindrical structure with a base which houses the different parts of the
ammunition
 May be:
 Cartridge with a Rim
 Rimless Cartridge
 Semi-rimless Cartridge
 Belted Cartridge
 Primer
 Functions to transform the mechanical energy of the firing pin to chemical
energy by its rapid combustion
 Located at the base of the cartridge and covered by a small disc of soft metal
known as percussion cap or primer cap
 May be:
 Center fire Cartridge
 Percussion Cap located at the center
 Most common
 Rimfire Cartridge
 Primer is placed inside the rim of the shell
 Common in 0.22 caliber firearm
 Firearm with a pin
 No longer in use due to inherent instability
 Powder or propellant
 Gunpowder/Propellant
 Primary propulsive force in the cartridge
 Types of Propellant
 Black Powder
 (80%KNO3, 15%S, 10%C)
 Smokeless Powder
 Single base (either cellulose nitrate or nitroglycerin)
 Double base (contains both)
 Semi-smokeless Powder
 (80%black and 20% smokeless)
 Bullet or projectile
 The projectile attached to the free end of the cartridge case
 Classification
 Shape of the tip
 Conical
 Hemispherical
  Wad cutter (square nose)
 Hollow point
 Presence or absence of jacket
 Naked Lead Bullet
 Jacketed Bullet
 Full Jacketed Bullet
 Semi-jacketed Bullet
 Special Bullets
 Armour Piercing Bullets
 Phosphorus flare or Tracer Bullet
 Plastic Bullet
 Bullet with Plastic Sabot
 Bullet with Secondary Explosion
 Soft Point Bullets
 Firearms
 Parts of the firearm of medicolegal importance:
 Trigger with firing pin
 Barrel

 Trigger
 Part of the firearm which causes the firing evolution.
 Classification:
 Relation of cocking and trigger pressure
 Single Action Firearm
 Double Action Firearm
 Number of Shots on Pressure on the Trigger
 Single Shot Firearm
 Automatic Firearm
 Barrel
 Riflings
 Series of parallel spiral grooves on the whole length
 Number – varies from 2-12
 Twist Rate - expression of 1 complete twist
 Direction – clockwise or counterclockwise
 Land
 Space between 2 grooves
 Determination of caliber
 Distance of the barrel between 2 lands

 Mechanism of Firearm Action

 The firing pin hits the primer cap which ignites the primer.
  Ignition of the primer initiates ignition of the gunpowder which produces pressure and
this pressure pushes out the bullet out of the barrel.

 Thing which come out of the muzzle after firing

 Bullet
 Flame
 Heated, compressed and expanded gas
 Residue coming from:
 Bullet
 Fragment
 Lubricant
 Primer
 Powder particles
 Powder grains
 Soot
 Graphite
 Rust, Dust
 Scraping from previous fire

 Bullet Movement
 Forward movement
 Spinning Movement
 Tumbling Movement
 Wobbling Movement
 Gravitational Pull

 Factors Responsible for Injurious Effect of the Bullet

 Inherent on the bullet
 Speed of the bullet
 Size and shape of the bullet
 Character of the missile’s momentum in flight
 Nature of the target
 Density of the target
 Length of tissue involvement
 Nature of media Traversed
 Importance of the Organ Involved

Effects of firing evolution

 Flame
 Brought about by the ignition of the propellant
 Does not usually go beyond a distance of 6 inches and in pistols is often less than 3
inches
  Causes burning of the skin in contact or near fire
 Heated, Compressed and Expanded Gas
 Brought about by the limited space in the chamber of the firearm
 Responsible for the propulsion of the projectile.
 Responsible for the muzzle blast.
 Smoke
 Product of the complete combustion of the gunpowder and the propellant.
 Light, almost black and only covers the skin.
 May be readily wiped off.
 May be seen up to a distance of 12 inches
 Powder Grains
 Product of the incomplete combustion of the gunpowder and the propellant together
with graphite.
 Relatively heavier than smoke.
 May not be readily wiped off and penetrates the dermal and epidermal layer of the skin.
 Responsible for the production of tattoing.
 May be seen up to a distance of 24 inches

 Contusion Collar
 Caused by the pressure of the bullet on the elasticity of the skin.

Characteristics of Point of Entry

 Depends upon:
 Caliber of the Wounding Weapon
 Characteristics inherent to entrance wound
 Direction of fire
 Shape and composition of missile
 Range
 Kind of weapon
 Point of Entry – contact fire
 Where bone is superficial
 Wound is large and stellate (star) shaped
 Edges may be everted
 Burns, tattooing, smudging and singeing of hair is present
 Muzzle imprint on the skin
 Where bone is deeply located
 Wound is usually large, circular and without radiating laceration
 Edges may be everted, some tissue may be found in the gun barrel
 Burns, tattooing, smudging and singeing of hair is present
 Muzzle imprint on the skin present
 Point of Entry – near contact fire
 Wound is usually large and circular depending on the angle of fire
  Contusion collar distinct
 Burns, tattooing, smudging and singeing of hair is present
 Muzzle imprint on the skin present
 Blackening of the bullet tract
 Point of Entry – short range fire about 1-15 cm distance
 Edges of the wound inverted
 Contusion collar distinct
 Tattooing and smudging is present
 If within 3 inches, burns may be present
 Point of Entry – medium range fire about 15-60 cm distance
 Edges of the wound inverted
 Contusion collar distinct
 Tattooing and smudging (if less than 30 cm) is present but of lesser density
 Burns and singeing is absent
 Point of Entry – greater than 60 cm distance
 Edges of the wound inverted
 Contusion collar distinct
 Tattooing, smudging, burns and singeing is absent

Point of Exit (Outshoot)

 No characteristic shape
 Edges are usually everted
 Point of Exit (Outshoot)

Special Consideration on Bullets

 Souvenir bullet
 Bullet migration
 Tandem Bullet
Shotgun Wounds
 Classes of Shot in a Shotgun Shell
 Birdshot – small and measuring 200-400 shots in the shell
 Buckshot- shot ranges from .24 to .33 inch in diameter. Std 12 gauge = 9 shots
 Single Projectile or rifled slug.

 Types of Shotgun
 As to number of barrels
 Single barrel
 Double barrel
 As to the manner of firing and reloading
 Bolt Action
 Lever action
 Pump Action
  Autoloading

Sex Crimes

 Rape
 Seduction
 Qualified Seduction
 Simple Seduction
 Acts of Lasciviousness
 Abduction
 Adultery and Concubinage
 Prostitution
 Corruption of Minors
 Anti Trafficking in Persons Act of 2003
 White Slave Trade
 Abuse against Chastity
 Sexual Harassment (RA. 7877)
 Anti Photo and Video Voyeurism Act of 2009

Rape
 Rape is committed:
 By a man who shall have carnal knowledge of a woman under any of the following
circumstances:
 Through force, threat, or intimidation
 When the offended party is deprived of reason or otherwise unconscious
 By means of fraudulent machination or grave abuse of authority
 When the offended party is under twelve (12) years of age or is demented, even
though none of the circumstances mentioned above be present.

 Carnal knowledge pertains to:

 Act of having sexual bodily connection with a woman
 Not necessary for the vagina to be entered or that the hymen be ruptured

 Deprived of reason or unconscious means:

 Committed on an insane or mentally deficient
 Under the influence of alcohol or drugs
 Under the influence of sexually stimulating drugs
 Unconscious
 In her natural sleep
 Knocked out by physical injuries
 Under the influence of narcotics
Rape is committed under paragraph 2:
 By any person who, under any of the circumstances mentioned in paragraph 1 hereof, shall
commit an act of sexual assault
 By inserting his penis into another person's mouth or anal orifice,
 Any instrument or object, into the genital or anal orifice of another person.

Seduction
 The act of a man enticing women to have unlawful sexual intercourse by means of
 Persuasion
 Solicitation
 Promises
 Bribes
 Other means except for force.
 May be either
 Qualified Seduction
 Ordinary
 Incestuous
 Simple seduction
Qualified Seduction
 Offended party must be a virgin
 12 to 18 years old
 Sexual intercourse must transpire
 Done through the abuse of authority or confidence
 The abuse of authority
 Person in public authority
 Guardian
 Teacher
 Abuse of confidence
 Priest
 House Servant
 Domestics
Incestuous Qualified Seduction
 Offended party must be a virgin
 12 to 18 years old
 Sexual intercourse must transpire
 With a blood relation
 Brother who seduces the sister
 Ascendant who seduces the descendant

Simple Seduction
 Offended party over 12 but less than 18 years old
  Must be single or widow of good reputation
 Must have sexual intercourse with the offender
 Sexual act must be done by means of deceit
 Deceit is a fraudulent or cheating misrepresentation

Acts of Lasciviousness
 Offender commits any act of lasciviousness
 By:
 using force or intimidation
 Depriving her of reason or otherwise unconscious
 The offended party may be either sex

Abduction
 Carrying away of a woman by an abductor with lewd design
 Either:
 Forcible
 Consented

Consented Abduction
 Carrying away of a woman by an abductor with lewd design with her consent.
 Woman must be a virgin
 12 to 18 years old

Adultery
 Woman is married
 Has had sexual intercourse with a man not her husband
 The man knows her to be married even if the marriage is subsequently declared void

Concubinage
 Keeping a mistress in the conjugal dwelling
 Having sexual intercourse under scandalous circumstances with a woman not his wife
 Cohabiting with her in any other place

Prostitution
 It is committed by a woman if:
 She habitually indulges in sexual intercourse or lascivious acts
 The above act is done for profit

Corruption of minors
 Any person who shall:
 Promote
 Facilitate
  Corruption of persons under age
 To satisfy the lust of another
 The penalty was increased by RA 7610 if committed on children less than 12 years old

Anti Trafficking in Persons Act of 2003

 It shall be unlawful for any person, natural or juridical, to commit any of the following acts:
 To recruit, transport, transfer; harbor, provide, or receive a person by any means,
including those done under the pretext of domestic or overseas employment or training
or apprenticeship, for the purpose of prostitution, pornography, sexual exploitation,
forced labor, slavery, involuntary servitude or debt bondage
 To introduce or match for money, profit, or material, economic or other consideration,
any person or, as provided for under Republic Act No. 6955, any Filipino woman to a
foreign national, for marriage for the purpose of acquiring, buying, offering, selling or
trading him/her to engage in prostitution, pornography, sexual exploitation, forced
labor, slavery, involuntary servitude or debt bondage
 To offer or contract marriage, real or simulated, for the purpose of acquiring, buying,
offering, selling, or trading them to engage in prostitution, pornography, sexual
exploitation, forced labor or slavery, involuntary servitude or debt bondage
 To undertake or organize tours and travel plans consisting of tourism packages or
activities for the purpose of utilizing and offering persons for prostitution, pornography
or sexual exploitation
 To maintain or hire a person to engage in prostitution or pornography
 To adopt or facilitate the adoption of persons for the purpose of prostitution,
pornography, sexual exploitation, forced labor, slavery, involuntary servitude or debt
bondage
 To maintain or hire a person to engage in prostitution or pornography
 To adopt or facilitate the adoption of persons for the purpose of prostitution,
pornography, sexual exploitation, forced labor, slavery, involuntary servitude or debt
bondage

White Slave Trade

 Any of the following is sufficient to constitute the offense which need not be habitual
 Engaging in the business of prostitution
 Profiting by prostitution
 Enlisting the services of women for the purpose of prostitution

Abuse Against Chastity

 By soliciting or making immoral or indecent advances to a woman who:
 Interested in matters pending before the offending officer for decision or which he is
required to make a report to or consult with a superior officer
 Under the offender’s custody
 To the wife, daughter or relative with the same affinity of a person under his custody
Sexual Harassment (RA. 7877)

 Who commits sexual harassment?

 Employer
 Employee
 Manager
 Supervisor
 Agent of the employer
 Teacher
 Instructor
 Professor
 Coach
 Trainor
 Any other person who, having authority, influence or moral ascendancy over another in
a work or training or education environment
 How is it committed?
 In a work-related or employment environment:
 The sexual favor is made as a condition:
 in the hiring
 in the employment, re-employment or continued employment of said individual
 in granting said individual favorable compensation, terms, conditions, promotions, or
privileges
 the refusal to grant the sexual favor results in limiting, segregating or classifying the
employee
 The previous acts would:
 Impair the employee's rights or privileges under existing labor laws
 Result in an intimidating, hostile, or offensive environment for the employee
 In an education or training environment, sexual harassment is committed:
 Against one who is under the care, custody or supervision of the offender
 Against one whose education, training, apprenticeship or tutorship is entrusted to the
offender
 When the sexual favor is made a condition to the giving of a passing grade, or the
granting of honors and scholarships, or the payment of a stipend, allowance or other
benefits, privileges or considerations
 When the sexual advances result in an intimidating, hostile or offensive environment for
the student, training or apprentice

Examination of Abuse Victims

 Should be done in a thorough and systematic manner

 Victims are encouraged not to:

 Bathe or shower
  Use the restroom
 Change clothes
 Comb hair
 Clean up the crime scene
 Move anything the offender may have touched

 Initial assessment
 Get informed consent
 Get the Complete Medical History including gynecologic history
 Menarche – date of first menstruation
 LMP – last menstrual period
 Previous sexual history – to determine the possibility of contamination of sample
 Collect all items of clothing or sanitary ware for further examination
 Should be stored in a sealed container for further testing
 Clothing of assault victim

 Improvised Rape Kit should include the following:

 Bags and sheets for evidence collection
 Swabs
 Comb
 Envelopes for hair and fibers
 Blood collection devices
 Documentation forms

Examination of Abuse Victims

 A “top to toe” physical examination should be done.
 Physical Examination Findings to be noted:
 Ligature marks
 Findings to be noted
 Fingertip bruising along the neck
 Fingertip bruising along the arm
 Lip Bruising
 A detailed genito-anal examination is done
 Examination Position – Dorsal Decubitus

 Determination of virginity:
 Difficult to determine.
 A requisite in the criminal cases of
 Qualified Seduction
 Consented Abduction
 Types of virginity
 Moral Virginity
  Physical Virginity
 True Physical Virginity
 False Physical Virginity
 Demi Virginity
 Virgo Intacta

 Hymenal Configurations
 Annular (oval or circular)
 Crescentic (Semilunar)
 Redundant (Fimbriated or Denticular)
 Septate
 Slitlike
 Cribrifrom
 Imperforate
 Hymenal Configurations
 Annular – 32%
 Crescentic – 36%
 Redundant – 25%
 Septate – 1%
 Slitlike
 Cribriform – 0%
 Imperforate 2%

 Timeline of Hymenal Laceration

 Fresh, bleeding – recent origin
 Fresh healing with fibrin formation and edema of the surrounding tissues – 4-10 days
(aka recently healed laceration)
 Healed laceration with sharp coaptible borders without congestion – 2-3 weeks
 Healed laceration with rounded coaptible borders and retraction of the edges – more
than 3 weeks
 Evidence Collection
 Photography of all injuries
 Swab all injuries that may have DNA transfers
 Bite marks
 Semen stains
 Vaginal/Rectal swabs

Conditions Consistent with Abuse

 Rape Trauma Syndrome
 stress response pattern of... a person who has experienced sexual violence”
 Manifested in somatic, cognitive, psychological and/or behavioural symptoms
 Usually consists of two phases:
  the acute phase
 Period of disorganization
 Usually last for 2 -3 weeks
 Victim presents with strong emotional reaction and may present with
physical symptoms
 Rooted in fear of physical injury, mutilation or death
 the long-term phase
 Period of reorganization
 May be adaptive or maladaptive
 Phobias begin to appear in this phase
 Victims initiate lifestyle changes
 Sexual dysfunction begin to appear.
 Sexual aversion
 Vaginismus
 Flashbacks of the event during intercourse

 Battered Woman Syndrome

 A series of abuse inflicted upon a victim
 Requires at least 2 cycles of:
 Battering
 Remorse
 Reconciliation
 Recognized by Phil Courts as an exempting circumstance (People v. Genosa)

 Post Traumatic Stress Disorder

 Usually manifested by victims of violent sexual assault and those perpetrated by
strangers
 Manifests as intrusions and avoidance
 Intrusions – reliving the event
 Avoidance symptoms include:
 Self imposed isolation
 Increase drug or alcohol use
 Intellectuallization of the event

 Battered Child Syndrome

 Physical, mental, moral and economic abuse of a child
 Usually done by parents who are
 Immature
 Self Centered
 Impulsive
 With poor control of aggression
 Causes of Abuse
  Unwanted Progeny
 Disputed paternity
 Illegitimate
 Out of wedlock
 Adultery
 Rape
 Congenital / acquired deformity
 A belief that the child is the source of bad luck to the family
 Abusive Parents
 Center of a triangle
 A belief that the child is a hindrance to the socio economic advancement of the
parents
 Kinds of Abuse
 Intermittent
 One time
 Constant
 Ignorant

Duties of the Physician

 Report all cases of abuse to the PNP or DSWD (R.A. 7610)
 Note for the following:
 Skin imprints
 Multiple healing injuries
 Repeated fractures
 Trauma
 Malnourishment

Paternity and Filiation

 Definitions
 Paternity – civil status of the father with respect to the child begotten by him.
 Filiation – Civil status of the child in relation to its mother and father
 Birth
 Medically means the entire delivery of a child from the mother.
 Legally
 The fetus is considered born if it is alive at the time it is completely delivered
from the mothers womb
 Exception:
 If the newborn was born with a gestational age of less then 210 days,
then the child must survive at least 24 hours to be considered as born
alive.
 Determines personality
 Conceived children shall be considered born for all purposes favourable to it.
  Examples
 Succession (Art. 760 NCC) on legitimes
 Donation
 Infanticide

Kinds of Children
 Legitimate
 Born within a valid and subsisting marriage
 Those who were conceived before the marriage but the parents got married before the
child was born.
 Child born within a valid marriage but the marriage is subsequently annulled
 Separated parents
 Children born of Artificial Insemination
 Is considered legitimate if the following conditions are met:
 Authorized and ratified in a written instrument executed and signed by
them before the birth of the child.
 Recorded in the civil registry
 Insemination must be made on the wife.
 Illegitimate
 Those children born outside of the above enumeration.
 Rights of illegitimate children:
 Use the surname of the father by virtue of RA 9255
 Recognized by the father by acknowledgement in the back of the birth
certificate and in an affidavit.
 Has a right to ½ of the share of a legitimate child in the legitime (inheritance)

 Legitimated Children
 These are children born out of wedlock but the parents were not disqualified to marry.
 They are legitimated by the subsequent valid marriage of their parents.
 Brought about by The Family Code

 Presumption of legitimacy
 If a child is born within 300 days after dissolution of the marriage if:
 There is a valid marriage
 Birth took place after 180 days after celebration of the marriage or within 300
days after its dissolution
 No physical impossibility of intercourse in the 1st 120 days of the 300 days
preceeding the birth of the child.

 Impugning Legitimacy
 Impotence of the husband
 Husband and wife living separately
  Serious illness of the husband
 DNA, HLA or other scientific basis
 Consent for artificial insemination obtained thru fraud, violence, intimidation or undue
influence.

 Presumption of illegitimacy due to ethnic reasons. (Art 257 NCC)

 No longer a valid presumption

 Premature Marriage
 Found in Art 351 of the Revised Penal Code
 Punishes a woman who shall marry within 301 days from the death of her husband,
 Arresto Mayor
 Fine of 500 pesos
 Purpose: to prevent confusion in connection with paternity
 Actual Cases
 US v. Dulay
 People v. Rosal
ABORTION
 Definition
 Willful killing of the fetus in utero
 Violent expulsion of the fetus from the maternal womb which results in the death of the
fetus
Intentional Abortion (ART 256 RPC)
 Ways of committing:
 Using any violence upon the person of the pregnant woman
 By acting but without using violence without the consent of the woman
 By acting with the consent of the woman.
 Elements:
 There is a pregnant woman
 Violence, drugs or beverages administered
 That as result the fetus dies
 That the abortion is intended.
 Difference from infanticide
 Test to be used:
 If the fetus could sustain independent life and the fetus is killed then it is infanticide
 Case: Pp v. Detaplan

Unintentional Abortion (Art. 257)

 Elements:
 There is a pregnant woman
 Violence is used upon such pregnant woman without intending an abortion
 Violence in intentionally exerted
  As a result of the violence, the fetus dies.
 Can be done thru imprudence and complexed with homicide and parricide

Abortion practiced by the woman/her parents (Art. 258)

 Elements:
 Pregnant woman has suffered an abortion
 Abortion is intended
 Caused by:
 The pregnant woman
 Any other parent with her consent
 Any of her parents with her consent

Abortion practiced by Physician or midwife and dispensing of abortives

 Elements (Physician/midwife):
 Pregnant woman has suffered an abortion
 Abortion is intended
 Done by a physician or midwife
 Takes advantage of his/her scientific knowledge and skill
 Elements (Pharmacist):
 Offender is a pharmacist
 No proper prescription has been made
 Offender dispenses any abortifacient
 Charged together with RA 4729 which regulates the sale, dispensation and distribution
of contraceptive drugs

Deception Detection
 Essential requirement for the administration of justice
 Initially the task of the investigator

Methods of Detection
 Devices which record the psycho-physiologic response
 Use of drugs that try to inhibit the inhibitor
 Hypnotism
 Observation
 Scientific interrogation
 Confession

Recording the Physiologic Response

 Based on the flight or fight reflex of the Autonomic Nervous System
 When a person is under stress, the sympathetic system predominates:
 Note the following which are all recordable parameters
 Heart rate increases
  Respiratory rate increases
 Pupils dilate
 Blood pressure increases

Tests which measure psychophysiologic response

 Polygraph Examination
 Word Association Test
 Psychological Stress Evaluator

Use of a polygraph/lie detector

 The fear of the subject in getting caught not telling the truth allows for the determination
 The instrument acts like an ECG
 The interview is recorded on a monitor and spikes are measured against a baseline

History of the polygraph examination

 Invented in 1921 by John Augustus Larson
 However, William Marston claims to be the father of the “Polygraph Machine”

Requirements for Polygraph Examination

 The room must be sound proof
 Must be quiet
 Isolated
 Free from any disturbance and distraction

How is the test conducted?

 Subject is instructed to sit up straight
 Subject is instructed to look straight ahead
 All questions are to be answered with a yes or no
 Declaratory responses are disallowed during the examination

Phases of the Examination

 Pre test interview
 To determine whether there is history of hypertension, psychiatric condition, and the
like
 To explain the purpose
 To develop test questions
 To relieve stress and apprehension
 To determine any criminal record of the subject.
 Actual Interview and Recording
 Irrelevant Questions
 No bearing to the case under investigation
 Relevant Questions
  Pertains to the issues under investigation
 Control Questions
 Unrelated to the matter under investigation but of a similar nature
 Probable-lie questions
 Supplementary Tests (needed if the test done are inconclusive)
 Peak of tension test
 Guilt Complex Test
 Silent Answer Test

 Post test Interview

 To clarify findings
 To learn if there are any other reasons for the subject’s knowledge of the crime
 To obtain additional information.

Reason for inadmissibility

 User/ operator dependent
 No assurance of a qualified examiner
 Opinion of the expert is the sole basis
 Violates the suspects constitutional rights
 Error prone (up to 25%)

Word Association Test

 Stimulus and Non stimulus Questions are asked
 Quickness of answering is an indicator of truthfulness
 The answer is unimportant; time interval in answering is what is important

Psychological Stress Evaluator

 AKA voice analysis
 Measures inaudible frequency modulation which occur with the oscillations of the vocal cords
called microtremors in the 8-14 Hz range
 Discovered in 1957 by Olaf Lippold
 Microtremors disappear when under stress
 Advantages of PSE:
 No attachment of sensors needed
 Outside distraction need not be eliminated
 No restriction of normal body movement

Use of Drugs that Inhibit the Inhibitor

 Truth Serum
 Hyoscine hydrobromide
 Scoplamine
 Narcoanalysis / Narcosynthesis
  Sodium Pentothal/Sodium Amytal
 SP 117
 Intoxication with Alcohol

Hypnosis
 Alteration of consciousness and concentration
 Heightened state of suggestibility
 Pseudoscience
 Inadmissible due to:
 Unreliability
 Suggestibility destroys the credibility of the admission

Observation
 Observes Physiologic/Psychological signs of Guilt
 Sweating
 Color change such as flushing
 Dryness of mouth (exhibited by asking for water)
 Excessive activity of the Adam’s Apple (secondary to dryness of the mouth)
 Fidgeting

Scientific Interrogation
 Interrogation – questioning of a person suspected of having committed an offense
 May be done on a suspect or a witness
 Techniques of Interrogation
 Emotional Appeal to Conscience
 Mutt & Jeff or Good Cop/Bad Cop
 Bluff on Split Pair Technique
 2 subjects interrogated separately
 Stern/Harsh Approach
 Making of a Narrative

Confession
 Defined in the Rules of Court as an expressed acknowledgement by the accused of the truth of
his guilt as to the crime charged
 Must comply with the Following to be admissible:
 Must be made in the presence of counsel
 Must be expressly made and not implied
 A judge must make probing questions as to the understanding of the accused of what he
is confessing to
 Kinds of Confessions
 Extrajudicial – must be accompanied by evidence of corpus delicti
 Voluntary
  Involuntary
 Judicial Confession – made before a judge in a judicial proceeding

Maltreatment of prisoners
 Public officer/employee
 Has under his charge a convicted/detention prisoner
 Maltreats the prisoner:
 Overdoing in handling the prisoner
 Maltreatment of a prisoner to extort a confession or to obtain some information from
the prisoner

RA 9745 or Anti Torture Act of 2009

 Any person who actually participated Or induced another in the commission of torture or other
cruel, inhuman and degrading treatment or punishment or who cooperated in the execution of
the act of torture or other cruel, inhuman and degrading treatment or punishment by previous
or simultaneous acts shall be liable as principal
 Any superior military, police or law enforcement officer or senior government official who
issued an order to any lower ranking personnel to commit torture for whatever purpose shall be
held equally liable as principals.
 The immediate commanding officer of the unit concerned of the AFP or the immediate senior
public official of the PNP and other law enforcement agencies shall be held liable as a principal
to the crime of torture or other cruel or inhuman and degrading treatment or punishment for
any act or omission, or negligence committed by him/her that shall have led, assisted, abetted
or allowed, whether directly or indirectly, the commission thereof by his/her subordinates..

RA 9745 or Anti Torture Act of 2009

 (a) Physical torture is a form of treatment or punishment inflicted by a person in authority or
agent of a person in authority upon another in his/her custody that causes severe pain,
exhaustion, disability or dysfunction of one or more parts of the body, such as:
 (1) Systematic beating, headbanging, punching, kicking, striking with truncheon or rifle
butt or other similar objects, and jumping on the stomach;
 (2) Food deprivation or forcible feeding with spoiled food, animal or human excreta and
other stuff or substances not normally eaten;
 (3) Electric shock;
 (4) Cigarette burning; burning by electrically heated rods, hot oil, acid; by the rubbing of
pepper or other chemical substances on mucous membranes, or acids or spices directly
on the wound(s);
 (5) The submersion of the head in water or water polluted with excrement, urine, vomit
and/or blood until the brink of suffocation;
 (6) Being tied or forced to assume fixed and stressful bodily position;
 (7) Rape and sexual abuse, including the insertion of foreign objects into the sex organ
or rectum, or electrical torture of the genitals;
  (8) Mutilation or amputation of the essential parts of the body such as the genitalia, ear,
tongue, etc.;
 (9) Dental torture or the forced extraction of the teeth;
 (10) Pulling out of fingernails;
 (11) Harmful exposure to the elements such as sunlight and extreme cold;
 (12) The use of plastic bag and other materials placed over the head to the point of
asphyxiation;
 (13) The use of psychoactive drugs to change the perception, memory. alertness or will
of a person, such as:
 (i) The administration or drugs to induce confession and/or reduce mental
competency; or
 (ii) The use of drugs to induce extreme pain or certain symptoms of a disease;
and
 (14) Other analogous acts of physical torture;
 (b) "Mental/Psychological Torture" refers to acts committed by a person in authority or agent of
a person in authority which are calculated to affect or confuse the mind and/or undermine a
person's dignity and morale, such as:
 (1) Blindfolding;
 (2) Threatening a person(s) or his/fher relative(s) with bodily harm, execution or other
wrongful acts;
 (3) Confinement in solitary cells or secret detention places;
 (4) Prolonged interrogation;
 (5) Preparing a prisoner for a "show trial", public display or public humiliation of a
detainee or prisoner;
 (6) Causing unscheduled transfer of a person deprived of liberty from one place to
another, creating the belief that he/she shall be summarily executed;
 (7) Maltreating a member/s of a person's family;
 (8) Causing the torture sessions to be witnessed by the person's family, relatives or any
third party;
 (9) Denial of sleep/rest;
 (10) Shame infliction such as stripping the person naked, parading him/her in public
places, shaving the victim's head or putting marks on his/her body against his/her will;
 (11) Deliberately prohibiting the victim to communicate with any member of his/her
family; and
 (12) Other analogous acts of mental/psychological torture.

 The TOKYO DECLARATION

 Endorsed by the World Medical Association in 1975
 Declares the abhorrence of physicians of acts of torture and that no physician shall
countenance , condone, or participate in its practice

Good Luck on your final examinations!