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 law-
enforcement 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
patient’s condition while confined at the Hospital.
When the patient’s 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 Medical Jurist
1. Sees an injury or illness 1. Sees an injury or illness
on the point of view of on the point of view of
TREATMENT CAUSE
2. Purpose in examining 2. include those bodily
patient is to arrive at lesions in his report
a definite Diagnosis- and testify before the
Rx Rx court before an
investigation body
result: justice where
justice is due-given.
 Ordinary Physician Medical Jurist
3. Minor or trivial ignored 3. Medical jurists must
–they do not require 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 it—either 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/stain-
examination 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 parent’s
wrath, she kept what happened to herself and came for medical
examination only today.
• Examination results:
• Recently healed hymeneal lacerations at 4 and 6 o’clock;
• 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 o’clock
-presence of Spermatozoa,
• Conclusion: recent sexual intercourse within the last 24 hrs.