Legal Medicine Compiled Reviewers

LEGAL MEDICINE DEFINITIONS Algor Mortis: Cooling of the body After death the metabolic process inside the body ceases. The progressive fall of the body temp. is one of the most prominent signs. First two hours after death the cooling is rapid. Fall of temp. of 15 to 20 degrees Fahrenheit is considered as a certain sign of death.

Anthropometry/Bertillon System For identification of human body Breach of Contract: Breach of meeting of minds between 2 persons whereby one binds himself with respect to the other to give something or to render some service Ex. MD-Px relationsship Circumstances: Aggravating Circumstances: Increase the penalty/crime Mitigating Circumstances: Lessen the penalty/crime Ordinary Mitigating Circumstances: Can be offset by aggravating circumstances Lessen penalty to a minimum period w/in a degree Privileged Mitigating Circumstances: Cannot be offset by aggravating circumstances Lessen penalty one or two degrees Exempting Cicumstances: Act is not voluntary No criminal liability but with civil liability except in accident and lawful or insuperable cause Ex. Imbecility & Insanity (except in lucid interval), Minority, Accident, Compulsion of irresistible force, Impulse of uncontrollable fear, absolutory causes Justifying Circumstances: the acts of the actor are in accordance with law No criminal and civil liability Ex. Self Defense, Defense of relative, Defense of stranger, State of necessity, Fulfillment of duty, Obedience to superior (w/ lawful purpose)

Complaint: A formal allegation or charge against a party by a private person Ex. Vs. Information Coroner: Investigative, judicial Barrister, solicitor, medically qualified MD >5yrs Vs. Medico Legal Officer - MD Corpus delicti Principle that it must be proven that a crime has occurred before a person can be convicted of committing the crime. Ex. Products of conception to prove abortion Crime: Attempted Crime: Offender has not yet performed all acts of execution which will produce felony (subject phase) Ex. Vs. Frustrated Crime Frustrated Crime: Offender has performed the acts that will produce felony (subjective phase) but did produce the crime (objective phase) due to some independent causes. Ex. Vs. Attempted Crime Complex Crime: A single act constituting 2 or more grave felonies OR one offense is a necessary means for committing the other. Ex. Rape with homicide where rapist with venereal disease and victim died due to peritonitis (?)  it’s complicated!

Privileged Communication: An exchange of information between two individuals in a confidential relationship. Subpoena Written notification commanding a person to attend to court as a witness Summons Written notification commanding a person to attend to court; addressed to a defendant Tokyo Declaration: Tokyo=Torture guidelines to be observed by physician concerning torture, inhuman and degrading punishment Torts Legal wrong independent of contract Includes Direct invasion of some legal right Infraction of some public duty Violation of some private obligation Elements Legal duty Breach of legal duty Injury is the approximate result GENERALITIES Medico-Legal Systems (3): Medico-legal officer Medical examiner Coroner

In pari delicto Two persons or entities are equally at fault Ex. Woman who had an abortion testifiying as witness against abortionist

Divisions of Civil Law: Persons Property Obligations and contracts

Information: A formal accusation of the public prosecutor or a proceeding in a prosecution Ex. Vs. Complaint

Ex-Officio medico legal officers (5): PHO Staff of Hospital

Postmortem Caloricity: The rise of temp. of the body after death due to rapid and early putrefactive changes. Usually in the first 2 hours.

Kinds of Damages: Nominal Actual/Compensatory Temperate/Moderate Moral

Types of Subpoena (court summons) (3): Testificandum - oral testimony Duces Tecum - for production of evidence Duces Tecum et ad Testificandum May not comply with subpoena: Court has no jurisdiction over the matter and person of case Residence if > 50km from the court Transportation allowance not given (civil case) MD w/ emergency case and no equal substitute If with infirmity aggravated if complies with subpoena EVIDENCES Forms of Medical Evidence (4): Real/Autoptic - can be perceived by the senses Testimonial – oral under oath Documentary Experimental Privileged Communication: Can be claimed in a civil case but not in criminal Once waived, can never be claimed Expressed waiver Implied waiver Hearsay Evidence: Dying declaration – the only exception to hearsay evidence rule Requisites: Consciousness of impending death Concerns the cause & circumstances of death Competent witness Use in criminal case & declarant is a victim Admissible: necessity, trustworthiness Presumption of Survivorship: < 15 yo – older survives >60 yo – younger survives < 15 yo survives vs >60yo 15-60 yo – male or older survives Presumption of Death: Absence of 10 years >75 yo absent for 5 years

Board a vessel lost during sea voyage or an aeroplane Armed forces in the war missing for 4 years Under danger of death missing for 4 years Diputable Presumption of Death: Not heard of for 7 years Presumption of Legitimacy: Requisites: Born after 180 days after marriage and before 300 days after dissolution or separation Valid marriage No physical impossibility Documentary Evidences: Formal written report Written opinions Certificates Dying Declaration Witness: Ordinary witness: Based on senses, may not be skilled Expert witness: May give opinion, deduction, conclusion, inference, must be skilled Stages in the Examination of a Medical Witness: Preliminary stage Direct examination (Prosecution) Cross-examination (Defense) Re-direct examination Re-cross examination *Expert medical testimonies are corroborative evidences *Not required in cases of Res Ipsa Loquitur Principals of Felony: Direct participation Inducement Cooperation Elements of Felony: Freedom Intelligence Methods of preserving evidence (6): Photo, videotape,photocopy Sketching Description

Manikin method In the mind of the witness Special methods: embalming Probative value of standard medical textbooks: Not admissible in court as evidence (hearsay) But medical witness can base opinion on textbook Legal Importance of Blood: Parentage Circumstantial or corroborative evidence Direction of escape Cause of death Approximate time of the crime Place of commission of crime Chemical Examination of Blood: Saline extract + NH$ Guanicum test Benzidine Test Phenolphthalein Leucomalachite Green Test Legal Importance of Sex Determination: Identification Marriage Exercise of right to one sex only Differences of rights granted by law Primogeniture - rights of firstborn to inheritance Bones to determine sex of skeleton (5): Skull Sternum Pelvis Humerus Femur Relative position of the victim: Testimony of witness Nature of the instrument Wound Location Direction For Dying Declaration to be admissible to court: Must concern the cause and circumstances of declarant’s death Conscious of impending death Competent witness

Victim in a criminal case to which this will be used

Peripheral Circulation

Ballistic Examination: Shell Bullet TEST

PURPOSE

Ascheim-Zendek Test

Sign of recent deliver/Pregnancy test

Breslau’s Test Fodere’s /Hydrosatic/ Static Test Gettler’s Test

Paraffin / Dermal Nitrate/ Diphenyllamine/ LUNG’S Test

Test

Magnus test Icard’s Test

RESULT

Diaphanous test

Winslow’s Test

Livebirth vs Stillborn

Unsectioned and Sectioned lungs float in water

Drowning in a fresh water pool

Chloride difference of 25mg Fresh – RV>LV Sea – LV>RV Blue reaction w/ Lung’s reagent (+) nitrite/ nitrate

Corroborative (+) even after 3 days & with washing Blood & Blood Stains

Saline extract + NH3 Benzidine Test

Brownish (alkaline hematin) Blue color in white filter paper Blue

Guaiacum/Van Deen’s Dyas/ Schombein’s Test Phenolphthalein/ Kastle-Meyer test Leucomalachite Green Test

Pink Green Microchemical Tests

Takayama Test/ Hemochromogen crystal Teichmann’s Blood crystals / Hemin crystal test

Aa

Best test Dark brown rhoimbic prisms of Cl, hematin

Wagenhaar’s/ Acetone-haemin test

Schourup’s Formula

Time of death

Walker/ Naphthalinamine

Presence of Gunpowder in clothings

CSF lactic acid 15mg  200mg in 5 hrs after death Aa, nitrogen, axillary temp Dark red spots on foto paper

Respiration

Ligature around base of the finger Flourescein SQ, greenish yellow discolor. Of skin Fingers are spread wide through a strong light - red no movement in the image formed by reflecting artificial light on the water in a saucer and placed in the chest if respiration is taking place.

Winslow’s test – no movement in the image formed by reflecting artificial light on the water in a saucer and placed in the chest if respiration is taking place. DECEPTION DETECTION Methods used (6): Lie detector / Keeler’s Polygraph Intoxication Word association – time interval between question & answer Truth serum Narcoanalysis – Na amytal, Na penthotal Hypnotism Factors for Unreliability of Polygraph: Extreme emotions Physiologic abnormalities Mental abnormalities * Use of control questions > Most reliable & effective questioning SEXUAL CRIMES Kinds of Virginity: Physical Moral Demi Virgo intacta

Annulment when concealed Rape: Carnal knowledge of a woman + Force/Intimidation Deprived of reason Unconscious Under 12 years old – Statutory Rape Simple Seduction: May not be a virgin Over 12, under 18 yo Single/Widow + good reputation Carnal knowledge With deceit Qualified Seduction: Must be a virgin Over 12, under 18 yo Carnal knowledge With abuse of authority, confidence, relationship Acts of Lasciviousness Consented Abduction: Must be a virgin Over 12, under 18 yo With consent With lewd design Forcible Abduction: Woman Against will With lewd design Extent of Hymenal Lacerations: Complete Incomplete Complicated Infection Hemorrhage Fistula Scar BIRTHING & ABORTION: Legal Importance of Pregnancy: Suspension of death sentence Conceived child Capable of receiving donation May exercise civil rights

Mutilation Administering injurious beverage?

Legal importance of birth: Personality Appearance is a ground for revocation of donation Proof of live birth before death in infanticide Reasons for abortion: Preserve life and health of woman Preserve body form Illegitimate pregnancy Financial constraints

Radiation Infection

Legal justification for therapeutic abortion: No other practical and most practical means Evil sought to be avoided exists Injury greater if it was not done Difficulty in prosecuting MDs with crime of abortion: Intelligent & aware of criminal act Medical justifications Products of conception as corpus delicti* is lost Woman, witness, is in pari delicto* Medical society lukewarm against helping state prosecute abortionist Legal viewpoint of when is a child born: Civil purposes, fetus is considered born if: Alive at the time it is completely delivered *Preterm (/= P1500 and/or 1-5 years imprisonment PATIENT’S RIGHTS: Right of Privacy from Privileged Communication

Description Temporary master must be responsible for the wrongful act of servant

Contract for Service Use of hospital for the px Due to negligence Exclusive control of Defendant No contribution from the plaintiff Contract of Service A master is liable for the wrongful acts of his servant w/in scope of authority (hospital) Administrative or ministerial duties Negligence of his partner Acts of his agent Not his partner Interns