Legal Medicine Solis Notes

FROGLETS NOTES CHAPTER I GENERAL CONSIDERATION Legal Medicine- branch of which deals with application of medical knowledge to the purposes of law and in the administration of justice. It is the application of basic and clinical, medical and paramedical sciences to elucidate legal matters. 

Concept and practice of Legal Medicine in the Philippines is of Spanish origin.

Legal Medicine Application of medicine to legal cases

Forensic Medicine Application of medical science to elucidate legal problems

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

Summary of Legal Medicine Book by Solis

treatment Purpose in examining a patient is to arrive at a definite diagnosis so that appropriate treatment can be instituted Minor or trivial injuries are usually ignored inasmuch as they do not require usual treatment.

Example: Presence of PHYSICAL INJURIES of a victim of sexual abuse = presumes that force was applied; hence, crime committed must be RAPE. Presence of PHYSICAL INJURIES on the offender of the crime of physical injuries= proof that the victim acted in SELF-DEFENSE. OTHER DEFINITIONS

NATURE OF THE STUDY OF LEGAL MEDICINE 

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Knowledge of legal medicine means the ability to acquire facts, the power to arrange those facts in their logical order, and to draw a conclusion from the facts which may be useful in the administration of justice. Medical Jurist (medical examiner, medico-legal officer, medico-legal expert) – a physician who specializes or is involved primarily with medicolegal duties. They are mostly in the service of the government. 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.‖ To be involved in medico-legal duties, a physician must possess sufficient knowledge of: o Pathology o Surgery o Gynecology o Toxicology o Other branches of Medicine germane to the issues involved.

Ordinary Physician Sees an injury or disease on the point of view of

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Medical Jurist Sees injury or disease on the point of view of cause

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Purpose in examining a patient is to include those bodily lesions in his report and testify before the court or before an investigative body Records all bodily injuries even if they are small or minor because these injuries may be proofs to qualify the crime or to justify the act.

1.

LAW- rule of conduct, just, obligatory, laid by legitimate power for common observance and benefit.

Characteristics of Law: -

It is a rule of conduct; It is dictated by legitimate power; and Compulsory and obligatory to all.

Forms of Law: A.

B.

2.

Written or Statutory Law (Lex Scripta) – composed of laws which are produced by the country’s legislations and which are defined, codified and incorporated by the law-making body. Ex. Philippine Laws. Unwritten or Common Law (Lex non Scripta) – composed of unwritten laws based on immemorial customs and usages. Sometimes referred to as case law, common law, jurisprudence or customary law. Ex. Laws of England.

FORENSIC- denotes anything belonging to the court of law or used in court or legal proceedings

FROGLETS NOTES or something fitted argumentations. 3.

4.

5.

for legal

or

public

MEDICINE- a science and art dealing with preventation, cure and alleviation of disease. It is that part of science and art of restoring and preserving health. It is the science and art of diagnosing, treating, curing and preventing disease, relieving pain, and improving the health of a person. LEGAL- that pertains to law, arising out of, by virtue of or included in law. Refers to anything conformable to the letters or rules of law as it is administered by the court. JURISPRUDENCE- science of giving a wise interpretation of the law and making just application of them to all cases as they arise. PRINCIPLE OF STARE DECISES

A principle that, when the court has once laid down a principle of law or interpretation as applied to a certain state of facts, it will adhere to and apply to all future cases where the facts are substantially the same. BRANCHES OF LAW WHERE LEGAL MEDICINE MAY BE APPLIED In CIVIL LAW, knowledge of legal medicine may be useful on the following: 1. 2. 3. 4. 5.

Determination and termination of civil personality (Art.40-41); Limitation or restriction of a natural person’s capacity to act (Art. 23 and 29); Marriage and legal separation Paternity and filiation Testamentary capacity of a person making a will.

2. 3.

Summary of Legal Medicine Book by Solis

Proceedings for hospitalization of an insane person (Rule 101); and Rules on evidences (Part IV).

In SPECIAL LAWS: 1. 2. 3. 4. 5. 6.

Dangerous Drug Act (RA 6425, as amended) Youth and Child Welfare Code (PD 603) Insurance Law (Act No. 2427 as amended) Code of Sanitation (PD 856) Labor Code (PD 442) Employee’s Compensation Law MEDICAL EVIDENCE

Evidence- the means, sanctioned by the Rules of Court, of ascertaining in a judicial proceeding the truth respecting a matter of fact. If the means employed to prove a fact is medical in nature then it becomes a medical evidence. TYPES OF MEDICAL EVIDENCE 1.

Autoptic or Real Evidence – evidence made known or addressed to the senses of the court. It is not limited to that which is known through the sense of vision but is extended to what the sense of hearing, taste, smell and touch is perceived. (Sec.1, Rule 130)

Limitations to the Presentation of Autoptic Evidence: a)

Ex: Court may not allow exposure of the genitalia of an alleged victim of sexual offense to show the presence and degree of the genitalia and extra-genitalia injuries suffered.

In CRIMINAL LAW, legal medicine is applicable in the following provisions of the Penal Code: 1. 2. 3.

Circumstances affecting criminal liability; Crimes against person; Crimes against chastity.

In REMEDIAL LAW, legal medicine is applied in the following provisions of the Rules of Court: 1.

Physical and mental examination of a person (Rule 28);

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Indecency and Impropriety – presentation of evidence may be necessary to serve the best interest of justice but the notion of decency and delicacy may cause inhibition of its presentation.

b)

Repulsive Objects and those Offensive to Sensibilities – foul smelling objects, persons suffering from highly infectious and communicable disease, or objects which when touch may mean potential danger to the life and health of the judge may not be presented.

FROGLETS NOTES However, if such evidence is necessary in the adjudication of the case, the question of indecency and impropriety or the fact that such evidence is repulsive or offensive to sensibilities, it may be presented. This will depend on the sound discretion of the court. 2.

4.

Documentary Evidence- Medical Documentary Evidence may be: a. Medical Certification or Report on: i. Medical examination ii. Physical examination iii. Necropsy/ autopsy iv. Laboratory v. Exhumation vi. Birth vii. Death b. Medical Expert Opinion c. Deposition

5.

Physical Evidence – these are articles and materials which are found in connection with the investigation and which aid in establishing the identity of the perpetrator or the circumstances under which the crime was committed, or in general assist in the prosecution of a criminal.

Testimonial Evidence – a physician may be commanded to appear before a court to give his testimony. His testimony must be given orally and under oath or affirmation. A physician may be presented in court as an ordinary witness and/or as an expert witness: ORDINARY WITNESS A physician who testifies in court on matters perceived from his patient in the course of physician-patient relationship. (Sec. 20, Rule 130, Rules of Court) Exception: Privilege of Communication between physician and patient. (Sec. 24 c, Rule 130)

EXPERT WITNESS A physician on account of his training and experience can give his opinion on a set of medical facts. He can deduce or infer something, determine the cause of death, or render opinion pertinent to the issue and medical nature.

Criminalistics - is the identification, collection, preservation and mode of presentation of physical evidence. It is the application of sciences such as physics, chemistry, medicine and other biological sciences in crime detection and investigation. Type of Physical Evidences:

Rule

a.

The probative value of the expert medical testimony depends upon the degree of learning and experience on the line of what the medical expert is testifying, the basis and logic of his conclusion, and other evidences tending to show the veracity or falsity of his testimony.

b.

(Sec. 130)

48-49,

c.

Experimental Evidence – A medical witness may be allowed by the court to confirm his allegation or as a corroborated proof to an opinion he previously stated.

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Corpus Delicti Evidence – objects or substances which may be a part of the body of the crime. Associative Evidence- these are physical evidence which link a suspect to the crime. Tracing Evidence- these are physical evidence which may assist the investigator in locating the suspect.

PRESERVATION OF EVIDENCE The physical evidence recovered during medico-legal investigation must be preserved to maintain their value when presented as exhibits in court. Methods of Preserving Evidence 1.

3.

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2.

Photographs, audio and/or video tape, microfilm, Photostat, Xerox, voice tracing, etc. Sketching- rough drawing of the scene or object to be preserve is done. It must be simple, identifying significant items and with exact measurement.

FROGLETS NOTES Kinds of Sketch:

 The preservation is co-terminus with the life of the witness.  Human mind can easily be subjected to too many extraneous factors that may cause distortion of the truth.

Rough Sketch- made at the crime scene or during examination of living or dead body. Finished Sketch- sketch prepared from the rough sketch for court presentation. Essential Elements to be Included in a Sketch: a. b. c. d. e.

3.

Measurement must be accurate; Compass direction must always be indicated to facilitate proper orientation in the case of crime scene; Essential item which has a bearing in the investigation must be included; Scale and proportion must be stated by mere estimation; There must be a title and legend to tell what it is and the meaning of certain marks indicated therein.

Description- putting into words the person or thing to be preserved. It must cause a vivid impression on the mind of the reader, a true picture of the thing described. Minimum Standard Requirements which must be satisfied in the description of the person or thing to make it complete: a. b. c. d.

4. 5.

Skin Lesion Penetrating wound Hymenal Laceration Person

Manikin Method- miniature model of a scene or of a human body indicating marks of a various aspects of the things to be preserved. Preservation in the Mind of the Witness Drawbacks of preserving evidence in the mind of the witness:  The capacity of a person to remember time, place and event may be destroyed or modified by the length of time, age of the witness, confusion with other evidence, trauma or disease, thereby making the recollection not reliable;

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6.

Special Methods- Special way of treating certain type of evidence may be necessary. Preservation may be essential from the time it is recovered to make the condition unchanged up to the period it reaches the criminal laboratory for appropriate examination. Special Ways of Preservation: a. b. c. d. e.

Whole human body- embalming. Soft tissues (skin, muscles, visceral organs) – 10% formalin solution. Blood- refrigeration, sealed bottle container, addition of chemical preservatives. Stains (blood, semen) – drying, placing in sealed container. Poison- sealed container.

CHAPTER II DECEPTION DETECTION Methods of deception detection used by law enforcement agencies: 1. Devices which record the psycho-physiological response a. Polygraph or lie detector machine – records physiological changes that occur in association with lying in a polygraph. Phases of Examination i. Pre-test interview ii. Actual interrogation and recording through the instrument Standard test questions: 1. Irrelevant questions – no bearing to the case under investigation (ex: age, citizenship, occupation, etc). 2. Relevant questions – pertaining to the issue under investigation (ex: Did you shoot to death Mr. X?). 3. Control questions – unrelated to the matter under investigation but are of similar nature although less serious as compared to those relevant questions (ex: Have you ever used a gun?).

FROGLETS NOTES iii. Post-test interrogation Supplementary tests: i. Peak-of-tension test – may be given if subject is not yet informed of the details of the offense for which he is being interrogated by the investigator. ii. Guilt complex test – applied when the response to relevant and control questions are similar in degree and consistency in a way that the examiner cannot determine whether the subject is telling the truth or not. iii. Silent answer test – conducted in the same manner as when relevant, irrelevant and control questions are asked, but the subject is instructed to answer the questions silently, to himself, without making any verbal response. Factors responsible for the 25% errors of the lie detector: 1. Nervousness or extreme emotional tension experienced by a subject who is telling the truth regarding the offense in question 2. Physiological abnormalities 3. Mental abnormalities 4. Unresponsiveness in a living or guilty subject 5. Attempt to ―beat the machine‖ by controlled breathing or by muscular flexing 6. Unobserved application of muscular pressure which produces ambiguities and misleading indications in the blood pressure tracing b. Word association test – A list of stimulus and nonstimulus words are read to the subject who is instructed to answer as quickly as possible. The time interval between the words uttered by the examiner and the answer of the subject is recorded. The test is not concerned with the answer, be it a ―yes‖ or ―no‖. The important factor is the time of response in relation to the stimulus or non-stimulus words. c. Psychological stress evaluator (PSE) – detects, measures, and graphically displays the voice modulations that we cannot hear. When a person speaks, there are audible voice frequencies, and superimposed on these are the inaudible frequency modulations which are products of minute oscillation of the muscles of the voice mechanism. Such oscillations of the muscles or microtremor occur at the rate of 8 to 14 cycles per second and controlled by the central nervous system. 2. Use of drugs that try to ―inhibit the inhibitor‖

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a. Truth serum – In the test, hyoscine hydrobromide is given hypodermically in repeated doses until a state of delirium is induced. When the proper point is reached, the questioning begins and the subject feels a compulsion to answer the questions truthfully. b. Narcoanalysis or narcosynthesis – practically the same as that of administration of truth serum. The only difference is the drug used. Psychiatric sodium amytal or sodium penthotal is administered to the subject. c. Intoxication – the apparent stimulation effect of alcohol is really the result of the control mechanism of the brain, so alcohol, like truth serum, and narcoanalytic drugs ―inhibit the inhibitor‖. (In vino veritas – in wine there is truth) 3. Hypnotism – the alteration of consciousness and concentration in which the subject manifests a heightened of suggestibility while awareness is maintained. 4. By observation Physiological and psychological signs and symptoms of guilt: a. Sweating – if accompanied with a flushed face indicate anger, embarrassment or extreme nervousness. If with a pallid face, may indicate shock or fear. Sweating hands indicate tension. b. Color change – flushed face may indicate anger, embarrassment or shame. Pale face is sign of guilt. c. Dryness of the mouth – nervous tension causes dryness of the mouth which causes continuous swallowing and licking of the lips. d. Excessive activity of the Adam’s apple – on account of dryness of the throat, subject will swallow saliva which causes frequent upward and downward movement of the Adam’s apple. e. Fidgeting – constantly moving about in the chair, pulling his ears, rubbing his face, picking and tweaking the nose, etc. Indicative of nervous tension. f. ―Peculiar feeling inside‖ – there is a sensation of lightness of the head and the subject is confused. Result of troubled conscience. g. Swearing to the truthfulness of his assertion – ―I swear to God I am telling the truth‖ h. ―Spotless past record‖ – subject may assert that it is not possible for him to do ―anything like that‖ inasmuch as he is a religious man and that he has a spotless record. i. Inability to look at the investigator “straight in the eye” – because of fear that his guilt may be seen in his eyes.

FROGLETS NOTES j. “Not that I remember” expression – resort to this expression to avoid committing something prejudicial to him. 5. Scientific interrogation – the questioning of a person suspected of having committed an offense or of persons who are reluctant to make a full disclosure of information in his possession which is pertinent to the investigation. Suspect – person whose guilt is considered on reasonable ground Witness – person other than the suspect who is requested to give information Different types of criminal offenders a. Based on behavioral attitude: i. Active aggressive offenders – commit crimes in an impulsive manner ii. Passive inadequate offenders – commit crimes because of inducement, promise or reward. b. Based on the state of mind i. Rational offenders – commit crime with motive or intention ii. Irrational offenders – commit crime without knowing the nature and quality of his act. c. Based on proficiency i. Ordinary offenders – engaged in crimes which require limited skill ii. Professional offenders – commit crimes which require special skills rather than violence. d. Psychological classification i. Emotional offenders – commit crimes in the heat of passion, anger, or revenge. ii. Non-emotional offenders – commit crimes for financial gain and are usually recidivist or repeaters. Techniques of Interrogation a. Emotional appeal – interrogator must create a mood that is conducive to confession b. Mutt and Jeff technique – there must be at least 2 investigators with opposite character; one (Mutt) who is arrogant and relentless, and the other (Jeff) who is friendly, sympathetic and kind. c. Bluff on split-pair technique – applicable where there are two or more persons who allegedly participated in the commission of a crime. While one of them is interrogated, the interrogator may claim that the subject was implicated by the author and that there is no use for him to deny participation. d. Stern approach – questions must be answered clearly, and the interrogator utilizes harsh language.

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Summary of Legal Medicine Book by Solis

e. The subject is given the opportunity to make a lengthy, time-consuming narration. 6. Confession – an expressed acknowledgment by the accused in a criminal case of the truth of his guilt as to the crime charged, or of some essentials thereof. Requirement for the Admissibility of Evidence Obtained Through Interrogation  

Custodial Investigation and Self-Incrimination (1987 Constitution) Miranda v. Arizona (Miranda Rights)- safeguards were established for the interrogation of suspected persons.

Some Techniques of Interrogation  

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Emotional Appeal- The interrogator creates a mood that is conducive to confession. He may be sympathetic or friendly to the subject. Mutt and Jeff Technique- One interrogator (Mutt) is arrogant and relentless; he knows the subject to be guilty. The other (Jeff) is friendly, sympathetic, and kind. When Mutt is not present, Jeff will advise the subject to make a quick decision and plea for cooperation. Bluff on Split-Pair Technique- Applicable where there are two or more persons who allegedly participated on the commission of a crime. All of them are interrogated separately and the interrogator may claim that the subject was implicated by the author and that there is no use for him to deny participation. Stern Approach- Immediate and clear response from the subject is demanded and the interrogator uses harsh language. The subject is given the opportunity to make a lengthy, time-consuming narration.

Basis of Interrogator’s Inference that the Subject is not Telling the Truth   

The statements have many improbabilities and gaps on its substantial parts. The statements are inconsistent with the material facts. The statements are incoherent.

Confession

FROGLETS NOTES  

Is an expressed acknowledgement by the accused of the truth of his guilt as to the crime charged, or of some essentials thereof. Confession is a statement of guilt while admission is usually a statement of fact by the accused which does not directly involve an acknowledgment of guilt.

Kinds of Confession 

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Extra-judicial Confession- is a confession made outside of the court prior to the trial of the case. o Under the Rules of Court, extra-judicial confession is not a sufficient ground for conviction unless corroborated by evidence of corpus delicti. o Extra-judicial confession may be:  Voluntary- the accused speaks on his free will and accord, without inducement of any kind, and with full and complete knowledge of the nature and consequence of the confession.  Involuntary- obtained through force, threat, intimidation, duress, or anything influencing the voluntary act of the confessor. Such are inadmissible in evidence. Judicial Confession- is the confession of an accused in court. It is conclusive upon the court and may be considered to be a mitigating circumstance. o Under the Rules of Court, admissions made by the parties in the pleadings, or in the course of the trial or other proceedings do not require proof and cannot be contradicted unless previously shown to have been made through palpable mistake.

Maltreatment of Prisoners 

Elements (Art. 235, RPC) o The offender is a public officer or employee o The offender has under his charge a convicted or detention prisoner o The offender maltreats the prisoner by overdoing in the correction and handling of the prisoner by the (1) imposition of punishment not

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authorized by the regulation, or (2) by inflicting such punishment in a cruel and humiliating manner; or by maltreating to extort a confession or obtain information. Tokyo Declaration- provides guidelines to be observed by physicians concerning torture and other inhuman treatment o The doctor shall not countenance, condone, or participate in the practice of torture or other forms of inhuman procedures o The doctor shall not provide premises, instruments, substances, or knowledge to facilitate such in practices o The doctor shall not be present during any procedure during which inhuman treatment is used or threatened o A doctor must have complete clinical independence in deciding upon the care of a person for whom he is medically responsible o Where the prisoner refuses nourishment and is considered by the doctor as capable of forming an unimpaired and rational judgment concerning the consequences of such voluntary refusal of nourishment (as confirmed by at least one other independent doctor), he or she shall not be fed artificially. Such consequences of the refusal of nourishment shall be explained by the doctor to the prisoner o The World Medical Association will support and encourage the international community, the national medical associations, and fellow doctors, to support the doctor as his/her family in the face of threats or reprisals resulting from refusal to condone the use of torture and inhuman treatment.

CHAPTER III MEDICO-LEGAL ASPECTS OF IDENTIFICATION Identification is the determination of the individuality of a person or thing. Importance of Identification

FROGLETS NOTES   

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To establish the identity of the offender and that of the victim in the prosecution of the criminal offense. To identify a person missing or presumed dead in order to facilitate the settlement of the estate, retirement, insurance, and other social benefits. Identification resolves the anxiety of the next-ofkin, other relatives and friends as to the whereabouts of a missing person or victim of calamity or criminal act. Identification may be needed in some transactions like cashing of check, entering a premise, sale of property, release of dead bodies to relatives, parties to a contract, etc..

Rules in Personal Identification 

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Law of Multiplicity of Evidence in Identificationthe greater the number of points of similarities and dissimilarities of two persons compared, the greater is the probability for the conclusion to be correct. The value of the different points of identification varies in the formulation of conclusion (e.g. visual recognition by relative or friends may be of lesser value as compared with fingerprints or dental comparison). The longer the interval between the death and the examination of the remains, the greater is the need for experts in establishing identity. It is necessary for the team to act in the shortest possible time specially in cases of mass disaster. There is no rigid rule to be observed in the procedure of identification of persons.

Methods of Identification  

By comparison-Identification criteria recovered during investigation are compared with records available in the file. By exclusion- If two or more persons have to be identified and all but one is not yet identified, then the one whose identity has not been established may be known by the process of elimination.

Identification of Persons Classification of the Bases of Human Identification 

Those which laymen use to prove identity- no special training or skill required

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Summary of Legal Medicine Book by Solis

Those which are based on scientific knowledgemade by trained men, well-seasoned by experience and observation

Ordinary Methods of Identification 

Points of Identification Applicable to Living Persons Only o Characteristics which may easily be changed  Growth of hair, beard or mustache  Clothing- a person may have a special preference for certain form, texture or style  Frequent place of visit- A person’s special desire or habit to be in a place if he has the opportunity to do so  Grade of profession- e.g. a mechanic may be recognized by his tools, a clergy man by his robe, or a nurse by her cap  Body ornamentationsearrings, necklaces, rings, pins, etc. Usually worn by persons o Characteristics that may not be easily changed  Mental memory- a recollection of time, place, and events.  Speech- a person may stammer, stutter, or lisp; manner of talking and quality of the voice.  Gait- a person, on account of disease or some inborn traits, may show a characteristic manner of walking.  Mannerism- stereotype movement or habit peculiar to an individual. (E.g. way of sitting, movement of hand, movement of body, movement of facial muscles, manner of leaning, etc.)  Hands and feet- Size, shape, and abnormalities.  Foot or hand impressiondevelops when a

FROGLETS NOTES

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foot or hand is pressed on mouldable materials like mud, clay, cement mixture, or other semi-solid mass.  Footprint or handprint- a footmark or handmark on a hard base contaminated or smeared with foreign matters like dust, floor, blood, etc. Complexion Changes in the eyes- nearsightedness, far-sightedness, state of being color blind, etc. Facies- different kinds of facial expressions brought about by disease or racial influence. Left- or right-handedness Degree of nutrition- in relation to height and age.

Points of Identification Applicable to Both Living and Dead before Onset of Decomposition o Occupational marks- certain occupations may result in some characteristic marks or identifying guide o Race  Color of the skin  Caucasian-Fair  Malayan-Brown  Mongolian-Fair  Negro- Black  Feature of the face  CaucasianProminent sharp nose  Malayan- Flat nose with round face  Mongolian- Almond eyes and prominent cheek bone

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Summary of Legal Medicine Book by Solis



o o o o o o o o

Negro- Thick lips and prominent eyes  Shape of the skull  CaucasianElongated skull  Malayan- Round head apparel  Mongolian- Round head  Red Indians and Eskimos- Flat head  Wearing Apparel- Casual and customary wearing may indicate race as well as religion, nationality, region, and custom. Stature- change in height; rate of growth Tattoo marks- introduction of coloring pigments in the layers of the skin by multiple puncture. Weight- not a good point of identification for it is easily changed from time to time. Deformities- may be congenital or acquired Birth marks Injuries leaving permanent results- e.g. amputation, improper union of fractured bones Moles Scar- a remaining mark after healing of the wound.  Age of scar  Recently formedslightly elevated, reddish or bluish in color, and tender to touch  Few weeks to two months- scar has inflammatory redness, and it is soft and sensitive  Two to six monthsbrownish or coppery red, free from contraction and corrugation, and soft

FROGLETS NOTES 

Six months or more- scar is white, glistening, contracted, and tough

Anthropometry (Bertillon System) - scheme utilizing anthropometrical measurement of the human body as the basis of identification Basis 1. 2. 3.

The human skeleton is unchangeable after twentieth year. It is impossible to find two human beings having bones exactly alike. The necessary measurement can easily be taken.

Information included 1. Descriptive Data - color of hair, eyes 2. Body marks - moles, scars 3. Anthropometrical measurements A. Body measurement B. Measurement of head C. Measurement of the limbs Portrait Parle (spoken picture) - verbal, accurate and picturesque description of the person identified. Such information may be given bybthe witness, relatives, or persons who ate acquainted with the physical features of the person to be identified 1. General impression 2. Age, sex 3. Race or color 4. Height 5. Weight 6. Built 7. Posture 8. Head 9. Hair 10. Face 11. Neck 12. Shoulder 13. Wrist 14. Hands 15. Fingers 16. Arms 17. Feet Extrinsic Factors in Identification 1. Ornamentation 2. Personal belongings

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3. 4. 5. 6. 7.

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Waering apparel Foreign bodies Identification by close friends and relatives Identification record Photographs

II. SCIENTIFIC METHODS OF IDENTIFICATION A. Fingerprinting B. Dental identication C. Handwriting D. Identification of skeleton E. Determination of sex F. Determination of Age G. Identification of Blood H. Identification of Hair and Fibers A. Fingerprinting considered to be the most valuable method of Identification the finger may be wounded or burned, but the whole pattern with all its details will reappear when the wound heals 1. There is no two identical fingerprints 2. Fingerprints are not changeable Practical uses 1. Help establish identity in cases of dead bodies 2. Prints recoveres from crime scene associate person 3. Prints on file are useful for comparative purposes 4. Among illiterates, right thumbprint is recognized as substitute for signature. Dactylography is the art and study of recording fingerprints as a means of identification Dactyloscopy is the art of identification by comparison of fingerprints Poroscopy is the study of the pores found on the pappillary or friction ridges of the skin Merhods of Producing Impression 1. Plain method - bulbs of the last phalanges of the fingers and thumb are pressed on the surface of the paper after pressing them on ink 2. Rolled method - bulbs of the thumb and other fingers are rolled on the surface of the paper after being rolled on an ink pad Kinds of Impression

FROGLETS NOTES 1. Real impression - impression of the finger bulbs with the use of printing ink on the surface of the paper 2. Chance impression - impresses by mere chance without any intention to produce it How to Get Fingerprint Impressions on Dead Bodies - In case of fresh bodies, the fingers are uncleanched and each one is inked individually with the aid of small rubber roller. - If the "floater" has been in the body if water for a longer time and the friction ridges have disappeared, the skin of the fingertips is cut away. This area of the skin is placed in a small labelled test tube containing formaldehyde solution. Types of Fingerprint Patterns 1. Arches - the ridgea go from one side of the pattern to another, never turning back to make a loop A. Plain arches B. Tented arches 2.

Loops - one or more ridges enter on either side, recurves and terminate on the same side from which it entered A. Ulnar loop B. Radial loop

3.

Whorls - patterns with two deltas and patterns too irregular in form to classify A. Simple whorl B. Central pocket loop C. Lateral pocket loop D. Twin loop E. Accidentals

Q: Can fingerprints be effaced? A: No, as long as the dermis of the bulbs of the finger is not completely destroyed, the fingerprints will always remain unchanged and indestructible. Q: Can fingerprints be forged? A: There is considerable controversy as various experiments could almost make an accurate reproduction, still there is no case in record known or have been written. B. DENTAL IDENTIFICATION 1. The possibility of two persons to have the same dentition is quite remote.

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The enamel of the teeth is the hardest substance in the body. It may outlast all other tissues. After death, the greater the degree of tissue deatruction, the greater is importance of the dental characteristic. The more recent the ante-mortem records of the person to be identified, the more reliable is the comparative or exclusionary mode of identification that can be done.

Causes of Unreliability of the Dental Records 1. The dentist may only concern himself with the affected teeth and may not care to have a detailed examination of the other teeth. 2. No uniformity in nomenclature in the charting of teeth 3. Although there may be a law obligating dentists to have a record of their patient, the law does not mention the agency which will enforce it 4. Changes in the teeth which are not seen by the dentist C. HANDWRITING - The handwriting of a person may be proved by a witness who believes it to be the handwiting of such person, and has seen the person write, or has seen writing purporting to be his upon which the witness has acted or been charged, and has thus acquired knowledge of the handwriting of such person. The genuineness of any disputed writing may be proven by any of the following ways 1. Acknowledgement of the alleged writer 2. Statement of the witness who saw the writing 3. Opinion of persons who are familiar with the handwriting of the alleged writer 4. Opinion of an expert Practical Uses of Handwriting Examination 1. Financial crime 2. Death inveatigation 3. Robberies 4. Kidnapping with ransom 5. Anonymous threatening letters 6. Falsification of documents Bibliotics - science of handwriting analysis Graphology - study of handwriting for the purpose of determining the writer's personality, character and aptitude.

FROGLETS NOTES Handwriting - complex interaction of nerves

c. d. e.

Writing - conscious act, but on the account of repeated act it becomes habitual and unconscious Movements in Writing 1. Finger movement- letters are made entirely by the action of the thumb, the pointing and middle fingers 2. Hand movement – letters are produced by the action of the hand as a whole with the wrist as the center of action 3. Arm movement – movement in writing is made by the hand and arm supported with the elbow at the center of later swing 4. Whole arm movement – action is produced by the entire arm without any rest

The Form, Style and Characteristics of the Handwriting of a Person are Basically Determined By: Primary Factors 1. Survival of the letters are formed when a person begins to write 2. Inclusion of some characteristics due to admiration of a peculiar design in writing 3. Identifying characteristics may be the result of the great volume of writing done 4. The presence or absence of physical abnormalities or defects originating from illness, injury, psychological variations and other similar conditions Secondary Factors 1. Position of writer 2. Temporary physical or psychological disturbance 3. Other external temporary variables 4. Physical and chemical factors A. Writing instrument a. Ballpen b. Fountain pen c. Steel pen d. Pencil B. Paper a. Color b. Surface appearance c. Watermarks d. Weight and thickness C. Ink a. Iron gallotannate ink b. Washable ink

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Summary of Legal Medicine Book by Solis

Logwood ink Carbon ink Ballpoint ink

CHAPTER III MEDICO-LEGAL ASPECTS OF IDENTIFICATION Instruments Necessary in Questioned Document Examination: 1. 2.

3. 4. 5.

Photographic instruments- to view the writing in sufficient magnification for detail examination and preparation of evidence for presentation Magnifying lend and stereoscopic binocular microscope- to determine unusual appearances of writing. Obliterations, erasures and alterations may be more visible UV lamp and infra red radiation- to mae visible the chemical erasures Measuring caliper Good lighting facilities

Purpose of Handwriting Examination 1. 2. 3. 4.

Whether the document was written by the suspect Whether the document was written by the person whose signature it bears Whether the writing contains additions or deletions Whether the document such as bills, receipts, suicide notes or checks are genuine or a forgery

Points to Consider in Questioned Document Examination  



Slant, spacing, size, proportion of the letters, speed and rhythm in writing, shading, pen strokes The greater the variation in the way of writing, the greater the amount of standard of writing needed to form a reliable impression To determine whether a certain instrument or document has been written by a certain person, compare the writings with some standard of writings of the same person o Two Types of Standard Writings:  Collected Standards: handwriting by the person who is suspected to have written the questioned document; may be found in the private or public records of the persons  Requested Standard: standards made by the alleged writer upon request of the examiner; usually

FROGLETS NOTES applicable only to recently written documents

7.

The deliberate attempt on the part of the writer to alter his writing habit to invent a new writing style of by imitating the writing of another person.  Done by changing the direction of the slant, changing the speed in writing, deliberate carelessness

8. 9.

Disguised writing

Signature forgery Signature forgery examination is the most common activity of a questioned document examiner Classifications of Signature Forgery 1. Traced forgery: the outlining of a genuine signature from one document onto another 2. Simulated forgery: an attempt to copy in freehand manner the characteristics of a genuine signature either from the memory of the signature or from as model. 3. Spurious forgery: one prepared primarily in the forger’s own handwriting wherein little or no attempt has been made to copy the characteristics of the genuine writing Typewriter Identification The identification of the typing machine used in a questioned document IDENTIFICATION OF THE SKELETON In the examination of bones, the following points can be determined: 1. Whether the remains are of human origin or not: Study the shape, size, and general nature of the remains, especially that of the skull 2. Whether the remains belong to a single person or not: Any plurality or excess of the bones after a complete lay out denotes that the remains belong to more than one person 3. Height 4. Sex: Study the pelvis, skull, sternum, femur and humerus 5. Race 6. Age: Determined by the appearance of ossification centers and union of bones and epiphyses, dental identification, and obliteration of cranial structures

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Length of interment or length from the time of death May be determined by the nature and presence of soft tissues and the degree of erosion of the bones. Ordinarily, all the soft tissues in a grave disappear within a year. Presence or absence of ante or post mortem injuries Congenital deformities and acquired injuries on the hard tissues causing permanent deformities

(pp. 86-102) Procedure of the Test Two Methods may be utilized and both should be employed in the examination: 1. Detection of Agglutinins 2. Detection of Agglutinogens Value of the Test  It may solve disputed parentage (maternity or paternity).  Positive result - not conclusive that the one in question is the offspring  Negative result - conclusive that he is not the child of the alleged parents. Grouping is true not only with blood but also with other body fluids like saliva, vaginal secretion, seminal fluid, milk, urine and others INHERITANCE PATTERNS OF ABO BLOOD GROUPS Group Parents OxO OxA OxB AxA AxB BxB O x AB A x AB B x AB AB x AB

of

Group of Children O O, A O, B O, A O, A, B, AB O, B A, B A, B, AB A, B, AB A, B, AB

Exclusion Cases A, B, AB B, AB A, AB B, AB A, AB O, AB O O O

Different Characteristics of Blood from Different Sources: 1. Arterial Blood – bright scarlet in color, leaves the blood vessel with pressure, high oxygen contents 2. Venous Blood – dark red in color, does not spill far from the wound, low oxygen content 3. Menstrual Blood – does not clot, acidic in reaction owing to mixture with vaginal mucous, on

FROGLETS NOTES microscopic examination, there are vaginal epithelial cells, contains large number of Deoderlein’s bacillus. 4. Man’s or Woman’s Blood- no method of differentiating man and woman’s blood 5. Child’s Blood- at birth, it is thin and soft compared with that of adult, red blood cells are nucleated and exhibit greater fragility, red blood cells count more than in adult. Identification of Hairs and Fibers 1.

Addition of a substance that will coat the outer surface of the hair so as to impart a different color. Ex.: Salts of bismuth, lead, silver and pyrogallic acid

2. Addition of substances which bleach change the natural color of the hair. Ex.: Hydrogen peroxide, chlorine diluted nitric acid

or fiber

or

and

Distinctions between Human and Animal Hair: Medulla

Human Air network in fine grains Cells invisible without treatment in water Value of I lower than 0.3 Fuzz without medulla

Cortex

Looks like a thick muff Pigments in the form of fine grains

Cuticle

Thin scales not protruding, covering one another to about 4/5

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Animal Air network in forms of large and small sacks. Cells visible

easily

Value of I higher than 0.5 Fuzz with medulla Looks like a fairly thin hollow cylinder Pigments in the form of irregular grains larger than that of human’s Thick scales protruding, do not cover one another the

Summary of Legal Medicine Book by Solis

same degree as human’s Note: Medullary index (I) is the relation between the diameter of the medulla and the diameter of the whole hair. The hair and fiber may be examined microscopically in its cross-section and longitudinal aspect.Comparative study must be made to show similarity of the hair and fiber. Other Points in the Identification of Hair: 1. Characteristics of the hair: Hair on body surfaces is fine while those from the beard, mustache and scalp are very thick. Hair from the eyebrows and lashes is tapering gradually to finepoints. 2. Length of the Hair: Hair from the scalp grows 2.5 cms. a month. Beard hair grows at the rate of 0.4 millimeter a day. 3. Color of the hair:  May be black, blonde or brunette.  Hair from older persons may be white or gray.  The hair may be artificially colored by bismuth, lead or silver salts.  It may be bleached by addition of hydrogen peroxide, chlorine or diluted hydrochloric or nitric acid. Male or a Female Hair In many instances it is quite impossible to state the sex from the hair, but certain points may be worthy of mention:  Hair on the scalp of male is shorter, thicker and more wiry than that of female's.  Eyebrow hair of a male is generally long and more wiry than that of a female's. Estimation of Age Based on the Hair:  Hair of children is fine, short, and deficient of pigments and, as a rule, devoid of medulla.  At the adolescent age, hair may appear at the pubis. Hair on the scalp becomes long, wiry, and thick.  In the case of older persons, the color is usually white or gray, with marked absorption of pigments and degenerative changes CHAPTER IV MEDICO-LEGAL ASPECTS OF DEATH Importance of Death Determination 1. The civil personality of a natural person is extinguished by death; 2. The property of a person is transmitted to his heirs at the time of death;

FROGLETS NOTES 3. The death of the partner is one of the causes of dissolution of partnership agreement; 4. The death of either the principal or the agent is a mode of extinguishment of agency; 5. The criminal liability of a person is extinguished by death; 6. The civil case for claims which does not survive is dismissed upon the death of the defendant. Death  is the termination of life.  it is the complete cessation of all the vital functions without possibility of resuscitation.  it is an irreversible loss of the properties of living matter.  an event that takes place at a precise time.  the ascertainment of death is a clinical and not a legal problem. Based on the Criterion Used in its Determination, death may be: 1. Brain Death  Death occurs when there is deep irreversible coma, absence of electrical brain activity and complete cessation of all the vital functions without possibility of resuscitation. 2. Cardio-Respiratory Death  Death occurs when there is a continuous and persistent cessation of heart action and respiration.  It is a condition in which the physician and the members of the family pronounced a person to be dead based on the common sense or intuition 3. Brain and Cardio-Respiratory Death A person will be considered medically and legally dead if in the opinion of a physician based on ordinary standards of medical practice, there is:  absence of spontaneous respiratory and cardiac function, and because of the disease or condition which caused, directly or indirectly, these functions to cease, or because of the passage of time since these functions ceased, attempts at resuscitation are considered hopeless;  absence of spontaneous brain function and if based on ordinary standards of medical practice during reasonable attempts to either maintain or restore spontaneous circulatory or respiratory function in the absence of aforesaid brain function, it appears that further attempts at resuscitation or supportive maintenance will not succeed.

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Death will have occurred when these conditions first coincide. (Section 1, Chapter 378 of Kansas Statute) Brain Death 1. According to Harvard Report of 1968, the following are the characteristics of ―irreversible coma‖: a. Unreceptivity and Unresponsibility  There is a total unawareness to externally applied stimuli and inner need and complete unresponsiveness b. No movements or breathing  Observation covering a period of at least l hour by physicians is adequate to satisfy the criteria c. No reflexes Irreversible coma with abolition of central-nervous system activity is evidenced in part by the absence of elicitable reflexes.  The pupil will be fixed and dilated and will not respond to a direct source of bright light.  Ocular movement (to head turning and to irrigation of the ears with ice water) and blinking are absent.  There is no evidence of postural activity (decerebrate or other).  Swallowing, yawning, vocalization are in abeyance.  Corneal and pharyngeal reflexes are absent.  As a rule, the stretch or tendon reflexes cannot be elicited, i.e. tapping the tendons of the biceps, triceps and pronator muscles, quadriceps and gastrocnemius muscles with the reflex hammer elicits no contraction of the respective muscles.  Plantar or noxious stimulation gives no response. d. Flat electro-encephalogram  Of great confirmatory value is the flat or iso-electric E.E.G. assuming that the electrodes have been properly applied, that the apparatus is functioning normally, and that the personnel in charge are competent. Note: All of these tests shall be repeated at least 24 hours later with no change. It is emphasized that the patient be declared dead before any effort is made to take him off the respirator, if he is then on respirator. 2. In 1969, the Ad Hoc Committee of Human Transplantation convened under the auspices of the Institute of Forensic Sciences, Duquesne University School of Law adopted the proposed criteriafor the determinationof death otherwise known as Philadelphia Protocol, and the following were considered:

FROGLETS NOTES a. Lack of responsiveness to internal and external environment; b. Absence of spontaneous breathing movements for 3 minutes, in the absence of hypocarbia and while breathing room air. c. No muscular movements with generalized flaccidity and no evidence of postural activity or shivering; d. Reflexes and response: d.1. Pupils fixed and dilated, non-reactive stimuli; d.2. Corneal reflexes absent; d.3. Supra-orbital or other pressure response absent (both pain response and decerebrate posturing); d.4. Absence of snucking or snouting response; d.5. No reflex response to upper airway stimulation; d.6. No reflex response to lower airway stimulation; d.7. No ocular response to ice water stimulation of the inner ear; d.8. No deep tendon reflexes; d.9. No superficial reflexes; d.10. No plantar responses.

to strong

e. Falling arterial pressure without support by drugs or other means. f. Iso-electric electro-encephalogram (in the absence of hypothermia, anesthetic agents and drugs intoxication) recorded spontaneously and during auditory and tactile stimulation. It is further laid down that these criteria shall have been present for at least 2 hours and that death should be certified by two physicians other than the physician of a potential organ recipient. Other Set of criteria to Establish Brain Death: 1. Mohandas and Chou (1971) – standards of Brain Death accepted at the University of Minnesota Science Center. 2. The Ottawa General Hospital (1970) guidelines for the criteria of cerebral death. 3. In France (1968) - the Council of Ministers published a decree which adopted the official definition of death on recommendation of the French Academy of Medicine. Note: The use of the criteria of brain death may only be applied to those persons who are potential organ donors.

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A. KINDS OF DEATH 1. SOMATIC DEATH OR CLINICAL DEATH  state of the body in which there is complete, persistent and continuous cessation of the vital functions of the brain, heart and lungs which maintain life and death;  hardly impossible to determine the exact time of death;  immediately after death, - the face and lips become pale - the muscles become flaccid - the sphincters are relax - the lower jaw tends to drop - the eyelids remain open - pupils dilate - skin loses its elasticity - body fluids tend to gravitate to the most dependent portions of the body - body heat gradually assumes the temperature of the surroundings 2. MOLECULAR OR CELLULAR DEATH  After cessation of the vital functions, there is still animal life among individual cells.  About 3-6 hours later, there is death of individual cells known as molecular or cellular death  Exact occurrence cannot be definitely determined due to several factors 3. APPARENT DEATH OR STATE OF SUSPENDED ANIMATION  This condition is not really death but merely a transient loss of the vital functions of the body on account of disease, external stimulus or other forms of influence.  It may arise especially hysteria, uremia, catalepsy and electric shock B. SIGNS OF DEATH 1. CESSATION OF HEART ACTION AND CIRCULATION  There must be continuous cessation of the heart action and the flow of blood in the whole vascular system Methods of Detecting the Cessation of Heart Action and Circulation a. Examination of the Heart a.1. Palpation of the Pulse- may be made at the region of the wrist or at the neck a.2. Auscultation for the heart sound at the precordial Area - the rhythmic contraction and relaxation of the heart is audible through the stethoscope. Heart sound can be audible during life even without the aid of a stethoscope by placing the ear at the precordial area

FROGLETS NOTES

Summary of Legal Medicine Book by Solis

Difficulties in Auscultation may be encountered in: (a) Stout person (b) Fatty degeneration of the heart. (c) Pericardial effusion.

 The fingers are spread wide and the finger webs are viewed through a strong light.  Living: the finger webs appear red Dead: yellow

a.3. Flouroscopic Examination- will reveal the shadow of the heart in its rhythmic contraction and relaxation. The shadow may be enlarged and the excursion made less visible due to pericardial effusion.

b.6. Application of Heat on the Shin  If heated material is applied on the skin Living: blister formation, congestion, and reactions of the injured area will be observed. Dead: will not produce true blister, no sign of congestion, or other vital reactions.

a.4. By the Use of Electrocardiograph This is the best method of determining action but quite impractical

heart

b. Examination of the Peripheral Circulation: b.1. Magnus’ Test:  A ligature is applied around the base of a finger with moderate tightness.  In a living person there appears a bloodless zone at the site of the application of the ligature and a livid area distal to the ligature.  If the ligature is applied to the finger of a dead man, there is no such change in color. b.2. Opening of Small Artery:  Living: the blood escapes in jerk and at a distance.  Dead: the blood vessel is white and there is no jerking escape of blood but may only ooze towards the nearby skin.  When bigger arteries are cut, blood may flow without pressure continuously. b.3. Icard's Test  This consists of the injection of a solution of fluorescein subcutaneously.  If circulation is still present, the dye will spread all over the body and the whole skin will have a gleenish-yellow discoloration due to flourescein.  This test should be applied only with the use of the daylight as the color is difficult to be appreciated with the use of artificial light. b.4. Pressure on the Fingernails:  lf pressure is applied on the fingernails intermittently, there will be a zone of paleness at the site of the application of pressure which become livid on release.  There will be no such change of color if the test is applied to a dead man. b.5. Diaphanous Test

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other vital

b.7. Palpation of the Radial Pulse With Fingers  Living: will feel the rhythmic pulsation of the vessel due to the flow of blood. Dead: No such pulsation will be observed b.8. Dropping of Melted Wax Melted sealing wax is dropped on the breast of a person. Dead: there will be no inflammatory edema at the neighborhood of the dropped melted wax. 2. CESSATION OF RESPIRATION  must be continuous and persistent. In the following conditions there may be suspension of respiration without death ensuing: a. In a purely voluntary act, as in divers, swimmers, etc. but it cannot be longer than two minutes; b. In some peculiar condition of respiration, like CheyneStokes respiration, but the apneic interval cannot be longer than fifteen to twenty seconds; c. In cases of apparent drowning; d. Newly-born infants may not breathe for a time after birth and may commence only after stimulation or spontaneously later. INTERNAL HYPOSTASIS IN VISCERAL ORGANS Post-mortem lividity occurs in internal organs. Post Mortem Lividity Staining in organs is irregular and occurs in most dependent parts. Dull and lustreless mucous membrane Imflammatory exudates is not seen, areas of redness alternating with pale areas found in a hollow viscus.

Simple Congestion Generally uniform and found all over the body. Not so. Not seen in simple congestion.

FROGLETS NOTES

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3. Liquefaction of the Soft Tissues Post Mortem Lividity

Haemorrhage of scurvy Presence can be revealed in history.

Skin lesion appears after death. Present in the most dependent portions of the body.

Skin lesion present before death May be found all over the skin and organs.

Phosphorus poisoning Presence can be revealed in history. Skin lesion present before death May be found all over the skin and organs.

Factors Modifying the Rate of Putrefaction Internal Factors Age Condition of the Body Cause of Death External Factors Free Air Earth Water Clothings

CHANGES IN THE BLOOD:

FACTORS INFLUENCING THE CHANGES IN THE BODY AFTER BURIAL

Hydrogen Ion Concentration Rise of non-protein nitrogen and free amino-acid Chemical: Chloride in the plasma, Magnesium as a result of diffusion, Potassium increases owing to diffusion.

State of the Body before Death: An emaciated person at the time of death will decompose slower than a wellnourished individual. Skinny persons have more tendency to decompose.

AUTOLYTIC OR AUTODIGESTIVE CHANGES AFTER DEATH After Death, proteolytic, glycolytic and lipolytic ferments of glandular tissues continue to act which lead to the autodigestion of organs. This action is facilitated by weak acid and higher temperature and delayed by the alkaline reaction of the tissues of the body and low temperature. Their early appearance is observed in the parenchyatous and glandular tissues.

PUTREFACTION OF THE BODY Putrefaction is the breaking down of the complex proteins into simpler components associated with the evolution of foul smelling gasses and accompanied by the change of color of the body. Tissue changes in Putrefaction: 1. Changes in the color of the tissue 2. Evolution of Gasses in the tissues Effects of the Pressure of Gasses of Putrefaction Displacement of Blood, Bloating of the Body, Fluid Coming out of both nostrils and mouth, Extrusion of the Fetus in a gravid uters, floating of the body.

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Time elapsed between death and burial and environment of the body. Effect of Coffin: the use of a coffin will delay decomposition if it is airtight and hard. Clothing and Any other Coverings on the Body when buried: Clothings retard decomposition because it affords protection from insects and aids adipocere formation. Depth at which Body is buried: the greater the depth the body is buried the better the preservation. Condition and type of soil: Dry, arid and sandy soil promotes mummification. Inclusion of something in the Grave which will hasten Decomposition Access of Air to the Body after Burial: Air may hasten evaporation of the body fluid and promotes mummification. Mass Grave: There is relatively rapid decomposition of the bodies Trauma on the Body: CHRONOLOGICAL SEQUENCE OF THE PUTREFACTIVE CHANGES OCCURING IN TEMPERATE REGIONS

FROGLETS NOTES Greenish Discoloration over the iliac fosae. Eyeballs are soft and yielding. Greenish discoloration spreading over the while abdomen, external genitals and other parts of the body. Frothy blood from the moth and nostrils. Abdomen distended with gas. Cornea fallen in and concave. Purplish red streaks of veins prominent on the extremities. Sphincters relaxed. Nails firm. Body greenish-brown. Blisters forming all over the body. Skin peels off. Features unrecognizable. Scrotum distended. Body swollen up owing to distention. Maggots found on the body. Nails and hair loose and easily detached. Soft parts changes into a thick, semi-fluid black mass

1-3 days 3-5 days

8-10 days

14 – 20 days

2-5 mos after death

12 hrs 24 hrs

48 hrs.

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4 wks 6 – 8 wks

Factors Influencing the Floating of the Body in Water

Sex: Women float sooner than men. Conditions of the body: Stout persons float quicker. Season of the Year: The moist hot air of summer is very favourable for putrefaction. Water: Dead body floats in a shallow and stagnant water of creeks or pond sooner than in deep water in running streams. External Influence: the presence of heavy-wearing apparel or addition weight in the pockets or attached to the body delays floating. Order of putrefaction when body is in water: Face, neck and sternum; shoulders; arms; abdomen; legs. INFLUENCE OF BACTERIA IN DECOMPOSITION

72 hrs 1 wk 2 wks 1 mo.

CHRONOLOGICAL SEQUENCE OF THE PUTREFACTIVE CHANGES WHEN THE BODY HAS BEEN SUBMERGED IN WATER Very little change if water is cold. Rigor mortis may persist. The skin on the hands and feet became sodden and bleached. The face appears softened and has a faded white color.

1 – 2 wks

Age: Bodies of fully-developed and well-nourished newlyborn infants float rapidly.

CHRONOLOGICAL SEQUENCE OF THE PUTREFACTIVE CHANGES OCCURING IN TROPICAL REGIONS Rigor mortis present all over. Hypostasis well developed and fixed. Greenish discoloration showing over the castum. Rigor mortis absent all over. Green discoloration over whole abdomen and spreading to chest. Abdomen distended with gasses. Ova of flies seen. Trunk bloated. Face discoloured. Blisters present. Moving maggots seen. Whole body grossly swollen and disfigured. Hair and nails loose. Tissues soft and discoloured. Soft viscera putrefied. Only more resistant viscera distinguishable. Soft tissues largely gone. Body skeletonised.

Face swollen and red. Greenish discoloration on the eyelids, lips, neck and sternum. Skin of the hands and feet wrinkled. Upper surface of brain greenish in color. Skin wrinkled. Srotum and penis distended with gas. Nails and hair still intact. Lungs emphysematous and covered the heart. Abdomen distended, skin of hands and feet come off with nails like a glove.

Summary of Legal Medicine Book by Solis

4-5 days 5-7 days

Decomposition is due to action of bacteria in various tissues of the body. Aerobic activities are present in the early stages of decomposition, later on activities of the anaerobes are the most prominent with the production of gasses. Softening of tissues is the result of bacterial action, proteolytic and autolytic ferments. The microorganism that plays an important role in decomposition is Clostridium Welchii. It grows in the parenchyatous organs and is responsible for the disintegration of cytoplasm, destruction of nuclei and generation of gasses in the cells. Other destructive agents during decomposition include flies and maggots, reptiles, rodents, other mammals, fishes and crabs, and molds. Special Modification of Putrefaction

FROGLETS NOTES I.

Mummification: the dehydration of the whole body which results in the shivering and preservation of the body. Mummification usually happens in warm countries where evaporation of body fluids takes place earlier and faster than decomposition.

Kinds of mummification: Natural: the body will become dehydrated and mummified due to the forces of nature. Artificial: (1) acceleration of the evaporation of the tissue fluids of the body before actual onset of decomposition; (2) addition of preservatives to inhibit decomposition. II.

Saponification or Adipocere Formation: a condition wherein the fatty tissues of the body are transformed to soft brownish-white substance known as adipocere.

Summary of Legal Medicine Book by Solis

approximate time of death may be deduced from the amount of food in the stomach in relation to his last meal. Presence of live fleas in the clothing (drowning cases): a flea can survive for approximately 24hrs submerged in water. Fleas recovered, usually from the clothing of the victim, is observed if it still living to approximate the time when said was submerged in water. Amount of urine in the bladder: the amount of urine in the urinary bladder may indicate the time of death when taken into consideration, he was last seen voiding his urine. State of the clothings: a circumstantial proof of the time of death is the apparel of the deceased Chemical changes in the Cerebro-Spinal Fluid

Factors Influencing Adipocere Formation

Post-mortem clotting and decoagulation of blood: blood clots inside the blood vessels in 6-8hrs after death.

State of Health before Death, Time interval between death and burial, effect of a coffin, presence of clothing, type of soil, access of air to the body after burial, mass grave.

Presence or absence of soft tissues in skeletal remains: under ordinary conditions, the soft tissues of the body may disappear 1-2yrs after burial.

III. Maceration: the softening of the tissues when in a fluid medium in the ansence of putrefactive microorganism which is frequently observed in the death of the fetus en utero.

Condition of the Bones: if all the soft tissues have already disappeared from the skeletal remains, the degree of erosion of the epiphyseal ends of long bones, pulverization of flat bones and diminution of weight due to the loss of animal matter may be the basis of the approximation.

Duration of Death Presence of Rigor Mortis: in warm countries, rigor mortis sets in from 2-3 hrs after death. It si fully developed in the body after 12 hrs. It may last from 18 – 36 hrs and its disappearance is concomitant with the onset of putrefaction. Presence of Post-mortem lividity: usually develops 3-6 hrs after death. Appears as small petechia-like red spots which later coalesce with each other to involve bigger areas in the most dependent portions of the body. Onset of Decomposition: In tropical areas, decomposition is early and the average time is 24-48hrs after death.

PRESUMPTION OF DEATH Rule 131 Section 5 Rules of Court Article 390 Civil Code 



Stage of Decomposition: the approximate time of death may be inferred from the degree of decomposition. Entomology of the Cadaver: to approximate the time of death, the presence of flies in the cadaver is sometimes used. Stage of digestion in the stomach: it normally takes 3-4 hrs for the stomach to evacuate its contents after a meal. The

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Disputable Presumption: not heard from for 7 years = DEAD o Dead for all purposes. EXCEPT: SUCCESSION Absentee shall not be presumed dead for the purpose of opening his succession till after absence of 10 years. o If he disappeared after 75 years old: Absence of 5 years SUFFICIENT to open succession.

Article 391 Civil Code 

Presumed DEAD FOR ALL PURPOSES:

FROGLETS NOTES o

o o

Lost on board a vessel lost during sea voyage, missing airplane, not been heard of for 4 years since loss of vessel or airplane. Person in armed forces who has taken part in war, missing for 4 years Person In danger of death other circumstances and his existence not known 4 years.

other, shall prove the same; in the absence of proof, it is presumed that they died at the same time and there shall be no transmission of rights from one to the other. CHAPTER VII SPECIAL DEATHS I.

1. 2. 3. 4.

If absentee appears or without appearing his existence is proved, he shall recover his property in the condition in which it may be found, and the price of any property that may have been alienated or the property acquired therewith; but he cannot claim either fruits or rents.

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

Rule 131 Section 5(jj) Rules of Court When 2 persons die in same calamity, such as: Wreck Battle Conflagration

1. 2. 3. 4.

5.

Both UNDER 15: Older presumed survived Both ABOVE 60: Younger presumed survived One UNDER 15, Other ABOVE 60: UNDER 15 presumed survived One OVER 15, Other UNDER 60, a. Different Sex: Male presumed survived b. Same Sex: Older One UNDER 15, or ABOVE 60, the other BETWEEN those ages: latter presumed survived

Article 43, Civil Code: If there is a doubt, as between 2 or more persons who are called to succeed each other, as to which of them died first, whoever alleges the death of one prior to the

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Death by Electrocution Death by Hanging Death by Musketry Death by Gas Chamber

OTHER METHODS OF CAPITAL PUNISHMENT

PRESUMPTION OF SURVIVORSHIP

Not shown who died first; there are no particular circumstances from which it can be inferred, the survivorship is presumed from the probabilities resulting from the strength and age of the sexes, according to the following:

JUDICIAL DEATH METHODS

Article 392 Civil Code

  

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II.

Beheading Crucifixion Beating Cutting Asunder Precipitation from a height Destruction by a wild beast Flaying Impaling Stoning Strangling Smothering Drowning

EUTHANASIA ―Mercy Killing‖ – deliberate and painless acceleration of death of a person usually suffering from an incurable and distressing disease. TYPES: 1. 2.

Active Euthanasia Passive Euthanasia a. Orthothanasia b. Dysthanasia

Ways of Performing Euthanasia 1. 2. 3. 4.

Administration of a lethal dose of poison Overdosage of sedatives, hypnotics, other pain relieving drugs Injection of air into bloodstream Application of strong electric currents

FROGLETS NOTES 5.

Failure to institute the necessary management procedure which is essential to preserve the life of the patient.

Ways of Performing Euthanasia 1. 2. 3.

Patient himself The physician, with or without the knowledge and and consent of the patient Poison was administered by the physician to the patient without the knowledge and consent of the patient, then it is murder. Treachery is inherent to the act of poisoning and treachery qualifies it to murder.

III. SUICIDE Psychological Classification of Suicide 1. First degree – deliberate, planned, premeditated, self-murder 2. Second degree – impulsive, unplanned, under great provocation or mitigating circumstances 3. Third degree – sometimes called accidental suicide. This occurs when a person puts his or her life into jeopardy by voluntary self – injury 4. Suicide under circumstances which suggest a lack of capacity for intention as when the person was psychotic or under influence and effects of drugs and alcohol. 5. Self-destruction due to negligence 6. Justifiable suicide – self- destruction action of a person with terminal illness. Evidence that will infer death is suicidal: 1. 2. 3.

4. 5. 6.

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Summary of Legal Medicine Book by Solis

History of depression, unresolved personal problem, mental disease Previous attempt of selfdestruction If committed by infliction of physical injuries, the wounds are located in areas accessible to the hand, vital parts of the body and usually solitary. Effects of act of self-destruction found in the body of the victim Presence of suicide note Suicide scene in place not susceptible to public view

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7.

Evidence which will rule out homicide, murder, parricide, and other manner of violent death.

CHAPTER VIII DISPOSAL OF THE DEAD BODY Persons Charged with Duty of Burial: 1. If married: surviving spouse if possesses means to pay the necessary expenses. 2. Unmarried or child: nearest kin if they be adults and within the Philippines and in possession of means to pay the necessary expenses. 3. Unmarried or no kin left with means: municipal authorities *Shall perform such duty within 48 hours after death, if able to do so. Right of Custody to body: To the person charged with the duty of burying the body except when inquest is required by law to determine cause of death or cause of death is accompanied by communicable disease, custody of which will remain to local board of health or municipal council until buried. Right of custody means possession, the holding of a thing or the enjoyment of a right. Enjoyment of a thing could either be in the concept of ownership or holder of a thing while ownership belongs to another. The right of possession of a corpse is equivalent to ownership and unlawful interference is an actionable wrong. Surviving spouse has the preferential right and duty to make the arrangements but if deceased spouse left a will stating among other things the manner his body will be disposed, such provision will prevail over the provisions of the Administrative Code. Methods of Disposal of the Dead Body 1. Embalming - Artificial way of preserving body be injecting formalin and perchloride of mercury or arsenic in the common arteries and the femoral arteries. 2. Burial or Inhumation - Body must be buried within 48 hours after death except when required for legal investigation or authorized

FROGLETS NOTES by local health authorities or when embalmed (impliedly allowed). After 48 hours, new permit is needed. If with communicable disease, within 12 hours after death unless directed otherwise by local board of health. In Philippines, body needs to be buried within 24 hours because of the climatic condition. 

Death Certificate necessary before burial except in cases of emergency. Primary duty of physician to furnish if available. If not, local health officer, mayor, the secretary or of a councilor. Order is successive and exclusive.

Summary of Legal Medicine Book by Solis

(b) A burial ground shall at least be 25 meters distant from any dwelling house and no house shall be constructed within the same distance from any burial ground. (c) No burial ground shall be located within 50 meters from either side of a river or within 50 meters from any source of water supply. The burial remain is subject to the following requirements: (a) Shipment of remains abroad shall be governed by the rules and regulations of the Bureau of Quarantine.

- It must be forwarded within 48 hours after death.

(b) The burial of remains in city or municipal burial grounds shall not be prohibited on account of race, nationality, religion or political persuasion.

* The person who issued the death certificate shall notify the justice of the peace or the auxiliary justice or the mayor if neither of the two is available if he observed any indication of violence or crime. Permission from the provincial fiscal or mayor is necessary if death due to violence or crime.

(c) Except when required by legal investigation or when permitted by the local health authority, no unembalmed remains shall remain unburied longer than 48 hours after death.

Burial and transfer Permits Municipal secretaries, in the capacity of secretaries of municipal boards of health or as clerks to municipal councils as the case may be, shall issue burial or transfer permits upon the presentation of the death certificate. Copy of death certificate shall accompany transfer permit if body will be transferred from one municipality to another. Those bodies with dangerous communicable disease shall not be carried from place to place except for burial or cremation. It is the duty of the local health authorities to cause such body to be thoroughly disinfected before being prepared for burial. Only adult members of the family may be permitted to attend the burial. Burial permit (death certificate) must be presented before burial. The Law Penalizes Desecration of Burial Premises (Sec. 2695, Revised Administrative Code) Burial Grounds Requirements (PD 856, Code of Sanitation) Burial Grounds Requirements the following requirements shall be applied and enforced: (a) It shall be unlawful for any person to bury remains in places other than those legally authorized in conformity with the provisions of this Chapter.

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Study Articles 305, 306, 307, 309 and 2219 of the NCC as well as Articles 132 and 133 of the RPC. Limitations to the Funeral Rites a. Will of the deceased b. Burial of the person sentenced to death must not be held with pomp (Art. 85, RPC) c. Restrictions as to funeral in cases of deaths due to communicable disease When the cause of death is a dangerous communicable disease, the remains shall be buried within 12 hours after death. They shall not be taken to any place of public assembly. Only the adult members of the family of the deceased may be permitted to attend the funeral. 3. Disposal of Dead Body to the Sea Allowed when death is not due to dangerous communicable disease. A special permit needs to be secured from officers authorized to issue permits. 4. Cremation Pulverization of the body into ashes by the application of heat. Body must first be identified and there must be a permit for cremation. When not granted:

FROGLETS NOTES

Summary of Legal Medicine Book by Solis

1. If deceased left a written direction that he will not be cremated

Persons who can grants permission to used body parts of deceased:

2. Identity has not yet been definitely ascertained

a. Before death:

3. Further inquiry needed to cause of death 5. Use of Body for Scientific Purposes Unclaimed remains may be used by medical schools and scientific institutions for studies and research subject to the rules and regulations prescribed by the department. Study RA 349 as amended by RA 1056 (Donations of Human Body Parts) Donation of Human Organs for Medical, Surgical and Scientific purposes Any person may donate an organ or any part of his body to a person, a physician, a scientist, a hospital or a scientific institution upon his death for transplant, medical, or research purposes subject to the following requirements: (a) The donation shall be authorized in writing by the donor specifying the recipient, the organ or part of his body to be donated and the specific purpose for which it will be utilized. (b) A married person may make such donation without the consent of his spouse. (c) After the death of a person the next of kin may authorize the donation of an organ or any part of the body of the deceased for similar purposes in accordance with the prescribed procedure. (d) If the deceased has no next of kin and his remains are in the custody of an accredited hospital, the Director of the hospital may donate an organ or any part of the body of the deceased in accordance with the requirement prescribed in this Section. (e) A simple written authorization signed by the donor in the presence of two witnesses shall be deemed sufficient for the donation of organs or parts of the human body required in this Section, notwithstanding the provisions of the Civil Code of the Philippines on matters of donation. A copy of the written authorization shall be forwarded to the Secretary. (f) Any authorization granted in accordance with the requirements of this Section is binding to the executors, administrators, and members of the family of the deceased.

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1. Deceased during his lifetime 2. If minor, guardian with the approval of the court or by the legitimate father or mother. Married woman can give consent without husbands consent. b. After death: 1. Nearest relative 2. Head of hospital or institution having custody in the absence of relatives Persons permitted to detach body parts: 1. License physician or surgeon 2. Known scientist banks.

3. Medical or scientific institutions including eye

Requirements: 1. Must be in writing 2. Specify the person/institution granted the authorization 3. Specify the organ/part to be detached persons

4. Signed by the grantor and 2 disinterested 5. Copy furnished to the Secretary of Health

Limitation to the Authorization Not allowed when died with dangerous communicable disease Penal Provision Imprisonment of not less than six months nor more than one year. Exhumation The deceased buried may be raised or disinterred upon lawful order from fiscals, court and any entity vested with authority to investigate. It must be

FROGLETS NOTES identified by relatives, friends or by marks on the body. Physician must describe the coffin, clothing and degree of decomposition before stating the actual disease or violence in his report. Even members of NBI are required to get permit from the Director of Health for exhumation. Person died with for a cause other than dangerous communicable disease may be disinterred after 3 years of being buried or in special cases, shorter time when in the opinion of Director of Health, the public health will not be endangered. It will be immediately disinfected and inclosed in a coffin, case or box. Disinterment of remains is subject to the following requirements: (a) Permission to disinter remains of persons who died of non-dangerous communicable diseases may be granted after a burial period of three years. (b) Permission to disinter remains of person who died of dangerous communicable diseases may be granted after a burial period of five years. (c) Disinterment of remains covered in paragraphs "a" and "b" of this Section may be permitted within a shorter time than that prescribed in special cases, subject to the approval of the Regional Director concerned or his duly authorized representative. (d) In all cases of disinterment, the remains shall be disinfected and places in a durable and sealed container prior to their final disposal.

- smears from vaginal canal and blood for alcohol determination d. Recover foreign bodies - Metalic fragment or whole slug for ballistic examinations - Operative sponge, medical instrument to prove medical negligence 2. If the next of kin refuses to give consent for exhumation autopsy, a petition in court must be done. How long can exhumation be done after interment: Sec 92 Code of Sanitation, Disinterment Requirements: 1. 2. 3.

4.

According to Art 305 of the Civil Code, no human remains shall be retained, interred, disposed of or exhumed without the consent of: spouse, descendants of the nearest degree, ascendants of the nearest degree, brothers and sisters



Sec 1098 Revised Administrative Code Shipment of remains at sea - no body or remains shall be shipped to the US except under such conditions as may be prescribed by the United States Public Health Service. The outside box containing the remains shall be plainly marked so as to show the name, age, nationality, of the deceased person, the cause of death, the destination and remains.



If dead body is a subject matter of criminal investigation, it may be exhumed anytime.

If the dead body is a subject matter of criminal investigation, it may be exhumed anytime

1. There must be a formal request from any of the law enforcement agencies authorized to make investigation addressed to any establishment authorized to perform medico-legal investigation. Reasons could be: a. Determine cause of death b. Determine identity c. Recover organs or tissues for further examination for: - toxicology analysis - histopathological examination

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Permission to disinter remains of persons who died of non - dangerous communicable disease may be granted after burial period of 3 years If death is due to a communicable dangerous disease, permission may be granted after a burial period of 5 years Shorter period may be granted in special cases, subject to the approval of Regional Director (Director of Health) concerned or his duly authorized representative. In all cases of disinterment, the remains shall be disinfected and placed in a sealed container prior to disposal.



Read article 308 of the NCC 

Summary of Legal Medicine Book by Solis

FROGLETS NOTES Requirements to be satisfied in exhumation: a. b.

Duration of interment as required Exhumation permit to be provided by the Director of Health Compliance of sanitary requirements, such that the body or remains, after exhumation shall immediately be disinfected and enclosed in a coffin or box and this box shall be placed in an outside box which shall also be securely fastened.

c.

Procedure in medico - legal exhumations a.

b.

c.     

There must be formal request from any law enforcement agency to make an investigation addressed to any person authorized to perform medico - legal investigation. The request must mention the name of the deceased, place and date of interment suspicion as to the cause of death etc. Reasons for the request are:  To determine the cause of death  Determine the identity of the deceased  Recover organs for further examination  Recover foreign bodies If the physician found that there is justification to the exhumation and a strong probability for the purpose to be realized, he may set the date and time for exhumation A written request for exhumation must be sent to the regional director or ministry of health stating: Name of deceased Place of exhumation Date and time of exhumation Duration of interment Purpose of exhumation

The Ministry of Health, aside from issuing the necessary permit, shall also infor the local health officer to assist the physician in the exhumation to ensure that public health will not be prejudiced. d. e. f.

During exhumation, the grave must be properly identified by the person who was present when the body was interred During disinterment, care and diligence must be observed to avoid destruction, deformity, contamination or such other effects After opening the coffin, the body must be viewed by any or more persons who can identify the deceased

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g. h.

Summary of Legal Medicine Book by Solis

Actual autopsy and adoption of procedure is needed to accomplish the purpose of exhumation Disinfection of the body and all areas involved must be carried out with the assistance of the local health officer and return of the body to the burial place

Included in the Exhumation Report: a. b. c. d. e. f. g. h. i. j. k. l.

The name of the deceased person and circumstances Purpose of exhumation Name address and designation of the requesting party Date, time place of exhumation Description of the burial place Name and address of the persons who identified the burial place Condition of the body and coffin if there is interment Name and address of the persons who identified the body of the deceased The post-mortem examination and accomplishment of the purpose of exhumation Conclusions based on the findings and result of examination Remarks if any Signature and designation of physician’

Problems in Exhumation: a. b.

identity of the deceased - often in disaster victims refusal of the next-of-kin to give consent or to cooperate in the exhumation-autopsy - often when the next-of-kin is involved in the investigation Remedy: petition in court for an order to exhume body CHAPTER IX MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES    

Physical injury is the effect of some stimulus on the body Effect is apparent: stimulus applied is insufficient to cause injury and body resistance is great Effect is real: effect is visible Effect of application of stimulus: Immediate (sharp object causing stab wound); Delayed (blunt object causing contusion)

FROGLETS NOTES

Summary of Legal Medicine Book by Solis

c.

Causes of Physical injuries: a. b. c. d. e. f. g.

Physical violence Heat or cold Electrical energy Chemical energy Radiation by radio-active substances Change of atmospheric pressure (barotrauma) Infection

A. PI by Physical Violence

dolor - pain on account of involvement of sensory nerve d. loss of function - on account of trauma, tissue may not be able to function normally Vital reaction differentiates an ante-mortem from postmortem injury In the ff instances, vital reactions or changes may not be observes even if injury was inflicted during life: a. b.

Effect is the production of wound. Wound is the solution of the natural continuity of any tissue of the living body. It is the disruption of the anatomic integrity of tissue in the body. Effect of physical violence may not always result to production of wound but wound is always an effect of physical violence. Physics of wound production:

If PI were inflicted during agonal state of a living person - body cells during that period may not have the potential capacity to react to trauma If death is so sudden as not to give the tissues in the body the chance to react properly e.g. deaths due to sudden coronary occlusion

Classification of wounds: 1.

As to severity: a. Mortal wound - capable of causing death immediately after infliction or shortly thereafter Parts of body where wound is inflicted considered mortal:

Wound is kinetic energy times time times area times ―other factors‖    

Kinetic energy: mass X velocity (squared) divided by 2. Velocity component is the important factor. Time: shorter period used for transfer of energy, greater likelihood of producing damage. Area of transfer: The larger the area of contract between the force applied on the body the lesser is the damage to the body. Other factors: the less elastic and plastic the tissue, the greater the likelihood that a laceration will result. Elasticity and plasticity refer to the ability of a tissue to return to its normal size and shape after being deformed by pressure.

 

b.

2.

Kind of instrument used: a. blunt instrument (contusion, hematoma, lacerated wound) b. sharp instrument: sharp-edged instrument (incised wound) sharp-pointed (puncture wound) sharp - edged and sharp - pointed (stab wound) c. tearing force (lacerated wound) d. change of atmospheric pressure (barotrauma) e. heat or cold (frostbite, burns or scald) f. chemical explosion (gunshot or shrapnel wound)

3.

As to manner of infliction:

Vital Reaction: sum total of all reactions of tissue or organ to trauma. Ff are common reactions of a living tissue to trauma: a. b.

rubor - redness or congestion of the area due to an increase of blood supply as a part of reparative machine calor - sensation of heat or increase in temperature

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Heart and big blood vessel Brain and upper portion of spinal cord  Lungs  Stomach, liver, spleen and intestine Non - mortal wound - not capable of causing death immediately

FROGLETS NOTES a. b. c. d.

hit - means of bolo, blunt, instrument, axe thrust or stab - bayonet, dagger gunpowder explosion - projectile or shrapnel wound sliding or rubbing or abrasion

4.

Depth of wound: a. superficial - only layers of skin b. deep - inner structure beyond layers of skin  penetrating - wounding agent enters the body but did not come out or mere piercing of solid organ or tissue or body Penetrating wound - wound where dimension of depth and direction is an important factor in its description. It involves the skin or mucous surface and the deeper underlying tissues or organs caused directly by the wounding instrument. Example: punctured, stab, gunshot wounds. 

Perforating - wounding agent produces communication between the inner and outer portion of the hollow organs. Traversing pr piercing completely a particular part of body

Summary of Legal Medicine Book by Solis

6. Special types of wounds: a. Defense wound - result of person’s instinctive reaction of self - protection; injuries suffered by a person to avoid or repel potential injury from aggressor (injury on flexed forearms when about to be hit by blunt object; incised or stab wound on palm when about to be stabbed by another) b. Patterned wound - Wound in the nature and shape of an object or instrument and which infers the object or instrument causing it. Ex. Impact of the face on the radiator grill of a car may cause imprint of the radiator grill on the face. c. Self-Inflicted Wound - Self inflicted wound is a wound produced on oneself. As distinguished from suicide, the person has no intention to end his life. Motive of Producing Self-Inflicted Wounds: (1) (2)

5.

Relation of site of application of force and location of injury: a. coup injury - physical injury which is located at the site of application of force b. contre - coup injury - physical injury found opposite the site of application of force c. coup contre - coup injury - physical injury located at site and also opposite the site of application of force (fixed head is hit with moving object then falls on another hard object) d. locus minoris Resistencia - PI located not at the side or opposite the site of application of force but in some areas offering the least resistance to the force applied. Blow on forehead may cause contusion at region of eyeball because of fracture on the papyraceous bone forming roof of orbit. e. Extensive injury - PI involving greater area of body beyond site of application of force not only wide are of injury but various types of injury. (fall from height or run-over of victim in vehicular accident) *stationary head is hit by moving object, contusion is with the site of impact.; when moving head hits a firm fixed and hard object, Brain contusion may develop at opposite side of impact.

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(3) (4) (5)

To create or deliberately magnify an existing injury of disease for pension or workman’s compensation; To escape certain obligations or punishment. During war time soldiers may cut their fingers to avoid frontline assignments and prisoners may inflict physical injuries on their body to avoid hard labor and just be confined in a hospital to receive food and rest. To create a new identity or destroy the existing one. Fingerprints may be destroyed by acid, by cutting or burning. To gain attention or sympathy. Psychotic behavior

Some Ways of Self-Mutilation: (1) Head banging or bumping - this is commonly observed in overactive children and causes hematoma. (2) Exposure of parts of the body to heat radiation from open fires, radiators, or protective grills over radiator thermophilia. (3) Penetrating nail or spike to the chest wall or insertion into the urinary bladder in a female. (4) Castration by amputation of the penis. (5) Trauma inflicted on the female genitalia to induce abortion or promotes hemorrhage and creates an anemia.

FROGLETS NOTES (6) Subcutaneous injection of fecal matters to promote abscess formation. (7) Pricking of acne eruption to lead to a severe facial disfigurement. (8) Subcutaneous injection of air to create a condition of emphysema. (9) Nail-biting (onychophagia) which may lead to maceration of the skin and an infection. (10) Grinding of the teeth (bruxism) is frequently seen in the mentally retarded and can lead to abnormal tooth wear, a bilateral hypertrophy of the masseter and a pain on chewing. (11) Pressure on the subcutaneous tissue by a tightly applied cord or belt around the body: (a) Tribal customs of metal band around the neck or a leg by some African tribes may cause a permanent disfigurement. (b) Use of shoes made of metal by chinese women. (12) Pulling of the body hair (Trichotillomania) (Forensic Medicine a Study in Trauma & Environment Hazards by Tedeschi, Eckert &Tedeschi, Vol, 1, p.496) Legal Classification of Physical Injuries:  Mutilation: Art. 262, Revised Penal Code Kinds of Mutilation Punishable Under the Code: 1.

Intentionally depriving a person, totally or partially of some of the essential organs for reproduction, and 2. Intentionally depriving a person of any part or parts of the human body other than the organs for reproduction. Mutilation is the act of looping or cutting off any part or parts of the living body. In order to be punishable under the Code, it must be intentional, otherwise it will be considered as a physical injury. 

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―Mayhem‖ is the unlawful and violent and deprival of another of the use of a part of the body so as to render him less able in fighting, either to defend himself or to annoy his adversary. Mutilation of other parts of the body other than the organ of reproduction may be classified as mayhem.

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Summary of Legal Medicine Book by Solis

However, if it is not deliberate then it may fall on paragraph 2, Art. 263, Revised Penal Code (Serious Physical Injuries). 

Is vasectomy and tubal ligation within the purview of mutilation as defined and penalized by Art. 262 of the Revised Penal Code? The Secretary of Justice rendered an opinion that vasectomy and tubal litigation are not mutilation and a legitimate method of contraception despite the fact that it is done intentionally and deprives a person of his power of reproduction. Because: …these two methods of surgical sterilization are affected by the closing of a pair of tubes in either man or the woman so that the sperm and ovum cannot meet; it does not involve the removal of reproductive glands or organs as in the case of castration, with which it is sometimes confused. Serious Physical Injuries: Art. 263, Revised Penal Code: to:

The Crime of serious physical injuries my be due 1. 2. 3. 4.

Wounding; Beating; Assaulting (Art. 263); or Administering injurious substances (Art. 264) without the intent to kill. It may be committed through a simple negligence or imprudence The main purpose of dividing the provision into four paragraphs is to graduate the penalties depending upon the nature and character of the wound inflicted and their consequences on the person of the victim. In paragraph one, the injured person became insane, imbecile, impotent, or blind. Article.

Insanity has not been defined or qualified by the

Imbecility infers that the injured person must be of the preadolescent age and that on account of the physical injuries inflicted there is an arrest of mental development. Impotency is the inability to grant to the partner sexual gratification.

FROGLETS NOTES

Summary of Legal Medicine Book by Solis

Blindness must be total or involvement of both eyes. If only one eye became blind, then the physical injury will fall in paragraph 2 of Article 263.

In paragraph four, the injured person becomes ill or incapacitated for labor for more than thirty days and impliedly less than 90 days.

In paragraph two, the following nature and character of the wound or consequences of the injuries inflicted must be present:

It is noteworthy to mention that in paragraph 3 and 4 of article 263 there is no mention of periods of medical attendance but merely incapacity.

a.

Loss of the use of speech or the power to hear or to smell, or loss of an eye, a hand, a foot, an arm, or a leg; b. Loss of the use of any such member; or c. Becomes incapacitated for the work in which he was therefore habitually engaged. There must be total loss of hearing capacity. If the loss of power to hear is only in one ear, it is a serious physical injury under paragraph 3, article 263 (People v. Hernandez, 94 Phil. 49) Insofar as loss of a hand is concerned, the prosecution must prove by clear and conclusive evidence that the offended party cannot actually make use of his hand and that such impairment is permanent (People V. Reli. C.A. 53 O.G. 5695). In paragraph 3, the following injuries of their consequences are included: a. b. c. d.

Deformity; Loss of any other member of his body; Loss the use thereof; or Becomes ill or incapacitated for the performance of the work in which he was habitually engaged for more than 90 days, as a consequence of the physical injuries inflicted.

Deformity is a condition of physical ugliness. It must be a permanent and conspicuous. The loss of the front teeth, the development of a pigmented scar on the face, or the loss of the pinna of the ear is considered deformities. However, the development of a scar in covered parts of the body may not be considered deformity because it is not a conspicuous and visible. ―The loss of any other part of his body‖ means loss of the parts of the body not mentioned in paragraph 2, Art. 263. Incapacity means the inability of the injured person to perform, or engage on a work or vocation before he sustained injury.

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Administering Injurious Substances or Beverages: Art. 264, Revised Penal Code: Elements of the Crime: a.

The offender inflicted upon another person or any serious physical injury. b. The infliction of physical injury was done knowing that the substance or the beverage administered is injurious or took advantage of the victim’s weakness or credulity; and c. There was no intent to kill on the part of the offender. If the offender does not know that the substance administered is injurious, he cannot be held liable under the above provision. The throwing of acid on the face of someone does not fall within the provision because what the provision contemplates is administering or taking in the injurious substance or beverages (U.S. Chiong Songco, 18 Phil 459). The provision does not contemplate of sight or less serious physical injuries are the consequence of injurious substances of beverages, but results only in serious physical injuries. If the administration of injuries substances or beverages is intentional, the crime committed is frustrated murder. Treachery is inherent when injurious substances or beverages are introduced into the body. Less Serious Physical Injuries: Art. 265, Revised Penal Code: The basis to determine whether the physical injury is less serious or not is by either the period of medical attendance or period of incapacity; both of which is ten days or more but not more than thirty days. The fact that the injury only requires medical attendance for two days but incapacitated the victim from attending to his ordinary work for a period of 29 days

FROGLETS NOTES

Summary of Legal Medicine Book by Solis

makes the crime less serious physical injuries (U.S. v. Trinidad, 4 Phil. 152).



There must be proof as to the period of medical attendance. In the absence of such proof of medical attendance or incapacity, although the wound actually healed in more than 30 days, the crime committed is only slight physical injuries (People v. Penesa, 81 Phil. 398)

 

The Crime of less serious physical injuries may be qualified and a fine or a higher penalty imposed when: a. b. c. d.



There is a manifest intent to insult or offend the injured person; There are circumstances adding ignominy to the offense; The victim is the offender’s parents, ascendants, guardian, curators or teachers; or The victim is a person of rank or person in authority, provided that the crime is not direct assault.

  

(pp.252-268) In the Description of a Stab Wound, the following must be included: a. b. c. d. e. f. g. h.

Length of the skin defect Condition of the extremities Condition of the edges Linear direction of the surface wound Location of the stab wound Direction of penetration Depth of the penetration Tissue and organs involved

Stab Wound(s) may be Suicidal, Homicidal or Accidental: a.

Suicidal – Evidences showing that the stab wound is suicidal:  Located over vital parts of the body  It is usually solitary. If multiple, located on one part of the body  If located on covered parts of the body, the clothing is not involved

b. Homicidal – stabbing with homicidal intent is the most common Characteristics: 1. 2. 3. 4.

5.

Injuries other than stab wound may be present Stab wound located in any part of the body Usually more than one stab wound There is a motive - If without motive offender is insane or under the influence of drugs There is a disturbance in the crime scene

Medical evidences showing intent of the offender to kill the victim: a. b. c. d. e.

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The stab wound is accessible to the hand of the victim The hand of the victim is smeared with blood The wounding weapon is firmly grasped by the hand of the victim (cadaveric spasm) If stabbing is accompanied with slashing movement, the wound tailing abrasion is seen towards the hand inflicting the injury A suicide note may be present There is the presence of a motive for selfdestruction No disturbance in the death scene, wounding instrument is found near the victim

More than one stab wounds Located on different parts of the body or on parts where vital organs are located Deep Stab wound with serrated or zigzag borders Irregular or stellate shape skin defects

FROGLETS NOTES     

Different measurement of the stab wounds may be produced by one weapon if it is tapering towards the sharp point Withdrawal of the instrument not on the same direction as when it was introduced may increases length of the skin defect Three-cornered file when used as a stabbing weapon- three-cornered skin defect The most common immediate cause of deathhemorrhage Accidental stab wounds are rare

4. Punctured Wound  A result of a thrust of a sharp pointed instrument  External injury small but depth is to a certain degree  Produced by: icepick, needle, nail, spear, pointed stick, thorn, fang of animal, hook  External hemorrhage is limited but internal injuries may be severe  Direct involvement of blood vessels and bloody organs may cause fatal consequences  Site of external wound can be easily sealed  Punctured would is usually accidental but in rare instances it may be homicidal or suicidal

a. b. c. d. e. f. g. h.

1.

a. Poison dart- cyanide or nicotine b. Fish spines c. Dog bites with hydrophobia virus d. Injection of air and poison as a way of euthanasia 5. Lacerated Wound (Tear, Rupture, Stretch, ―Putok‖) 

2. 3.



The opening on the skin is very small and may become unnoticeable because of clotted blood and elasticity of the skin. The wound is much deeper than it is wide. External hemorrhage is limited although internally severe Sealing of the external opening will be favorable for the growth of anaerobic microorganism

Medical Evidences that tend to show it is homicidal: a. b. c. d.

It is multiple and usually located on different parts of the body Deep Defense wounds on the victim Disturbance of the crime scene- sign of struggle

Proof to show it is suicidal:

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Located where vital organs are located Usually singular but may be multiple but located in one area Parts of the body involved is accessible to the hand of the victim Clothing is usually not involved Wounding is made while the victim is sitting or standing. There is bleeding towards the lower part of the body No disturbance of the crime scene Presence of suicide note Wounding instrument found near the body

Punctured would with puncturing instrument loaded with poison:

 Characteristics:

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

A tear of the skin and the underlying tissues due to forcible contact with a blunt instrument Produced by: wood, iron bar, fist blow, stone, butt of firearm, others without sharp objects Force applied to tissue is greater than its cohesive force and elasticity The tissue tears and laceration is produced

Characteristics: a. b. c. d. e. f. g. h.

Shape and size of the injury do not correspond to the wounding instrument Tear on the skin is rugged with extremities irregular and ill-defined Injury developed is at the site where the blunt force is applied Borders of the wound are contused and swollen Usually on areas where the bone is superficially located, like scalp, malar region on the face, front part of the leg, dorsum of the foot Examination shows bridging tissue joining the edges and hair bulbs intact Bleeding is not extensive because blood vessels are not severed evenly Healing process is delayed

FROGLETS NOTES Classification of lacerated wounds: a. Splitting caused by crushing of the skin between two hard objects - Best seen in laceration of the scalp, cut eyebrow of boxer, laceration of the chin of motorcyclist b. Overstretching of the skin - When pressure is applied on one side of the bone, the skin over the area will be stretched up to a breaking point to cause laceration and exposure of the fractured bone - In avulsion, the edges of the remaining tissue is that of laceration c. Grinding Compression - Weight and grinding movement may cause separation of the skin d. Tearing - Produced by semi-sharp-edged instrument which causes irregular edges on the would - Hatchet and choppers  

-Healing is faster

- Healing is delayed

-Scar is linear or spindleshaped

- Scar is irregular

-Caused by a sharp-edged instrument

- caused by a blunt instrument

Gaping of Wound:

The separation of the edges especially in deep wound may be due to the following: 1.

Mechanical stretching or dilatation - Presence of a mechanical device on the edges to prevent coaptation will cause separation

2.

Loss of Tissue - Separation of edges of a wound may be on account of loss of tissue bridging them. The loss of tissue may be due to: i. Destruction by pressure, infection, cell lysis, burning or chemical reaction ii. Avulsion or physical or mechanical stretching resulting to separation of a portion of the tissue iii. Trimming of the edges

3.

Retraction of the Edges - Underneath the skin are dense networks of fibrous and elastic connective tissue fibers running on the same direction and forming a pattern more or less present in all persons. This is called cleavage direction or lines of cleavage of the skin. - If an incised wound or stab wound was inflicted wherein the long axis of the wound is parallel or on the same direction as the cleavage line of the part of the body involved, the wound will appear narrow or slit-like because the

Lacerated wounds may involve deeper tissues like laceration of the muscles and fracture bones It may be homicidal or accidental but rarely suicidal

Distinction between and incised wound and a lacerated wound: Incised Wound

Lacerated Wound

-Edges are clean cut; regular; well-defined

- Edges are roughly cut; irregular; ill-defined

-No swelling or contusions around the incised wound

- There is swelling and contusion around the lacerated wound

-Extremities of the wound are sharp or may be round or contused

- Extremities of the wound are ill-defined and irregular

-Examination by means of a magnifying lens shows that the hair bulbs are cut

- Examination with a magnifying lens shows that the hair bulbs are preserved

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FROGLETS NOTES

-

edges of the wound will not be subjected to the lateral pull of the severed connective tissue fibers If the long axis of the wound is perpendicular to or with an angle with the lines of cleavage, the tendency of the borders of the wound is to separate on account of the retraction of the severed fibers

Practical ways of determining how much of the skin surface is involved in an injury or disease:       

Skin serves as the mechanical protection of the body It is punctuated with sensory nerve endings for pain, temperature and touch It acts as thermo-regulator, storage of water, excretor of sweat and organ for absorption Determination of how much skin is involved is important to determine the mode of treatment and prognosis Significant in cases of: burns, contusion, dermal manifestation of certain diseases Burns in children and old age persons, involvement of more than 70% of the body surface- fatal Estimation as to how much of the body surface involved, the rule of the nine is used

Body surface expressed as percentage using the rule of nine: Whole of head and neck

9%

9%

Whole of one upper extremity

9%

18%

Whole of front chest and abdomen

18%

18%

Whole of posterior chest and abdomen

18%

18%

Whole of one lower extremity (front)

9%

18%

Whole of one lower extremity (back)

9%

18%

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Pudental areas

1%

Total

1% 100%

Factors responsible for the severity of wounds: 1.

blood:

Hemorrhage a. Hemorrhage may influence the severity of wound by: a.1. Loss of blood incompatible with 

Blood constitutes about 1/20 of the body weight of an adult  By volume, an average size adult has 5 to 6 quarts of blood  A loss of 1/3 to 2/5 of the circulating blood may result to irreversible hypovolemic shock and may be fatal  The volume of blood lost may be related to the rate or space of time a certain volume of blood has been shed  Males can stand more lost of blood than females a.2. Hemorrhage may result in an increase in pressure in or on the vital organs to affect the normal function: 

Intracranial hemorrhage may cause compression of the vital centers of the brain.  Hemopericardium may cause embarrassment of the contraction of the heart.  Hemorrhage into the chest cavity may cause diminution of the respiratory output with subsequent anoxia a.3. Hemorrhage may cause mechanical barriers to the function of organs: 

Hemorrhage into the tracheobronchial lumina can cause asphyxia

FROGLETS NOTES b.

Cause of Hemorrhage: b.1. Trauma: 

Destruction of the blood vessel wall or increase permeability of its wall due to external force b.2. Natural Causes: 

Common causes of hemorrhage due to natural causes: o Intra-cerebral hemorrhage (apoplexy) o Spontaneous subarachnoid hemorrhage o Rupture of the arteriosclerotic aneurysm of the aorta o Rupture of the esophageal varices in cases of cirrhosis of the liver and bleeding of peptic ulcer of the stomach and duodenum o Pulmonary hemorrhage o Ruptured ectopic pregnancy o Spontaneous rupture of cavernous hemangioma or hepatoma o Rupture of the enlarged spleen

2. Size of Injury:  

Burns affecting 1/3 of the body surface of the third degree type is usually fatal Bigger wounds are more exposed to infection and other physical conditions of the surroundings

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3. Organs Involved  

Trauma on the vital organs of the body are always serious Crushing wounds of the heart, brain or longs are almost fatal

4. Shock   

May occur with or without violence Slight blow on genitalia, slight burns in children or old persons, or slight violence on the head or neck may cause severe shock But violent traumas to healthy, strong persons may not produce shock

5. Foreign body or substance introduced into the body:  

Incision with an unsterilized scalpel may not be serious as the bite of a venomous snake A foreign substance or body may be toxic by itself or may act as a physical irritant

The foreign body or substance may be: a. Bacterial: - Tetanus - Pathogenic microorganism b. Viral: - Hydrophobia - Hepatitis c. Foreign body: - Bullet - Glass fragments - Shrapnel - Gauze or rubber drain d. Chemical: - Cyanide

FROGLETS NOTES - Nicotine

b. Tourniquette above the site of the wound

e. Toxin 

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c. Placing ice on the bite site d. Sucking the wound to drain venom

Snake Venom o Characterized as two punctured wounds at the center of the reddened affected area

e. Administration of anti-snake venom serum



Scorpion Venom o Has neurotoxic, hemolytic and hemorrhagic effect o Produces only one punctured wound on the center of a reddened area o Main symptoms are pain edema and reddening



Coelenterate Sting (jellyfish) o The tentacles penetrate into the skin and cause explosion of the nematocyst and liberation of the venom o Symptoms are extreme pain, urticarial rash, abdominal pain, dilated pupils, paleness and labored breathing

Snake venom toxicity will depend on: a. Potency of venom injected b. The amount of venom depends on the season of the year and the length of time the snake has eaten. If a snake has just killed his prey, the toxic content is smaller c. Size of Patient d. The immediate treatment instituted

Snake venoms are of two principal classes: a. Neurotoxic - primarily paralyzes the respiratory and cardiac center of the brain. May cause nausea, vomiting, ascending paralysis, coma, convulsion, and cardiac and respiratory arrest. b. Hematoxic - affects particularly the blood. The manifestations are pain and swelling of the affected area, intravascular hemolysis, abdominal pain, nausea, vomiting, petechial hemorrhage on the gum, pulmonary and cardiac edema.

Emergency treatment may be: a. Incision of the wound to promote more external hemorrhage to drain the venom

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6. Absence of medical or surgical intervention: 

A wound may not be fatal, but because of neglect in its management it may become serious or fatal

Fatal Effect of Wounds: 1. Wound may be directly fatal by reason of: a. Hemorrhage 

Incised wound on carotid artery without surgical intervention is fatal

b. Mechanical injuries on the vital organs 

Blow on the head may not necessarily produce external lesions but may produce severe meningeal hemorrhage producing compression of the brain

FROGLETS NOTES c. Shock 

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2.

Changes producing separate pathological lesions which in turn proves to be fatal Ex: Operation performed on a patient to ligate bleeding vessel inside the abdominal cavity with reasonable skill and due diligence but as a result of which peritonitis developed and caused death of patient

3.

Changes where a definite pathological condition was present before the injury Ex: A person suffering from tumor or cyst and was stabbed by someone. The stab is not capable of producing death ordinarily. The person may die of the pathological condition and the accused is liable for his death

4.

Changes where a definite pathological condition of totally different nature arises after the wounding and the

Disturbance of the balance of fluid in the body capable of producing delayed or immediate death

2. Wound may be indirectly fatal by reason of: a. Secondary hemorrhage following sepsis 

On account of infection that sets in, deeper tissues are involved

b. Specific Infection 

Pathogenic microorganisms may develop and multiply in the wound causing septicemia, bacteremia, or toxemia

c. Scarring Effect 

Chronic gonorrheal infection may cause stricture or urethra

d. Secondary Shock Nature or death due to secondary shock -

A person may have recovered from the immediate effects of the trauma or violence, but may later die of its secondary effects or changes These changes may be classified as follows: 1.

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Changes whose natural sequence are direct and obvious Ex: Septicimia, tetanus or complications arising from wounds

FROGLETS NOTES consequential sequence is doubtful Ex: Tuberculosis meningitis that develops following a blow on the head

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 The extravasation or loss of blood from the circulation brought about by wounds in the cardio-vascular system.  The degree and nature of hemorrhage depends upon the size, kind and location of the blood vessel cut. Kinds of Hemorrhage:

Complication of trauma or injury: 1.

Shock 

 

The disturbance of fluid balance resulting to peripheral deficiency which is manifested by the decreased volume of blood, reduced volume of flow, hemoconcentration and rental deficiency Clinically characterized by severe depression of the nervous system Three major factors operate in the production of shock and all are likely to be associated together as the condition develops a. Injury to the receptive nervous system b. Anoxemia – reduction of effective volume of oxygen carrying capacity of the blood c. Endothelial damage, thus increasing capillary permeability

3.

a.

Primary Hemorrhage  It is the bleeding which occurs immediately after the traumatic injury of the blood vessel

b.

Secondary Hemorrhage  This occurs not immediately after the infliction of the injury but sometime thereafter on or near the injured area

Infection:  Infection is the appearance, growth and development of microorganisms at the site of the injury How injury or trauma acquires infections: a. b.

Kinds of Shock: a.

b.

2.

Delayed or Secondary Shock  Patient shows sign of general collapse which develop some time after the infliction of injury

Hemorrhage

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c.

Primary Shock  Caused by immediate nerve impulse set up at the injured area which are conveyed to the central nervous system

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d.

e.

4.

From the instrument or substance which produces the injury From the organs involved in the trauma applied As an indirect effect of the injury which creates a local area of diminished resistance causing the invasion and multiplication of microorganisms Injury may depress the general vitality, especially among the aged and the young children and makes the patient succumb to terminal disease Deliberate introduction of microorganisms at the site of the injury

Embolism:  A condition in which foreign matters are introduced in the blood stream causing

FROGLETS NOTES sudden block to the blood flow in the finer arterioles and capillaries

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 

The most common emboli in the blood stream are: a.

b.

Fat Embolus  Causes of Fat Embolus: o By injection of oily substance into the circulation o By injury of the adipose tissue which forces fat into the circulation Air Embolism  Causes of Air Embolism: o Gaping incised wound of the jugular vein o Injection of soapsuds or air into pregnant uterus for the purpose of tubal insuflation or criminal abortion o Injection of air into the urinary bladder for radiological study o Insuflation of the other non-potent tubes or hollow organs o Injection of air under pressure into the nasal sinus after a therapeutic lavage

Capacity for regeneration decreases as age increases State of nutrition of the individual affects capacity or regeneration

The following regenerates rapidly: a. b. c.

Connective tissues Blood forming tissues Surface epithelium of the skin

Those having no power or limited capacity to regenerate: a. b. c.

Highly specialized glandular epithelium Smooth muscle Neurons of the central nervous system



Small clean-cut wound is covered with lymph in 36 hours The edges adhere in two days and wound heals on the 7th day leaving a linear scar Larger incised wound shows swelling of the edges 8 to 12 hours Blood-stained serum is present in 2 days which afterwards become seropurulent on the 3rd day, lasting in state from 4 to 5 days Small red granulation forms in 12 to 15 days and the epithelium grows from the edges Scar develops later

    

Healing of Wounds The time of healing wounds is dependent on the following: vascularity, age of person, degree of rest or immobilization and nature of the injury. 2. Kinds of Healing Wounds

Healing of Wounds

1.

Power of the human tissue to regenerate  Regeneration is the replacement of destroyed tissue by newly formed similar tissue  The more highly specialized the tissue, the less capacity for regeneration

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a. Healing by Primary (First) Intention It takes place when there is minimal tissue loss, more approximation of the edges and without significant bacterial contamination. Within 24 hours after the injury, there is an acute neutrophilic response and scab will be formed due to dehydration of the surface clot. After three days, microphages and fribroblasts will appear. Collagen fibers will bridge the raw area and differentiated surface cells begin to proliferate to cover the exposed area. The normal state of the area may

FROGLETS NOTES return after a lapse of one month with or without the formation of a scar.

cuts, hair and other foreign bodies in the scene; (c) witnesses to the incident; (d) wounding instrument; (e) photography, sketching or accurate description of the scene of the crime for preservation

b. Healing by Secondary Intention It take place when the injury causes more extensive loss of cells and tissues. Inflammatory reaction is more intense and granulation tissue growth bears all the responsibility for its closure. Production of a large scar and greater loss of skin appendages (hair, sweat and sebaceous glands) and slower reparative process may occur. c. Aberrated Healing Process In some instances, healing process may deviate from the normal way on a normal individual and may result to: (1) Formation of Excessive Granulation Tissue or "Proud Flesh" - It may prevent the closing of wound and can be remedied by excision or cautery. (2) Keloid Formation - It is the a large bulging tumorous scar produced by an abnormal amount of collagen in the connective tissue. (3) Stricture - It is the contraction of the fibrous tissue of the scar formed. (4) Fistula or Sinus Formation - Fistula is a communication between an inner cavity and the outside while sinus is a tract of infection traversing the inner part of the body. It may remain for a lone time unless the causal factor (infection or foreign body) is removed. CHAPTER X MEDICO-LEGAL INVESTIGATION OF WOUNDS Rules to observe by the physician in examining wounds:   

ALL injuries must be described. Description must be comprehensive with sketches or photographs if possible. Examination must not be influenced by other information obtained from others in making a report or conclusion.

Outline of Medico-Legal Investigation of Physical Injuries 1.

General Investigation of the Surroundings: (a) place of the commission of the crime; (b) clothing, stains,

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2.

Examination of the Wounded Body Living Victim

Dead Victim Age of the wound from degree of healing Weapon used Reasons for multiplicity of wounds Whether injury is accidental, suicidal or homicidal Ante-mortem or postDangerous to life of injury mortem wound Permanent deformity Mortal or non-mortal wound caused by injury Presence of disease or abnormal development at Shock produced by wounds time of wounding which may accelerate death Complications produced by Cause of wound (accident, injury suicide, homicide) 3.

Examination of the Wound  Character - State the type of wound, characteristic marks, presence of contusion collar, scab formation, infection, surgical intervention, etc.  Location - Region of the body where it is situated, distance of the wound from some fixed point in the body prominence. Location is important in determining trajectory or course of the wounding weapon  Depth - It is measurable if the outer wound and inner end is fixed. It must not be attempted in a living subject if it will prejudice the health or life or in a stabbed wound in the abdomen due to movability of the abdominal wall  Condition of Area Surrounding the Wound - Presence of burning or tattooing in gunshot wounds by near or contact fire, hesitation cuts in suicidal incised wound or contusion in lacerated wound  Extent - Extensive injury may show marked degree of force applied  Direction - It is material in determining the relative position of the victim and offender.  Number - Multiple wounds in different parts of the body are generally indicative homicide or murder.

FROGLETS NOTES  Conditions of the Locality - (a) degree of hemorrhage; (b) evidence of struggle; (c) position of the body; (d) presence of suicide note; (e) condition of weapon. Factors in Determining Whether Wounds were Inflicted During Life or After Death 1.

2.

3.

Hemorrhage is more profuse when the wound was inflicted during lifetime. If wounds are inflicted after death, the amount of bleeding is comparatively less due to loss of tone of blood vessels, absence of heart action and post-mortem clotting of blood. Violence upon a living body may not show bruise until after death. Signs of Inflammation such as pus, adhesion of the edges and other vital reactions may be present whenever the wound was inflicted during lifetime although they may be less pronounced when resistance of the victim is markedly weakened. Postmortem wounds do not show any manifesting signs of vital reaction.

and cellular tissues not removed by washing Edges gape owing to the reaction of the skin and muscle fibers

Inflammation and reparative processes

1.

Signs of Repair such as fibrin formation, growth of epithelium, scab or scar formation conclusively show that wound was inflicted during lifetime. But absence of such does not show wound was inflicted after death since the tissue may not have been given ample time to repair before death took place. Retraction of the Edges of the Wound inflicted during life cause gaping of the wound while in case of wound inflicted after, edges do not gape and are closely approximated to each other.

Distinction between Ante-Mortem and Post-Mortem Wounds AnteMortem Wound Hemorrhage more or less copious and generally arterial Marks of spouting of blood from arteries Deep staining of the edges

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PostMortem Wound Hemorrhage slight or none at all and always venous No spouting of blood Blood is not clotted or a soft

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clot Edges and cellular tissues are not deeply stained and can be removed by washing. Edges do not gape but are closely approximated to each other unless wound is caused within one or two hours after death. No inflammation or reparative processes

Factors in Determining Whether Wound is Homicidal, Suicidal or Accidental

2. 4.

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3. 4. 5. 6.

Nature of the wound inflicted  Abrasions - extensive in accidental death, rare in suicidal, not common in murder unless the body is dragged on the ground, common in homicide especially when victim offered some degree of resistance.  Contusion - rare in suicide unless done by jumping from a height, may be found in accidental death often due to a fall or forcible contact with some hard object.  Incised wound - common in suicide and homicide. Accidental cuts are frequent everyday occurrences but rarely cause of death. External signs and position and attitude of the body when found Location of the weapon or manner it is held Motive Personal character of the deceased Other information such as:  Signs of struggle - Its absence is more in suicide, accident or murder. Presence of hair or portion of skin on nails of assailant or deceased  Number and direction of wound - Multiple wounds in concealed parts of the body are indicative of homicide. Single wound in a position the deceased could have been conveniently inflicted is suicidal. In cut-throat, generally transverse in homicide while oblique in suicide.  Nature and extent of wound - Homicidal wounds may be caused by any wounding instrument while suicidal wounds are due to sharp instruments.

FROGLETS NOTES  State of clothings - Usually no change in its condition in suicide while it may be in disorderly position due to struggle in homicide. Factors in Determining Length of Time of Survival of the Victim After Infliction of the Wound



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Determining which of the wounds were inflicted first depends on relative position of the parties, trajectory of the wound inside the body, organs involved and degree of injury, testimony of witnesses and presence of defense wounds.

Effect of Medical and Surgical Intervention on the Death

1.

Degree of Healing Signs of repair appear in less than a day after infliction of injury. By the degree of the granulation of tissue formation and other reparative changes, the age of the wound may be estimated.

2.

Changes in the Body Systemic changes such as degree of wasting, anemia, condition of the face and bed sore formation may provide for a basis.

3.

Age of the Blood Stain It may be determined from the physical color changes of the skin although it is not reliable.

4.

Testimony of the Witnesses In cases where witnesses testify as to the exact time, medical evidence as to duration of survival is merely corroborative.

Negligence of the victim in the proper care and treatment of the injury will not exonerate the offender since he is not bound to submit himself to medical treatment. But if negligence is deliberate and is really the cause of death, offender can only be held liable for physical injuries.

Possible Instruments Used by Assailant Inferred from Nature of Wound

Power of Volitional Acts of the Victim After Receiving a Fatal Blow

 Contusion - blunt instrument  Incised wound - sharp-edged instrument inflicted by hitting  Lacerated wound - blunt instrument  Punctured wound - sharp-pointed instrument  Abrasion - body surface rubbed on rough hard surface  Gunshot wound - diameter of the wound of entrance may approximate caliber of firearm

The determination of the victim's capacity to perform volitional acts rests upon the medical witness.





A physician can only state that it is possible that a certain injury is possibly caused by a certain instrument presented. He must be cautious in making categorical statements. In case of multiple offenders and there is conspiracy, it is not necessary to determine who inflicted the fatal blow. Where victim received multiple injuries, determining which injury caused the death depends on the testimony of the physician by examining which of the wounds caused injury to some vital organs or large vessels or led to secondary results causing death.

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1. If death occurred after medical intervention, offender is still liable provided (1) death is shown to be inevitable and even without intervention, death is a normal and direct consequence; (2) physician must be competent and exercised care and diligence. 2. Minor wounds were received by victim but death resulted on account of gross incompetence or negligence of physician, offender is liable only for the physical injuries inflicted. Effect of Negligence of the Injured on the Death

 Severe injury of the brain and cranial box usually produces unconsciousness but power to perform volitional acts depends upon areas of the brain involved.  Wounds of big blood vessels (carotid, jugular, even aorta) - not prevent performance of voluntary acts  Penetrating wound of heart - instantaneously fatal but experience shows victim may still be capable of locomotion  Rupture of organs - victim may still move and speak Extrinsic Evidences in Wounds 1.

From Wounding Weapon (a) Position - Near the body of the victim in suicidal and accidental death or firmly grasped by the victim in case of suicide

FROGLETS NOTES (b) Presence of blood - In some cases, absence of blood stains is due to the rapidity of the blow and compression of the blood vessels or blood may be wiped out by the clothings in the process of withdrawal. (c) Presence of hair and other substance 2.

3.

4.

In the Clothings of the Victim In gunshot wounds, holes in the clothing may determine the wound of entrance whole presence of gunpowder at the hole indicates distance. Clean-cut tears indicates use of sharp-edged instrument. Severe tearing may show struggle. The degree of soaking of the clothing with blood may depict hemorrhage. From Examination of the Assailant Determination of the degree of intoxication, mental condition, physical power, etc of the offender may be necessary. From the Scene of the Crime CHAPTER XIII GUNSHOT WOUNDS

Death or physical injuries brought about by the powder propelled substances may be due to the following:  Firearm shot - The injury is caused by the missile propelled by the explosion of the gunpowder in the cartridge shell and at the rear of the missile. The missile may be single as in the case of a pistol or revolver or multiple shots or pellets in case of a shotgun.  Detonation of high explosives as in grenades, bombs and mine explosion. Firearm Wound

as being of small caliber and limited range are used a toys. The barrel of any firearm shall be considered as complete firearm for all purposes thereof (Section 877, Revised Administrative Code) Penal Provisions of Law Relative to Firearm Alarms and Scandals (Art. 155, Revised Penal Code) The penalty of arresto menor or fine not exceeding 200 pesos shall be imposed upon: 1. Any person who within any town or public place shall discharge any firearm, rocket, firecracker, or other explosive calculated to cause alarm or danger; xxxxxxxxxx Discharge of Firearms (Art. 254, Revised Penal Code) Any person who shall shoot at another with any firearm shall suffer the penalty of prision correccional in its minimum and medium periods, unless the facts of the case are such that the act can be held to constitute frustrated or attempted parricide, murder, homicide or any other crime for which higher penalty is prescribed by any of the articles of the Code. Classification of Small Firearms Small firearms are those which will propel projectile of less than one inch in diameter. 1.

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As to Wounding Power a. Low Velocity Firearm - With muzzle velocity of not more than 1,400 feet/second (i.e. revolver) b. High Power Firearm - 2,200 - 2500 feet/second (i.e. military riffle)

2.

Definition An instrument used for the propulsion of a projectile by the expansive force of gases coming from the burning of gunpowder Includes rifles, muskets, shotguns, revolvers, pistols, and all other deadly weapons from which a bullet, ball, shot, shell, or other missile may be discharges by means of gunpowder or other explosives. it also includes air rifles except such

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As to Nature of the Bore a. Smooth Bore Weapon - Inside portion of the barrel is perfectly smooth (i.e. shotgun) b. Rifled Bore Firearm - The bore of the barrel has spiral lands and grooves which run parallel with one another but twisted spirally from breech to muzzle (i.e. military rifle)

3.

As to the Manner of Firing a. Pistol - Fired only by a single hand (i.e. revolver) b. Rifle - Fired from shoulder (i.e. shotgun)

FROGLETS NOTES 4.

As to the Nature of Magazine a. Cylindrical Revolving Magazine - Cartridge is in a cylindrical magazine which rotates at the rear portion of the barrel (i.e. revolver) b. Vertical or Horizontal Magazine - Cartridge is held one after another vertically or horizontally by a spring side to side or end to end (i.e. pistol)

Gunshot Wound of Entrance (Entrance Defect, Inshoot): The appearance of the gunshot wound of entrance depends upon the following: 1.

Caliber of the Wounding Weapon: Excluding other factors which may influence the size of the wound of entrance, the higher the caliber of the wounding bullet the greater will be the size of the wound of entrance.

2.

Characteristics Inherent to the Wound of Entrance: The wound of entrance, as a general rule, is oval or circular with inverted edges, except in near shot or in gazing or slap wound. The wound of exit is usually larger than the wound of entrance.

3.

Direction of the Fire: A right angle approach of the bullet will make the wound of entrance circular in shape, except when the missile is deformed or the fire is in contact or near. In cases of an acute angle of approach of the bullet, the wound of entrance is oval in shape with the contusion or abrasion collar widest on the side of the acute angle of approach.

4.

Shape and Composition of the Missile: Deformity of the bullet modifies the shape of the wound of entrance.

5.

Range: In close range fire, the injury is not only due to the missile but also due to the pressure of the expanded gases, flame and other solid products of combustion. Distant fire usually produces the characteristic effect of the bullet alone.

6.

Kind of Weapon: High power weapon has more destructive effect as compared with low power one. The shape of the bullet also plays an important role. Conical shape free end bullets have more piercing power without marked tissue destruction while missiles with hemispherical free ends are more destructive.

Types of Small Firearms of Medico-Legal Interest  Revolver - It has a cylindrical magazine at the rear of the barrel capable of revolving motion and can accommodate of five or six cartridges housed in separate chamber. It has muzzle velocity of 600 feet/second.  Automatic Pistol - More appropriately called "selfloading firearm". Empty shell is ejected when the cartridge is fired and a new one is slipped into the breech automatically. It has muzzle velocity of 1,200 feet/second.  Rifle - It has a long barrel and butt and is fired from a shoulder. A military riffle has a magazine and volt action. It has a muzzle velocity of 2,500 feet/second and a range of 3,000 feet. A miniature riffle is a single self-loading weapon. (pp.336-352) 6. Fragmentation of Hard Brittle Object in the Trajectory: Bone involvement along the trajectory may cause comminuted fracture and each bone fragment may cause additional damage on the surrounding tissues and even in the wound of exit. 7. Muzzle Blast in Contact Fire: When gun muzzle is pressed on the skin when fired, all of the products of combustion primarily the muzzle blast will penetrate the tissues causing severe mechanical destruction on account of pressure. The explosive effect will cause extensive laceration of soft tissues and fracture of bones. 8. Other Consequential Effects on the Body of the Victim: Aside from direct involvement of vital structures of the body, pressure to other organs and tissues, the gunshot wound may be the source of hemorrhage, infection, paralysis, shock, loss of functioning etc. which may cause disability or death on the victim.

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Contact Fire: The nature and extent of the injury is caused not only by the force of the bullet but also by the gas of the muzzle blast and part of the body involved. The following factors must be taken into consideration:

FROGLETS NOTES 1. The Effectiveness of the Sealing Between the Gun Muzzle and the Shin: If all the gaseous product of combustion is prevented from being spilled out, there will be more destructive effects on the tissues. 2. The Amount of Gas Liberated by the Combustion of the Propellant: The greater is the amount of gas in a confined area, the greater will be the tissue destruction. 3. Nature of Bullet: Bigger caliber bullet is obviously more destructive than smaller ones. 4. Part of the Body Involved: The nature, character and extent of injury in contact fire is different (1) when the bone is superficially located under the skin, and (2) when the bone is deeply located in loose or soft parts of the body. Pressed and Firm Contact Fire: 1.

On Parts of the Body Where Bone is Superficial: This is commonly observed on the head where the skull is just underneath the scalp. The following are the characteristics of the injuries: a. The wound of entrance is large, frequently star-shaped b. Edges of the wound may be everted. c. Areas in the entrance wound is blackened by burns, tattooing and smudging. d. Muzzle imprint, Barrel impression (Profile of the muzzle) on the skin e. The bullet may cause radiating fracture f. Blood and tissue become pink due to carbon monoxide. g. Fragments of lead and bullet jacket may be found. Metal Fouling - When the bullet travels the whole length of the tight fitting barrel, it is rotated by the lands and grooves. Its surface is scraped by the lands and the scraping is ejected from the barrel and strikes the target. It may lodge on the clothings or may cause small abrasions or superficial lacerations on the skin around the main wound. h. Singeing of hair.

2. Parts of the Body Where the Bone is Deeply Located:

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a. Wound of entrance is usually large, circular and without radiating laceration. b. Edges are everted due to outward slapping of the skin. c. Singeing of the hair, blackening of the wound due to fouling, burn, and tattooing. d. Muzzle imprint due to outward slapping of the skin and heat. e. Pinkish color of the deeper structures due to carbon monoxide. Loose Contact or Near Fire: 1. Entrance wound may be large circular or oval depending upon the angle of approach of the bullet. 2. Abrasion collar or ring is distinct. 3. Smudging, burning and tattooing are prominent with singeing of the hair. 4. Muzzle imprint may be seen depending upon the degree of slapping of the skin of the gun muzzle. 5. There is blackening of the bullet tract to a certain depth' 6.Carboxyhemoglobinispresentinthewoundandsurrounding areas. Short Range Fire (1 to 15 cm. distance) Medium Range Fire (more than 15 cm. but less than 60 cm) Fired More Than 60 cm. Distance Instances When the Size of the Wound of Entrance Do Not Approximate the Caliber of the Firearm: In distant fire, the rule is that the diameter of the gunshot wound of entrance is almost the same as the caliber of the wounding firearm, but in the following instances, the rule is not followed: 1. Factors which make the wound of entrance bigger than the caliber: a. In contact or near fire b. Deformity of the bullet which entered c. Bullet might have entered the skin sidewise d. Acute angular approach of the bullet 2. Factors which make the wound of entrance smaller than the caliber: a. b.

Fragmentation of the bullet before penetrating the skin Contraction of the elastic tissues of the

FROGLETS NOTES In shotgun fire, the size of the wound of entrance is dependent upon the distance of the fire. Near fire causes concentration of entry of the pellets, and as distance increases the pellets disperse with individual pellets causing individual wounds of entry. Only in this instance may the wound of entrance of the same size as the gauge of the shotgun pellets. Other Pieces of Evidence or Findings Used to Determine Entrance of Gunshot: 1. Examination of the clothing, if involved in the course of the bullet 2. Examination of the internal injuries caused by the bullet 3. Testimony of witnesses: Determination of the Traiectory of the Bullet Inside the Body of the Victim: 1.

External Examination :

a. Shape of the Wound of Entrance b. Shape and Distribution of the Contusion or Abrasion Collar c. Difference in Level Between the Entrance and Exit Wounds d. By Probing the Wound of Entrance 2.

Internal Examination :

a. Actual Dissection and Tracing the Course of the Wound at Autopsy b. Fracture of Bones and Course in Visceral Organs c. Location of Bone Fragments and Lead Particles d. X-ray examination Exit (Outshoot) Wound: An exit wound does not show characteristic shape unlike the wound of entrance. It may be slit-like, stellate, irregular or even similar to the wound of entrance. This is due to the absence of external support beyond the skin so the bullet tends to tear or shatter the skin while sufficient amount of kinetic energy is still in the bullet during the process of piercing the skin. Variation on the shape of the wound of exit may be attributable to the deformity of the bullet in its passage in the body and to the wabbling and stumbling movement of the bullet during its course and fragmentation of the missiles. Shored Gunshot wound of Exit - If the place where the gunshot wound of exit is pressed on a hard object as

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when the victim is lying on his back on a hard object or in small caliber shots the wound of exit tends to be circular or nearly circular with abrasion at its border. It is also observed that tight-fitting clothings, waist band, belt collar, brassiere may also support the skin to enhance formation of a circular wound of exit. Distinction Between Gunshot Wound of Entrance and Wound ot Exit: Entrance Wound Exit Wound Appears to be smaller than Always bigger than the the missile owing to the missile elasticity of the tissue Edges are inverted. Edges are everted Usually oval or round It does not manifest any depending upon the angle definite shape of approach finite shape of the bullet. "Contusion collar" or ―Contusion‖ is absent "Contact ring is present due to the invagination of the skin and spinning of missile Tattooing or smudging may be present when firing is near Underlying tissues are not protruding. Paraffin test may be positive

Always absent.. Underlying tissues may be seen protruding from the wound. Paraffin test always negative.

The "Odd and Even Rule" in Gunshot Wounds: If the number of gunshot wounds of entrance and exit found in the body of the victim is even the presumption is that no bullet is lodged in the body, but if the number of the gunshot wounds of entrance and exit is odd, the presumption is that one or more bullets might have been lodged in the body. The rule is merely presumptive and actual inspection and autopsy will verify the truth of the presumption. It may be possible that all of those wounds or a majority of them are entrance wounds with some bullets lodged, yet the number may still be even. How to Determine the Number of Fires Made by the Offender:

FROGLETS NOTES l. Determination of the Number of Spent Shells: 2. Determination of Entrance Wounds in the Body of the Victim 3. Number of Shots Heard by Witnesses Instances when the Number of Gunshot wounds of Entrance is Less than the Number of Gunshot Wounds of Exit in the Body of the Victim: 1. A bullet might have entered the body but split into several fragments, each of which made a separate exit. 2. One of the bullets might have entered a natural orifice of the body, e.g. mouth, nostrils, thereby making it not visible and then producing a wound of exit. 3. There might be two or more bullets which entered the body through a common entrance and later making individual exit wounds. 4.

In near shot with a shotgun, the pellets might have entered in a common wound and later dispersed while inside the body and making separate wounds of exit.

Instances when the Number of Gunshot wounds of Entrance is More than the Number of Gunshot Wounds of Exit in the Body of the Victim: 1. When one or more bullets are not through and through and the bullet is lodged in the bodY. 2. When alt of the bullets produce through and through wounds but one or more made an exit in the natural orifices of the body 3. When different shots produced different wounds of entrance but two or more shots produced a common exit wound Instances when there is No Gunshot wound of Exit but the Bullet is Not Found in the Body of the Victim: 1. When the bullet is lodged in the gastro-intestinal tract and expelled through the bowel, or lodged in the pharynx and expelled through the mouth by coughing. 2. Near fire with a blank cartridge produced a wound of entrance but no slug may be recovered. 3. The bullet may enter the wound of entrance and upon

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hitting the bone the course is deflected to have the wound of entrance as the wound of exit Determining whether the wound is Ante mortem or postmortem: If the wounds inflicted after death show no evidence of profuse hemorrhage, or there are signs of vital reactions in the tissue, then the gunshot wound is ante-mortem. Wounds inflicted after death show no evidence of profuse hemorrhage, no retraction of the edges, and there are no vital reactions. Problems confronting Forensic physician in the identification of Gunshot Wounds: 1. Alteration of the Lesion Due to Natural process 2. Medical and Surgical Intervention 3. Embalming 4. Problem Inherent to the Injury itself 6. X-ray Examination The use of an X-ray is almost indispensable in the examination of gunshot injuries. The use of the apparatus will facilitate recovery of the lodged bullet together with the location of its fragments Special Consideration on Bullets: L. Souvenir Bullet: Bullet has been lodged and has remained in the body. Its long presence causes the development of a dense fibrous tissue capsule around the bullet causing no untoward effect. It may be located just underneath the skin to be easily palpated and may cause 'inconvenience and irritation. Deep seated location may not cause any problem to warrant its immediate removal. 2. Bullet Migration: Bullet that is not lodged in a place where it was previously located. A bullet which strikes the neck may enter the air passage, and it may be coughed out or swallowed and recovered in the stomach or intestine. Bullets Embolism - a special form of bullet migration when the bullet loses its momentum u'hile inside the charnber of the heart or inside the big blood vessels and carried by the circulating blood to some parts of the body where it may be lodged. It may cause sudden loss of function of the area supplied or death if vital organs are involved. 3. Tandem Bullet: Two or more bullets leaving the barrel one after another. In cases of misfire or a defect in the cartridge, the bullet may be lodged in ihe barrel and a succeeding shot may cause the initial and the succeeding bullet to travel in tandem. There is a strong possibility for them to enter the target in a common hole. This might

FROGLETS NOTES create doubt to the statement made by the firer that he made only a single shot, but ballistic examination can show as to whether the bullet travelled in tandem. GUNSHOT WOUNDS MAY BE SUICIDAL, HOMICIDAL OR ACCIDENTAL Pieces of evidence that tend to show that the Gunshot(s) wound is Suicidal: 1. The shot was fired in a closed or locked room' usually in the office or bedroom. 2. The death weapon is almost always found near the place where the victim was found. 3. The strot was fired with the muzzle of the gun in contact with the part of the body involved or at close range. The wound of entrance may show signs of muzzle impression, burning, smudging and tattooing. 4. The location of the gunshot wound of entrance is in an accessible part of the body to the wounding hand. It may be at the temple, roof of the mouth, precordial or epigastric region. A person committing suicide wilI do the act in his most convenient way, unless he has the intention of deceiving the investigator. 5. The shot is usually solitary. If the shot is made on the head involving the brain, the shocking effect of the injury will not make him capable of firing another shot. However, shots in some parts of the body which may not produce immediate death cir sudden loss of consciousness, the possibility of additional shots is not remote 6. The direction of the fire is compatible with the usual trajectory of the bullet considering the hand used and the part of the body involved.

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13. no disturbance in the place of death Russian Roulette: -agreement among persons to load a revolver with live cartridge; each member will cock and pull trigger with muzzle directed to the temple or other vital parts; the person who will pull trigger with live cartridge in the firing chamber will suffer the fatal consequence -may be considered suicidal Evidences to show the gunshot wound is homicidal: 1. no point of election in he wound entrance 2. fire is made when victim is at some distance 3. defense wounds (signs of struggle) 4. disturbance of the surroundings 5. wounding firearm cannot be found at crime scene 6. witness testimony Evidences to show that the wound is accidental: 1. usually one shot 2. no special area of body involved 3. determination of relative position of victim and assailant 4. witness testimony Points to be considered and included in the report of the physician: 1. complete description of wound of entrance and exit 2. location of the wound 3. direction and length of bullet tract 4. organs or tissues involved 5. location of missile, if lodges in the body 6. diagram and other illustration showing location of wounds

11. victim’s fingerprints on butt

Questions that a physician is expected to answer in court: 1. Could the wound be inflicted by the weapon? 2. At what range was it fired? 3. Direction of the fire 4. Possibility that gunshot wounds are self-inflicted 5. Signs of struggle 6. Possibility of the victim to fire or resist the attack after being injured 7. Did the victim die instantaneously? 8. Relative position of assailant and victim

12. place where the shot took place may reveal suicide note

Can the Caliber of the Wounding Firearm be determined from the size of the gunshot wound of

7. Personal history may reveal social, economic, business or marital problem which the victim cannot solve. He may have history of mental disease, depression, severe frustration or previous attempt of self-destruction. 8. Examination of the hand of the victim may show presence of gunpowder. 9. Entrance wound do not usually involve clothings.

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FROGLETS NOTES entrance? Yes. The caliber may be inferred from the diameter of the gunshot wound. Determination of the Length of Survival of the Victim: 1. nature of wound 2. organs involved 3. presence or absence of infection 4. amount of blood loss 5. physical condition of victim Capacity of the Victim to Perform Volitional Acts: Depends upon the following: 1. area of body involved 2. vital organs involved 3. resistance of victim *Injuries in the brain and spinal cord which cause incapacity to do voluntary acts negates the capacity. Determination as to length of time a firearm had been fired: 1. Odor of the gas inside the barrel *mixture of gases has peculiar characteristic order which is noticeable several hours afar discharge. Later, the odor will disappear as gases usually evaporate or chemical transform to doorless compounds 2. Chemical changes inside the barrel 3. Evidence that may be deduced from the wound 1. age of wound 2. degree of healing 3. degree of infection Determination Whether the Wounding Weapon is an Automatic Pistol or Revolver: 1. Location of empty shells revolver VS automatic pistol in clylindrical magazine chamber after fire driven out of weapon after shot 2. Nature of spent bullet revolver VS automatic pistol no coating bullet is copper jacketed 3. Nature of base of cartridge or spent shell revolver VS automatic pistol wider diameter than no such difference that of cylindrical body

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*It is not possible to determine the direction of the shot from the direction of the sound UNLESS that flash or the person firing the shot is seen at that time. *It is impossible to distinguish and memorise the report from two firearm of the came caliber. *It may be possible for a person who is accustomed to sound of firearms of different calibers to identify firearm by the sound produced. Gunshot wound may not be a near fire: 1. when a device is set up to hold the firearm 2. clothings are interposed between the victim and the firearm 3. failure of examining physician to distinguish between a near or far shot wound 4. product of a near shot wound has been washed out of the wound X-ray examinations may: 1. facilitate location of bullet 2. reveal fragmentation and location 3. show bone involvement 4. reveal trajectory of bullet 5. show effects of bullet wound and other injuries SHOTGUN WOUNDS Shotgun- shoulder-fired firearm having a barrel that is smooth-bored Classes of shot in a shotgun shell: 1. Birdshot- shot are small (0.5 inch to 0.15 diameter); use for hunting fowls and small animals 2. Buckshot- shot ranges form 0.24 to 0.33 inch in diameter; fewer in number of shots (9shots) 3. Single Projectile (rifled slug)- only a single or slug in a shell Systems employed in the determination of the diameter of barrel of a shotgun: 1. Gauge System - determination of number of lead balls, each fitting of the bore totals to one pound in weight 2. Expression of the bore diameter in inches-0.410 bore shotgun is the only shotgun at present designated 3. Metric system - bore in millimeters *Not standard length of barrel.

FROGLETS NOTES Grade of choke: 1. Unchoke- diameter of barrel from rear to muzzle is the same 2. Choke- diameter of barrel at muzzle end is smaller than rest of the barrel *The lethal range is in an area of 30 inches in diameter at 30 to 40 yards according to degree of choking. Types of shotgun: 1. As to number of barrel a. Single Barrel Shotgun b. Double Barrel Shotgun 2. As to manner of firing and reloading: a. Bolt action b. Lever Action c. Pump action d. Autoloading *A shotgun cartridge is usually 2-3/4 or 3 inches long and diameter depends on the gauge of the firearm Shotgun wound of entrance: 1. Contact or near contact shot - not more than 6 inches Indicators: a. shape of wound b. entrance wound is burned c. blackening due to smoke d. gunpowder tattooing is densely located e. contusion of tissue f. singeing of hair (less than 6 inches) g. disrupted deeper tissues h. presence of carbon monoxide along the bullet tract i. recovery of wad together with shot (pellets) 2. Long range shot - more than 6 inches skin-muzzle distance Indicators a. 2-3 feet muzzle distance-> single wound of entry b. 3-4 feet distance-> serrated wound of entry referred to as ―rat hole‖ c. 5-6 feet-> wad tends to produce independent injury, usually an abrasion d. 6 feet-> shots begins to separate from conglomerate shot 10 feet-> produces independent wounds of entry ―Billiard ball ricochetted effect‖- tendency for one shot to stoke another causing changes of the shot course

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e. smudging due to smoke up to 15 inches f. gunpowder tattooing up to 24 inches g. in an unchoked shotgun, to estimate the distance: measure the distance between the farthest shot in inches and subtract one, the number obtained will give the muzzle-target distance in yards *A close shot produces more serious injuries because of concentration on specific target and greater kinetic energy of pellets. DETERMINATION OF THE PRESENCE GUNPOWDER AND PRIMER COMPONENTS

OF

The importance of determining the gunpowder on the skin of the victim: 1. Determination of the distance of the gun muzzle from the victim’s body when fired *The presence of gunpowder at or near the wound of entrance shows that the gun muzzle when fired is not more than 24 inches but its absence will not preclude near fire because other factors might have intervened 2. Determining whether a person has fired a firearm *When a person fires a gun, the powder particles which escape may cling on the dorsum of the hand *Detection of metallic residue on the primer palm hand may indicate that the individual was making a defensive movement trying to ward off the weapon *In suicide, residue may be deposited on the palm of the hand used to steady the barrel at the time of discharge Procedures in determining the presence of gunpowder: 1. Gross examination or examination with the use of hand lens *This examination is not conclusive because other foreign particles may be mistaken for gun powder or other primer components. 2. Microscopic examination 3. Chemical tests a. Laboratory test to determine firearm residues *There is inference of contact or near distance of the gun muzzle to the skin when there is burning, tattooing, smudging visible *The same test may be applied to dorsum of hand of persons suspected to have fired the gun

FROGLETS NOTES *The test may involve determination of presence of gunpowder residues of primer components

the

Test for the presence of gunpowder residues: 1. On the skin (Dorsum of the hand or site of the wound of entrance): 1. Dermal nitrate test (Paraffin test, Diphenylamin test, Lung’s test or Gonzales’ test) *The presence of small particles containing either nitrate or nitrite will be indicated by a blue reaction of the particles upon contact with Lung’s reagent. *Test is not conclusive as to the presence of gunpowder because fertilizers, cosmetics, cigarettes, urine and other nitrogenous compounds with nitrites and nitrates will give a positive reaction *Subjection of suspect is not selfincriminatory; act purely mechanical 2. On clothing's (Especially coloured ones) Walker’s tes (C-acid test, H-acid test) *A glossy photographic paper is fixed thoroughly in hypo solution for 20 minutes to remove all silver salts and then washed for 45 minutes and dried. *If unburned powder grains are present, it will result to production of dark red or orange-brown spots on the prepared paper. Test for the presence of Primer Components: 1. Harrison and Gilroy Test *A cotton swab moistened with 0.1 molar hydrochloric acid is used to gather antimony, barium and lead. *The test does not enjoy substantial utilisation in forensic laboratory because: 1. lacks specificity of color reaction 2. inadequately sensitive 3. interference of color reaction among three elements themselves 4. development of instability of color 2. Neutron Activation Analysis (NAA) *A sample is obtained from the hands by the use of paraffin or washing the hand with dilute acid. It is then exposed to radiation from a nuclear react emitting neurons. *The test requires access to a nuclear reactor (very expensive test) *Unable to detect lead *Principle: Barium and antimony are converted into isotopes by means of neutron

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bombardment, afterwards their quantity is measured. 3. Flameless Atomic Absorption Spectroscopy (FAAS) *Sample of hand washing is subjected to a high temperature to vaporise the metallic elements of the primer residue. *This method is quick, sensitive and employs equipment within economic means *Can determine presence of barium, antimony and lead 4. Use of Scanning Electron Microscope with a Linked Xray Analyzer *Adhesive material is used to remove any residue particles from the hand. The material then examined under the scanning electron microscope with a linked X-ray analyzer. FIREARM IDENTIFICATION Factors: 1. Caliber of the weapon 2. Fingerprints *may determine if homicidal or suicidal nature of death 3. Fouling of the barrel *recently fired firearm may have a characteristic door smoke inside the barrel 4. Serial number Procedure of restoring serial number if tampered: 1. Cleaning *All oil, dirt, grease and paint should be removed with gasoline, xylol and acetone 2. Polishing (Most important) *Whole surface should be smoothly polished using a fine file followed by a medium to fine grade carborondum cloth *The area should always have the mirror-like surface 3. Etching *For all iron or steel materials, the following etching may be used Hydrochloric acid - 80 cc Distilled water - 60 cc Ethyl alcohol - 50 cc Copper chloride - 10 grams *The solution is swabbed until the numbers appear. 4. Ballistic examination *Ballistics - study of physical forces reaction on projectiles *Foreign ballistics - also known as firearm identification; deals with examination of fired bullets

FROGLETS NOTES and cartridge cases in a particular gun to the exclusion of all others Three separate and distinct area of Ballistics: 1. Interior Ballistics - deals with what happened to the cartridge and its bullet from the time trigger is pulled until the bullet exits from the barrel 2. Exterior Ballistics - deals with what happened to the bullet or projectile from the moment it leaves the gun barrel to the moment of impact on the target or object 3. Terminal Ballistics- concerns with the effect of the bullet on the target or until it comes to rest 4. Medical Ballistics- concerned with the penetration, severity and appearance of the wound due to bullet or missile Basic Principles Involved in Firearm Identification: 1. Quality of metal in the manufacture of firearm is much harder and resistant to deformity than the quality of metal used n the manufacture of cartridge. In the process of contact between the part of the gun involved and the cartridge, the surface condition of the part of the gun can easily be impressed on the shell or bullet. 2. Firearms have certain physical characteristics of certain type of caliber which differentiate it from others. 3. No two firearms can be manufactured with identical surface characteristics; referred to as ―individual characteristics‖ Instruments Use in Firearm Identification: 1. Comparison Microscopes- instrument consists of two compound microscopes which allows comparison of two objects by looking through single eyepiece. The individual or accidental characteristics of two objects may be compared. There is an attachment for photographic camera to facilitate the taking of pictures of the findings. 2. Bullet Recovery Box- instrument for the purpose of recovering the test bullet and shell. It is a long cylindrical container filled with cotton and an open shooting end. *The test shell and bullet may be used for comparison with the evidence bullet or shell. Other ways of recovering test bullet as used in other countries: 1. Shot may be fired on a box with oil and sawdust 2. Vertical or horizontal shot on water tank 3. Shot fired on a block of ice

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3. Hand lens 4. Sharp pointed instrument for scraping I.D. marks 5. Caliper 6. Analytical Balance See illustration on page 386 Types of marking on the examination through Comparison Microscope:

1.

2.

Impression type Mark (Stamp Mark) – the forcible application of hard surface against the softer one leaving an impression on the softer surface. E.g. striking of the firing pin on the percussion cup. Striation or serration mark – produced by a harder surface scraping, dragging, siding or slipping cross the softer one leaving a series of abrasions, serrations and scrapes. E.g. bullet surface may show the rifling marks on its surface of the barrel. When the cartridge is fired from the firearm, the following marks are found in the shell and from the bullet: Marks found in the Shell: a. b. c. d.

e.

Marks of firing pin – impressions in the percussion cap Marks from the extractor – marks found in front of the rim of the shell Marks from the ejector- marks found in the head of the shell Marks from breechblock: the impact of the shell in the bleechblock in the recoil impresses the ridges of the bleechblock and often gives identification mark characteristic of a firearm. Marks on the cylindrical surface of the shell- mark brought about by the magazine.

Marks found in the bullet:

FROGLETS NOTES

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i. The refling barrel is reflected in the bullet as it passes through it. ii. Firing pin mark: when the base of the cartridge is hit by the firing pi, the pin produces distinct markings which can be reproduced by succeeding shots. iii. Breechblock mark: as the bullet is propelled forward by the force of the expanded gas, the casing is forcibly moved backward against the breech force or recoil plate. The backward force transfers the marking on the breechblock to the base of the cartridge. iv. Extractor mark: mark made by the extractor on the cartridge rim when pulled away from the firing chamber. v. Ejector mark: mark produced by the ejector in the process of throwing away the spent shell.

a. Number of lands and groovesnumber of grooves, depth, and width depend upon the manufacturer of the firearm. b. Direction of the twist of the Rifling Marks- the direction of the spiral lands and grooves may twist to the right or to the lest. Each manufacturers of firearms make certain marks which will distinguish firearms manufacturered by them and makes specific number of spiral grooves and direction of the twist in the brrel of the firearm. The bullet recovered from the ody may show those marks in the examination and the examiner may have the presumption where the firearm came. In fire Arm Identification the Examiner must take into consideration the following: 1.

2.

gross examination or examination with magnifying lense: a. caliber of the bullet b. presence or absence of deformity or loss part c. presence of foreign elements. E.g. blood, flesh d. identity marks placed by previous possessor. Examination with the use of comparison microscope: this is the comparison between evidence shell or bullet with the test shell or bullet a.

b.

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Determination of the clss characteristics: physical characteristics of certain caliber of firearm used by the manufacturer: i. Number of rifling ii. Direction and rates of rifiling marks iii. Dimension of the lands and grooves iv. Depth of the grooves v. Style of the cannelure Determination of individual accidental characteristics:

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or

GUNSHOT WOUNDS IN DIFFERENT PARTS OF THE BODY Head and Neck 1.

Cranium: Close or near contact fire in the head may produce marked laceration of the skin, burning and tattooing of the surrounding skin. The skull is fractured without any definite shape with the linear extensions to almost all of the bones comprising the cranial box. Fire from distance with the bullet having a right angle of approach to the skull, the fracture is oval at the outer table. There will be radiating linear fractures from point of entrance. The wound exit will be clean-cut oval round

FROGLETS NOTES opening at the inner table with beveled fracture at the outer table.

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4.

The bullet may pierce the front portion of the neck and may involve the cervical portion of the spinal cord; causing instantaneous death if the upper portion is involved. If involve the carotid or jugular vessel and death may be due to profused hemorrhage. Injury to trachea and upper bronchi may cause asphyxia or aspiration pneumonia.

Grazing approach of the bullet may produce an elongated gutterlike depressed fracture of the cranium. The tangential impact of the bullet may cause it to split and it is not uncommon to see a fragment lodging in the brain substance while the other ricochet outside hitting other objects nearby.

2.

Brain Substance: Usually a rugged tunnel with a diameter larger than that of the caliber of the bullet, with mark ecchymosis of the surrounding area and filled with fresh and clotted blood. Fragments of bones may be felt in the tunneled bullet tract. In jury of the brain causes sudden loss of consciousness and incapable of voluntary movement.

Injury in the cerebral hemispheres is as a rule not immdediately fatal and the victim may survive the injury, however if the bullet courses the medulla, pons, and other vital centers causes the immediate death. Some victims may live for a while but developed epileptiform convalsions as a sequel.

3.

Face May noy cause serious trouble except that it becomes potential avenue for infection that may cause deformity.

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Neck

5.

Chest: 1. Chest wall: usually has an upward course and may involve both sides. The bullet may strike the rib, sternum or the body of the vertebra and may cause deformity or deflection of its course. When the intercostal or mammary vessel are injured there will be perfused hemorrhage. 2.

Lungs: it produces a cylindrical tunnel much larger than the diameter of the projectile with the bloody contents and ecchymotic borders. When the pulmonary vessel is involved, the profuse hemorrhage is observe that produces death before medical intervention can be done. If only the lungs is involve, the profuse hemorrhage may cause collapse of the lungs, displacement of the heart. Emphysema is present when there is marked injury to the air sacs. The victim may not die immediately but later may develop aspiration pneumonia or cerebral embolism.

FROGLETS NOTES 3.

4.

5.

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Heart: wound may be circular or stellate with subepicardial hemorrhage in the surrounding tissue. As a general rule does not prevent the victim from running, walking or to do other forms of volitional acts for death is not usually instantaneous. wound of the auricle is more rapidly fatal as compared with the would of the ventricle on the account of thickness of the musculature of the latter which produces temporary closure of the wound. Abdomen: wounds are quite frequent but not as serious as those of the chest and head because of its ability to surgical operation. It is limited to one or several organs. Bullet wound of the liver and other parenchymatous abdominal organs may cause stellate perforations which are usually larger than the caliber of the bullets that causes them. The tunnel may contain fragmented tissue, fresh and clotted blood. Loss of function, of the kidney, pancreas, etc may lead to fatal resuls. Bullet wounds in the stomach and other hollow areas are usually small on the account of he contractility of the walls. The wound entrance is smaller than the exit wound. Timely surgical intervention may prevent untoward complications. However, death due to peritonitis is not rare on the account of the spilling of its contents into abdominal cavity. Spine or Spinal Cord: injury of the spine may not involve the spinal cord but injury of

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6.

the spinal cord may be due to: a. Bullet affects the canal and the spinal cord causing either partial or complete severance b. Injury in the body of other parts of the vertebra and contusion, concussion or compression on the account of impact. Injury of the upper cervical spinal cord may cause immediate death because the vital nerve tracts may be involved. Lower spinal cord injury may cause motor or sensory paralysis and may later succumb to hypostatic pneumonia, suppuration or other complications. Extremities: it may show the characteristic lesion of gunshot wounds. Usually the wound is not so serious except when it involves the principal blood vessels and nerves. The bony tissue may involves the principal blood vessels and nerves.

CHAPTER XVII DEATH BY ASPHYXIA

Asphyxia – general term applied to all forms of violent death which results primarily from interference with the process of respiration or the condition in which the

FROGLETS NOTES supply of oxygen to the blood or to the tissues or both has been reduced below normal level.

3.

Types of death by Asphyxia: 1.

2.

3.

4.

Anoxic Death: associated with failure of the arterial blood to become normally saturated with oxygen may be due to : a. High altitude b. Traumatic crush asphyxia c. Paralysis of the respiratory centerdue to poisoning, injury or anesthesia, etc. d. Mechanical interference with the passage of air into or down the respiratory tract due to: i. Closure of external respiratory ortifice ii. Obstruction of air passage iii. Respiratory abnormalities e. shutting blood from the right side of the heart to the left without passage through the lungs Anemic Anoxic Death: this is due to a decreased capacity of the blood to carry oxygen. This condition may be due severe hemorrhage, poisoning, or low hemoglobin level in the blood. Stagnant Anoxic Death: this is brought about by the failure of circulation which may be due to heart failure, shock, or arterial and venous obstruction. Histotoxic Anoxic Death: this is due o the failure of the circulation of the cellular oxidatives process, although the oxygen is delivered to the tissues, it cannot be utilized properly. Cyanide and alcohol is common agents responsible.

Phases of Asphyxial Death: 1.

2.

Dyspenic Phase: symptoms due to lack of oxygen and retention of carbon dioxide in the body tissue. Breathing becomes rapid and deep, pulse rate increase and rise of blood pressure. Convulsive phase: this is due to simulation of the cntral nervous system by carbon dioxide. The cyanosis becomes more pronounced and yes becomes staring and pupils are dilated. Visceral organs shows petechial hemorrhages known as Tardieu Spots (caused by the hemorrhage produced by the rapture of the capillaries on account of the increase if intra-capillaries pressure). The victim may become unconscious in the convulsive stage.

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Apneic Phase: is due to the paralysis of the respiratory center of the brain. The breathing shallow and gasping and the rate becomes slower till death. The heart later fails.

Classification of Asphyxia: 1. 2.

3.

4. 5. 6.

Hanging Strangulation: a. By ligature b. Manual strangulation or throattling c. Special forms of strangulations: i. Palmar strangulation ii. Garroting iii. Mugging or yoking iv. Compression of the neck with stick Suffocation: a. Closing the mouth and nostrils by solid object b. Choking or closing of the air passage by the obstruction of its lumen asphyxia by submersion or drowning. Asphyxia by pressure on the chest Asphyxia by irrespirable gases

Asphyxia By Hanging: is a form of violent death brought about by the suspension of the body by a ligature which encircles the neck and the constricting force is the weight of the body. The victim may be sitting or lying with the face down provided that the pressure is present in front or in the side of the neck. Classification of asphyxia by hanging: 1.

2.

as to location of the ligature and knot: a. typical: ligature runs from the midline above the thyroid cartilage symmetrically encircling the neck on both sides to occipital region. b. Atypical: the ligature is tied or noosed and present on one side of the neck, in front or behind the ear or on the chin. as to amount of constricting force: a. complete: body is completely suspended and he constricting force is the whole weight b. partial: body is partially suspended as when the victim is sitting, kneeling, reclining, prone or in any other positions.

FROGLETS NOTES 3.

as symmetry: a. symmetrical: the knot or noose is at the midline of the body either at the occiput or just below the chin. b. Asymmetrical: knot or noose is not is not in the midline but on the one side, with the head tilted to the side opposite the location of the noose or knot.

There may be no sliding noose at the end of the ligature. It may be tightened after it has been encircled around the neck and the pressure on the air passage, blood vessels and nerves of the neck is established when the body is suspended. 3.

Mode of Application of the Ligature The ligature may be placed around the neck with a single loop or with two or more hoops. This can be distinguished on the nature of the ligature marks. In single loop, there is but one ligature furrow, but if there are several, there will be several ligature marks with an intervening redness between the furrow. There is more pressure in a single loop ligature on account of concentration of force at the weight compare to several loops.

4.

Position of the Knot The knot or joint is usually located on either side of the neck. The head is flexed opposite the location of the knot. The level of the ligature around the neck may differentiate hanging from strangulation by ligature. In hanging, the ligature is usually pull of the constricting force, while in case of strangulation by ligature, the loop is found below the thyroid cartilage. It is not easy to retain the knot beneath the chin.

5.

Course of the ligature around the neck The usual appearance is that the groove or ligature mark is deepest opposite the location of the knot. However, if the not is just underneath the chin, the groove at the back of the neck is not deep on account of the firmer skin and muscular tissue.

Mechanism of Death: There is a ligature around the neck with a knot or with a sliding noose and the other end is fastened to an elevated object like peg, nail, window casing, door knob, tree, etc.. Upon suspension of the body, the weight causes the noose or band to tighten, producing pressure at the region of the neck. The pressure of the band will cause the air passage to constrict, the larynx is pushed backwards and its opening is closed by the contact of the anterior to the posterior laryngeal wall producing asphyxia. Pressure of the ligature may also cause compression of the superior laryngeal nerve, ceratoid arteries and jugular veins producing cerebral anoxia. Forms of furrow that develops in the neck depends upon the type of ligature, the number of loops around the neck and the point of suspension. Protrusion of the tongue depends upon how pressure is applied around the neck. If above the larynx and in an upward direction, the tongue will be pushed outward and will protrude from the mouth but if the pressure is below, the tongue is kept inside the buccal cavity. Ligature in Hanging 1.

2.

Materials used in Ligature. The thinner the ligature and the tougher the material, the more pronounced will the the mark on the skin of the neck. If the material is soft and broad the ligature impression on the neck is less marked. The rope is commonly used as ligature because it is easily available and strong. Other materials includes beddings, belts, electric wire etc. Noose

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

Gradual loss of sensibilities Sensation of constriction of the neck Loss of consciousness and muscular power Numbness of the legs and clonic convulsion Sensation of ringing inside the ear Sensation of flash of light before the eyes Face becomes red with eyes prominent and feeling of heat in the head.

If the victim is timely rescued and revived after artificial respiration, he will suffer the following symptoms: 1. 2.

Whistling sensation insede the ear Watering of the eyes

FROGLETS NOTES 3. Difficulty of breathing and swallowing 4. Sensation of number ness of both legs. All the above symptoms may last for 12 days after rescue.

c.

Cause of Death in Hanging 1. 2. 3. 4. 5. 6.

Simple asphyxia by blocking the air passage Congestion of the venous blood vessel in the brain Lack of arterial blood in the brain due to pressure on the carotid arteries Syncope due to pressure on the vagus and carotid sinus which leads to reflex irritation and paralysis of the medullary autonomic centers Injury on the spinal column and spinal cord. Any combination of the above

Time Required in the Process of Death Time is influenced by the following: 1.

Severity of the constricting force If the constricting force is only sufficient to occlude the windpipe, death may be delayed; but if the pressure is sufficient to occlude the carotid arteries, jugular veins and vagus nerve, then unconsciousness develops immediately and death is accelerated.

2.

Point of application of the ligature When the ligature is made below the larynx, death is almost instantaneous, but when applied above the larynx, death may not occur for three to five minutes. Hanging with the knot situated on one side of the neck may delay death because of closure of cerebral vessels cannot be maintained. If knot is below the jaw, maximum pressure is at the back of the neck cause merely partial occlusion of the windpipe and blood vessels of the neck, thereby delaying death.

3.

Other factors a. Physical condition of the subject b. The rate of consumption of oxygen in the blood and tissues. Treatment 1.

Induce the natural act of respiration a. Ligature must be loosened and mouth msut be wiped to remove all obstacle to free air. b. Tongue must be pulled forward and the body must be laid on back rest.

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2.

3.

Place the patient where there is free current of fresh air d. Electrical stimulation of the phrenic nerve e. Administration of respiratory stimulant, like ammonia. Stimulate the heart to renew action if it ceases to beat. a. Apply heat at the region of the precordium b. Hypodermic injection of coramine, strychnine, or other stimulants c. Administration of brandy. Maintain the natural body temperature a. Cover the body with blanket b. Place the patient in a warm room

Post mortem findings in death by hanging 1.

2.

General External Appearance a. Neck elongated and stretched with the head inclined on the side opposite the knot or noose b. Eyes closed or partially opened with pupils usually dialted on one side and small on the other side (facies sympathetic) c. Lividity or pallor of the face with swelling and protrusion of the tongue d. Hands are clenched firmly and purple colored fingernails e. Lips livid or blue f. Saliva dribbled from the mouth with froth g. State of erection or semi erection of the penis with seminal flued in the urethral meatus h. Post mortem lividity with ecchymosis are mostly marked at the legs i. Urination or defecation due to the loss of power of sphincter muscles. Internal Findings: a. Engorgement of the lungs b. Venous system contains dark-colored fluid blood. c. Right side of the heart and the big blood vessels connected with it are distended with blood. d. Blood vessels of the brain is generally congested. e. Kidneys are congested.

FROGLETS NOTES f.

3.

Sub-pleural, sub-pericardial punction hemorrhages Findings on the neck: a. Neck is flexed opposite the side where the knot is located. b. Ligature mark which forms groove is about or rather leass than the knot. c. The course of the ligature is inverted vshape with the apex of the v at the site of the knot. d. The skin at the site of the ligature is hard with red line of congestion and hemorrhage in some points. e. Ecchymosis of the neck depends upon the width and softness of the ligature. f. There may be rapture of the underlying blood vessels, muscles and other soft tissue g. The lining membrane of the blood vessels may be lacerated. h. Fracture of the hyoid bone or tracheal rings.

Different diagnosis: 1. 2.

Fold markings on the neck of an obese individual – the marks are not continuous and removed on stretching the skin of the neck Marks of tight neckwear – the location and history will differentiate this from ligature marks.

Determinations Whether Hanging is Ante Mortem or Post Mortem The principal criterion is the vital reaction. But, hanging made immediately after death may also show to a certain extent vital reaction, while hanging of a living subject whose bodily resistance has been markedly weakened may show slight vital reaction

The following finding show that hanging is ante mortem 1. 2. 3. 4.

redness or ecchymosis at the site of ligature ecchymosis of the pharynx and epiglottis line of redness or rupture if the intima of the carotid artery subpleural, subepicardial punctiform hemorrhages

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It is advisable to look for other injuries which are capable of producing death to eliminate the possibility of hanging as the cause of death. Determinations whether hanging is accidental, homicidal or suicidal 1.

Evidence in support of homicidal hanging a. Nature of windows and doors - whether entrance was forcibly opened or have been used as an escape by the offender in homicide case b. Presence of signs of struggle- furniture and beddings may be disturbed whenever there is a previous struggle. c. Presence of stains, bodily injuries in the body of the victim d. Presence of defense wounds in the body of the victim ―Lynching‖ a form of homicidal hanging usually found in southern states of US. Usually practiced by Americans against the Negros who commit crime against the white American. Whenever colored offenders are apprehended, they are hanged by means of a rope on a tree or some similar objects. The Negroes are executed without due process of the law.

B. Asphyxia by Strangulation Strangulation by Ligature: It is produced by compression of the neck by means of a ligature which is tightened by a force other than the weight of the body. It may be observed in infanticide using the umbilical cord as the constricting material. This must be differentiated from accidental strangulation during child birth, the umbilical cord is abnormally long and there is no disturbance in the wharton's jelly. Strangulation by ligature is commonly observed in rape cases, but the presence of findings in the genitalia and other physical injuries are distinctive findings. Causes of Death in Strangulation by Ligature 1. Asphyxia due to the occlusion of the windpipe. 2. Coma due to arrest of cerebral circulation. 3. Shock or syncope. 4. Inhibition of the respiratory center due to the pressure on the vagus and sympathetic nerves. Accidental, Homicidal or Suicidal Strangulation by Ligature

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FROGLETS NOTES Homicidal strangulation is the most common of the three forms of strangulation by ligature. Aside from the ligature mark in the neck, there are evidence of struggle or marks of violence in other parts of the body. Suicidal strangulation by ligature is quite rare. It may be done by placing a ligature around the neck and tightened by means of twisting a piece of stick. There are a few instances of strangulation which are accidental and most of the victims are children or epileptics who are helpless and incapable of extricating themselves. Manual Strangulation or Throttling This is a form of asphyxial death whereby the constricting force applied in the neck is the hand. Methods of Throttling 1. Using one hand 2. Using both hands with assailant in front 3. Using both hands with assailant at the back Manners of Death in Manual Strangling 1. The air passage may be blocked and death is due to asphyxia 2. The pressure on the neck may cause compression of the blood vessels and disturb the blood supply of the brain 3. The nerves of the neck may be traumatized especially the superior laryngeal branch of the glossipharyngal, hypoglossal nerves and the plexus surrounding Bifurcation of the common carotid artery or of the vagus producing shock. Accidental, Homicidal or Suicidal Manual Strangulation 1. Suicidal throttling is impossible because of the pressure of the person's own hand must be maintained for sometime but when unconsciousness begins, the hands are relaxed and the victim recovers. 2. Accidental throttling may occur but the victim never died of asphyxia but of other causes. 3. Homicidal manual strangulation is the most common. It is a method of choice in infanticide. Special Forms of Strangulation 1. Palmar Strangulation The palm of the hand of the offender is pressed in front of the neck without employing fingers. 2. Garroting A ligature, a metal collar or a bowstring is placed around the neck and tightened at the back. 3. Mugging (strangle-hold)

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This is a form of strangulation with the assailant standing at the back and the forearm is applied in front of the neck. 4. Compression of the Neck with a Stick The victim may be forced to place his back behind a post. C. Asphyxia by Suffocation Asphyxia by suffocation is exclusion of air from the lungs by closure of air openings or obstruction of the air passageway from the external openings to the air sacs. Smothering This is a form of asphyxial death caused by the closing of the external respiratory orifices, either by the use of the hand or by some other means. The nostrils and mouth may be blocked by the introduction of foreign substances, like mud, paper, cloth, etc. Suicidal smothering by means of his own hand is not possible Homicidal and accidental smothering is frequent. It may occur when a person is under the influence of alcohol, epilepsy or in any other helpless state. It is common among children. Examples: overlaying, accidental smothering of epileptic, gagging, plastic bag suffocation Choking

This is a form of suffocation brought about by the impaction of foreign body in the respiratory passage. Most of suffocation by choking is accidental, although it may be utilized in suicide or in homicide. D. Asphyxia by Submersion or Drowning This is a form of asphyxia wherein the nostrils and mouth has been submerged in any watery, viscid or pultaceous fluid for a time to prevent the free entrance of air into the air passage and lungs. Time Required for Death in Drowning Submersion for 1-1/2 minutes is considered fatal, if ordinary efforts for respiration is made, however, a person may survive even after 4 minutes of submersion. The average time required for death in drowning is 2 to 5 minutes. Emergency Treatment in Drowning Remove the bodily clothings especially the tight ones and wrap the body with blanket. Place the face down and perform artificial respiration, using any of the following methods: Schaefer's Method or Sylvester's Method.

FROGLETS NOTES Administration of stimulants as ammonia, aromatic vinegar, etc. Injection of strchnine, coramine, caffeine, etc. Inhalation of oxygen combined with 5% to 8% carbon dioxide to stimulate respiration. Floating of the Body in Drowning The body may not immediately be recovered after drowning because it is under water. The specific gravity of human body is slightly more than of the water. Within 24 hours, on account of the decomposition which causes the accumulation of gas in the body, the body floats. The floating of the body is markedly influenced by the weather, condition of the fluid medium where drowning took place, presence of wearing apparel, age, sex and body built. The body when recovered, floats usually with flexed extremities. The head is submerged because it has a higher specific gravity than the rest of the body. "tete de negri" - the bronze color of the head and neck of a person who died in water during the process of decomposition. E. Compression Asphyxia (Traumatic or Crush Asphyxia) This is a form of asphyxia whereby the free exchange of air in the lungs is prevented by the immobility of the chest and abdomen due to external pressure or crush injury. In homicidal cases, the assailant may kneel on the chest of the victim or squeeze the victim between the arms and legs as in wrestling. In accidental cases, the body may be pinned between two big objects or collapsing building on the ground. Very rarely is traumatic asphyxia attempted in suicide.

and charcoal used in heating or cooking, or gasoline engine in cars. Accidental and suicidal death by carbon monoxide poisoning is common. Victims may be accidentally imprisoned or deliberately enclose themselves in a room or garage with motor engine running or slow burning is present. Qualitative Test for Carbon Monoxide in the Blood 1. Kunkel's Test 2. Potassium Ferrocyanide Test 3. Examination Through a Spectroscope 4. Gas Chromatograph 5. Infrared Analysis Carbon Dioxide (Carbonic Gas Acid) Carbon Dioxide is the gas blown out of the lungs during respiration, product of complete combustion of carbon containing compounds, and the end result of fermentation and decomposition of organic matters. HYDROGEN SULFIDE (SULPHURETTED HYDROGEN, H2S) NATURE and CHARACTERISTICS   

Death by Crucifixion When person is nailed on a cross the weight is supported by the nailed feet. Classified as traumatic asphyxia. F. Asphyxia by Breathing Irrespirable Gases Carbon Monoxide (Carbonic Oxide Gas, Co "Silent Killer") Carbon Monoxide is formed from the incomplete combustion of carbon fuel. The fatal carbon monoxide poisoning usually involves burning wood, oil,coal, kerosene

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COLORLESS, Transparent gas, sweetish taste and emitting an odor similar to a rotten egg. Formed during a decomposition process of organic substances containing sulphur. Found in large quantities in a sewer, septic tanks, drainage pipes, and deep wells.

EFFECTS 

Burking

This is a form of traumatic asphyxial death invented by Burke and Hare for the purpose of murdering people to be sold to medical schools for dissection.

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

A dilute solution produces irritation of the eyes, nose, throat and air passages, followed by dizziness, headache, nausea, vomiting, abdominal pain, cyanosis, dilated pupils, cold extremities, and labored breathing Prolonged exposure on a diluted atmosphere may cause tetanic convulsion, delirium, stupor, coma and death.

POST-MORTEM FINDINGS    

Putrefaction sets rapidly. Offensive odor is noticed on opening the body. Blood in fluid state, dark brown in color is due to conversion of hemoglobin to sulmethemoglobin. Lungs are congested and edematous.

FROGLETS NOTES 

Other organs are congested and dark colored.

HYDROGEN CYANIDE NATURE and CHARACTERISTICS   

One of the most toxic and rapid acting gases. Formed by addition of acid to potassium or sodium salt of cyanide. Found in leaves of cherry-laurel, in bitter almond, in kernels of common cherry, plum, peaches, in ordinary bamboo shoots, and in certain oil seeds and beans.

EFFECTS 

Loss of muscular power, giddiness, slow and stertorous breathing with loss of consciousness which may or not be preceded by convulsion before death

POST-MORTEM FINDINGS       

Body is livid or violet in color Post-mortem lividity is bright red or pink due to the formation of cyanmenthhemoglobin Fingers are clenched, fingernails are blue and jaws firmly closed Eyes are bright and glistening and pupils are dilated Odor of the acid may be noticed on opening the body Heart is engorged with bright red blood Mucous membrane of the esophagus and the stomach may be congested and covered with froth.

SULFUR DIOXIDE NATURE and CHARACTERISTICS   

COLORLESS gas Employed as a disinfectant, bleaching agent Found in eruption of volcanoes

EFFECTS  

Irritation of the respiratory passage, thus causes sneezing, coughing, spasm of the glottis and suffocation Irritates the eyes and caused congestion and lacrimation

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POST-MORTEM FINDINGS 

Not characteristics but there may be cyanosis with signs of asphyxia

WAR GASES ESSENTIAL CHARACTERISTICS       

Heavier than air Capable of spreading rapidly on the area where the chemical effects is desired Capable of producing effect even in low concentration on a specified area May be a true gas, smoke, volatilized liquid or finely divided solid Manufactured in big quantity in a relatively cheap price Stable substance or not easily made non-toxic by rapid chemical reaction Capable of storage for an ample length of time

CLASSIFFICATION BASED ON THE PHYSIOLOGICAL ACTION LACRIMATOR or TEAR GAS KINDS:   

Chloracetophenone (C.A.P.) Bromobenzyl Cyanide (B.B.C.) Ethyl Iodoacetate (K.S.K.)

EFFECTS:    

Irritation of the eyes with copious flow of tears Severe lacrimation, spasm of the eyelids, congestion of the conjunctivae and temporary blindness Irritation of the respiratory passages and lungs, burning sensation in the throat and discomfort on the chest Vomiting, nausea, bronchitis and blistering of the skin

PREVENTIVE MEASURES   

Wearing of Gas mask Washing of the affected eyes with boric acid solution Sodium bicarbonate solution may be applied in other affected areas

FROGLETS NOTES VESICANT or BLISTERING GAS



KINDS

 



Mustard Gas (Dichlordiethyl Sulfide, Yellow Cross, ―Ypertite‖) Lewisite (Chlorovinyl-dichlorarsine)



Contact with the skin may cause bleb or blister formation

Hydrocyanic Acid (Hydrogen Cyanide or Prussic Acid) Hydrogen Sulfide (Sulphurated Hydrogen) Carbon Monoxide (Carbonated Oxide, C0)

CHAPTER XVIII DEATH OR PHYSICAL INJURIES DUE TO AUTOMOTIVE CRASH OR ACCIDENT

EFFECTS 

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AUTOMATIVE CRASH:

LUNG IRRITANTS (Asphyxiant or Choking Gas) FACTORS RESPONSIBLE TO AN AUTOMOTIVE CRASH

KINDS    

Chlorine (CL2) Phosgene (COCL2) Chloropierin Diphosgene

EFFECTS 

1.



When inhaled, they cause dyspnea, tightness of chest and coughing, varying degree of conjunctival irritation, vomiting, coma and death

STERNUTATOR (Nasal Irritants or Vomiting Gases) KINDS   

Diphenyl chlorarsine (D.A.) Diphenylamine chlorarsine (D.M.) Diphenyl cyanarsine (D.C.)

2.

EFFECTS 

Nausea, stricken with coryza, malaise, headache, vomiting, salivation and pain in the chest, and prostration

PARALYSANTS (Nerve Gas)



Paralysis at the myoneural junction

BLOOD POISONS KINDS

ENVIRONMENTAL FACTOR – ex. Roads, weather, absence of road signs, blind intersections, stiff and slippery road may prolong the sked time Sked time – the space of time between the actual application of the brake and the stopping of the car

3.

MECHANICAL FACTOR – ex. Defect in the steering wheel, poor brake, transmission failure, worn out tires, unstable body

4.

SOCIAL FACTOR – ex. Speed, Insurance – develop ―devil may care‖ attitude on the driver inasmuch as he will not be financially held liable for damages as a consequence of a crash PEDESTRIAN

EFFECT 

HUMAN FACTOR a. Mental Attitude – ex. Reckless driving, showing of, inattention, fatigue, inexperience b. Perceptive Defect – ex. Defective vision, defective hearing c. Delayed or Sluggish Reaction Time – Reaction Time – the space of time the driver perceives an impending danger and the actual application of the brake. d. Disease – the driver may develop an epileptic fit or suffer from a heart attack while on the steering wheel e. Chemical Factor – ex. Driving under influence of alcohol or drugs (depressant drugs, marijuana, psychotrophic drugs) , leak in the exhaust system of the vehicle

5.

INJURIES AND DEATH ON THE DRIVER AND PASSENGERS

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FROGLETS NOTES KINDS OF COLLISIONS IN AUTOMOTIVE CRASH 1. 2.

First Collision – the impact of the moving vehicle with another vehicle or a fixed object Second Collision – the impact of the unrestricted occupants with the interior of the vehicle





FACTORS RESPONSIBLE FOR PASSENGERS AND DRIVER INJURY 1. 2. 3.

Displacement of the occupants within the vehicle with impact against structures Ejection Distribution of the passengers in the compartment resulting in direct impact injuries

FRONT IMPACT CRASH 1.

2.

3.

Driver a. Severe impact of the driver’s head on the windshield may cause laceration of the scalp, face or neck. b. Impact of the lower extremities against the dashboard may cause fracture of the tibia, fibula, femur, or pelvis as well as lacerations and abrasion of the skin of the area. c. The impact of the face to the circular rim of the steering wheel may cause fractures of the teeth, jaw and facial bones. Front Seat Passenger a. Abrasion of the face and scalp. b. Laceration of the face and scalp. c. Fracture of the skull. d. Laceration or rupture of the heart. e. Crashing injury of the neck. f. Fracture of the ribs and sternum. g. Laceration of the liver and/or spleen. Rear Seat Occupants – they may strike the back of the front seat, the pillar between the front and rear side doors, or may be propelled over the front seat striking the front seat passenger and driver, dashboard or windshield.

SIDE IMPACT CRASH   

Common impact in street intersections The lateral impact to the chest may cause fracture of the ribs, contusion with laceration of the lungs. Laceration of the spleen and kidneys and pelvic may also be observed.

REAR IMPACT CRASH

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With the impact at the rear, the head moves backward or hyperextended, then the head will move forward until the chin strikes the front portion of the chest and with the neck hyperflexed. The backward and forward movement of the head is known as ―acceleration-deceleration injury‖ or ―whiplash‖. It may result to muscle spasm or injury to the ligament of the neck resulting to pain.

ROLL OVER CRASH (Turn-turtle Impact)  

In the process of rolling, the occupants may be pinned, crushed or may be thrown away and fall on the ground. On account of the ling period of the process of rolling, the passenger does not sustain severe injuries. The rolling process causes the different sides of the vehicle to absorb the force of the impact.

EJECTION OF THE OCCUPANTS  

The primary impact of the vehicle may forcibly open the unlocked door. Ejection may increase further the injury sustained by the occupant.

MEANS EMPLOYED TO MINIMIZE INJURY TO DRIVER AND PASSENGER 1.

2.

3.

4.

Use of soft padded dashboard, windshield safety glass, dashboard with perforation to allow metal to deform easily, enlarged and padded central steering wheel hub and collapsible steering column The interior of the passenger compartment, including the steering wheel, dashboard, side doors are prevented from intruding into the passenger compartment and strike the occupants. The fender, bumper and other parts of the car commonly involved in the impact are made of metal which can absorb energy, dissipate such force and prevent its transmission to the driver and passengers. Special restraints to the occupants are being applied to reduce the severity of the second collision in the forms of lap and shoulder belt and air bag. But the use of seat belt is not absolutely considered as a safety device. It may cause

FROGLETS NOTES injuries to the abdominal wall, visceral organs and vertebral column. Seat belt Syndrome – the acute flexion of the trunk (jackknifing) with the belt as the central fulcrum may cause fracture of the trunk with the visceral organs in forward motion, may stretch the mesentery and causes injury to the intestine and mesentery itself. There may be abrasion, contusion and hematoma of the lower portion of the abdomen.



Accounts for the multiple abrasions and contusions on the body of the pedestrian-victim

3.

RUN OVER INJURIES

  

The pedestrian may be run over by the moving vehicle during the initial impact or thereafter Usually, the victim dies of shock Crash fracture, skid or tire marks, rupture of organs and internal hemorrhage may be seen at autopsy

4.

HIT-AND-RUN INJURIES



A fast moving vehicle may run over, hit or sideswipe a pedestrian or collide with another vehicle or fixed object and get away from the scene without regard to the unfortunate victim This usually happens when the driver is drunk or ―high‖ at night time, in an isolated road and with no eyewitnesses or someone who could take note of the identity of the vehicle

SUICIDAL CRASH   

Usually a single vehicle and single occupant crash Head on collision with roadside object, pole or bridge support at a high speed. No evidence of any effort to apply the brake or to avoid striking the object (foot still on the accelerator pedal)



HOMICIDE BY MOTOR VEHICLE  

The simulation of a crash may occur to conceal a prior homicide Victim of other means of violent death may be placed on the road to simulate that he is a victim of ―hit and run‖.

EVIDENCE IN VEHICULAR CRASH 1.

FROM THE SCENE OF THE CRIME



The area of the road – a photograph sketch must be taken to determine who violated the traffic rules and regulation The skid and tire marks on the road – for identification of vehicle and whether the driver stepped on the brake immediately before the crash Condition and position of the victim – whether pedestrian or occupants Condition of the vehicle and of other structures in the vicinity Blood, paint strains, pieces of clothing that may be found in the body of the victim, ground or on the vehicle Narrations of witnesses as to how the incident took place including the identity of the vehicle and the victims

PEDESTRIAN – VEHICLE COLLISION DEATH OR PHYSICAL INJURIES TO PEDESTRIAN

Summary of Legal Medicine Book by Solis



1.

PRIMARY IMPACT



First violent contact between the pedestrian and the motor vehicle The severity of the injury depends on the position of the victim when the impact occurred, speed of the moving vehicle, and the amount of bodily support (clothing and other apparel) The movement of the body after the primary impact depends on the location of the impact Bumper Fracture – Fracture of the leg bones as a consequence of the primary impact



2.

SECONDARY IMPACT

2.

FROM THE DRIVER



The subsequent impact of the pedestrian to the ground after the first impact The injury sustained by the pedestrian depends mostly on the force of the ground impact, nature of the road and part of the body involved



Fitness to drive – capacity to manipulate the steering wheel, step on the brake and accelerator, visual and hearing perception, reflex time, heart condition, history of epileptic seizure, etc.



 



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  

FROGLETS NOTES  

Alcoholic drunkenness – a person with at least 0.15% alcohol in the blood is considered drunk Injuries due to second collision – like steering hub imprint, fractured skull, multiple abrasions and laceration of the face and scalp, fracture of the leg bones, ribs and sternum

3.

FROM THE VICTIM IN VEHICLE-PEDESTRIAN COLLISION

      

Crush injury Tire Thread Marks Abrasion Marks Paint Marks Blood, hair or Clothing of the Victim Physical Defects of the Victim Inebriation of the Victim – the victim might have been under the influence of alcohol and other depressant drugs

PURPOSES OF THE AUTOPSY OF VICTIMS OF VEHICULAR ACCIDENTS 1. 2.

3. 4.

Determine deceased’s position on the vehicle or the pattern of injuries Determine whether death occurred as a result of the crash and not due to natural disease, poisoning, gunshot wound or other causes prior to the crash Question of survivorship when more than one member of the family died in a crash Size of monetary reward in a civil suit may depend on the nature and extent of the injuries suffered

MOTORCYCLE CRASH REASONS WHY THERE IS A HIGH PERCENTAGE OF MOTORCYCLE CRASH 1. 2. 3.

A motorcycle can attain a high speed compared with other ordinary road vehicle. It has a small profile that the driver of other vehicles may fall to see it. At high speed and frequently in curves, the cyclist may lose control of the brake. it may hit a fixed object, the tire may skid, or the cyclist may be drunk.

Whenever the motorcycle strikes another vehicle or a fixed object the injuries is quite severe because:

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1. 2.

Summary of Legal Medicine Book by Solis

There are so little crushable materials to absorb the impact that the motorist himself is subjected to the severe force. No restraint system is available to keep the operator and the passenger on the bike and as a result, ejection from the motorcycle is common.

Inasmuch as the cyclist is exposed to crashes, the only alternative approach is the protective wearing apparel. 1. 2. 3.

Leather jacket, thick pants, and gloves to protect the skin from injuries that result from ejection Leather boots to protect from injuries of the bones of the feet and legs. Motorcyclist helmet which must be buckled to protect the head.

CHAPTER XXI MEDICO-LEGAL ASPECTS OF SEX CRIMES A.

VIRGINITY AND DEFLORATION Virginity- is a condition of a female who has not experienced sexual intercourse and whose genital organs have not been altered by carnal connection. A woman is a VIRTOUS FEMALE if her body is pure and if she has never had any sexual intercourse with another, though her mind and heart is impure.

There is a presumption that a woman is virgin whenever it is shown that she is single and continuous until overthrown by proof to be contrary. KINDS OF VIRGINITY 1. 2.

3.

Moral Virginity- the state of not knowing the nature of sexual life and not having experienced sexual relation. Physical Virginity- a condition where a woman is conscious of the nature of the sexual life but has not experienced sexual intercourse. a. True Physical Virginity- the hymen is intact. b. False Physical Virginity- hymen is unruptured but the orifice is wide and elastic. Demi-Virginity- condition of a woman who permits any form of sexual liberties as long as they abstain from rupturing the hymen by sexual act.

FROGLETS NOTES 4.

Virgo Intacta- a truly virgin woman. There are no structural changes in her organ to infer previous sexual intercourse and that she is a virtuous woman.

PARTS OF THE FEMALE BODY TO BE CONSIDERED IN THE DETERMINATION OF THE CONDITION OF VIRGINITY. 1. 2. 3. 4. 5.

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Breast Viginal Canal Labia Majora and Labia Minora Fourchette (present a V-shape appearance as the two labia minora unite posteriorly.) Hymen a. As to the shape and size of the opening: i. Annular or Circular- the opening is oval or circular located at the center of the hymen. ii. Infantile- the opening is small. iii. Semilunar or crescentric- the concavity may be facing either side or upwards or downwards. iv. Linear- the opening is slit-like and usually running vertically. v. Cribiform- the hymen presents several openings instead of a single one. vi. Stellate- hymenal opening is like a star. vii. Septate- there are two openings separated by a bridge of hymenal tissue. viii. Fimbriated- the border of the opening shows small irregular protrusiontowards the opening. ix. Imperforate- no opening in the hymen. b. As to structure and consistency: i. Firm and with strong connective tissue and plenty of blood vessels. ii. Thick yielding hymen with scarce blood vessels. iii. Membranous hymen- hymen is parchment like, may be transparent and may be

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c.

lacerate without pain or appreciable bleeding. As to number of opening: i. Single orifice ii. Septate- two openings iii. Multiple- several openings iv. Imperforate- no opening

Virginity is NOT synonymous with Chastity. A woman may resort to many forms of homosexual as well as heterosexual practices without losing her virginity, yet she may be unchaste. B. DEFLORATION Defloration is the laceration or rupture of the hymen as a result of sexual intercourse. Parts of the female genitalia that must be examined to determine defloration: 1. 2. 3. 4.

Condition of the Vulva Fourchette Viginal canal Hymen- the fact that hymen is intact does not prove absence of previous sexual intercourse and the presence of laceration does not mean defloration. a. Other causes of hymenal laeration: i. Passage of clotted blood during menstruation ii. Ulceration due to disease iii. Jumping or running iv. Falling on hard and sharp object v. Medical instrumentation vi. Local medication vii. Self-scratching due to irritation viii. Masturbation ix. Insertion of foreign bodies x. Previous operation

IN THE MEDICAL EXAMINATION OF THE HYMEN, THE FOLLOWING FACTS MUST BE INCLUDED; a. b. c.

General condition of the hymen Original shape of the orifice (opening) If lacerated, the following must be noted:

FROGLETS NOTES i. Degree of laceration (complete, incomplete or complicated laceration) ii. Location of laceration iii. Duration of laceration(fresh bleeding, fresh healing, healed with sharp coaptible borders without congestion or healed laceration with rounded non-coaptible borders and retraction of the edges.) iv. Complications of laceration PSYCHOLOGICAL CONSIDERATION A.

B.

During sexual excitement a. Local Changes – the parasymphatetic innervations of the sex organ is from the 2nd , 3rd and 4th spinal sacral segments, and the sympathetic innervations is from the 11th thoracic down to the 1st lumbar. Brrr brrr brrr b. Sysmetic effects: i. Increase of pulse rate ii. Marked increase in blood pressure making its peak during orgasm iii. An increase of peripheral flow of blood experienced as an increase of body warmth iv. Tumescence- consequence of this peripheral flow concentrating on erectile tissue v. Increased respiration vi. A decrease in bleeding during arousal vii. A decrease of sensory perception During Orgasm In the male, orgasm is the sensation resulting from the contraction of the smooth muscles of the genital and the striated muscles of the pelvic floor coinciding with ejaculation. In the female, during orgasm, there is contraction of the smooth muscles of the uterus and rhythmic contraction of the viginal sphincter, the ischiocavernousus and the pelvic floor musculature. Brrr brr brr

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Summary of Legal Medicine Book by Solis

DEATH RELATED TO SEXUAL ACT A.

Death by male partner a. Death from natural cause- because of increased blood pressure, tachycardia and hyperventilation due to emotional response and muscular exertion. b. Death may be due to the defensive act of the woman-victim. B. Death by female partner a. The sexual intercourse might be done in a relatively confined space like the back of the seat of a car. b. In case of oral sex (fellatio) wherein the male penis is placed in the mouth of the female partner. The Size and the length of the penis may cause total or partial block of the air passage, causing asphyxia. c. In case of cunnillingus (a prevented sexual act wherein the male licks the female genital organ) the male partner may blow air in the vulva and may cause embolism especially when the woman is pregnant. d. Sadist who may not be sexually satisfied by sexual intercourse but by inflicting physical injuries to the partner . e. In concealing the crime. f. The female may die of shock as a result of the extreme trauma in case of rape. g. Hemorrhage. h. Infection C. Death of BOTH partners a. May be due to the performance of the sexual act in an enclosed place with carbon monoxide or asphyxiant gas. b. Homicide-suicide pact. Brrrr brr brr Character of the Offended Party: -The person is guilty of rape if force and violence were used regardless of the good or bad morals of the offended party. Evidences of Force or Intimidation: or -Mere initial reluctance of the offended party or verbal refusal alone will not prove force. Must be a manifested and tenacious resistance.

FROGLETS NOTES

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-Force, as an element in rape, need not be irresistible as long as it brings the desired result.

c. Sexual act on a woman under the influence of sex stimulating drugs

-If the offender is the father of the girl who is of a tender age, it is not necessary that there are signs that she put up a determined resistance.

-if did not deprive her of reason, not rape (US v. Lung), BUT local courts would consider this as rape because actually deprived her of reason

-Employment of force is established not only by testimony of the injured girl but also by the signs of finger grips on the front part of her neck, on the arms and the fact that the garments worn at the time were torn and heavily stained with blood.

2. The woman-victim is unconscious a. Sexual act committed while the woman is on her natural sleep

- Strong evidence of force is the presence of physical injures found on the person of the victim in the course of medical examination. The victim may suffer all types of physical injuries depending upon the resistance offered by her and the degree of force applied by the offender.

b. Sexual act on a woman suffering from sleeping sickness - because woman is unconscious

Rape Committed by Employment of Intimidation

-if offender inflicted physical injuries on a woman sufficient to make her unconscious before the sexual act was done

- Application of threat will cause fear in the victim of the untoward consequence. If she will not accede to the will of the offender, the crime may constitute intimidation. -Intimidation purely subjective, cannot be proven by medical evidence. Rape Committed by Depriving the Victim of Her Reason or Otherwise Made Unconscious 1. Deprival of Reason a. Rape committed on insane or mentally deficient woman -victim: woman, 14 years of age, feeble-minded and can only speak mono-syllables -sexual intercourse with insane woman -BUT, sexual intercourse with a deafmute woman is not rape in the absence of proof that she is an imbecile -proof of mental condition of the victim by medical findings of the physician who needed b. Rape committed while the woman is under the influence of alcohol or other depressant drugs -in the absence of decided cases, also

rape

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c. Sexual act on a woman who is unconscious because she was knocked-out

d. Sexual act after administration of narcotics or other "knock out" drugs 3. When the woman is under 12 years of age -called statutory rape -regardless of whether or not force or intimidation is applied or the child is not deprived of her reasons or otherwise unconscious -even if child consented or even if child a prostitute -reason: one must not take advantage of the meager intelligence and incomplete physical development of a child below the age of 12 -multiple rapes committed by each accused was independent to others -victim and accused must immediately be examined by the physician to have a strong medical evidence of rape, BUT lack of medical examination of victim NOT an indispensable element in the prosecution of rape. WON it will prosper depend upon the evidences offered. -complaint for rape NOT valid unless it is a complaint by the offended party. Information not signed by the offended party is insufficient to

FROGLETS NOTES confer jurisdiction on the court. Filing of complaint by father of a girl who is only 14 years old, sufficient compliance with RPC. Instances When Rape is Punishable by Death 1. When by reason or on the occasion of the rape, the victim becomes insane 2. When the rape is attempted or frustrated and a homicide is committed by reason or on the occasion thereof 3. When by reason or on the occasion of the rape, a homicide is committed Medical Evidences in Rape 1. Evidences from the victim -written consent from victim or guardian if not of age, if confined on correctional institution by the head of the institution -short history of the rape in writing -the following must be recorded by the physician: a. date, time and place of the alleged commission of rape -to determine how long has elapsed after alleged commission of crime before filed complaint or subjected herself to medical examination

Summary of Legal Medicine Book by Solis

e. physical and mental development of the victim -height, strength and degree of muscular development of woman must be noted to determine whether she has capacity to resist unlawful resistance -describe mental state of victim f. examination of the body for signs of violence -signs of physical violence on the body if actual force was applied -whole body subjected for inspection -may use xray for bone lesions -determine of probable age of the physical injuries-- does it correspond to the alleged date of commission? g. examination of including the breast

genitalia,

-breast roughly handled or presence of finger marks, nipples bitten, vulva swelling, hymen fresh lacerations etc.

-place: determine which court can acquire jurisdiction

-in the pubic hair the ff may be gathered:

b. date, time and place of the examination

1. pubic hair of offender

-material to the determination of the possible findings of the physician on the victim

2. semen spermatozoa 3. blood stains

c. condition of the clothings d. physician must observe the gait, the facial expression and the bodily and mental attitude of the subject

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4. body louse 2. Examination of the alleged offender

and

FROGLETS NOTES

Summary of Legal Medicine Book by Solis

a. physical development, mental condition and strength

1. Disturbances in the place of commission may infer or affirm the statement of victim that she did offer resistance

-won offender can overpower the resistance offered by the victim

2. Strands of hair, blood, seminal and other stains may be recovered to prove consummation and struggle

b. evidence of physical injuries -whole body must be examined -victim in the course of struggle may have inflicted injurie upon him

3. Pieces of personal belongings of offender and/or victim may be recovered to prove consummation and struggle 4. Investigation of witnesses who may possibly be material to the prosecution of the case may be conducted EXAMINATION FOR SEMINAL FLUID AND SPERMATOZOA

c. condition of the sex organ -blood, seminal stain, vaginal epithelium and doderleins bacillus, urethral meatus moist d. evidence from pubi hair -matted together due to blood stains or seminal fluid discharge -presence of body louse e. potency of the offender

- Semen: the viscid, albuminous fluid with faint grayishyellow color, having the characteristic fishy odor, and containing spermatozoa, epithelial cells, lecithin bodies and other substances -Spermatozoon: living organism, normally present in the seminal fluid consisting of a head, neck and tail. From 5055 microns in length. The head is ovoid and flattened when viewed in front and pearshape when viewed on the profile. -The ff specimens may be examimed for seminal fluid and spermatozoa:

- defense that he is impotent f. evidence of genital infection

accused

2. vaginal smear from victim

3. Evidences form the companion of the victim a. history of the incident, won they are consistent with narration of facts of victim b. if companion helped victim when force was applied by offender, companion must be subjected to physical and medical examination for physical injuries c. examination of clothings d. to determine whether the companion might have participated as an accomplice e. mental condition, physical power, age and emotional state to determine capacity to resist unlawful aggression from offender f. presence of alcohol or other depressants Investigation of the Crime Scene:

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1. wearing apparel of the victim and alleged

3. stains on the body of the victim and accused 4. stains found at the site of the commission of the offense PROCEDURE: 1. Gross Examinations a. Inspection by means of the naked eye or with the use of the hand lens color

-stain is grayish-white to faint yellow in b. Inspection by means of Ultraviolet light

patches

-to make visible small seminal stains or -shows bluish fluorescence

FROGLETS NOTES 2. Micro-chemical Examinations -moisten portion of stained fabric with diluted hydrochloric acid solution and let soaking stay for 1/2 to 5 hrs depending on age of stain. Allow the liquid portion to dry on the side. Perform any of the following: a. Florence Test: produced by the action of iodine on choline, not a proof of seminal fluid but only of the presence of some vegetable or animal substance, positive result: merely presumptive evidence of small fluid, negative result: in all probability it is not that of the seminal fluid b. Berberio's Test: some allege this test is specific for spermatic fluid, reaction probably depends on the presence of spermatic secretion c. Puramen Reaction: based on the presence of spermine in the prostatic fluid, Puramen reaction is found to be very reliable and rather characteristic of seminal fluid d. Acid Phosphate Test: semen produces a very high phosphate activity as compared with other body fluids the ff are needed: 1. citrate buffer solution 2. suitable substrate 3. diazonium salt 3. Microscopic Examinations -presence of complete spermatozoon will undoubtedly infer presence of seminal fluid, although semen may be present without spermatozoa, such as in cases of aspermia (semen without spermatozoa) or oligospermia (semen with few spermatozoa) a. Dr. Hankin's Method b. Gaguli's Method: best way to stain spermatozoa in India 4. Biological Examinations a. Precipitin Test (Biological test of Farnum) -to determine whether semen is of human origin or not

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Summary of Legal Medicine Book by Solis

-test of unknown semen in the same way as blood precipitin is done b. Seminal Grouping -test is of value for elimination -positive result does not definitely imply that the person is owner of sperm in question, negative result: totally exclude alleged accused as possible owner of semen How long after sexual intercourse can spermatozoa be found in the vaginal canal? Short period of time in vagina but in uterus, differing views (2 or 3 days at most, 43 hours, 17 days, more than 2 weeks, 48 hrs after intercourse) Can a woman be raped while she is on her natural sleep? Occasionally it may happen, but highly improbable. Normal virgin: hard to conceive such could be committed, BUT possible to woman who had several sexual intercourse and to those who have given birth Can a woman commit the crime of rape on a man? "commited by having carnal knowledge of a woman" thus, no. BUT, under present laws, WOMAN CAN COMMIT CRIME OF RAPE ON A MAN. (See crim :p) Can rape cause death? Although not usual, introduction of matured male sex organ into vagina of young girl may produce injury sufficient to produce death. Death may be due to hemorrhage brought about by laceration of vaginal canal, shock, subsequent infection such as gangrene or peritonitis. Laceration of vagina with accompanying hemorrhage can also occur even in adult women if man's sex organ is exceptionally big and sexual act was done roughly. Can husband commit the crime of rape on his wife? NO. Marriage is a license of the husband to have sexual intercourse with his wife. Purpose of marriage is procreation and there can be no procreation if there is no sexual intercourse. However, if there is a decree of legal separation by the court, husband may be guilty of rape on wife. Legal separation does not dissolve the matrimonial tie between husband and wife, but merely separation in bed. The husband may also be guilty of rape on his wife if he is a principal by cooperation or by inducement for the act committed by another man.

FROGLETS NOTES OTHER CRIMES AGAINST CHASTITY

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2. Incestuous Qualified Seduction -

A. SEDUCTION

a. Brother who seduces his sister b. Ascendant who seduces his descendant

A. QUALIFIED SEDUCTION

-seduction where there is blood relationship between the seducer and the seduced. Father seducing daughter or other descendants, or brother seducing sister.

Art. 337, Revised Penal Code - The seduction of a virgin over twelve years and under eighteen years of age, committed by any person in public authority, priests, house servant, domestic, guardian, teacher or any person who, in any capacity, shall be entrusted with the education or custody of the woman seduced, shall be punished by prision correcional in its minimum and medium periods.

-In this type of seduction, woman seduced need not be a virgin or may be more than eighteen years of age and the penalty is higher basis: father and brother obliged to lead the descendant or sister to the path of rectitude and morality, but instead virtually persuader her to become immoral or be a party to the condemnable act

The penalty next higher in degree shall be imposed upon any person who shall seduce his sister or descendant, whether or not she be a virgin or over eighteen years of age. Under the provisions of this Chapter, seduction is committed when the offender has carnal knowledge of any of the persons and under the circumstances described therein. Types of Qualified Seduction 1. Ordinary Qualified Seduction a. offended party must be a virgin b. offendede party must be over twelve years and under eighteen years of age c. there must be sexual intercourse between the offender and the offended party; and d. the sexual act was done through abuse of authority or confidence (1) those who acted with abuse of authority (a) Person in public authority (b) Guardian (c) Teahcher - need not be teacher, but same school (d) Person who, in any capacity, is entrusted with the education or custody of the woman seduced

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B. SIMPLE SEDUCTION: Art. 338. Simple seduction. — The seduction of a woman who is single or a widow of good reputation, over twelve but under eighteen years of age, committed by means of deceit, shall be punished by arresto mayor. Elements: 1. The offended party is over 12 but less than 18 years of age; 2. The offended party must be single or a widow of good reputation; 3. There must be sexual intercourse done by the offender with her; and 4. The sexual act must be committed by means of deceit. 

The statute making simple seduction a crime is not to punish illicit intercourse, but to punish the seducer who by means of his promise of marriage, destroyed the chastity of an unmarried female of previous chaste character, and who draws her aside from the path of virtue and rectitude, and then fails or refuses to fulfill his promise. (People v. Iman)

FROGLETS NOTES Medical Evidences in the Crime of Seduction 

Medico-legal investigation of a victim of seduction is practically the same as in the case of rape.



Medical proofs on account of the application of force, and conditions that will cause the victim to be deprived of her reason or otherwise unconscious are no longer relevant.





When the issue of age of the victim becomes a problem and its determination may be proved through medical proofs When the alleged criminal act developed into pregnancy and birth of the child, the question of paternity may be necessary.

Summary of Legal Medicine Book by Solis

Art. 339. Acts of lasciviousness with the consent of the offended party. — The penalty of arresto mayor shall be imposed to punish any other acts of lasciviousness committed by the same persons and the same circumstances as those provided in Articles 337 and 338. Elements: 1. The offender commits acts of lasciviousness; 2. The offended woman must be over 12 but under 18 years of age, except when the victim is the sister or descendant of the offender; 3. The offender commits the act by abuse of authority, confidence, relationship or deceit; 4. The victim must be a woman, virgin, single, or widow of good reputation, except when she is the sister or descendant of the offender where virginity is not required. Medical Evidences in the Crime of Acts of Lasciviousness

B. ACTS OF LASCIVIOUSNESS



Like in the crimes of rape and seduction, medico-legal investigation is involved in proving the lascivious act itself and the other elements to constitute the crime.



Physical injuries may be suffered by the victim on the part of the body where the lascivious act was committed.

Acts of Lasciviousness are acts which tend to excite lust; conduct which is wanton, lewd, voluptuous or lewd emotion. A. ACTS OF LASCIVIOUSNESS: Art. 336. Acts of lasciviousness. — Any person who shall commit any act of lasciviousness upon other persons of either sex, under any of the circumstances mentioned in the preceding article, shall be punished by prision correccional. Elements:

C. ABDUCTION

1. The offender commits any acts of lasciviousness;

Abduction is the carrying away of a woman by an abductor with lewd design.

2. The lascivious act is done under any of the following circumstances: a. By using force or intimidation. b. By depriving her of her reasons or otherwise unconscious; c. When the woman is under 12 years of age; 3. The offended party must be a person of either sex. B. ACTS OF LASCIVIOUSNESS WITH THE CONSENT OF THE OFFENED PARTY:

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Lewd design is the intent of the abductor to have sexual intercourse with the woman abducted. A. FORCIBLE ABDUCTION: Art. 342. Forcible abduction. — The abduction of any woman against her will and with lewd designs shall be punished by reclusion temporal. The same penalty shall be imposed in every case, if the female abducted be under twelve years of age. Elements:

FROGLETS NOTES

Summary of Legal Medicine Book by Solis

1. The victim abducted is a woman;

B. CONCUBINAGE:

2. The abduction is against her will;

Art. 334. Concubinage. — Any husband who shall keep a mistress in the conjugal dwelling, or shall have sexual intercourse, under scandalous circumstances, with a woman who is not his wife, or shall cohabit with her in any other place, shall be punished by prision correccional in its minimum and medium periods.

3. The abduction is with lewd design. B. CONSENTED ABDUCTION: Art. 343. Consented abduction. — The abduction of a virgin over twelve years and under eighteen years of age, carried out with her consent and with lewd designs, shall be punished by the penalty of prision correccional in its minimum and medium periods.

Ways of Committing the Crime: 1. Keeping a mistress in the conjugal dwelling;

Elements:

2. Having sexual intercourse, under circumstances, with a woman not his wife; or

1. The offended party must be a virgin;

3. Cohabiting with her in any other place.

2. The offended party must be over 12 but under 18 years old;

PROSTITUTION

3. The carrying away of the offended party is with her consent; and 4. The taking away must be with lewd design. D. ADULTERY AND CONCUBINAGE A. ADULTERY: Art. 333. Who are guilty of adultery. — Adultery is committed by any married woman who shall have sexual intercourse with a man not her husband and by the man who has carnal knowledge of her knowing her to be married, even if the marriage be subsequently declared void. Adultery shall be punished by prision correccional in its medium and maximum periods.

If the person guilty of adultery committed this offense while being abandoned without justification by the offended spouse, the penalty next lower in degree than that provided in the next preceding paragraph shall be imposed.

Prostitutes are women who, for money or profit, habitually indulge in sexual intercourse or lascivious conduct. Reasons why some women become prostitutes:    

Physiological and psychological traits; Economic factors; Home and neighborhood; Influence of contraceptives

Medico-legal Aspects of Prostitution  

Prostitution is one of the venues in spreading venereal and other diseases Evidences may be gathered to prove sexual or lascivious acts

Types of Prostitutes: 1. Call girl; 2. Hustler:

Elements:

a) Bar or tavern ―pick-up:

1. The woman is married;

b) Street walker

2. She has had sexual intercourse with a man not her husband; and 3. The man with whom she had sexual intercourse knows her to be married even if the marriage has subsequently been declared void.

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scandalous

3. Door knocker; 4. Factory Girl Effects of Prostitution

FROGLETS NOTES       

Arrest and imprisonment; Venereal infection; Social ostracism; Poor personal hygiene; Excessive use of alcohol; Irregular habit of eating and sleeping; Demoralization and physical deterioration

Summary of Legal Medicine Book by Solis

a superior officer; 2. Any warden or other public officer directly charged with the care and custody of prisoners or persons under arrest who shall solicit or make immoral or indecent advances to a woman under his custody.

Methods of Control:

If the person solicited be the wife, daughter, sister of relative within the same degree by affinity of any person in the custody of such warden or officer, the penalties shall be prision correccional in its minimum and medium periods and temporary special disqualification.

1. Legalized but regulated; or

Ways of Committing Abuse of Chastity:

2. Strict prohibition

1. By soliciting or making immoral or indecent advances to a woman interested in matters pending before the offending officer for decision or with respect to which he is required to submit a report to, or consult with a superior officer;

Medical Evidence in Prostitution- Genital examination required is the same as in any other sexual offense

OTHER PERSONS INVOLVED IN THE BUSINESS OF PROSTITUTION ARE PUNISHED BY THE FOLLOWING PROVISIONS OF THE RPC: A. Corruption of Minors: Art. 340. Corruption of minors. — Any person who shall promote or facilitate the prostitution or corruption of persons underage to satisfy the lust of another, shall be punished by prision mayor, and if the culprit is a pubic officer or employee, including those in government-owned or controlled corporations, he shall also suffer the penalty of temporary absolute disqualification. (As amended by Batas Pambansa Blg. 92). B. White Slave Trade: Art. 341. White slave trade. — The penalty of prision mayor in its medium and maximum period shall be imposed upon any person who, in any manner, or under any pretext, shall engage in the business or shall profit by prostitution or shall enlist the services of any other for the purpose of prostitution (As amended by Batas Pambansa Blg. 186.) C. Abuse Against Chastity: Art. 245. Abuses against chastity; Penalties. — The penalties of prision correccional in its medium and maximum periods and temporary special disqualification shall be imposed: 1. Upon any public officer who shall solicit or make immoral or indecent advances to a woman interested in matters pending before such officer for decision, or with respect to which he is required to submit a report to or consult with

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2. By soliciting or making immoral or indecent advances to a woman under the offender’s custody; 3. By soliciting or making immoral or indecent advances to the wife, daughter or relatives with the same degree by affinity of any person in custody of the offending warden or officer. UNNATURAL SEXUAL OFFENSES AND SEXUAL ABNORMALITIES Unnatural Sexual Offenses are not only a deviation to the normal course of nature but also commonly observed manifestations of sexual perversion. Most of those persons suffering from the conditions do not exhibit criminal intent but manifesting aberrations which may be a subject-matter for the psychiatrist to treat. Provisions of the Penal Code which may be Applicable to Unnatural Sexual Offenses: 1. Grave Scandal: Art. 200. Grave scandal. — The penalties of arresto mayor and public censure shall be imposed upon any person who shall offend against decency or good customs by any highly scandalous conduct not expressly falling within any other article of this Code. 2. Immoral doctrines, obscene publications and exhibitions: Art. 201. Immoral doctrines, obscene publications and

FROGLETS NOTES exhibitions and indecent shows. — The penalty of prision mayor or a fine ranging from six thousand to twelve thousand pesos, or both such imprisonment and fine, shall be imposed upon: (1) Those who shall publicly expound or proclaim doctrines openly contrary to public morals; (2) (a) the authors of obscene literature, published with their knowledge in any form; the editors publishing such literature; and the owners/operators of the establishment selling the same; 
 (b) Those who, in theaters, fairs, cinematographs or any other place, exhibit, indecent or immoral plays, scenes, acts or shows, whether live or in film, which are prescribed by virtue hereof, shall include those which (1) glorify criminals or condone crimes; (2) serve no other purpose but to satisfy the market for violence, lust or pornography; (3) offend any race or religion; (4) tend to abet traffic in and use of prohibited drugs; and (5) are contrary to law, public order, morals, and good customs, established policies, lawful orders, decrees and edicts; 


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4. Any person who, not being included in the provisions of other articles of this Code, shall be found loitering in any inhabited or uninhabited place belonging to another without any lawful or justifiable purpose; 
 5. Prostitutes. 4. Unjust vexation or any other coercion: Art. 287. Light coercions. — xxx xxx xxx xxx

xxx xxx

xxx xxx

Any other coercions or unjust vexations shall be punished by arresto menor or a fine ranging from 5 pesos to 200 pesos, or both. SEXUAL ABNORMALITIES As to the Choice of Sexual Partner: 1. Heterosexual- sexual desire towards opposite sex. 2. Homosexual- sexual desire towards same sex. a) Overt- persons who re conscious o their homosexual cravings, and who make no attempts to disguise their intention.

(3) Those who shall sell, give away or exhibit films, prints, engravings, sculpture or literature which are offensive to morals. (As amended by PD Nos. 960 and 969). 3. Vagrants and Prostitutes:

b) Latent- persons who may or may not be aware of the tendency in that direction but are inclined to repress the urge to give way to their homosexual yearning.

Art. 202. Vagrants and prostitutes; penalty. — The following are vagrants:

3. Infantosexual- sexual desire towards an immature person.

1. Any person having no apparent means of subsistence, who has the physical ability to work and who neglects to apply himself or herself to some lawful calling;

a) Pedophilia- a form of sexual perversion wherein a person has the

2. Any person found loitering about public or semi-public buildings or places or trampling or wandering about the country or the streets without visible means of support; 3. Any idle or dissolute person who ledges in houses of ill fame; ruffians or pimps and those who habitually associate with prostitutes; 


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compulsive desire to have sexual intercourse with a child of either sex. A Pedophile may be: either oral or anal victim.

a. Homosexual pedophile- may attempt intercourse with his

b. Heterosexual pedophile- may attempt either oral, vaginal, anal,

FROGLETS NOTES intracrural intercourse as well as cunnilingus, but attempts at vaginal penetration are most common. Theories Why Adults become Interested in Children: a. Emotional congruence- Children are sexually attractive to adult:   

Children are non-dominant; Adults have low self-esteem, immaturity, socialization to male dominance or narcissism; and Unconscious impulse, compulsively to repeat child-adult sex contact to master, and his or her own early experience of child-adult sexual abuse.

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6. Gerontophilia- sexual desire with elder person. 7. Necrophilia- a sexual perversion characterized by erotic desire or actual sexual intercourse with a corpse. 8. Incest- sexual relations between persons who, by reason of blood relationship cannot legally marry. As to Instinctual Strength of Sexual Urge: 1. Over Sex: a. Satyriasis- excessive desire of men to intercourse; b. Nymphomania- strong sexual desire of women 2. Under Sex (Sexual frigidity):

b. Conditioning Modeling- behavioral modeling begins with the early childhood experience, positive or negative, and is conditioned by hormonal abnormalities, child pornography and the misattribution of arousal as being only from children. c. Blockage- alternative sexual gratification may become blocked due to poor social skills with adults of the opposite sex, anxiety about sex, unresolved oedipal conflicts, unavailability of or conflict with a committed partner, as well as repressive social sexual norms. d. Disinhibition- sexual controls may become disinhibited due to senility, dementia, mental retardation, psychosis, drug or alcohol, impulse disorders, situational stress, failure of incest avoidance, a general cultural acceptance.

a. Sexual anesthesia- absence of sexual desire or arousal during sexual act in women. b. Dyspareunia- painful sexual act in women. c. Vaginisimus- painful spasm of the vagina during sexual act. elderly.

d. Old age- weakening of sexual feeling in the

As to Mode of Sexual Expression or Way of Sexual Satisfaction: 1. Oralism- the use of the mouth as a way of sexual gratification.

4. Bestosexual- sexual desire towards animals.

5. Autosexual (Self-gratification or maturbation)- it is a form of ―self-abuse‖ or ―solitary vice‖ carried without the cooperation of another person. Types of Masturbation:

a. Fellatio (Irrumation)- The female agent receives the penis of a man into her mouth and by friction with the lips and tongue coupled with the act of sucking initiates orgasm. b. Cunnilingus- sexual gratification is attained by licking or sucking the external female genitalia

a. Conscious Type- the person deliberately resorts to some mechanical means of producing sexual excitement with or without orgasm;

c. Anilism (anilingus)- a form of sexual perversion wherein a person derives excitement by licking the anus of another person of either sex.

b. Unconscious Type- the release of sexual tension may come about via the mechanism of nocturnal stimulation with or without emission, which may also be considered as ―masturbation equivalent‖.

2. Sado-masochism (Algolagnia)- pain or cruel act as a factor for gratification.

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Sexual Abnormalities

FROGLETS NOTES

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As to Instinctual Strength of Sexual Urge: 1.



Over Sex: a. Satyriasis – excessive sexual desire of men to intercourse b. Nymphomania – strong sexual feeling of women; ―hot‖ or ―fighter‖  Both are general expressions of compulsive neurosis.

c.

3. 2.

Under-sex or Sexual Frigidity: a. Sexual anesthesia – absence of sexual arousal during intercourse in women b. Dyspaureunia – painful sexual act in women c. Vaginismus – painful spasm of the vagina during intercourse d. Old age – weakening of sexual feeling in the elderly; there is desire, but accomplishment is difficult; accompanied by odd behaviour like exhibitionism, incest, homosexuality

As to Mode of Sexual Expression or Way of Sexual Satisfaction: 1.

Oralism – use of mouth a. Fellation (Irrumation) – female receives the penis into her mouth, by friction with the lips and tongue, coupled with the act of sucking, initiates orgasm b. Cunnilungus – licking and sucking the external female genitalia c. Anilism (Anilingus) – licking the anus of another; form of sexual perversion

2.

Sado-masochism (Algolagnia) – pain or cruel act a. Flaegellation – act of whipping or being whipped b. Sadism (Active algolagnia) – infliction of pain on another is necessary or sometimes the sole factor in sexual enjoyment i. Cannibalism – biting without flesheating, but with presumed unconscious wish to consume ii. Love bites – superficial punctuate contusions seen usually at the side of the neck, breast, other body parts caused by forcible sucking of the mouth (teeth guarded by the lips) applied to the loose tissue

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Necrosadism (Lust murder) – victim dies; deviate has a strong homicidal urge, suffering from organic brain disease, a schizo, epileptic or a psychopath Masochism (Passive algolagnia) – pain or humiliation from opposite sex is the primary factor for sexual gratification

Fetishism – real or fantasied presence of an object or bodily part is necessary for sexual stimulation and/or gratification a. Anatomic – particular portions of the body (ex. breasts, buttocks) b. Clothing – shoes, handkerchiefs, undergarments, etc. c. Necrophilic – near a dead body; may or may not violate dead person d. Odor (Ospresiophilia) – pleasant or foul odor i. Urolagnia – sight of women urinating; sometimes, even a desire to drink the urine ii. Coprolognia – sight of women defecating iii. Mysophilia – filth or excretion e. Pygmalionism – statues f. Manikinism – manikins g. Narcissism – extreme admiration and love of one’s self; looking at the mirror and appreciating oneself h. Negative fetish – marked dislike for things i. Saboteur fetish – deviate does damage while he gets satisfaction (ex. cutting clothes or hair) j. Incendiarism – from setting fire k. Vampirism – sight of blood

As to the Part of the Body: 1. 2. 3.

4.

Sodomy – sexual act through anus Uranism – fingering, fondling with breast, licking parts of the body, etc. Frottage – compulsive desire of a person to rub his sex organ against some body parts of another (ex. rubbing or pressing organs against women’s buttocks in crowded places and pretends it is ―accidental‖) Partialism – special affinity to certain part of the female body; usually, intercourse is merely secondary to satisfy the sexual desire; differs

FROGLETS NOTES from frottage in that there may not only be rubbing but actual intercourse

1.

As to Visual Stimulus: 1.

2.

Voyeurism – compulsion to peep to see persons undress or perform other personal activities and usually, masturbates in excess afterwards; ―Peeping Tom‖ Mixoscopia (Scoptophilia) – watching a couple undress or during their sex intimacies

2.

3. As to Number: (sexual deviation because more than two persons are participating) 1.

2.

Troilism (Menage a trois) – three persons are participating in sexual orgies where the usual activity may be fellatio, kissing the buttock, ―suixante-neuf‖ or 69, coitus; ―eternal triangle‖ Pluralism – group of persons participate in sexual orgies; two or more couples perform intercourse in one room and may agree to exchange for ―variety’s sake‖ during the ―sexual festival‖

Other Sexual Deviates: 1.

2.

3.

Coprolalia – need to use obscene language to obtain gratification; sometimes, go beyond uttering by making some writings and sketches on the walls of toilets Don Juanism – applied by psychiatrists to describe characteristics of promiscuity and making seduction of many women as part of his career; cannot find anyone to be a permanent companion Indecent exposure (Exhibitionism) – wilful exposure in a public place of one’s genital organ in the presence of others, usually of the opposite sex; with or without masturbatory act; women may expose themselves as in ―bubble and fan‖ dances and the ―strip tease‖ acts in night clubs  People v. Aparici (G.R. 13375): Dancer in a burlesque show in a night club was apprehended and charged for immoral exhibition because her act of dancing only wearing nylon panties and patches on her breasts corrupted those minds which were susceptible to immoral influence.

Sexual Reversal:

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Transvestism (Sexo-esthetic inversion; Psychical hermaphroditism; Metamorphosis sexualis paranoia) – male derives pleasure from wearing female apparel and vice versa; generally harmless insofar as they have no desire to assault anyone, but merely to attract attention Transexualism – identify themselves with the opposite sex as completely as possible and to discard forever their anatomical sex; hate their genitalia that sometimes they attempt to castrate or mutilate themselves, take sex hormones or subject themselves to surgery Intersexuality – genetic defect wherein an individual shows intermingling of the characteristics of both sexes including physical form, reproductive organs, sexual behaviour a. Gonadal agenesis – testes or ovaries have never developed; determined very early in fetal life b. Gonadal dysgenesis – external sexual structures are present but at puberty fail to develop i. Klenefetter’s syndrome – male type where the anatomical structure is male, but the nuclear sexing is female (Chromatin positive); XXY chromosomes ii. Turner’s syndrome – structurally and phenotypically female but the ovaries are small; sterility with the absence of the second X chromosomes c. True hermaphroditism – bisexuality, having both ovaries and testicles; nuclear sex is usually female; sex character may be neutral or whichever is dominant d. Pseudohermaphrodite – anatomically of one sex but the sex character is that of the opposite sex i. Male pseudohermaphrodite – gonads are testicles but the character is effeminate ii. Female pseudohermaphrodite – gonads are ovaries but the character is masculine CHAPTER XXII PREGNANCY

Introduction Definition: state of a woman who has, within her body, the growing product of conception or a fecundated germ

FROGLETS NOTES Commencement: from time egg cell is fertilized and terminates at the time such product is expelled or delivered Duration: 270-280 days from first day or onset of last menstruation; inasmuch as some authorities consider more than two weeks as the life span of the spermatozoa in the vaginal canal, it is hard to ascertain the exact date of the fertilization; no synchrony between coitus and fertilization 

Abnormally Prolonged Gestation – extends to 300 days Minimum Period of Gestation Compatible with Viability of Child – a child born at 180 days of gestation may live; child born before this period may be born alive but is not viable or capable of living Methods of Estimating the Date of Expected Delivery: 1. From the date of the first day of the last menstruation, add seven days and count three months backward. 2. Count forward nine calendar months from the date of the first day of the last menstruation and add one week. 3. Count forty weeks or ten lunar months from the date of the first day of the last menstruation. 4. Determination of the level of the fundus of the uterus 5. MacDonald Method – distance from the symphysis pubis up to the fundus of the uterus in centimters divided by 3.5 gives the age in month gestation 6. Date of the quickening – count ahead in 24 weeks multigravidas and 22 weeks in primagravidas from date of quickening; found not to be reliable





Legal Importance: 1. 2. 3. 4.

Pregnancy is a ground for the suspension of the execution of the death sentence in a woman. (Art. 83, RPC) A conceived child is capable of receiving donation. (Art. 742, NCC) A conceived child may exercise civil rights. (Arts. 40-41, NCC) Concealment of the woman that she is pregnant at the time of the marriage is a ground for annulment of the marriage. (Arts. 85-87, NCC)

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Instances Why Some Women Claim Pregnancy Even if None Exists: 1. 2. 3. 4. 5.

Ground for suspension of death sentence in a woman Lawful plea in mitigation when charged with theft – kleptomania may be brought about by her temporary insanity due to conception Ground for widow’s larger claim Claim for the posthumous child For black-mailing purposes or inducing a man to marry her

Instances Why Some Women Deny the Existence of Pregnancy: 1. 2. 3.

No ground to become pregnant – unmarried, divorced, living separately from husbands; to defend moral and social reputation Defense when accused of infanticide or abortion Marriage inducement

Medical Evidences of Pregnancy: A. Presumptive or Probable Signs and Symptoms 1. Cessation of menstruation – it must be noted that a woman is capable of menstruating even during pregnancy during the first three months; nursing mother may not menstruate 2. Morning sickness 3. Changes in the breast 4. Progressive enlargement of the abdomen – at the end of the third month, the fundus of the uterus is at the level of the brim of the pubic bone 5. Changes in color of the vagina and softening of the cervix  Different Signs to Show Changing of Color: a. Jacquemin-Chadwick’s Sign – pale violet discoloration of the anterior wall of the vagina b. Hegar’s Sign – bi-manual examination of the gravid uterus shows extreme softening of the cervix c. MacDonald’s Sign – softening of the isthmus, fundus of the uterus is anteflex d. Goodell’s Sign – cervix of the uterus feels as hard as the tip of the nose, no pregnancy; but when as soft as the lips, uterus is gravid

FROGLETS NOTES Funic soufflé or Umbilical soufflé – whistling sound synchronous with the fetal heart 7. Ballottement – feeling perceptible to the fingers on giving sudden impulse to the child through the neck of the uterus; hand placed on abdomen 8. Braxton-Hick’s Sign – rhythmical contraction and relaxation of the uterus, perceptible to the hand on the abdomen 9. Bladder irritability or Frequent urination – usually at second month 10. Capricious appetite 11. Abnormality in pigmentation – especially in abdomen and perineum 12. Easy Fatigability – due to weight of the gravid uterus and insufficiency of nutrient and oxygen supply to the tissues due to a deviation of a portion to the growing fetus

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6.

B. Positive Signs and Symptoms of Pregnancy: 1. Hearing of the fetal heart sounds (Mayor’s Sign) – compared to ticking of a watch under a pillow; rate is 120-140 beats per minute 2. Outlining of the fetal parts – through palpation 3. Movement of the fetus (Quickening) – at the fifth month 4. X-ray Examination Laboratory Test for Pregnancy: A. Pregnancy Slide Test (PST) 1. Principle – an agglutination-inhibition reaction is used to demonstrate the hormone human chorionic gonadotropin (HCG) which is excreted into the urine during pregnancy 2. Regeants: a. Pregnancy Slide Test antiserum – human HCG antiserum from rabbit b. Pregnancy Slide Test antigen – HCG latex suspension, chemically-bound 3. Procedure: a. Place 1 drop of urine then 1 drop of PST antiserum 1 in one of the circles on the test slide and mix thoroughly. b. Add 1 drop of PST antigen 2. Shake well and mix well. c. Carefully agitate the slide with a circular motion to ensure that the fluid revolves slowly within the circle.

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d.

4.

5.

6.

Read the results after two minutes. Interpretation of results: a. No agglutination (homogeneous) – pregnant b. Agglutination (granular) – not pregnant Sensitivity – often possible within 5 days after missed menstrual period; pregnancy will be diagnosed 12 days after the missed menstrual period Remarks – fresh morning urine is preferable and suitable; if result is doubtful, repeat test after a few days

B. Gravindex HCG Slide Test – same principle and procedure involved as PST; Gravindex is merely a trade name Signs of Pregnancy in the Dead: (additional findings to the objective signs already mentioned) 1. 2. 3.

Presence of ovum or fetus Findings on the uterus itself Corpus Luteum – usually well-developed at the time of delivery

Proofs of Pregnancy: 1. Laxity of abdominal wall. 2. Presence of Striae of pregnancy on the abdominal wall. 3. Perineum is lax with a scar if there was previous laceration. Fourchette is markedly restracted. 4. Vestige only of the hymen is present. 5. Breast is lax with enlarged nipples. 6. Vaginal examination showed previous laceration of cervix. -

-

Superfecundation is the fertilization made by separate intercourses of two ova which have escaped at the same act of ovulation. Superfoetation is the fertilization of two ova which have escaped at different acts of ovulation. Spurious Pregnancy is an imaginary pregnancy usually observed among women nearing menopause or younger women who are very desirous of having children. The patient may imagine fetal movement which is in reality a muscle contraction.

Diagnosis of Fetal Death (Proof of Fetal Death):

FROGLETS NOTES 1. 2. 3. 4. 5. 6.

-

The size remains stationary even after the lapse of a number of weeks or months. Endocrine test for pregnancy is negative on more than one occasion. Cessation of fetal movement after they have been felt. Absence of fetal heart sounds after repeated and prolonged examination. Palpation of softened macerated fetal head with bones freely movable on each other and the scalp hanging over a loose sac. Breasts cease to be enlarged and become soft and flabby. In the Philippines, menstruation begins at the age of 12-14 years old and ceases at the age of 45. As long as the woman starts menstruating, she has the potential of becoming pregnant. CHAPTER XXIII DELIVERY

-

Delivery is the process by which a woman gives birth to her offspring. The study of delivery is important because proof of delivery is necessary in judicial action on: legitimacy, abortion, infanticide, concealment of birth, and in slander or libel.

Methods of Delivery: 1. Natural Route – expulsion of the products of conception through the normal passage, that is through the vaginal canal. 2. Surgical Route – expulsion of the products of conception is not through normal openings of the female generative tract but through some artificial openings brought about by surgery. Signs of Recent Delivery: 1. Languid look, with pulse and temperature slightly increased. 2. Peculiar odor which is present up to the 10th day of confinement. 3. Changes in the breast (sensation of tightness in breasts and milk may be expressed). 4. Flaccidity of the abdominal wall. 5. Linea Albicantes (Striae of Pregnancy) present in the abdominal wall. 6. Presence of Linea Negra. 7. Uterus is enlarged and palpable. 8. Laxity of the perineum with possible tear. 9. Vaginal canal is lax and with possible lacerations.

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10. Cervix is the uterus is flabby, patulous and may be torn. 11. Presence of lachial disahcrage. 12. Evidence of placenta, umbilical cord and newborn child. 13. Positive pregnancy slide test. CHAPTER XXIV ABORTION -

Abortion is the expulsion of the contents of a gravid uterus anytime before full term while others consider it as the forcible expulsion of the product of conception anytime before the age of viability. Viability is at the point at which the fetus is potentially able to live outside of the mother’s womb, albeit with respiratory aid.

Principal Elements of Abortion: 1. That the expulsion of the product of conception is induced. 2. That the fetus dies either as an effect of the violence used, drug administered or the fetus was expelled before the term of its viability. Clinical Types of Abortion: 1. Missed Abortion – an ovum destroyed by hemorrhage into the choriospace usually before the 4th month of the pregnancy. 2. Threatened Abortion – hemorrhage without dilatation of the internal os. 3. Inevitable Abortion – hemorrhage with dilatation if the internal os and the presence of rhythmical pain. 4. Incomplete Abortion – not all products of conception had been expelled from the uterus; fragments or portions of which is retained. 5. Complete Abortion – the whole product of conception is expelled. Causes of Abortion: 1. Death of the fetus 2. Abnormality of the uterus 3. Emotional condition 4. Aborifacent drugs 5. Trauma whether direct or indirect 6. Hormonal deficiency 7. Acute specific fever and high temperature Provisions of the RPC on Abortion: 1. Intentional Abortion (Elements) a. That the woman is pregnant.

FROGLETS NOTES b. c. d. 2.

3.

4.

That violence was applied, or drug was administered, or a person acts upon such pregnant woman. That the effect of such violence, drug, or acts of the offender, the fetus dies or is expelled. That the offender has the intention to abort the pregnant woman.

Unintentional Abortion (Elements) a. The woman must be pregnant. b. Violence was applied on such pregnant woman without the intention of aborting her. c. The woman aborted as a result of the violence. Abortion practiced by the woman herself or by her parents (Elements) a. The woman is pregnant. b. Abortion is intended to be committed. c. Abortion is induced by: (1) The pregnant woman herself. (2) Other persons with the consent of the pregnant woman herself. (3) The parents of the woman, or either of them for the purpose of concealing her dishonor and with the consent of the woman herself. Abortion practiced by a physician or midwife and dispensing abortive (Elements) a. The woman is pregnant. b. The physician induced or assisted in causing the abortion with the use of scientific knowledge. c. The acts done by the physician or midwife was intended to cause abortion.

Kinds of Abortion: 1. Spontaneous Abortion – occurs without any form of inducement or intervention. 2. Induced Abortion – this will not take place had it not been for some form of inducement or intervention. Induced abortion may be: a. Therapeutic Abortion – abortion purposely done to preserve the life of the mother. b. Criminal Abortion – done without therapeutic indication but with criminal intent is punishable by law. -

Post-mortem Abortion is the expulsion of the product of conception after death of the pregnant

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woman brought about by the post-mortem contraction of the uterine muscles. Reasons why some people procure Abortion: 1. Preserve the life and health of the pregnant woman. 2. Terminate prematurely illegitimate pregnancy in order to conceal the dishonor of the woman. 3. Financial difficulty. 4. To preserve body form. How Abortion is Induced or Procured: 1. By General Violence – includes intentional violence, exerting strong physical efforts and other forms of strenuous and exhaustive exercises. 2. By Local Violence – violence is applied in any portion of the generative organ. This is usually resorted to when general violence and the use of drugs fails to give the desired result. Local violence may be applied by the pregnant woman herself, by the physician, midwife or the parents. 3. By the Use of Drugs 4. By Surgical Intervention 5. Modern Methods like Amniocentesis and Vacuum Suction Complications of Abortion 1.

Immediate Untoward Effects: a.

Shock – may be due to the laceration of the uterus or the adjacent organ like the bladder, rectum, intestine or blood vessels. The injury may be due to the introduction of instruments or the application of hot fluid or corrosive substances.

b.

Hemorrhage and Anemia – Adherent placental tissue, infection, presence of foreign bodies and atony of the uterus may cause hemorrhage for failure of the uterine muscles to contract.

c.

Embolism: (1) Air Embolism (2) Fat Embolism (3)Thrombo-Embolism (4) Bacterial Embolism

d.

Infection – Pathogenic organism may be introduced into the uterus and produce systemic symptoms. If death occurs, signs of toxemia may be observed at autopsy.

FROGLETS NOTES e.

Poisoning – Lysol, corrosive sublimate, iodine solution are frequently used for vaginal douche and may cause systemic poisoning.

f.

Vaginal Inhibition – Sudden dilatation of the cervix due to the introduction of some objects may cause sudden collapse due to reflex inhibition of the vagus nerve.

g. 2.

Perforation of the bladder or any of the neighboring organs

b.

Infection – The infection may originate from the vaginal canal or from the blood stream coming from a focus of infection in the body.

Sterility – Plugging of the fallopian tubes, infection of the ovaries may cause sterility.

d.

Pelvic Adhesion – Infection and trauma may cause the uterus or vagina to become adherent to the surrounding organs or tissues.

Medical Evidences of Abortion Medical Evidences of Abortion in the Living a.

b.

Presence of external signs of violence in the form of contusions, abrasions, hematoma, open wounds of whatever form on the body surface if induced by general violence. If violence is applied locally in the generative tract, injuries of whatever form or description may be seen therein

3)

Note the size of the uterus, its consistency and location.

d.

History – Note the state of health beforehand after abortion. Inquire as to the motive of the abortion and history of having ingested with abortives.

e.

Signs of previous pregnancy:

f.

1)

Condition of the breasts

2)

Laxity of the abdominal wall

3)

Paleness of integument

4)

General body weakness

5)

Presence of characteristic lochial discharge and odor

6)

Palpability of the uterus and laceration of the cervix and perineum

Examination of the expelled product of conception 1)

Blood examination for maternity and paternity

2)

Marks of instrumentation

3)

Signs of physical violence

4)

Proof of viability or nonviability of the fetus

5)

Presence of abortives and other toxic materials in the fetal blood

6)

Presence or absence of malformation

7)

Completeness of the placenta

8)

Other identifying marks

Examination of the generative tract: 1)

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Examine the external os for softness, tear and discharge.

Examination of the instrument used for the presence of blood, placental tissue or fetal parts.

Fistula Formation – Communication between the vagina or the uterus with the rectum or bladder may be an after effect of perforation due to instrumentation.

c.

2)

c.

Delayed Untoward Effects a.

1.

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Appearance of the external genitalia and vagina may show laceration, contusion, abrasions and other marks of instrumentation.

FROGLETS NOTES

2.

g.

Laboratory test for pregnancy

h.

Testimony of the physician who completed the abortion or of other persons who witnessed the criminal act

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following: (1) infection (2) stage of pregnancy (3) other complication of abortion. e.

Medical evidence of abortion in the dead: 

Aside from the evidences of abortion in the living which may be found in the dead, the following may be observed at autopsy: a.

Evidence of instrumentation 

b.

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Like the stomach and its contents, other organs like the kidneys, liver, spleen must be subjected to a qualitative and quantitative examination for the presence of irritant poisons.

Examination of uterine contents - Remnant of the product of conception for the

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1)

Paternity test

2)

Test for pregnanc

Examination of some untoward effects of abortion: (1) infection, toxemia or bacteremia (2) embolism (3) fistulae formation (4) pelvic adhesions.

Therapeutic Abortion 

An abortion which the law allows under some justifications

Legal Justification to Therapeutic Abortion 

Art. 11, No. 4, Revised Penal Code o

Abortifacent drugs and other irritants may be found inside the stomach upon chemical examination.

Examination of the kidneys and other organs for irritants 

d.

This will include the presence of punctured wounds in the placenta, presence of remnants of the placenta inside the uterine cavity, presence of perforation of the uterus.

Examination of stomach and its contents: 

c.

f.

Biological test

Any person who, in order to avoid an evil or injury, does an act which causes damage to another, provided that the following requisites are present: (1) that the evil sought to be avoided actually exists; (2) that the injury feared be greater than that done to avoid it; (3) that there be no other practical and less harmful means of preventing it.



In the performance of an abortion, two lives are involved, namely, the life of the mother and the life of the fetus. One life must be sacrificed to save the life of another in case of therapeutic abortion.



The evil sought to be avoided is the danger on the life of the mother if such pregnancy will be allowed to continue. Such evil may be infection, organic condition or abnormality existing on the person of the woman and which under ordinary course of event will cause death.

FROGLETS NOTES 

In the evaluation as to whose life must be spared, it is a common concept that the life of the mother must be preferred than that of the unborn child. A conceived child is not definitely sure of its independent existence while the mother has already manifested real life.

2.

Abortion in order to be justifiable must be performed to save the life or to preserve the health of the mother. But modern advancement of medical science has reduced the number of diseases which will endanger the life and health if pregnancy is allowed to progress to full term. A physician must exercise due diligence in considering a disease or a combination of diseases or conditions as grounds for the therapeutic abortion.

3.

Abortion must be performed openly in a hospital to avoid suspicion that it was done for some cause other than to save the life of the mother. Abortion performed in a private clinic wherein there are no sufficient facilities to cope with emergency which may arise in the course of the operation may be a ground for malpractice.

4.

It is advisable to have the opinion of other competent physicians as to the justifiability of such therapeutic abortion. The opinion of one might be influenced by prejudice and misjudgment.

5.

Enlightened and expressed consent must be obtained from the woman herself if she has no impediment to give consent. It is advisable to have also the consent of the husband, inasmuch as abortion will affect marital relationship.

Grounds for Therapeutic Abortion: 1. 2. 3. 4. 5. 6. 7. 8.

Cardio-vascular conditions as congestive heart failure, auricular fibrillations, repeated hemoptysis, paroxysmal tachycardia. Renal conditions as chronic nephritis, previous eclampsia, pyelitis, tuberculosis Pulmonary conditions as advanced tuberculosis. Blood condition as severe anemia. Gynecological conditions as refractory chorea gravidarum. Organic nervous conditions as psychosis. Miscellaneous conditions as diabetes, exophthalmic goiter. Hereditary conditions as insanity.

Is the eminent danger of committing suicide on account of her existing pregnancy be a ground to induce therapeutic abortion to save the life of the woman? 



Hatchard v. State (48 N.W. 380 Wis.) a woman who threatened to commit suicide unless she could be relieved of the child with which she was pregnant does not present such a necessity for the performance of the operation to save the life of the woman. The intention of the law applies only to cases where death of the mother might reasonably be anticipated from natural causes unless the product of conception is destroyed. In a case cited by Camp and Purchase (Practical Forensic Medicine, p. 32, 1957), a married woman with unstable character finding herself pregnant, threatened to commit suicide. The physician whom she repeatedly made her threat during her unexpected visits referred her to a psychiatrist who recommended abortion. The operation was carried on by a reputed gynecologist but unfortunately, the patient died of gangrene of the uterus. The coroner did not recommend prosecution because the operation was done to save the life of the mother.

Safeguards to be Observed by Physician in Performing Therapeutic Abortion: 1.

The lawful abortion must be performed by a licensed physician or surgeon.

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Reasons Why It Is Difficult to Prosecute Physicians Committing the Crime of Abortion 1.

The crime is performed clandestinely by an intelligent being who is fully aware of his criminal act.

2.

The physician has several medical reasons to justify his act. There is no hard and fast rule in medicine. He may claim that there is medical justification to such abortion because the woman is suffering from a disease which might imperil her life if pregnancy will be allowed to progress to full term.

3.

In most cases, the products of conception removed which may be utilized as corpus delcti in the crime is lost.

4.

The pregnant woman herself is in connivance with the physician and it is quite difficult to let her testify truthfully as to the actual happening. She, herself, is in pari delicto to the crime of criminal abortion.

FROGLETS NOTES 5.

Medical society seems to have a lukewarm attitude in helping the state prosecute the abortionist.

a.

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Still Birth – when the child has not breathed or has not shown any sign of life after being completely born. 

CHAPTER XXV BIRTH Legal Importance of the Study of Birth 1.

2.

3.

Birth determines personality:  Art. 40,Civil Code: Birth determines personality; but the conceived child shall be considered born for all purposes that are favorable to it, provided it be born later with the conditions specified in the following article.  Art. 41, Civil Code: For civil purposes, the foetus is considered born if it is alive at the time it is completely delivered from the mother’s womb. However, if the foetus had an intrauterine life of less than seven months, it is not deemed born if it dies within twenty-four hours after its complete delivery from the maternal womb. Appearance of a child is a ground for the revocation of donation:  Art. 760, Civil Code: Every donation inter vivos, made by a person having no children or descendants, legitimate or legitimated by subsequent marriage, or illegitimate, may be revoked or reduced as provided in the next article, by the happening of any of these events. (1) if the donor, after the donation has legitimate or legitimated or illegitimate children, even though they be posthumous. Proof of live-birth must first be shown before death of the child by the prosecution in the case of infanticide:  Art. 255, RPC – Infanticide: The penalty provided for parricide (reclusion perpetua to death) in article 246 and for murder (reclusion temporal in its maximum period to death) in article 248 shall be imposed upon any person who shall kill any child less than three days of age.

Birth may be:

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b.

Causes of Still Birth 1. Immaturity 2. Congenital diseases or malformation 3. General debilitating diseases (acute specific infection, toxemia, kidney disease, acute liver disease, septicemia) 4. Local disease of the generative organ (syphilis; ablation placenta, intraplacental hemorrhage, or extensive infarction; kind of the cord; placenta previa 5. Accidents in the delivery 6. Violence, either deliberate or accidental at birth.

Live-Birth – the child after birth exhibited clear signs of vitality and viability is not necessary. 

In law, the presumption is every newborn child found dead was born dead. The burden of proof lies on those who declare otherwise. To have a child acquire a personality distinct as that of the mother, there must be proof of life after complete separation from the mother’s womb.



Proofs of Live Birth 1)

Presence of Heart Action and Circulation

2)

Movement of the Child and Crying

3)

Presence of Respiration

4)

Examination of the Stomach and Intestine

5)

Changes in the Middle Ear (Wredin’s Test: The middle ear of the a child before birth is filled with gelatinous, embryonic connective

FROGLETS NOTES

Summary of Legal Medicine Book by Solis

tissue. This disappears after the birth of the child.)) 6)

Condition of the Skin

7)

Marks of Violence

8)

Changes in the Umbilical Cord

9)

Condition of the Heart and Blood Vessels

Proof of Live-Birth can be deduced in the following: 1)

Well-developed signs of breathing

2)

Presence of air or food in the stomach

3)

Changes having taken place in the region of the umbilicus

If Born Alive, How Long Did the Child Survive? 

It is not possible to determine the exact length of time the child has lived after birth, but an approximate idea may be formed after consideration of the following points: 1)

Changes in the skin

2)

Presence of caput succedaneum

3)

Changes in the umbilical cord

4)

Changes in the circulation

Signs of Maturity of the Child at Birth 1.

Length of the fetus – 50 centimeters

2.

Weight – 3.0 kilos

3.

Lanugo hair almost disappeared

4.

Limbs and body plump

5.

Face lost its wrinkles

6.

Skin covered with vernix caseosa

7.

Head covered with hair about 2 inches long

Proof of Live-Birth can be deduced in the following: 1. 2. 3.

Well-developed sings of breathing Presence of air or food in the stomach Changes having taken place in the region of the umbilicus

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If born alive, how long did the child survive?  

It is not possible to determine the exact length of time that the child has lived after birth. An approximate may be formed after consideration of the following points: 1. Changes in the skin a. At birth – body of the child is bright-red in color; covered with vernix caseosa which may be present up to 2 days b. At a week’s time – normal color of the skin c. First 3 days after birth – exfoliation of the skin in the abdomen 2. Presence of Caput Succedaneum a. If present – the child was born with head presentation b. There are color changes in the course of its absorption c. The Caput lasts up to the 7th day

FROGLETS NOTES 3.

4.

Changes in the Umbilical Cord a. Mummification of the cord does not occur if the child is submerged in water after birth b. A mummified cord may again be soft after continuous soaking in water Changes in the Circulation a. Umbilical artery begins to contract – about 10 hours after birth b. Umbilical vein and ductus venosus obliterate – 4th and 5th day c. Ductus arteriosus – on the 3rd day d. Foramen ovale closes on the 2nd or 3rd month

Signs of maturity of the child at birth 1. 2. 3. 4. 5. 6.

Length of the fetus – 50 cm Weight – 3 kg Lanugo hair almost disappeared Limbs and body plump Face lost its wrinkles Skin covered with vernix caseosa (waxy or cheese-like white substance found coating the skin of newborn human babies) 7. Head covered with haird about 2 inches long 8. Nails project from the fingers; toe-nails reach only to the end 9. One or both testes are in the scrotum, or labia have close the vulva 10. Lower end of femur may show center of ossification about 0.6 cm in diameter CHAPTER XXVI INFANTICIDE (NEONATICIDE) Infanticide - The killing of a child less than 3 days old. RPC. Art. 255. Infanticide. — The penalty provided for parricide in Article 246 and for murder in Article 248 shall be imposed upon any person who shall kill any child less than three days of age.

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If the crime penalized in this article be committed by the mother of the child for the purpose of concealing her dishonor, she shall suffer the penalty of prision correccional in its medium and maximum periods, and if said crime be committed for the same purpose by the maternal grandparents or either of them, the penalty shall be prision mayor. Penalties   

If killing done by parents, grandparents, or other direct ascendants  penalty: parricide If killing done by any other person  penalty: murder If killing done by mother or maternal grandparents for the purpose of concealing her dishonor  lenient penalty

Problems: 1.

2.

3.

Infancy is the period in the life of a child from birth up to one year. a. Why is the crime of infanticide applied only to kiiling of less than 3-day old infant rather than within the 1st year of the life of the child? When the head and neck of the child are already out of the birth canal and the child has breathed through the lungs but the child is not yet capable of independent existence and it was deliberately put to death, is it considered infanticide? When a child was born less than 7 months of uterogestaton. With modern neonatal management, the child had all the chances to live. After a few hours after birth, the chold was deliberately killed. Is the killing a case of infanticide? Can the crime of infanticide be committed on someone who is not yet a person as contemplated by law?

Motives for committing infanticide 1. 2. 3. 4. 5.

To conceal dishonor (single, widowed, estranged from husband, living separately from husband) Financial reason Desired number of children has already been attained (substitute for ineffective family planning) Congenital abnormality of the child Mental abnormality of the parent

FROGLETS NOTES 6.

Belief that child will bring bad luck to the family

a.

Criminological Characteristics of infanticide 1. 2. 3. 4. 5.

Most often committed by the mother Almost always committed at home Crime scene: no manifest disturbance, no witnesses, no noise, no outcry Trauma applied is so minimal A newly born child found dead was born dead. Burden of proof that a living child has been killed is placed on the prosecution

What must be proven by evidence 1. 2. 3.

That the child was born alive That the child was deliberately killed That the child killed was less than 3 days old

Summary of Legal Medicine Book by Solis

2.

3. 4. 5. 6.

Presence of marks of physical violence (fingernail marks at the neck) b. Abrasion c. Contusion d. Hematoma e. Lacerated wounds f. Ligature or pressure marks on the neck Examination of mouth and upper portion of the alimentary tract (the tubular passage extending from the mouth to the anus, through which food is passed and digested) a. Can show signs of poisoning In case of poisoning, the organs must be preserved and sent to a competent toxicologist for proper analysis Laceration or other injury of the upper portion of air passage Lungs may show signs of drowning Fracture of the bones, laceration of the internal organs

How Infanticide is committed 1.

2.

By omission or neglect a. Failure to ligate the umbilical cord (if not cut or not tightly ligated, child may bleed to death) b. Failure to protect the child from heat and cold (depriving the child of necessary clothing) c. Failure to take the necessary help of a midwife or a skilled physician d. Failure to supply the child with proper food (child starved to death) e. Failure to remove the child from the mother’s discharge which resulted to suffocation By commission a. Inflicting physical injuries (use of kitchen utensils, hard or sharp objects) b. Suffocation c. Strangulatioin d. Drowning (child disposed in a sewerage disposal in a creek) e. Poisoning f. Burning g. Delibreate exposure to heat cold (direct sunshine, basin of cold water)

Post-mortem findings in cases of infanticide 1.

Complete examination of skin surfaces

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CHAPTER XXVII PATERNITY AND FILIATION 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 or father Legal importance of determining paternity and filiation 1. 2.

For succession a. Right of legitimate children is different from that of illegitimate childrem For enforcement of naturalization and immigration laws a. Naturalized citizens give ipso facto Philippine citizenship to their minor children. Thus, the minors must prove that they are legitimate children of the naturalized citizen. b. A minor child of a naturalized or permanent resident alien may be given the right to land in the Philippines upon proof that he is a legitimate child of the latter.

FROGLETS NOTES (Hello blockmates, the book used provisions from the Civil Code re: Paternity and Filiation but I think we now use the Family Code for this so I will put here the relevant FC provisions instead. Thanks.)

d.

Kinds of Children 1.

Legitimate Children a.

b.

c.

Who are considered legitimate children i. Children conceived or born during the marriage of the parents ii. Children conceived as a result of artificial insemination of the wife with the sperm of the husband or that of a donor or both are likewise legitimate children of the husband and his wife, provided, that both of them authorized or ratified such insemination in a written instrument executed and signed by them before the birth of the child. The instrument shall be recorded in the civil registry together with the birth certificate of the child. Grounds to impugn legitimacy of a child: i. That it was physically impossible for the husband to have sexual intercourse with his wife within the first 120 days of the 300 days which immediately preceded the birth of the child because of: 1. the physical incapacity of the husband to have sexual intercourse with his wife; 2. the fact that the husband and wife were living separately in such a way that sexual intercourse was not possible; or 3. serious illness of the husband, which absolutely prevented sexual intercourse; ii. That it is proved that for biological or other scientific reasons, the child could not have been that of the husband, except in the instance provided in the second paragraph of Article 164; or iii. That in case of children conceived through artificial insemination, the written authorization or ratification of either parent was obtained through mistake, fraud, violence, intimidation, or undue influence. The child shall be considered legitimate although the mother may have declared against its

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e.

f.

g.

Summary of Legal Medicine Book by Solis

legitimacy or may have been sentenced as an adulteress. If the marriage is terminated and the mother contracted another marriage within three hundred days after such termination of the former marriage, these rules shall govern in the absence of proof to the contrary: i. A child born before one hundred eighty days after the solemnization of the subsequent marriage is considered to have been conceived during the former marriage, provided it be born within three hundred days after the termination of the former marriage; ii. A child born after one hundred eighty days following the celebration of the subsequent marriage is considered to have been conceived during such marriage, even though it be born within the three hundred days after the termination of the former marriage. The legitimacy or illegitimacy of a child born after three hundred days following the termination of the marriage shall be proved by whoever alleges such legitimacy or illegitimacy. The action to impugn the legitimacy of the child shall be brought i. Within 1 year from the knowledge of the birth or its recording in the civil register, if the husband or, in a proper case, any of his heirs, should reside in the city or municipality where the birth took place or was recorded. ii. If the husband or, in his default, all of his heirs do not reside at the place of birth as defined in the first paragraph or where it was recorded, the period shall be two years if they should reside in the Philippines; and three years if abroad. iii. If the birth of the child has been concealed from or was unknown to the husband or his heirs, the period shall be counted from the discovery or knowledge of the birth of the child or of the fact of registration of said birth, whichever is earlier. The heirs of the husband may impugn the filiation of the child within the period prescribed in the preceding article only in the following cases: i. If the husband should died before the expiration of the period fixed for bringing his action;

FROGLETS NOTES ii. If he should die after the filing of the complaint without having desisted therefrom; or iii. If the child was born after the death of the husband. 2.

Legitimated Children a. Children conceived and born outside of wedlock of parents who, at the time of the conception of the former, were not disqualified by any impediment to marry each other may be legitimated.  Legitimation shall take place by a subsequent valid marriage between parents. The annulment of a voidable marriage shall not affect the legitimation.  Legitimated children shall enjoy the same rights as legitimate children.  The effects of legitimation shall retroact to the time of the child's birth.  The legitimation of children who died before the celebration of the marriage shall benefit their descendants.  Legitimation may be impugned only by those who are prejudiced in their rights, within five years from the time their cause of action accrues.

3.

Adopted Children a. Who may adopt i. Any Filipino citizen of legal age, in possession of full civil capacity and legal rights, of good moral character, has not been convicted of any crime involving moral turpitude, emotionally and psychologically capable of caring for children, at least sixteen (16) years older than the adoptee, and who is in a position to support and care for his/her children in keeping with the means of the family. The requirement of sixteen (16) year difference between the age of the adopter and adoptee may be waived when the adopter is the biological parent of the adoptee, or is the spouse of the adoptee's parent; ii. Any alien possessing the same qualifications as above stated for Filipino nationals: Provided, That his/her country has diplomatic relations with the Republic of the Philippines, that he/she has been living in the Philippines for at least three

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b.

Summary of Legal Medicine Book by Solis

(3) continuous years prior to the filing of the application for adoption and maintains such residence until the adoption decree is entered, that he/she has been certified by his/her diplomatic or consular office or any appropriate government agency that he/she has the legal capacity to adopt in his/her country, and that his/her government allows the adoptee to enter his/her country as his/her adopted son/daughter: Provided, Further, That the requirements on residency and certification of the alien's qualification to adopt in his/her country may be waived for the following: 1. a former Filipino citizen who seeks to adopt a relative within the fourth (4th) degree of consanguinity or affinity; or 2. one who seeks to adopt the legitimate son/daughter of his/her Filipino spouse; or 3. one who is married to a Filipino citizen and seeks to adopt jointly with his/her spouse a relative within the fourth (4th) degree of consanguinity or affinity of the Filipino spouse; or iii. The guardian with respect to the ward after the termination of the guardianship and clearance of his/her financial accountabilities. iv. Husband and wife shall jointly adopt, except in the following cases: 1. if one spouse seeks to adopt the legitimate son/daughter of the other; or 2. if one spouse seeks to adopt his/her own illegitimate son/daughter: Provided, However, that the other spouse has signified his/her consent thereto; or 3. if the spouses are legally separated from each other. v. In case husband and wife jointly adopt, or one spouse adopts the illegitimate son/daughter of the other, joint parental authority shall be exercised by the spouses. Who may be adopted

FROGLETS NOTES i. Any person below eighteen (18) years of age who has been administratively or judicially declared available for adoption; ii. The legitimate son/daughter of one spouse by the other spouse; iii. An illegitimate son/daughter by a qualified adopter to improve his/her status to that of legitimacy; iv. A person of legal age if, prior to the adoption, said person has been consistently considered and treated by the adopter(s) as his/her own child since minority; v. A child whose adoption has been previously rescinded; or vi. A child whose biological or adoptive parent(s) has died: Provided, That no proceedings shall be initiated within six (6) months from the time of death of said parent(s). 4.

Illegitimate Children a. Children conceived and born outside a valid marriage are illegitimate, unless otherwise provided in this Code.

B. Illegitimate Children  Those who were born out of lawful wedlock or after a competent time after its dissolution. 1. Natural Children: a. Natural Children (Proper): -those born outside wedlock of parents who, at the time of the conception of the former, were not disqualified by any impediment to marry each other (Art. 269, Civil Code). b. Natural Children by Legal Fiction: -those children born out of void marriages or those born of voidable marriages after the decree of annulment. c. Natural Children by Presumption: -those natural children acknowledged by the father or the mother separately if the acknowledging parent was legally competent to contract marriage at the time of conception. 2. Spurious Children:  Illegitimate children who are not natural.

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a. Adulterous Children: - children conceived in an act of adultery or concubinage. b. Sacrilegious Children: -children born of parents who have been ordained in sacris (priest and nun). c. Incestuous Children: -children born by parents who are legally incapable of contracting valid marriage because of their blood relationship. d. Manceres: -children conceived by prostitutes. Civil Liability of Persons Guilty of Crimes Against Chastity:  Art. 345, Revised Penal Code: Persons guilty of rape, seduction or abduction shall also be sentenced: 1. To indemnify the offended woman. 2. To acknowledge the offspring, unless the law should prevent him from so doing. 3. In every case to support the offspring. 

 

The adulterer and the concubine may also be sentenced, in the same proceeding or in a separate civil proceeding, to indemnify for damages caused to the offended spouse. In cases of multiple rape, the offenders may not be required to recognize the offspring. If the woman abused is married, the child born subsequently cannot be recognized and support cannot be demanded from the offender.

Evidence of Paternity and Filiation A. Medical Evidences 1. Parental Likeness: -Heredity transmits traits and characteristics from parents to the offsprings. -There must be some gross manifestation of the children which may be in common with the father.

FROGLETS NOTES 2. Blood Grouping Test: -blood type of the child is a possible product of the parents  not conclusively show that the child is born by such parents. -blood type of the child is not the possible product of the parents  conclusively show that the child is not that of the husband. 3. Evidences from the Mother: a. Proofs of Previous Delivery: -supposed mother may be subjected to an examination to determine the presence of signs of previous childbirth and which are compatible with the age of the child. b. Proofs of Physical Potency and Fertility: -the woman may be manifesting some acquired or congenital defect wherein impotency may be inferred. -fertility may be inferred from the presence of other pregnancies and the absence of organic abnormalities of the generative system. c. Proof of Capacity to have Access with the Husband: -general physical examination of the woman is necessary to determine whether she is physically capable of having sexual intercourse with her husband.

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4. Evidences from the Father: a. Proof of Physical Potency and Fertility: -medical examination must be done whether husband is capable of erection. -examination of spermatozoa in the seminal fluid is necessary to determine fertility. -presence of disease, congenital or acquired abnormalities, etc. may be factors that may bring about impotency or sterility. b. Proof of Access: -physician must determine the health and vigor of the father, the presence of disease, which may bring about his incapacity to perform sexual intercourse. B. Non-medical Evidences 1. Record of birth in the Civil Registrar, or by an authentic document or a final judgment (Art. 265, Civil Code). 2. Continuous possession of the status of a legitimate child (Art. 266, Civil Code). 3. Any other evidences allowed by the Rules of Court and special laws (Art. 267, Civil Code). CHAPTER XXVIII PATERNITY AND FILIATION ON NON-CONVENTIONAL METHODS OF PROCREATION 

The standard method of reproduction is the introduction of the male sperm into the generative organ of a female through sexual intercourse followed by fertilization, growth and

FROGLETS NOTES 

development of the conceptus and its subsequent delivery. However, modern advancement of medicine modified the conventional method as a solution to some specific problems of reproduction.

A. Artificial Insemination  A medical procedure by which the semen is introduced into the vagina by means other than copulation for the purpose of procreation.  ―therapeutic insemination‖ – more suitable term for the procedure. Artificial Insemination Classified According to the Source of Semen: 1. A.I.H. (Artificial Insemination Homologous, Artificial Insemination Husband) – Sperm comes from the husband. 2. A.I.D. (Artificial Insemination Donor, Artificial Insemination Heterologous) – Sperm comes from a donor other than the husband. 3. A.I.H.D. (Artificial Insemination Husband Donor, Polled Donor Semen) – Donor semen comes from the husband and a third party donor. Medical Indications for Artificial Insemination: 1. For A.I.H.: a. When the deposition of the husband’s semen within the vagina is by coitus; b. When the infertility is due to poor motility, paucity or otherwise defective sperm cells or too small a volume of the ejaculant. 2. For A.I.D. or A.I.H.D.: a. Absolute male sterility (Azoospermia); b. Oligospermia – Less than 10-15 million sperm per cc. of semen with infertility of long duration; c. Hereditary disease in the husband making propagation inadvisable for eugenic reason; or d. An Rh blood incompatability is expected to cause an abnormal baby on situations where other techniques to overcome such incompatability are not applicable.

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Selection of Donor of Semen:  In A.I.D., the selection of the appropriate donor of semen resides in the physician.  If the child born becomes defective which can be traced from a physician’s negligence or carelessness in choosing the donor, the physician may be held liable.  Obligations imposed on a physician in the selection of donors: 1. Proper screening must be made of the donor. 2. Donor must have the racial characteristic and physical proportion as those of the husband and wife and the blood type must be compatible with A.B.O. and Rh genotype of the wife. 3. Physician must ensure that the identity of the donor is not known to the parents and vice versa. 4. Complete physical examination with standard test for syphilis and gonorrhea is obtained not more than 1 week before the seminal fluid is collected. Precautions to be Observed by the Physician in Performing Artificial Insemination: 1. Physician should make certain by reasonable testing that the procedure is medically indicated for the couple. Husband is infertile and such condition is permanent. 2. Physician should establish by proper evaluation that the couple is emotionally stable and psychologically suited for this type of parenthood. 3. Physician must use all reasonable precautions in selecting the donor. 4. Physician must, under no circumstances except by court order, reveal the fact of artificial insemination or the identity of the donor or of the couple to each other or to other persons. 5. Physician must use freshly donated sperm or frozen semen. 6. The insemination procedure must be performed by the physician in accordance with the currently accepted techniques.

FROGLETS NOTES 7. Full and valid consents and releases should be obtained in writing from all parties involved, and each consent must be an ―informed consent.‖ Status of the Child Born by Artificial Insemination: husband.

 

1. In A.I.H. – child is a legitimate child of the 2. In A.I.D., with consent of the husband – child is legitimate although the fertilization semen is not from the husband. 3. In A.I.D., without consent or against the will of the husband – child is illegitimate

Consent on A.I.D.:  The consent and release for any future claim must be obtained by the physician from all parties in writing.  Consent of wife is necessary to avoid being held liable for an assault.  Consent of husband is necessary to avoid the wife being charged with adultery  Consent and release of the donor should be obtained for the unrestricted use of the semen supplied  Donor should also certify in writing that he will make no effort to ascertain the identity of the couple involved.  If the donor is married, consent of the wife must also be obtained B. In Vitro Fertilization  Also known as test tube baby, it is the fertilization of the egg cell by the sperm cell extracted from the respective donors placed in an artificial medium and after reaching a certain stage of cellular division and development: 1. Implanted into the woman’s uterus, or 2. Gestation (development of the embryo to a child) in an artificial womb. o Ectogenesis (extra corporeal gestation) – whenever the embryo is allowed to develop in an artificial womb Procedure of In Vitro Fertilization:

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  



Summary of Legal Medicine Book by Solis

Process begins with injections into the oocyte (ovum) donor of a hormone known as gonadotropin, which induces super-ovulation. Approximately 30 hours later, the oocytes are removed from the ovary by laparoscopy, a surgical procedure accomplished by inserting two thin glass tubes into the ovary through a small incisiom in the abdomen. The removed oocytes are placed in a Petri dish or a test tube containing growth medium simulating the environment of the woman’s body. The oocytes are then fertilized by a sperm which has been held in vitro. The resulting conceptus, after it divides and grows for a few days until it reaches the blastocyst stage (stage at which the embryo normally enters the uterus), is then inserted through the vagina and cervix into the uterus where it is implanted at a proper time in menstrual cycle. After successful transplantation, the woman carried the blastocyst to term.

Possible Situations in In Vitro Fertilization: 1. The ovum removed from the wife is fertilized by the husband’s sperm and the resulting zygote is implanted into the wife’s uterus. 2. The ovum removed from the wife is fertilized by the sperm coming from a third party (sperm donor) and is implanted into the wife’s uterus. 3. The ovum coming from a third party (ovum donor) is fertilized by the husband’s sperm and the blastocyst is implanted into wife’s uterus. 4. The ovum taken from the ovum donor is fertilized by the sperm coming from the sperm donor and the blastocyst is implanted into the wife’s uterus. 5. The ovum removed from a single woman is fertilized by the sperm taken from a male donor, the blastocyst is implanted into the single woman’s uterus. 6. The ovum removed from the wife is fertilized by the husband’s sperm and the blastocyst is implanted to a ―host‖ or surrogate.

FROGLETS NOTES 7. The ovum coming from the wife is fertilized artificially by the sperm coming from the sperm donor and the blastocyst is implanted into the surrogate’s uterus. 8. The ovum coming from the ovum donor is fertilized by the sperm coming from the husband and the blastocyst is placed into the surrogate’s uterus. 9. The ovum coming from the ovum donor is fertilized by the sperm coming from the sperm donor and the blastocyst is implanted into the surrogate’s uterus. Basis of Legality of In Vitro Fertilization: 

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No person shall be deprived of life, liberty, or property without due process of law, nor shall any person be denied the equal protection of the laws. (Art. III, Sec. 1, 1987 Constitution) From the term ―liberty‖ emanates the right of privacy The right of privacy means the right to be left alone. It is the right of an individual to the possession and control of his own person, free from all restraints or interference of others, unless by clear and unquestionable authority of law. It is the right of parents or guardians to establish their family life as they see fit. Other implication of the right of privacy which may be the basis of legality of in vitro fertilization: o Right of procreation – A ban on the use of in vitro fertilization would prevent an individual from using means to fulfill his or her procreative mission. o Right of marital privacy – Prohibition of in vitro fertilization as a way to have children will mean government intrusion into the marital bedroom in search of evidence for violating the law. o Right to decide whether to bear or beget – The right of a person to determine whether to carry or not to carry a product of conception, to be or not to be a mother or to raise or not to raise a family. o Right of self-determination – ―Every human being of adult age and of sound mind has the right to determine what shall be done on his own body.‖

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Summary of Legal Medicine Book by Solis

Problems in In Vitro Fertilization: 1. The probability that the child to be born will be defective. -Some of the probable causes of the birth of a defective child: a. Administration of hormone to the prospective source of ovum b. Mechanical manipulation of the oocyte and embryo c. Mistake in the ―screening process‖ or selection of the best ovum for fertilization d. Defective donors (sperm or ovum) -A physician need not fear too much of the possible liability on account of a defective child because: a. The plaintiff will find difficulty in proving negligence because birth defects are well known to occur in normal or natural pregnancies. b. Prospective parents are normally briefed of the potential risks of the procedure before their consent is obtained. c. In vitro fertilization has yet to evolve a clearly defined standard of care by which to determine whether the action of the physician is negligent. d. The plaintiff is required to meet the difficult task of proving negligence. -Social Problem in In Vitro Fertilization:  The progress of science must be geared towards improvement in the quality of men and not towards retrogression or deterioration. 2. Problem of surrogate mother: -Reasons why the services of a surrogate mother may be necessary: a. Necessity

FROGLETS NOTES  Genetic mother is unable to carry the child to term because of disease or injury.  Genetic mother may believe either that she is too old to safely carry a child to term, or that the child may be born with abnormalities.  Genetic mother may possess deleterious genetic traits which may be passed on to the child.  Couple is unable to adopt a child. b. Convenience  A woman may not want to interrupt her career during the gestational period. -Motivation of a woman to become a surrogate mother: a. Altruistic motive b. Material consideration  If the surrogate mother merely receives all expenses incurred in carrying the fetus to term and then delivered: altruistic motive If payment is beyond the reasonable cost of pregnancy, it is tantamount to ―rental‖ for the use of the uterus. -Problems that may arise in the agreement in the use of surrogate mother for gestational purpose: a. If the surrogate mother decided to abort the child contrary to the wish of the genetic parents. b. The surrogate mother may decide to keep the child after birth rather than surrender him to the genetic parents. c. The parents may decide to abort the child because of the fear that abnormality may be present but the surrogate mother refuses to do so. d. If the child was born with abnormality and the parents

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Summary of Legal Medicine Book by Solis

refused to take the child from the surrogate mother. e. Can the couple enforce the contract in the event that the surrogate mother committed other breaches? f. Is there a need to go through the procedure of adoption in order to legitimatize the child at birth? -Potential solution to the problems of surrogate mother: a. By contract – There must be a contract specifically mentioning the rights and duties of each party. b. By legislation – The court is bound to enforce the legislation unless found to be unconstitutional. (better solution) 3. Problem of the status of the child born by in vitro fertilization (please refer to possible situations in in vitro fertilization portion above) a. Situation 1 – Child is legitimate b. Situation 5 – Child is illegitimate c. Situation 2 and 3 – Child may still be legitimate if there is consent of the sterile party to the in vitro fertilization. If child is not considered legitimate, adoption may be done The status that the child may be a problem may change if the in vitro fertilization was done with the knowledge and consent or against the will of the sterile spouse. d. Situation 4, 6, 7, 8 and 9 – Genetic parents are different from the gestational mother. Adoption may be a legal remedy provided there is no impediment to the application of the procedure, otherwise a special legislation may be necessary. C. Other Non-Conventional Methods of Procreation 1. Artificial Inovulation – The removal of an unfertilized egg from a woman and placing it on the reproductive tract of another woman.

FROGLETS NOTES 2. Embryo Transplantation – The removal of a fertilized egg from a woman’s uterus to transfer to that of another woman’s uterus. 3. Parthenogenesis (―Virgin Birth‖) – A type of sexual reproduction whereby the unfertilized egg with 23 chromosome compliment doubled its content to become a diploid cell that starts dividing as if it is a fertilized egg without the intervention of a male sperm cell, the resulting offspring is a female. 4. Cloning – A type of sexual reproduction whereby the nucleus of a female egg is removed (enucleation) which contains the genetic material and replaced with the nucleus of a body (somatic) cell of the same or another woman (renucleation). The renucleated egg is then placed in a uterus for gestation and normal development. Resulting offspring is genetically identical to the parent.

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Summary of Legal Medicine Book by Solis