legal medicine

EDISON  JOHN  A.  ARRIOLA,  JD  

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�  Branch  of  medicine      

that  deals  with  the    

�  Application  of  medical  knowledge    �  To  the  purposes  of  law  and    �  In  the  administration  of  justice  

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�  Knowledge  of  law    in  relation  to  the  practice  of  medicine  

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�  Application  of  medical  science  to  elucidate  legal  problems  

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Men  of  Law  and  Justice  

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�  Police  �  Taxation  �  Eminent  Domain  

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�  Constitution  �  Statute  �  Rules  

�  Judicial  decisions  applying  or  interpreting  the  laws  or  the  Constitution  form  part  of  the  legal  system  of  the  Philippines  (JURISPRUDENCE).  

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�  Executive    �  Legislative  �  Judiciary  

�  Once  the  Supreme  Court  has  laid  down  a  principle  of  law  or  interpretation  to  a  set  of  facts,  such  principle  or  interpretation  will  apply  to  all  future  cases  where  the  facts  are  substantially  the  same  (STARE  DECISIS).  

� Which  branch  is  the  most  powerful?  

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Political,  Civil,  Social,  and  Economic  

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With  great  power  comes  great  responsibility.  

�  Ignorance  of  the  law  excuses  no  one  from  compliance  therewith.    

�  Laws  shall  have  no  retroactive  effect,  unless  the  contrary  is  provided.  

�  There  is  no  crime  where  there  is  no  law  punishing  it.  �  Laws  shall  take  effect  only  after  their  publication.  

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�  Rights  may  be  waived,  unless  the  waiver  is  contrary  to  law,  public  order,  public  policy,  morals  or  good  customs  or  prejudicial  to  a  third  person  with  a  right  recognized  by  law.  

�  Customs  which  are  contrary  to  law,  public  order  or  public  policy  shall  not  be  countenanced.  

�  Laws  are  repealed  only  by  subsequent  ones,  and  their  violation  or  non-­‐observance  shall  not  be  excused  by  disuse,  or  custom  or  practice  to  the  contrary.  

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Substantive  &  Adjective  Law  

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�  CIVIL  LAW  –  determines    and  regulates    the  relation  of  assistance,  authority  and  obedience    between  and  among  members  of  a  family  and  society  

�  CRIMINAL  LAW  –  defines  crimes,  treats  of  their  nature  and  provides  for  their  punishment  

�  SPECIAL  LAWS  –  statutes  passed  by  Congress  to  cover  areas  not    covered  by  existing  laws  �  Special  Penal  Law  –  imposes  imprisonment  

�  ORDINANCES  –  regulates  acts  within  a  local  government  unit  

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�  Dangerous  Drugs  �  Child  Welfare  �  Child  Abuse  �  Violence  against  Women  and  Children    �  Trafficking  in  Persons  �  Sanitation  �  Insurance  (HMO)  �  Labor  /Employee  Compensation  

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Perspective  

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PHYSICIAN   MEDICO-­‐LEGAL  

INJURY   Treatment   Cause  

PATIENT  EXAMINATION  

Diagnose   Testify    

MINOR  INJURIES   Ignored   Recorded  

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� Means,  sanctioned  by  the  Rules  of  Court,  of  ascertaining  in  judicial  proceeding  the  truth  respecting  a  matter  of  fact  

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�  Real/Object/Autoptic  �  Documentary  �  Testimonial  �  Experimental  

Remember  the  “index  card”  example.    

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Only  admitted  evidence  can  be  weighed.  

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ADMISSIBILITY    

�  Competent  �  Relevant  

�  Proof  beyond  reasonable  doubt  (criminal  cases)  

�  Preponderance  of  evidence  (civil  cases)  

�  Substantial  Evidence  (administrative  cases)  

SUFFICIENCY  

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�  Establish  Victim  &  Offender  (Ground  for  Acquittal)  �  Settlement  of  Estate  (Presumed  Dead  –  7  years)  �  Necessary  for  Some  Transactions    

�  Encashing  check  �  Entering  premise  �  Delivery  of  parcels/mails  �  Contracts  �  Release  of  dead  body  to  kin  

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� Multiplicity  of  evidence  in  identification  �  Different  points  of  identification  (fingerprints,  dental  comparison)  

�  Visual  recognition  by  kin  �  Act  fast  in  cases  of  death  (putrefaction  destroys  external  bodily  marks)  

�  Non-­‐rigidity    of  rule  in  identification  

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�  Comparison  or  Exclusion  �  Ordinary  or  Scientific  

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�  Easily  Changed  �  Hair  Growth  �  Clothing  �  Frequented  place  �  Grade  of  profession  �  Body  ornamentations  

�  Not  Easily  Changed  �  Mental  Memory  �  Speech  �  Gait  �  Mannerism  �  Hands  and  feet  �  Complexion  �  Changes  in  the  eye  �  Facies  �  Left-­‐  or  right-­‐handedness  �  Nutrition  

�  Fingerprinting  (Visible,  Plastic,  Latent)  �  Dental  Identification  (PD1575,  Record  of  Dentition)  �  Handwriting  (Bibliotics,  Graphology)  �  Bone  Identification  �  Sex  Determination  �  Age  Determination  (Criminal  liability,  exercise  of  rights,  crime  classification  

�  Blood  Identification  �  Hair  &  Fiber  Identification  

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�  Civil  personality  extinguished  �  Succession  �  Partnership  dissolved  �  Agency  extinguished  �  Criminal  liability  extinguished  �  Non-­‐surviving  claims  dismissed  

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�  Somatic/Clinical  �  Complete,  persistent  and  continuous  cessation  of  the  vital  functions  of  the  brain,  heart  and  lungs  

� Molecular/Cellular  �  About  3-­‐6  hours  after  cessation  of  the  vital  functions  of  the  body  with  death  of  individual  cells  

�  Apparent/Suspended  Animation  �  Transient  loss  of  consciousness  or  temporary  cessation  of  the  vital  functions  of  the  body  on  account  of  disease,  external  stimulus  or  other  forms  of  influence  

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1.  Cessation  of  heart  action  &  circulation  (entire  and  continuous)  

2.  Cessation  of  respiration  (continuous  and  persistent)  3.  Cooling  of  body  (algor  mortis)  4.  Insensibility  of  body  &  loss  of  power  to  move  5.  Skin  changes  (opacity,  livid  discoloration,  contact  

flattening,  no  blister)  6.  Eye  changes  (corneal  clouding,  loss  of  corneal  reflex,  

eyeball  flaccidity)    7.  Action  of  heat  on  skin  (dry  blister  with  no  redness  

of  surrounding  skin)  

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1.  Primary  Flaccidity  �  Muscles  relaxed  and  capable  of  contracting  when  stimulated  

�  Pupils  dilated,  sphincters  relaxed,  incontinence  2.  Post-­‐mortem  Rigidity  

�  Develops  3-­‐6  hours  after  death  �  May  last  from  24  to  36  hours  

3.  Secondary  Flaccidity  �  No  longer  capable  of  responding  to  mechanical  or  electric  stimulus  

�  Reaction  becomes  alkaline  

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1.  Natural  �  Did  the  person  die  of  a  natural  death  and  were  the  physical  injuries  inflicted  immediately  after  death?  �  Impossible  Crimes  

�  Was  the  victim  suffering  from  a  natural  disease  and  the  violence  only  accelerated  the  death?  �  Praeter  Intentionem  

�  Did  the  victim  die  of  a  natural  cause  independent  of  the  violence  inflicted?  

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2.  Violent  �  Accidental  �  Negligent  �  Infanticidal  Death  �  Parricidal  Death  �  Murder    �  Homicidal  Death  

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1.  Homicide  2.  Murder  3.  Parricide  4.  Infanticide  5.  Abortion  6.  Reckless  Imprudence  resulting  in  Homicide  

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�  Physical  violence  �  Heat  or  cold  �  Electrical  energy  �  Chemical  energy  �  Radiation  by  radioactive  substances  �  Change  of  atmospheric  pressure  (barotrauma)  �  Infection  

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�  Sum  total  of  all  reactions  of  tissue  or  organ  to  trauma  � Macroscopic  or  microscopic  �  Presence  differentiates  an  ante-­‐mortem  from  a  post-­‐mortem  injury  

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�  Rubor  �  Calor  �  Dolor  �  Loss  of  Function  

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�  Injury  inflicted  during  the  agonal  state  since  cells  or  tissues  no  longer  have  the  potential  capacity  to  react  to  trauma  

�  Very  sudden  death,  giving  tissues  no  chance  to  react;  ie,  sudden  coronary  occlusion  

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1.  As  to  severity  2.  As  to  kind  of  instrument  used  3.  As  to  manner  of  infliction  4.  As  to  depth  of  wound  5.  As  to  relation  of  site  of  application  of  force  and  

location  of  injury  6.  As  to  regions  or  organs  of  the  body  involved  7.  Special  types  of  wounds  

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�  Hit  �  Thrust  or  stab  �  Gunpowder  explosion  �  Sliding  or  rubbing  or  abrasion  

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�  Stab  wound  �  Lacerated/Avulsed  wound  �  Incised  (Sliced/cut)  wound  �  Hacking  �  Contusion  (bruise)  �  Hematoma  �  Gunshot  wound  

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�  Superficial  �  Deep  

�  Penetrating  �  Perforating  

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�  Coup  injury  �  Contre-­‐coup  injury  �  Coup  contre-­‐coup  injury  �  Locus  minoris  resistencia  �  Extensive  injury  

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Ante-­‐Mortem  �  Copious  hemorrrhage,  arterial  

�  Spouting  of  blood  �  Clotted  blood  �  Deep  staining  of  tissue  edges,  can’t  be  washed  off  

�  Gaping  skin  edges  �  Inflammation  and  reparative  processes  

�  Slight  or  none,  venous  

�  No  spouting  of  blood  �  Soft  or  not  clotted  blood  �  Edges  not  deeply  stained,  can  be  washed  off  

�  Edges  do  not  gape  �  No  inflammation  or  reparative  processes  

Post-­‐Mortem  

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Open    1.  Abrasion  2.  Laceration  3.  Incision  4.  Puncture  

1.  Petechiae  2.  Contusion  3.  Hematoma  

Close  

�  Defense  wound  �  Patterned  wound  �  Self-­‐inflicted  wound  

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� Mutilation  �  Serious  physical  injuries  �  Less  serious  physical  injuries  �  Slight  physical  injuries  �  Physical  injuries  inflicted  in  a  tumultuous  affray  

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1.  There  is  tumultuous  affray  2.  Participants  suffered  from  serious  physical  injuries  3.  The  persons  who  inflicted  such  serious  physical  

injuries  cannot  be  identified;  and  4.  All  those  who  appear  to  have  used  violence  upon  

the  person  of  the  offended  party  shall  be  penalized  by  arrest  from  five  to  fifteen  days  

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