Lecture 1:

General
Considerations

Atty Molly Cr Abiog, MD,

LlB
University of the Cordilleras
Baguio City

Definition of Terms
Legal Medicine
Branch of Medicine which deals with
the application of medical knowledge
to the purposes of law and in the
administration of justice
Legal Medicine, Forensic Medicine and
Medical Jurisprudence - synonymous
with each other, and in common
practice are used interchangeably

Definitions & Differences

Strictly speaking
Legal Medicine is primarily the
application of medicine to legal cases
Forensic Medicine concerns with
the application of medical knowledge
to elucidate legal problems.

Differences in Scopes
William J. Curran
a prominent Harvard professor of legal
medicine defines
Legal Medicine as encompassing those
specialty areas of medicine concerned with
relations to substantive law and legal
institutions
Forensic Medicine deals with investigation ,
preparation, preservation and presentation of
evidence and medical opinion in courts and
other legal, correctional and other lawenforcement settings

According to Dr Henry C. Lee

an eminent U.S. forensic expert who claims
that Forensic Medicine has a broader
definition than Legal Medicine

FM encompasses a variety of fields in forensic

science such as, pathology, anthropology,
odontology, toxicology, entomology, et al
Its application is limited not only to legal issues but
also covers historical, environmental and social
political issues
Legal Medicine refers to substantive law defining
the relationship between and among hospitals,
doctors, patients, whereas Forensic Medicine deals
with activities or acts punishable under our local
laws

 Dr. Henry C. Lee,

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

Nature of the Study of Legal

Medicine:
Knowledge of legal medicine means:
ability to acquire facts
power to arrange those facts in their
logical order
draw a conclusion from the facts which
may be useful in the administration of
justice
power to impart to others verbally or in
writing all those he has observed.

Facts & Fallacies

Misconceptions among the public
Medicolegal practitioners must also be
lawyers
One has to be a pathologist to be
involved in this line of work

Who is who?
A physician who specializes or is involved
primarily with medico-legal duties is known
as a Medical Jurist (aka Medical
Examiner, Medico-legal Officer,
Medico-legal Expert)

e.g. Dr V.V. Villasenor (PNP Crime Laboratory)

Dr. Ronaldo Bandonill (NBI)

Atty. Molly Cr. Abiog, M.D. is a doctor and

a lawyer, but not a Medico-legal Officer!

Who are the Medico-Legal

Practitioners?
Can either be in the service of the government or
in private practice.
In government
Connected with law enforcement agencies such as the police
departments
Legitimate investigative bodies such as the PNP Crime
Laboratory
Medicolegal division of the National Bureau of Investigation
Physicians employed by the government as they are mandated
by law to perform autopsies on medicolegal cases
Municipal Health Officer
Provincial Health Officers

Who are the Medico-Legal

Practitioners?
As private practitioners
Consultants in private hospitals to whom are
referred medicolegal patients.
As part of the Hospital Team that monitors the
patients condition while confined at the Hospital.
When the patients case goes to court, the
medicolegal practitioner is called to testify on the fact
of the injury, the treatment the patient received in the
Hospital, his expert opinion as to the cause of the
patienty

Who are authorized by law to

perform autopsies?
Sec. 95, P.D. 856, Code of Sanitation:

Health Officers
Medical Officers of Law enforcement agencies
Members of the Medical Staff of Accredited
hospitals

Code of Medical Ethics of the Medical Profession of

the Philippines. Sec. 2. Art. III states:
However, it is the duty of every physician, when
called upon by the judicial authorities, to assist in
the administration of justice on matters which are
medico-legal in character

Ordinary Physician
3. Minor or trivial ignored
they do not require

Medical Jurist
3. Medical jurists must
record all bodily
injuries even if they are
minor because these
injuries may be proofs
to qualify the crime or
to justify an act

Distinction between an ordinary

physician and a medical jurist:
Ordinary Physician
1. Sees an injury or illness
on the point of view of
TREATMENT

Medical Jurist
1. Sees an injury or illness
on the point of view of
CAUSE

2. Purpose in examining 2. include those bodily

patient is to arrive at
lesions in his report
a definite Diagnosisand testify before the
Rx Rx
court before an
investigation body
result: justice where
justice is due-given.

What are these so-called

MEDICOLEGAL CASES?
Injuries or deaths involving persons who have no means of
being identified
Persons pronounced as dead on arrival (DOA)
Deaths under the following circumstances:
Death occurring within 24 hours of admission when the
clinical cause of death is unknown or undeterminable;
Unexpected sudden death especially when the
deceased is in apparent good health;
Death due to natural disease but associated with
physical evidence suspicious of foul play;
Death as a result of violence, accident, suicide or
poisoning;
Death due to improper of negligent act of another
person;

 Victims of physical injuries caused by

the following:
Physical violence such as gunshot wound,
stab wound, mauling, etc.;
Vehicular accident
Asphyxia
Electrocution
Chemical or thermal insult
Accident
Attempted Homicide or suicide
Poisoning

 Cases of child abuse, domestic violence, rape,

alcoholism and drug addiction;
Cases involving the mental competency of the
patient;
Iatrogenic causes brought about by negligent
acts or omissions of the hospital staff
resulting in violation of rights of patients or
leading to his physical and mental
incapacitation, physical injury and death.

 Under Philippine laws, medico-legal

deaths must undergo mandatory autopsy
No consent is required for the autopsy
although the next of kin is informed of this
requirement and his signed consent
obtained as a matter of courtesy
Death certificate cannot be completed
without the autopsy.

 If the hospital has no authority to conduct autopsy,

it refers the case to a government body which can
do iteither to the PNP or the NBI or top a
Municipal or Provincial Heath Officer
If the Hospital has the authority to conduct autopsy
but the relatives refuse to cooperate, the death
certificate is merely filled up by putting as the
cause of death undetermined
In effect, it is also as if no death certificate has
been issued because legally the body cannot be
buried without a cause of death

Major capabilities of a medicolegal officer:

Conducts
autopsy
examination of victims of sexual crimes
examination of victims of Physical injuries
examination of skeletal remains
blood and blood stain, seminal fluid/stainexamination of body fluids
Exhumation of bodies
Histopathological examinations

Branches of Law where Legal

Medicine maybe applied:
Civil Law
Paternity and filiations;
Determination of or change in Civil Personality/Status of persons;
Adoption, Declaration of Nullity of Marriage, Legal Separation, etc.

Criminal Law
Circumstances affecting criminal liability
Crimes against persons
Crimes against chastity

Remedial Law
Rules on evidence
Proceedings for hospitalization
Physical/mental examination of a person

Autopsies shall be performed in

the following cases:
Whenever required by special laws
Upon order of a competent court, mayor and a
provincial or city fiscal
Upon written request by police authorities
Whenever the Solicitor General, provincial or
city fiscal deem it necessary to dissenter and
take possession of the remains for examination
to determine cause of death
Whenever the nearest kin shall request in
writing the authorities concerned to ascertain
the cause of death

FORENSIC Science
Disciplines:
Hair Analysis
Fiber Analysis
Glass fragments and paint chips
analyses
Pathology
Ballistics and Tool marks
Fingerprints
analysis
Footwear
Psychology
Tire Impressions

DNA Analysis
Forensic Anthropology
Forensic Archaeology
Forensic
Forensic Odontology
Questioned Document
Forensic Psychiatry &
Blood Splatter Analysis

ASSIGNMENT:
Bring to class next meeting
Medico-legal certificate
Autopsy Report

Case Discussion:

An 18 year old female, single, came to a medical clinic complaining that

she has been raped.
History of the Present Complaint:

One (1) month PTC, Mr. X by use of force and intimidation had carnal
knowledge with her at Burnham Park @ 2:00 p.m. For fear of her parents
wrath, she kept what happened to herself and came for medical examination
only today.

Examination results:

Recently healed hymeneal lacerations at 4 and 6 oclock;

No signs of recent application of force at the perineal area;
Internal Examination, admits 2 examining fingers with ease; shallow vaginal
rugosities;

Laboratory Examinations: Positive for spermatozoa, no gram negative

cocci.
Conclusions: -non-virgin state;
-healed lacerations at 4 and 6 oclock
-presence of Spermatozoa,
Conclusion: recent sexual intercourse within the last 24 hrs.