LEGAL MEDICINE

CHAPTER 31
Name:
 RYAN N. RAGUB
BS- CRIMINILOGY III
 CHRISTIAN DAVE B.PINEDA
BS- CRIMINOLOGY IV

PROF:
MRS. IGNACIO
Chapter XXXI MEDICO-LEGAL
ASPECT OF DISTURBANCE OF
MENTALITY
 I. INSANITY
 Insanity may be defined in its sociological, medical
and legal concept. In the sociological viewpoint,
insanity is the persistent inability through mental
causes to adapt oneself to the ordinary environment.
It is the loss of power of the individual to regulate
his actions and conduct according to the rules of
society in which he moves. Insanity in medicine is
the prolonged departure of the individual from his
natural mental state arising from bodily disease.
Insanity in law covers nothing more than the relation
of a person and the particular act which is the
subject of judicial investigation. The term insanity is
commonly used to be synonymous with lunacy,
madness, unsoundness of mind, mental
derangement, mental disorder or mental aberration
or alienation.
 Legal Importance of the
Determination:
1. In the Civil Code:

A. Insanity is a restriction on the

capacity of a natural person to act:
Art. 38, Civil Code — Minority,
insanity or imbecility, the state of
being a deaf-mute, prodigality and
civil interdiction are mere
restrictions on capacity to act, and
do not exempt the incapacitated
person from certain obligations, as
when the latter arise from his acts
or from property relations, such as
easements.
 B. Insanity modifies or limits the
capacity of a natural person to
act: Art. 39, Civil Code — The
following circumstances, among
others, modify or limit capacity
to act: age, insanity, imbecility,
state of being a deaf-mute. . . .
The consequences of these
circumstances are governed in this
Code, other codes, the Rules of
Court and in special laws.
Capacity to act is not limited on
account of religious belief or
political opinion.
c. Insanity at the time of
marriage of any or both
parties is a ground for the
annulment of marriage:
Art. 85, Civil Code – a
marriage may be annulled
for any of the following
causes; existing at the
time of marriage:
(3) That either party
was of unsound mind, unless
such party, after coming to
reason, freely cohabited
with the other as husband
and wife.
d. A testator must be of sound mind
at the time of execution of a
will:
Art. 798, Civil Code – in order to
make a will it is essential than
the testator be of sound mind at
the time of its execution.
Art. 799, Civil Code – to be of
sound mind, it is not necessary
that the testator be in full
possession of all his reasoning
faculties, or that his mind be
wholly unbroken, unimpaired, or
unshattered by disease, injury or
other cause.
 Art. 800, Civil Code – The law
presumes that every person mind,
in the absence o proof to the
contrary.
Succession is a legal mode by
virtue of which the property,
right and obligations which in
life belong to be a person is
acquired by his heirs.
A will is a specie of conveyance
whereby a person is permitted.
A codicil is an addition or
supplement to a will either to
add to or to take from the
provisions of the principal
disposition of the will.
e. A witness to a will must be of
sound mind:
Art. 820, Civil Code – any person
of sound mid and of the age of
eighteen years or more, and not
blind, deaf or dumb, and able to
read and write, may be a witness
to the execution of will…
f. Insanity of the testator is a
ground for disallowance of a
will:
Art. 839, Civil Code – The will
shall be disallowed in any of the
following cases:
(2) If the testator was insane, or
otherwise mentally incapable of
making a will, at the of its
execution.
g. An insane cannot give consent
to a contract:
Art. 1327, Civil Code – The
following cannot give consent to
a contract:
(1) Unemancipated minors:
(2) Insane or demented persons,
and deaf-mutes who do not know
how to write.
h.The guardian or the insane himself,
if there is no parent or guardian
shall be held liable for damages due
to his insanity:
Art. 2180, Civil Code – Guardians are
liable for damages caused by the
minors or incapacitated persons who
are under their authority and live in
their company.
Art. 2182, Civil Code – If the minor
or insane person causing the damage
has no parents or guardian, the minor
or insane person shall be answerable
with his own property in an action
against him where a guardian ad litem
shall be appointed.
2.In the Revised Penal Code:
a. Insanity exempts a person
from criminal liability
b. A person who becomes insane
after final sentence
3.In the rules of Court:
a. A guardian on the person of
the insane must be appointed
b. An insane cannot be a
witness in court
 Factors Having Positive
Correlation with the
Development of Mental Disorder:
1. Heredity
2. Incestuous marriage
3. Impaired vitality
4. Poor moral training and breeding
5. Psychic factors
6. Physical factors:
a. Non-toxic
b. Toxic
 Some Manifestation of
Mental Disorders:
1. Disorder of Cognition ( knowing ):
a. Disorder in Perception:
 Illusion – a false
interpretation of an internal
stimulus.
 Hallucination – an erreneous
perception without external
object of stimulus.
Some types of Hallucination:
a. Visual – seeing things
through not present
b. Auditory – hearing voivce in
absolute silence
c. Olfactory – false perception
of smell
d. Gustatory – false perception
of taste
e. Tactile – false perception of
touch
f. Kinesthetic – false
perception of movement
g. Hypnagogic – false sensory
perception
h. Lilliputian – perception of
object
 b. Disorder of Memory:
(1) Dementia - a form of
insanity resulting from
degenaration or disorder of the
brain
Some types of Dementia:
a. Acute Dementia – a form of
temporary dementia, occurring in
young people and induced by
conditions likely to produce that
state, like malnutrition, over
work, dissipation or too rapid
growth.
b. Dementia Paralytica –
General Paralysis of the Insane,
degeneration of
physical,intellectual
 and moral power leading to
paralysis “cirrhosis of the brain”.
c. Dementia Praecox – dementia
of the adolescence and
characterized by loss of memory.
d. Senile Dementia – occurring
in advanced age and characterized
by loss of memory, with childish
and silly behavior and physical
degeneration.
e. Toxic Dementia –
characterized by weakness of mind
or feeble cerebral activity
resulting from continuous
administration or use of toxic
chemicals.
 (2) Amnesia – loss o memory
a. Anterograde Amnesia –
loss of memory of recent event.
b. Retrograde Amnesia –
loss of memory of past events
and observed in trauma of the
head.
c. Disorder of Content of
Thought:
(1) Delusion – a false or
erroneous belief in something
which is not fact.
Some types of Delusion:
a. Delusion of Grandeur –
erroneous belief that he is in
possession of great power,
wealth, wisdom, physical
strenght, etc. It is not a sign
of insanity.
b. Delusion of Persecution – a
false belief that one is being
persecuted.
c. Delusion of Self-accusation
– a false belief to have
committed a crime or hurt the
feeling of others.
 d. Delusion of Reference –
one thinks that he is always
the subject-matter of
conversation, news, speech, or
action although it is not a
fact.
e. Delusion of Infidelity –
a false belief derived from
pathological jealousy that
one’s lover is unfaithful
although she is chaste, and try
to assault her.
f. Nihilistic Delusion – a
false belief that there is no
world, that one does not exist,
and that his body is dead.
 g. Delusion of Poverty – a
false belief that one is
financially ruined and that he
has no money, is starving,
sick or even dead.
h. Delusion of Control – a
false feeling that one is
being controlled by other
persons.
i. Hypochondriacal Delusion
– a false feeling that one is
suffering from an incurable
disease, some parts of the are
not functioning.
 j. Delusion of Depression
– patient experiences
feelings of uneasiness,
worthlessness and futility.
k. Delusion of Negation –
feeling that some parts of
the body are missing.
(2) Obsession – Thought and
impulse which continually
occur in the person’s mind
despite all his attempts to
keep them out.
 d. Disorder on the Trend of
Thought:
(1) Mania – a state of
excitement accompanied by
exaltation or a feeling of
well-being which is out of
harmony with the surrounding
circumstances of the patient.
(2) Melancholia – Intense
feeling of depression and
misery which is unwarranted
by his physical condition an
external environment.
2. Disorder of Emotion ( Feeling):
a. Exaltation – feeling of
unwarranted well-being and
happiness
b. Depression – feeling of
miserable thought
c. Apathy – serious disregard of
the surrounding environment
d. Phobia – excessive,
irrational and uncontrollable
fear of a perfectly natural
situation or object
 Some Types of Phobia:
(1) Fear of Specific Objects
(2) Fear of Specific Situation
(3) Fear of Place
(4) Fear of Illness or Death
3. Disorder of Volition or Conation
(Doing):
a. Impulsion or Impulse (Compulsion)
– sudden and irresistible force
compelling a person to the conscious
performance of some action without
motive or forethought.
 Some Types of Impulsion
(Compulsion Neurosis):
(1) Pyromania – an
irresistible impulse to set
things afire.
(2) Kleptomania – an
irresistible impulse to steal
articles of not much value.
(3) Multilomania – an
irresistible impulse to maim
animals.
(4) Dipsomania – an
irresistible impulse to
indulge in intoxication either
in alcohol or drugs.
 (5) Homicidal Impulse – an
irresistible inclination
impulse to commit homicide
prompted usually by insane
delusion.
(6) Sex Impulse – this
includes all irresistible acts
of sexual perversion.
(7) Suicidal Impulse – a
strong desire to terminate
one’s life.
 Steps in the Diagnostic
Procedure of Mental
Affection:
1.Anamnesis
a. Family History
b. Personal History
c. Information from relatives,
friends and neighbors
2. Physical Examination
3. Instrumentations
4. Mental Examinations
 INSANITY AND CRIMINAL
RESPONSIBILITY:
Fundamentals Principles in Criminal
Responsibility:
1. A sane man is assumed to be wholly
responsible for the consequence of his
criminal act.
2. A person who commits a criminal act is
presumed to be insane.
3. The crime is always considered to be an
affair of the mind as well the body and
to make an act or omission a crime,
there must be a criminal act (actus
reus) and a criminal mind (mens rea).
 Mental Illness may be an
Exempting or Mitigating
Circumstance to Criminal
Liability:
1. As an Exempting Circumstance:
Art. 12, Revised Penal Code –
Circumstances which exempt from
criminal liability:
1. An imbecile or an insane
person, unless the latter has
acted during a lucid interval
 2. As a Mitigating
Circumstance:
Act. 13, Revised Penal Code
– Mitigating circumstances:
8. That the offender is
deaf and dumb, blind or
otherwise suffering from
physical defect
9. Such illness of the
offender as would diminish the
exercise of the will-power of
the offender without however
depriving him of consciousness
of his acts.
 Phase In The Criminal Act
Where The Evidence Of Insanity
Of The Accused Must be
Established:
The evidence of insanity must
be referred to at the time
preceding the act under
prosecution or to the very
moment of its execution. In
order to ascertain a person’s
mental condition at the time
of the act, it is permissible
to receive evidence of the
condition of his mind during a
reasonable peiod.
 The following rules have been
adopted by courts to determine
whether an accused is suffering
from insanity to exempt him
from criminal liability:
1. Earlier Test for Insanity
a. Wild Beast Rule
b. Delusion Rule
2. Later Test for Insanity
a. McNaghten’s Rule
b. Irresistible Impulse Rule
c. Durham Rule
d. Currens Rule
e. American Law Institute Rule
 II. MENTAL DEFICIENCY
Mental deficiency (mental
subnormality, mental
retardation) is the below-
normal intellectual functioning
which originates from the arrest
or incomplete development of the
mind during the development
period below the age of 18 which
may be induced by various
factors associated with the
impairment of learning, social
adjustment or maturation.
 Classical Classification:
1. Idiot – usually congenital
and due to defective development
of the mental faculties.
2. Imbecile – although the
mental defect is not as severe
as that of idiots, he cannot
manage his own affairs.
3. Feeble-minded – person whose
mental defect, although not
amounting to imbecility, is
pronounced such that he requires
care, supervision, and control
for his protection an for the
protection of others.
4. Moral Defective – in addition
to the mental defect, there are
strong vicious and criminal
propensities, so that the person
requires care, supervision and
control for the protection of
others.
Mental retardation is classified
as follows:
1. Profound – I.Q is under 20
2. Severe – I.Q is between 20&35
3. Moderate – I.Q is 36 to 51
4. Mild – I.Q is 52-57
 Methods of Estimating Mental
Capacity:
1. Intelligence Tests
a. Performance Tests
(Don’t Require the Use of
Language:
(1) Good Enough Draw-a-
person Test
(2) Raven Progressive
Matrices Test
b. Verbal Test
 c. Mixed (Verbal and Non-verbal)
Test: (1) Binet Test (2) Wechsler Test

2. Intelligence Quotient (I.Q):

I. Q. Classification
Above 140 “Near” genius or genius
120- 140 Very superior intelligence
110 – 120 Superior intelligence
90 – 110 Normal or average
intelligence
80 – 90 Dullness, rarely classified
as feeble-minded
70 – 80 Borderline deficiency,
sometimes classified as
dullness, often as feeble-
mined
Below 70 Definitely feeble-minded
 Ways of Hospitalizing an
Insane Person:
1. Judicial Method
a. Upon petition by the
Director of Health.
b. The court upon
knowledge that the
imbecile or insane
committed a felony.

2. Extra-judicial Method
a. Voluntary
b. Involuntary
 III. MALINGERING
Malingering is the feigning or
simulation of a disease or
injury characterized by
ostentation, exaggeration and
inconsistency.
Causes of Malingering:
1. To avoid military or Naval
Training
2. To avoid court summons
3. As a defense to a criminal
prosecution
4. To increase civil liability
5. To promulgate sympathy
 Types of Malingering
1. “Feigned or Fictitious”
Malingering
- Malingering is built up out
of pure imagination and does not
have the slight basis of fact.
2. “Factitious” Malingering
- this is a form of
malingering whereby something
really exists as a fact, but is
converted to a more serious
disability or injury, or to an
exaggeration of the real
complaint.
 Points which Make a Physician
Suspect that a Person is
Malingering:
1. Presence of a cause for the
subject to malinger
2. Inconsistency between the
injuries or disease suffered
from and the symptoms or
disability manifested
3. Symptoms not supported with
organic lesion
4. Abrupt onset of symptoms
5. Refusal to be subjected to
painful or annoying treatment
 Ways to Determine
Malingering:
There is no specific test
for a specific form of
malingering. The test
applicable depends upon
the demand of the occasion
considering the attitude
of the subject and the
nature of the malingering.
The test may be:
1. General Procedure – the method
is applicable to all forms of
malingering:
a. Observation of the
subject during his unguarded
moments: a person cannot
always be conscious that
somebody is observing him.
He may for some moments
unconsciously show his
normal condition and not
exhibit the disability
feigned.
 b. Complete history and
physical examination: the
history that may be narrated by
the subject may not be
compatible with the result of
the physical examination and the
manifesting symptoms are common
among malingers.
c. Application of general
anesthesia.
d. Application of sudden
unexpected minimal amount of
electrical stimulus.
2. Specific Procedure:
a. Feigning Blindness:
(1) Place a convex 12D lens
before the “good” eye and a weak
concave lens (say 0.25D) before
the “blind” eye and ask the
patient to read Snellen’s test
types from a distance of 6
meters. If he succeeds in reading
it is a definite proof that he is
malingering, since it is
impossible to read the type
through such convex lens.
 (2) Place a lighted candle at
a distance of 6 meters from the
patient, and a prism with base
upwards or downwards, before the
good eye. If the patient can see
two flame it means that good
vision is present on both eyes.
(3) Take a firearm and with
the patient focusing his eyes
towards the revolver, fire three
or four shots in the air. Then
all of a sudden aim the firearm
towards him. If the patient is
blind there will be no
instinctive act of dodging.
 b. Feigning Deafness:
(1) This is a method to
determine whether only one of
the ears is allegedly deaf.
Place a loud tickling watch
in the supposed sound ear and
ask if he is able to hear the
tickling . If he answers in
the affirmative, gradually
withdraw the watch and ask
him when on the “deaf” ear
and ask him if he hears the
tick. He will certainly give
a negative answer.
 Now let him close both eyes
and you place something
metallic (which will make him
believe it to be a watch)
against the back of the deaf
ear, at the same time hold the
watch behind (but not touching)
the sound ear and ask him if he
is able to hear the tick.
If he says no, then he is
malingering.
(2) Close the sound ear with
cotton. Make a loud noise on
the “deaf” ear. Notice the
expression of the face.
c. Feigning Insanity:
There is no specific test
or procedure to determine
feigning insanity. A keen
observation of the behavior
coupled with the history and
physical findings probably are
most reliable.
IV. OTHER CONDITIONS
MANIFESTING OR STIMULATING
DISTURBANCE OF MENTALITY
1. Somnambulism – is an abnormal
mental condition
2. Semi Somnolence or Somnolencia
– a condition between sleep and
walking
3. Hypnotism or Mesmerism – a
person is made unconscious by
the suggestive influence of the
hypnotist
4. Delirium – is a state of
confusion of the mind
 REACTION
 My reaction to my report about disturbance of
mentality is to study people who are
headaches because of different things that
people think and study well with factor having
positive correlation with the development of
mental disorder things that people get They
are offended by the problems they face in life
and you will also find out here when you study
the disturbance of mentality what laws do
they violate when you are sick and can help
you when you are a police officer Because you
will soon learn how to treat when someone is
sick like this.