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Legal Medicine

Branch of medicine, which deals with the application


of medical knowledge for the purposes of law.
Medicine applied to legal cases

Medical Jurisprudence
Branch of law which deals with the organization and
regulation of medical profession, with the contractual
obligations existing between practitioner and his patient, and
the duties imposed on the practitioner by the State.

must not be revealed are the matters that tend to blacken


the reputation of the Patient.

Right of the Patient to Confidentiality and Privacy


Nothing that the Patient uttered can be repeated to any other
person. Blanket Authority: Yes, Court ruled, information
can be used but identity of the Patient cannot be revealed.
Only the initials and the sex, but never the name because that
would be a violation of the Patients right.

Ordinary Witness vs Expert Witness


Legal Terminologies related to the Medical Profession and
Existing Jurisprudence

Informed Consent- consent directly given orally or in writing,


positive, direct, unequivocal requiring no inference as to its
meaning.

Dying Declaration- statements made by a person who is lying


at the point of death and conscious of his approaching
dissolution, in reference to the manner in which he received
the injuries; which statements are admissible in evidence in
a trial where the killing of the declarant is the crime
charged to the defendant.
Witness-one who, being present personally sees or perceives
a thing and who testified be it may declaration under oath is
received as evidence for any purpose, whether made on an
examination or by deposition or affidavit.
Adverse witness- a witness whose mind discloses a bias
hostile to the party examining him.
Subpoena
Subpoena duces tecum
Subpoena ad testificandum
Summons
Search Warrant

Ordinary Witness- testifies on matters that came to his


knowledge through his own senses and testifies on facts.
Expert Witness- gives testimony on matters he knows a lot
about or he has plenty of experience about and what he will be
giving is opinion evidence.
Prescription- period within a person may prosecute a course
of action.
Dead on Arrival- Extremis who dies within 12 hours upon
arrival at an institution.

The Medical Act of 1959 as amended


(R.A. 2382)
Prerequisite to the practice of medicine (sec.8)
a.
b.
c.

Candidates for Board Examination (sec.9)


Acts constituting practice of medicine (sec.10)
Exemptions (Sec.11)
Limited practice without any certificate of registration (sec.12)
Administrative Investigations (sec.22)
a.

Two Types of Privileged Communication


Absolute Privileged Communication- under no circumstance
can a person be forced to reveal communication:

The existing rules of evidence shall be observed


during all administrative investigations.

Procedure and Rules (sec.23)


a.

1.Information that is passed on by a client to his lawyer.


2.Advice by the lawyer to the client.
3.Files of the lawyer where the information regarding the case
of the client was kept.

Qualified Privilege Communication- communication given by


a patient to a doctor in the course of a Patient-doctor
relationship. The information that is considered absolute and

21 years of age
Passed the Medical Board Examination
Holder of a valid certificate of registration

Within 5 days after the filing of written charges under


oath, the respondent physician shall be furnished a
copy thereof, without requiring him or her to
answer the same and the Board shall conduct the
investigation within 5 days after the receipt of
such copy by the respondent. The investigation
shall be completed as soon as practicable.

Grounds for reprimand, suspension


registration certificate (sec.24)

or

revocation

Rights of Respondent (sec.25)


a.

The respondent physician shall be entitled to be:

of

1. represented by counsel or be heard in person, or


2. to have a speedy public hearing,
3. to confront and to cross-examine witness against
him or her, and
4. to all other rights guaranteed by the Constitution
and provided for in the Rules of Court.
Appeal from judgment (sec.26)
a. The decision of the Board of Medicine shall
automatically become final 30 days after the date
of its promulgation unless the respondent, during
the same period, has appealed to the
Commissioner of Civil Service and later to the
Office of the Philippines. If final decision is not
satisfactory, the respondent may fie in court a
petition for certiorari.
Reinstatement (sec.27)
a.

After 2 years, the Board may order reinstatement


of any physician whose certificate of registration
has been revoked, if the respondent has acted in
an exemplary manner in the community wherein
he resides and has not committed any illegal,
immoral, or dishonorable conduct.

Penalties (sec.28)

Medico-legal Division
Capabilities
1.

Autopsy- to determine the cause, mechanism,


and manner of death
2. Exhaumation- to determine/verify the exact cause
of death
3. Physical examination- sexual offenses, physical
injuries, arrested and to be released persons
4. Skeletal Remains Exam- to determine the cause
of death and identification
5. Hispatological Examination- to determine the
cause of death through tissue examination
6. Serological Examination- to determine presence
of human blood and type
7. DNA Examination- tissue matching examination
8. Lecturers/Demonstration/Seminars
9. Court Duties-testify in court
10. Scene of Crime Operation (SOCO)-collection,
preservation, and handling of evidence
Identification of Persons and Materials
1. Anthropmetry (Bertillons System)

Rights of Physicians:

-study of measurements of human body, esp., in


comparative basis.

a. To choose patients

2. Fingerprinting/Dactyloscopy

b. Limit his medical practice

-the art of identification by comparison of fingerprints,


study and utilization of fingerprints.

c. Avail of hospital services


d. Determine the appropriate management procedure
e. Right of way in a call for emergency
f. Exemption of instruments from execution
g. Hold certain public or private offices
h. Perform certain services
i. Membership in medical societies
j. Compensation
Rights of Patients:

3. Lie Detector Test/Polygraphy


-to determine truth or deception based on the
presence of emotional disturbance of the subject as
appearing on the recorded physiological responses to
question relative to the case under investigation.
4. Handwriting/Graphology
-study of the handwriting, especially as it is to indicate
writers personality, character, aptitude, etc. Explains
the characteristics of the handwriting reflecting the
character, weakness, personal idiosyncrasies,
mannerism and ambition of the writer.

a. To give consent
b. Religious belief
c. Privacy

Physical Injuries

d. Disclosure of information

Types of Wounds

e. Confidential information

A.

f. Choose his physician


g. Treatment
h. Refuse necessary treatment

Close Wounds
1.Superficial Close Wound

a. Petechiae- are minute, pinpoint extravasation of


blood in the subcutaneous tissue.
b. Contusion (Bruise) shape is usually round or oval
but may follow the shape of the wounding weapon,
so that the position of the bruise may indicate the

manner of assault. Age and healing of contusion is


based on its color.
c. Hematoma-a large extravasations of blood in a
newly formed cavity secondary to trauma,
characterized by swelling, discoloration of tissues.
2. Deep Close Wound
a. Sprain-straining or tearing of the articular tendon,
ligaments and muscles characterized by swelling,
discoloration and extreme pain.
b. Fracture- break or solution in the continuity of the
bone resulting from violence or from existing
pathology.

Presence
Absence
wound

or
of

Always
present

Protrusion of
tissue
Paraffin Test

Absent

Determination whether gunshot is Suicidal, Homicidal, or


Accidental
A.

Evidence to prove that gunshot wound is suicidal;


1. Accessibility of the involved part to the hand of
the victim
2. Usually only one gunshot wound
3. Usually the distance is short or close range
4. Presence of suicidal note
5. History of frustration of the victim
6. Wounding weapon held tight by the victim
7. Exclusion of other evidences to prove that it is
not suicidal

B.

Evidence to prove that gunshot wound is homicidal;


1.Wound is located at any part of the body
2. Victim usually at a certain distance from the
assailant
3. Signs of struggle (defense wound) may be present
in the victim
4. Disturbances of the surrounding
5. Wounding weapon usually not found at the scene
of the crime

C.

Evidence to prove that gunshot wound is accidental;


1. Usually one gunshot wound
2. Wound located at any part of the body
3. Absence of personal grudge between the victim
and the one who fired the gun
4. Testimony from witnesses

B. Open Wound
1.Abrasion- characterized by removal of the epithelial
layer of the skin brought about by friction against a
hard, rough object.
2. Incised wound-produced by forcible contact with
sharp-edged instrument characterized by gaping and
smooth edges of the wound.
3. Lacerated wound- produced by blunt instrument
and is characterized by inflammation and contusion.
Gunshot Wounds
a.

b.

c.

Contact fire- wound of entrance bunted due to


explosion of the powder, which produces the
heated and expended gases. Size of the wound
is small.
Near Contact Up to 6 inches Fire- there is
bursting of tissues, burning and blackening of the
skin as in contact fire but particles of gunpowder
are present inside as well as around the wound
entrance.
Distance Above 6 inches Up to 24 inches- size of
the wound gradually approximates the size of the
missile.

Differentiation between Gunshot wound of Entrance and


wound of Exit
Differentiatio
n
Points
Size
Edge
Shape
Contusion
Collar

Gunpowder
Tattooing

Entrance
wounds

Exit
wounds

Smaller than
missile
Inverted
Round or Oval

Bigger
than
missile
Everted
No
definite
shape
Absent

Present
in
contact
and
near
contact
fire
Present
in
contact
and
near
contact
fire

Absent

Contact fire

May be absent
if the slug is
lodged inside
the body
May
be
present
Absent