LEGAL MEDICINE
THE DOCTOR AS A WITNESS
Atty. Antonio D. Rebosa, M.D.
REFERENCE:
 Audio Recording of Atty. Tony Rebosa’s lecture on
Sept. 9, 2017 
 Pedro Solis (1987). Legal Medicine. Quezon City: R. P. Garcia
Publishing Co.
Part of the Exam would be on the chapter that is common to
both Legal Medicine and Medical Jurisprudence – The
Doctor as a Witness.
HOW DOES THE LAW DEFINE A “WITNESS”?
 In Legal Med, we said Legal Med is Forensic Medicine.
The doctor goes to testify as a witness in court.
 Witness: A person who by proceeding can make known
his perception to others.
 When we talk about perception, it refers to the five
senses.
What is wrong with that definition? Para sa akin there is
something redundant, is there a need to really put the
word ‘person’ there? What the law makers were
thinking, by the use of the word “person’ – only those
from planet earth can testify. Extraterrestrial beings and
aliens if ever they will come here cannot testify.
 Even the WHO defines the Doctor / Physician, starts
with the word ‘a person who knows how to treat people’
so hindi din pwedeng manggamot ang galing sa ibang
planeta. Martian cannot testify or practice medicine.
 Based on that definition there, who are disqualified to
be a witness?
o Those who cannot make known their perception to
others --
1. Children of tender age
 You do not expect a 2 or 3 year old boy/girl
to testify on the witness stand,
monosyllabic pa lang yan. They cannot
understand, they cannot express
themselves.
 What about a 4 year old, precautious girl
who says “kapag kayo wala siya lagi
hawak pepe ko “? Can she now go to court
and testify? Yes, she can talk. She can
answer; she can tell you what she had
perceived. But of course, the accused is
entitled to cross examine any witness that
would be presented against them so that 4
year old girl will have to be presented in
court.
 In the Phils. how is a child witness usually
presented? The child is being carried by
the mom or by any person whom she is
comfortable with.
 Ideally in other countries especially sa
States, ideally if you’re going to subject a
child as a witness. She should be in
another room with a child psychologist.
 First, a TV for the ward in which the
lawyers and the judge and anybody else
would be able to monitor and see for
themselves the demeanor of both the child
psychologist and the child. The questions
will be asked by the lawyers and the judge
through the child psychologists who in turn
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would ask as questions in a way the child
would fully understand and comprehend
and would not be … And would come up
with honest, accurate and truthful
narration. That is the ideal.
 Is a child capable of lying? The common
perception is that children don’t lie. But I’m
telling you now, children do lie. I’ve already
encountered, 2 witnesses although they
were ages 8 and 10. They were
pathological liars; they belong to a family
of criminals. But they were so good with
their testimony that I’m sure that the judge
would have been persuaded with their
testimony. The only way I can discredit
that, by presenting an expert witness in the
person of a child psychiatrist who would
say that – Yes, children do lie, they can be
coached.
 Just like that mother, kalong kalong niya
yung anak niya. How sure are we that the
child is not being coached?
 In clinical cases, the evidence required
in order to convict the accused is guilt
beyond reasonable doubt. What does
that mean? If you compare it sa grade, the
passing score is 90. Ang taas nun, you get
a score of 89. That’s very high but there’s
11% doubt. These are basic constitutional
right, that you’re entitled to presumption
of innocence unless proven otherwise.
 The burden of proof to prove that
you’re guilty is always on the
prosecution. It’s very easy to file a
criminal case but very difficult to win.
WHY? Because of your presumption of
your innocence. You will be convicted on
the basis of the strife of the evidence?
Presented by the prosecution and not on
the basis of a witness of your evidence.
You cannot be forced to testify or be a
witness against yourself in court. You may
not testify if you don’t want to, you may
invoke your Right against Self-
incrimination. Also a Basic Constitutional
Right. You need not prove that you are
innocent; you only have to produce
doubts. Because doubts should always be
construed in favor of the accused.
Because of the Legal dictum: It is better
to set the guilty free than send an
innocent person to jail.
 When there are doubts, in favor of the
accused. Rape is one of the most difficult
crimes because usually there are no
witnesses. It’s a matter of he-said she-
said. The rapist does not have to prove
that he is innocent, he just have to
introduce doubts saying that the sex is
consensual. How? Claiming that the
woman consented to the sex because she
is a former girlfriend, for old times’ sake,
and can prove that with love letters, text
messages, etc.
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 LEGAL MEDICINE THE DOCTOR AS A WITNESS TONY REBOSA, MD

 Let’s say you are about to be raped, Exception to the non-admissibility of HEARSAY EVIDENCE: Dying
there’s no more chance of escaping. Declaration
You’re in a dark alley and this guy is so  Sec. 31, Rule 130, Dying Declaration – The declaration of a
big. Full of tattoos and probably killed you dying person, made under a consciousness of an impending
if you don’t give in. You are now cornered. death, may be received in a criminal case wherein his death is
But before he will have sex with you, you the subject of the inquiry, as evidence of the cause and
took out a condom. Please use this surrounding circumstances of such death.
condom because either you’re scared of
 Admissible in spite of the fact that it is hearsay, it is made so
getting HIV or getting pregnant? Is that
consent? In the states, no that is rape. because of necessity and it is trustworthy.
Because there is no way for the woman to  Physicians are frequent recipients of dying declaration in the
escape rape and she just had to protect medical clinics and emergency rooms of hospitals.
herself.  To be admissible it must be shown that the –
2. Senile – those with Alzheimer’s, those who  Declarant was conscious of his impending death
have problems with memory recall although not  Declarant was in full possession of his mental faculties
absolute. when he made the declaration; and
3. Insane – Naniniwala ka sa buang, pareho  Such evidence is presented in court in a case of
kayong buang. homicide, murder or parricide wherein the Declarant was
4. Those who committed crimes of perjury – the victim.
lying under oath
TWO KINDS OF WITNESS
Sec. 18, Rule 130, Rules of Court – Witnesses: Their qualification –  A physician may be presented I court as ordinary witness
Except as provided in the next succeeding section, all persons who, and/or as an expert witness:
having organs of sense, can perceive, and perceiving, can make
known their perception to others, may be witnesses. ORDINARY EXPERT
 Neither parties nor other persons interested in the WITNESS WITNESS
outcome of the case shall be excluded; nor those who Will go to court to testify He goes to court to
have been convicted of a crime; nor any person on what he just perceived and enlighten the court, to
account of his opinion on matters of religious belief. those that are of his share his expertise in
personal knowledge. matters which he may be
Exceptions to the ordinary witness rule – considered as an expert.
1. Privilege of communication (confidential) between physician Can a blind man go to
and patient court to testify? Yes He goes to court to give
 Although the physician perceived something through his his opinion.
organ of sense and has the power to transmit to others A physician who testifies in A physician on account of his
what he perceived, he is not allowed to disclose those court on matters he training and experience can
information to others as regards to matters he perceived perceived from his patient in give his opinion on a set of
from his patient during the physician-patient the course of physician- medical facts.
relationship. patient relationship. He can deduce or infer
 Sec. 21 (c), Rule 130, Rules of Court – Privileged something, determine the
communication – A person authorized to practice cause of death, or render
opinion pertinent to the
medicine, surgery or obstetrics cannot in a civil case,
without the consent of the patient, be examined as to issue and medical in nature.
any information which he may have acquired in
Sec. 42, Rule 130, Rules of Court – Opinion Rule – General Rule –
attending such patient in a professional capacity, which
The opinion of a witness is not admissible, except as indicated in
information was necessary to enable him to act in that
the following section.
capacity, and which would blacken the character of the
o Sec 43, Rule 130, Rules of Court – Expert Evidence – The
patient.
opinion of a witness regarding a question of science, art
2. A medical witness can only testify on matters derived by his
own perception or trade, when he is skilled therein, may be received in
evidence.
 Hearsay information are as a rule not admissible in court.
o Probative value of expert medical testimony depends
o Hearsay evidences are those not proceeding from
upon –
the personal knowledge of the witness but from
 Degree of learning; and
mere repetition of what he has heard others say.
 Experience on the line of what the medical expert is
o It is“second hand” evidence which rest mainly on
testifying;
the veracity and competence of its source.
 Basis and logic of his conclusion; and
 Sec. 30, Rule 130, Rules of Court – Testimony generally
 Other evidences tending to show the veracity or
confined to personal knowledge – A witness can testify
falsity of his testimony.
only to those facts which he knows of his own
knowledge; that is, which are derived from his
 When a doctor goes to court, he is usually
perception, except as otherwise provided in this rule. presented both as an ordinary and expert witness.
He goes to court to testify his findings and also he goes
to court to give his opinion on medical and health
correspondence (?).

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 LEGAL MEDICINE THE DOCTOR AS A WITNESS
 For example, Doctor Lodroňo was mauled by the wife.
He was patient and I issued a medical certificate for him.
After 3 years, I receive a subpoena to appear in court to
testify as witness. I am now in court and I am being
asked these questions –
Did I answer as
Ordinary or
Expert Witness?
Dr. Rebosa what were the injuries Ordinary witness;
sustained by Dr. Lodroňo? the question was
He sustained multiple lacerations, what was your
punctured wounds, incised wounds, stab finding? Although
wounds, contusions, hematoma, I answered in
desquamation, fracture, burns, scalding medical term
etc.
So Dr Rebosa what were the procedures Ordinary witness
performed? I performed craniotomy,
exploratory laparotomy, splenectomy,
hemorrhoidectomy, circumcision, D&C
How long do you think is the distance Expert witness
between the victim and the assailant?
How long will he require medical
attendance?
What d’you think is the caliber of the gun
used?
Which of these injuries were inflicted
first?
Which of these injuries are important?
 But sometimes the doctor is being presented merely
as an ordinary witness. He is just there to identify
something. Ex. Dr Rebosa I am showing to you a
metallic fragment that was allegedly extracted from the
body of the victim, you earlier testified that you extracted
the metallic fragment. Will you please go over this
fragment and please tell us the relation of this fragment,
the fragment that should be extracted from the body of
the victim? I am being asked to identify, ordinary /
expert? Ordinary witness.
 So what do you think is the metallic composition?
Expert witness.
 But sometimes also, the doctor is being presented as
purely as an expert witness. The doctor doesn’t know
who the patient is. He never attended the patient, he just
goes to court to testify on the basis of the medical record
of the -ator. He is there to give his comments on
testimony given by other doctors.
Example The patient dies on account of suspicion of
medical negligence. Patient undergoes autopsy, the
doctor who performed the autopsy is now in the witness
stand.
Ordinary/Expert?
Doctor what are your findings? Ordinary
I found out that there was a
cellphone that was left in the
abdominal cavity.
Doctors is that a usual occurrence Expert
after exploratory laparotomy?
No that is not a usual occurrence.
Doctor if a doctor leaves a cellular Expert
phone or a foreign body is that
indicative of negligence? Yes
 The doctor there was presented both as an ordinary and
as an expert. So yung doctor ngayon na defendant
kailangan niya mag-present ng Expert witness to rebut
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TONY REBOSA, MD
the testimony given by the doctor who performed
autopsy. Kunwari ako yung witness niya –
 So Dr Rebosa here is being presented purely as an
expert witness to testify on the basis of the autopsy
report and to give his comments on the testimony given
by the doctor who performed the autopsy.
Doctor Rebosa did you see the patient? No
Doctor Rebosa, have you read the TSF on the testimony
o the other doctor? Yes
Doctor Rebosa is it usual for doctors to leave foreign
bodies like a cellphone during exploratory laparotomy?
Yes, that can happen anytime.
Doctor Rebosa, if somebody leaves a cellphone is that
indicative of negligence? No, it can happen even to the
best of them
Did I testify as ordinary/expert? Expert.
WHEN WILL A DOCTOR GO TO COURT?
 If he receives a subpoena
 Subpoena – an order of the court directed to a
particular person to appear at a specified date, time and
place.
o Subpoena testificandum – subpoena for them to
go to court and testify.
o Subpoena duces tecum - For them to go to court
and read documents and the medical records or the
autopsy report for the stab or the bullet
 When a doctor receives a subpoena, the decision to go
is a subpoena testificandum and duces tecum. For the
doctor to go to court, bring the medical documents and
then testify.
 Why go to court especially in criminal cases? Because if
you don’t go, you will be cited for contempt.
Testimonial Evidence: A physician may be commanded to appear
before a court to give his testimony. While in the witness stand, he
is obliged to answer questions propounded by counsel and
presiding officer of the court. His testimony must be given orally
and under oath or affirmation (p. 13).
IN COURT ROOMS –
 We do not conduct hearings in tagalong, everything
is in English.
 All the witnesses being presented if their testimony
is given in tagalong or the vernacular, it is translated
into English.
 In the TSF, what will appear in the Transcript of
Stenographic notes will be in English.
TWO KINDS OF CONTEMPT
1. Direct Contempt
 Inside or anywhere near the court room
 How can a Judge cite you for direct contempt?
o Being disrespectful: eating, slouching, sleeping,
chewing gum, an act of cellphone (kapag nag-
ring ‘yan), you’re suppose to pay attention to
proceedings you cannot play games (on your
cellphone), you cannot read newspapers, you
cannot read books
o Yung ibang court bawal naka-slouch or cross
legs. Everybody must pay attention.
o And you must be decently dressed.
o And you must address the lawyers with
respect; lawyers are considered officers of the
court. You have to address them as
Sir/Ma’am. What about judges? “Your Honor”
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 LEGAL MEDICINE THE DOCTOR AS A WITNESS TONY REBOSA, MD

o The people outside are so noisy, you cannot to get medical certificates. Get doctors who will testify
hear each other and they’re interfering with the for us and besides are we forbidden to issue medical
proceedings, they can also be cited for Direct certificates for ourselves? Is there are that forbids me?
Contempt. There is none! There is nothing in the rules that we
o Penalty of a Fine of up to 200 pesos and a cannot issue medical certificates for ourselves and for
prison term of up to 10 days. There should our immediate family.
be a receipt when imposed with a fine.  What is prohibited from us is issuing medical certificate
o Lawyers when we appear in court we must for the dog of our neighbor. That is illegal practice of
wear long sleeves barong or coat and tie. We veterinary medicine. You issue medical certificate for
cannot wear short sleeves, short sleeves is humans, not animals.
only for the prosecutors’ office or only for the
SKELETAL REMAINS, BLOOD
PRC? Hindi pwedeng coat without the necktie
or long sleeves with necktie without the coat.
o Lady lawyers should wear blazer and probably, SKELETAL REMAINS
hindi pwede miniskirts, up to knee siguro.
Bawal yung plunging. Lady lawyers bawal ang If you see a skeletal remain, are you sure it’s a bone?
earrings, long hair dapat naka-ponytail. Baka naman plastic lang.
2. Indirect Contempt  
 Outside of the court Human bone Animal bone
Example 
 There was an order of the court for you to do Male or a Female?
something, you refused to do it. Determine the sex –
 There was an order of the court for you to stop  By way of the Pelvis
doing whatever it is that you are doing  cease  With radio-
and desist order but you defy the order. What is the race?
 Nakatatlong subpoena ka na to appear in court ni-  Caucasian
ho ni-ha hindi mo ininform the court you’re going.  European
So usually before you’re cited for Indirect contempt,  Malaysian
the court will send you a love letter  show cause  Chinese
order  contains - you are hereby ordered to How? Ako siguro, estimate
explain in writing within three days from receive? the height of the bones
and explain why you should not be cited for o > 6 feet, I don’t think
contempt for your failure to appear in today’s it’s FIlipino
hearing despite due notice thereby delaying the o Ave Height of Filipino:
speedy disposition of justice. Male – 5’6’;
 Hindi ka pa din sumulat, you did not even attend the Female – 5’2”
next scheduled hearing. You are now cited with
indirect contempt which carries with it a penalty of a In the Examination of Bones, the following points can be
Fine of up to 30,000 pesos and prison term of up determined approximately:
to 6 months. 1. Whether the remains are of human origin or not
2. Whether the remains belong to a single person or not
WHAT ARE THE USUAL VALID REASONS GIVEN BY 3. Height
DOCTORS WHY THEY ARE ABSENT? 4. Sex
 You have an emergency 5. Race
st
o Example, The 1 time I could not leave the hospital 6. Age
because of too many patients who are needing 7. Length of interment or length of time from date of death
medical treatment. 8. Presence or absence of ante-mortem or post-mortem bone
o Second time around your honor, I was already injuries
going to court but then I received a phone call to go 9. Congenital deformities and acquired injuries on the hard
back to the hospital. tissues causing permanent deformities.
o Third time your honor, I was already within the
premises of the court but I was called again.  Suggestive of Human Remains –
o Fourth time your honor, I was sick. a. Oval or round shape of the skull
o Fifth time your honor, I died but I was revived. b. Less prominent lower jam and nasal bone
o Sixth time I was abroad.
o So yun yung mga reason.
In determination of the Sex of the Skeleton, the following bones
 When lawyers or litigants are absent, they are usually
must be studied:
required by the court to present a medical certificate if
their reason for being absent is that because they are  Pelvis  Femur
sick. So the court would not ordinarily believe he’s sick.  Skull  Humerus
So they are supposed to present a notarized medical  Sternum
certificate.
 But how come when it’s the doctor to tell the court he
was absent because he was sick, more often than not
the court will not anymore require the doctor to submit a
medical certificate. Why? Because it’s very easy for us

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 LEGAL MEDICINE THE DOCTOR AS A WITNESS TONY REBOSA, MD

DIFFERENCE BETWEEN A MALE AND A FEMALE PELVIS BLOOD

MALE FEMALE
Heavier construction wall more Lighter construction wall less If you see Blood
pronounced pronounced 
Human blood Animal blood
Height greater and flays off its Height lesser and flays off its

wall more pronounced wall less pronounced
Is that of a Male or
Pubic arch narrow and less Pubic arch wider and rounder Female?
round How? Usually through
Diameter of the true pelvis less Diameter of the true pelvis hormones.
greater  Maraming estrogen  Babae
Curve of the iliac crest reaches Curve of the iliac crest is of the Maraming testosterone Lalake
a higher level lower level But that’s not truthful anymore, maraming mga lalake
Narrow greater sciatic notch Wide greater sciatic notch mataas ang estrogen. Marami namang mga babae
Body of the pubis narrow Body of the pubis wider nagtetestosterone.
Iliopectineal line sharp Iliopectineal line rounded  Even if they’re not having problems with their sexual
Obturator foramen egg-shaped Obturator foramen triangular orientation, there are some people who really have
higher testosterone level.
Sacrum short and narrow Sacrum long and wide
LEGALIMPORTANCE OF THE STUDY OF BLOOD
CRANIUM
MALE FEMALE 1. Paternity and maternity (for disputed parentage)
Less curve of shaft More curve of shaft  In the Philippines, maternity is not a problem. We
really know who the mother is.
Mastoid process larger Predominance of cranial roof
 In vitro fertilization or surrogate motherhood is
over cranial base Mastoid
usually done elsewhere.
process smaller
 The problem here is Paternity testing. Everybody is
Cranium placed horizontally Cranium placed horizontally a denial king.
rests on mastoid process rests on the occipital and  The test is called HLA test – Human Leukocytic
maxillary bones Antigen Test (DNA-based)
Styloid process shorter Styloid process longer and o Just like DNA, cannot be 100% accurate. It’s
slender only about 99%, in some institution – 94-97%.
Forehead higher and more Forehead less high and more o Even at 99%, there’s a 1% chance that even if
oblique vertical the blood test is positive and compatible. You
Superciliary ridges less sharp or Superciliary ridges sharper may not be the father. Why? What is the total
more rounded population of the world right now? 7 Billion. Ano
Zygomatic arches and frontal Zygomatic arches and frontal pinakamarami? Mainland China (about 1.6
sinuses more prominent sinuses less prominent Billion, if you had to count the Chinese in all
over the world, not the China town, yung
Lower jaw larger and wider Lower jaw narrower and lighter
Chinese decent. Most probably it’ll be
and chin not projecting
numbering in 3 Billion. Half of the total
population is Chinese) who’s next? Indians in
Other Differential Racial Characteristics of Skeletons: 1.2 Billion. So there are only 2 kinds of people
Caucasian Mongolian Negro in the world, either you’re Chinese or your
Skull Elongated Square Narrow and Indian.
elongated o Philippines, total population: 103 – 104 Million
Forehead Raised Inclined Small and o America, US; About 500+ Million
compressed o Even if the Paternity test is 99% accurate, may
Face Proportionately Small Malar bones and 1%. The total population of the world is 7
small jaw projecting; Billion; half of them are males (3.5Billion). 1%
teeth set obliquely of 3.5 Billion is 35 Million. So even if the test is
positive, it is possible that there could have
Upper Small Small Long in proportion
been some 35 Million other males.. But what
Extremity to body; forearm
are the odds?
large in proportion o Test is only presumptive, not conclusive. But if
to arm; hand small the blood test is negative, it is 101% sure you
Lower Normal Small Legs large in are not the father.
Extremity proportion to 2. Circumstantial or Corroborative evidence against or in favor of
thighs; feet wide the perpetrator of a crime
and flat, heel bones  “A” was found dead with a deep stab wound on the
projecting chest
backwards  “B” was found with a kitchen knife in his hand stained
with blood
 Examination of the weapon showed that the stain was
blood of human origin and belonging to the same group
as that of the deceased “A’.

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 LEGAL MEDICINE THE DOCTOR AS A WITNESS TONY REBOSA, MD

 With such result of examination, investigating authorities
have a very strong presumption that “B” was the one
who committed the crime.
3. Determination of the Cause of Death
 The amount of blood or blood stains found in the scene
of the crime or found inside the body of the deceased
outside the blood vessels may imply that the cause of
death of the person is hemorrhage.
4. Determination of the direction of escape of the victim or the
assailant
 The shape of the blood or blood stains will give the
investigator an idea on the direction of the source of
blood. Usually in small drops, the tapering end of the
blood spot is towards the direction of the moving source
of blood.
5. Determination of the approximate time the crime was
committed
 Although there are variations as to the color and soluble
changes as to regards the age of the stain, we can only
say that when there is too much change, it is not very
recent.
6. Determination of the place of commission of the crime
7. Determination of the presence of certain diseases
Disputed paternity may arise –
1. When the wife committed adultery and the husband denied
to be the father of the child
2. When a child was born out of lawful wedlock and the mother
claimed someone to be the father but he vehemently denied
it
3. In a claim for support or right of succession of the alleged
illegitimate child.
Disputed maternity may arise –
1. In case of allegation of interchange of children in a hospital or
nursery home, either accidentally or deliberately
2. In cases of wayward or stray children being claimed by two or
more women
3. For ownership of dead fetus or newly born child found in
street trash.
 Does it belong to the person in question?
 The manner, degree and condition of the article which have
been stained
 Age of the stain.
FIN!
UT IN OMNIBUS GLORIFICETUR DEUS !
Attempted vs Frustrated –
I shot Rj in the face Attempted
I shot him again, grazed his ear Attempted
I shot him in between the eyes through Frustrated
and through
In the Attempted stage even if there is no medical
attendance, you will surely survive. Pero through and
through and if not for timely medical intervention
independent of the will of the perpetrator, he would have
surely died.
2 TYPES OF CRIMES
1. Private Crimes
 Crimes against chastity, acts of lasciviousness,
seduction, abduction, adultery, pilferage
 Only the victim has the right to file the complaint
with the exclusion of all others unless the victim is a
minor and the guardian/the parents refuse to file a
case then the state may file the case for his behalf.
2. Public Crimes
 Even if the victim does not want to file the case, the
case will prosper.
 Like for instance, I killed my brother. Of course my
parents would not want to file a case against me.
The state would have to file a case against either
homicide or murder. Not parricide kasi brother ko
yun. Parricide – killing the wife, ascendants and
descendants.
 Rape used to be a private crime, now a public
crime.

For parties who do not want to undergo a paternity test or

simply the test is not available. How will the court decide
paternity?
1. Parental Likeness – there is no doubt you are the
father. Magkamukhang magkamukha kayo, parang
pinagbiyak na buko.
2. Public Acknowledgement
 Guys listen, you don’t have to acknowledge the
child as yours. Gusto mo kamustahin talaga yung
anak mo. When you text the mother, you text –
Kamusta na ang anak mo? Because if you text –
Kamusta na ang anak natin? You have just
acknowledged that he is your child.
 Text messages, letters, emails are admissible
evidence.
 Never never acknowledge. Do not acknowledge
because you cannot anymore deny paternity

Problems to be answered in the Examination of Blood

 Determine whether the stain is due to blood.
 If due to blood, determine whether it is of human origin or
not.
 If it is of human origin, to what group does it belong?

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