INTRODUCTION

LEGAL MEDICINE
-branch of medicine which deals with the
application of medical knowledge to the
purposes of law and in the administration
of justice
Forensic medicine
-application of medical science to
elucidate legal problems
Medical jurisprudence
-application of legal knowledge to the
practice of
medicine

Nature of the Study of Legal Medicine

-a knowledge of legal medicine means the
ability to acquire facts, the power to
arrange those facts in their logical order
and to draw conclusion from the facts
which may be useful in the administration
of justice
Medical Jurist (Medical Examiner/Medico-legal Officer/
Medico-legal Expert)
-physician who is involved primarily with medicolegal duties

Sec.95, Code of Sanitation

-health officers, medical officers of law
enforcement agencies and members of the
medical staff of accredited hospitals are
authorized to perform autopsies
Sec.2, A.III, Code of Medical Ethics of the
Medical Profession of the Phil.
-it is the duty of every physician, when called
upon
by the judicial authorities, to assist in the
administration of justice which are medico-legal
in character

Distinction between an Ordinary Physician

and Medico-legal Officer
Ordinary Physician
Medico-legal Officer
- point of view of Tx
-point of view of cause
-arrive at definite Dx -testify in court/body
-ignores minor injuries records all injuries
Scope of Legal Medicine
-broad and encompassing
Application of Legal Medicine to Law
1.Civil law-determination and termination of civil personality
-limitation /restriction of a natural persons capacity to
act
-marriage and legal separation
-testamentary capacity of a person making a will

2.Criminal law-circumstances affecting criminal

liability
-crimes against persons
-crimes against chastity
3.Remedial/Procedural law
-physical and mental exam of
a person
-proceedings for hospitalization
of insane person
-rules on evidence
4.Special laws-Comprehensive Dangerous Drugs Act
-Child Abuse
-Anti-violence against Women and Children
-Anti-Photo and Voyeurism Act

Some Basic Principles Governing the

Application and Effects of Law:
1.Ignorance of the law excuses no one from
compliance therewith.(A.3 CC)
2.Laws shall have no retroactive effect unless
the contrary is provided. (A.4 CC)
3.Rights may be waived, unless the waiver is
contrary to law, public order, public policy,
morals, or good customs or prejudicial to a
3rd person with a right recognized by law. (A.6 CC)
4.Customs which are contrary to law, public order or public policy
shall not be countenanced. (A.12 CC)
5.Laws are repealed only by subsequent ones, and their violation or
nonobservance shall not be excused by disuse, or custom or practice
to the
contary.

When the courts declare a law to be inconsistent with the Constitution, the former shall be void and the
latter shall govern.
Administrative or executive acts, orders and
regulations shall be valid only when they are
not contrary to the laws or Constitution.
(A.7 CC)
Medical Evidence
Evidence-means, sanctioned by these rules, of ascertaining
in a
judicial proceeding the truth respecting a matter
of fact.
Admissibility of evidence- evidence is admissible when it is
relevant and is not excluded by law or these rules

Relevancy of evidence; collateral matters

-evidence must have such a relation to the
fact in issue as to induce belief in its
existence or non-existence; evidence on
collateral matters shall not be allowed,
except when it tends in any reasonable
degree to establish the probability or
improbability of the fact in issue
Types of Medical Evidence:
1.Autoptic/Real Evidence
-addressed to the senses of the court; exhibited,
examined
or viewed by the court

-limitations-indecency and impropriety

-repulsive and offensive
2.Testimonial Evidence
-physician may be summoned to appear in
court to give his testimony as an ordinary
or expert witness
-ordinary witness-can perceive and can
make known their perception to others
-expert witness-requires special knowledge, skill,
experience or
training which he is shown to possess
Disqualification by reason of privileged
communication-the

following persons cannot testify as to

matters learned in confidence in the
following cases:
a)xxx
b)xxx
c)A person authorized to practice medicine,
surgery or obstetrics cannot in a civil case, without the
consent
of the patient, be examined as to any advice or treatment
given
by him or any information which he may have acquired in
attending such patient in a professional capacity, which
information was necessary to enable him to act in that capacity,
and
which would blacken the reputation of the patient.

Testimony generally confined to personal

knowledge; hearsay excluded- a witness can
testify only to those facts which he knows of
his personal knowledge; that is, which are
derived from his own perception, except as
otherwise provided in these rules.
-exceptions-dying declaration-the declaration of a dying person
made under the consciousness of an impending
death,
may be received in any case wherein his death is the
subject of inquiry, as evidence of the cause and
surrounding circumstances of such death
-entries in official records-by a person in the
performance of a
duty enjoined by law, is a prima facie evidence of
the facts

3. Experimental Evidence
-confirmatory or as a corroborative proof
to an opinion previously stated
4.Documentary Evidence
-in the form of:
a)medical certification or report on:
1)medical exam
2)physical exam
3)necropsy/autopsy
4)lab. reports
5)exhumation
6)birth
7)death

b)medical expert opinion

c)deposition
5.Physical Evidence
-articles/materials found in connection
with the investigation and which aid in
establishing the identity of the perpetrator or the circumstances under which the
crime was committed or which aid in the
prosecution of a criminal
-types-corpus delicti-body of the crime
-associative evidence-links suspect to the crime
-tracing evidence-aid in locating the suspect
-criminalistics-application of sciences in crime detection
/investigation

Preservation of Evidence
-to maintain their value when presented
in court
Methods of preserving evidence:
1.photographs, audio &/ video tape,
microfilm, photostat, etc.
2.sketching-rough, finished
3.description-needs keen observation and a good power of attention,
perception, intelligence and experience
-must cause a vivid impression on the mind of the
reader
a true picture of the thing described
a)skin lesion-type, measurement, location, other information
b)wound-type, measurement, location, other information
c)hymenal laceration-location, degree, location, duration, other
info.
d)person

4.Manikin method
5.Preservation in the mind of the witness
6.Special methods-embalming, etc.
Kinds of Evidence Necessary for Conviction:
1.direct evidence-corresponds to the actual
point at issue
2.circumstancial evidence-existence of a fact in dispute may be
inferred from the fact/s taken singly or
collectively
Weight and Sufficiency of Evidence
Preponderance of Evidence-superior weight of evidence
-civil case
Proof Beyond Reasonable Doubt-criminal case
-moral certainty

DECEPTION DETECTION
Methods of Deception Detection
1.devices which record the psychophysiological response
a)polygraph/lie detector machine
b)word association test
c)psychological stress evaluator
2.drugs that try to inhibit the inhibitor
a)truth serum
b)narcoanalysis/narcosynthesis
c)intoxication
3)hypnotism
4)by observation
5)scientific interrogation
6)confession/admission

Lie Detector/ Polygraph

-records physiological changes that occur in
association with lying in a polygraph
-fear of detection of the subject
-phases of the exam
-pre-test interview
-actual interrogation and recording thru
the instrument
-post-test interrogation
Pre-test interview
-purposes-det. If subject has any medical/psychiatric condition or
has used drugs that prevent the testing
-explain to the subject the purpose of exam
-develop the test questions
-relieve subject of apprehension and satisfy to the
efficiency of exam
-know any anti-social or criminal record of the subject

Actual Interrogation and Recording

a)Irrelevant questions-no bearing to the case
under investigation
b)relevant questions-related to the issue
under investigation; must be
unambiguous, unequivocal and
understandable to the subject; must be
very specific to get an accurate result
c)control questions-unrelated to the issue under
investigation but of same nature and less serious; most reliable and
effective questioning technique; used if there is doubt in the
interpretation of response to relevant and irrelevant questions
Relevant-irrelevant question technique is used in practice. The subject
is truthful if there is no significant difference between the relevant and
irrelevant questions. The subject is said to be lying if he responds more to
relevant questions.

Post-test Interrogation
-purposes-clarify the findings
-learn if there are any other
reasons for the subject responding to a relevant question other
than the knowledge of the crime
-get additional info.and admission
Supplementary tests
1.Peak-of-tension test
-subject not yet informed of the details of the crime
2.Guilt complex test
-used when response to relevant and control questions are
similar in degree
and consistency and examiner cannot det. if subject is telling
the truth/not

3.Silent answer test

-subject is instructed to answer the
questions silently; this is effective if
the subjects verbal response causes
distortion in the tracing such as sniff
or clearing of throat
A person cannot be compelled to take the lie
detector test as it infers the use of intelligence and attention or other
mental faculties which is self-incriminatory.
The test is inadmissible in court.
Factors responsible for the 25% errors of the lie detector:
1.Nervousness or extreme emotional tension experienced
by the subject who is telling the truth regarding the offense but who is
affected by:
a)apprehension by the fact that suspicion or accusation has been
directed against him
b)apprehension over possibility of inaccurate result
c)over-anxiety to cooperate to assure an accurate result

d)apprehension over possibility of

physical hurt from the machine
e)anger resentment over having to
take the test
f)over-anxiety over serious personal
problems unrelated to the offense
under investigation
g)previous extensive interrogation esp.
when accompanied by physical abuse
h)guilt-complex or fear of detection over other offense done
by the subject
2.Physiological abnormalities;
a)excessively high/low BP
b)diseases of the heart
c)respiratory disorder

3.Mental abnormalities:
a)feeblemindedness
b)psychosis or insanities
c)psychoneurosis and psychopathy
4.Unresponsiveness of guilty subject due to:
a)no fear of detection
b)apparent inability to consciously control response by means
of certain mental sets of attitudes
c)condition of sub-shock or adrenal exhaustion at time of test
d)rationalization of the crime in advance- arouse little or no
emotional
disturbance
e)extensive interrogation prior to the test

5.attempt to beat the machineby controlled

breathing or by muscular flexing
6.unobserved application of muscular pressure
which produces ambiguities and misleading
indications in the BP tracing
Word Association test
-the time interval between the words said by the examiner
and
the answer of the subject is recorded
-if the subject is asked with non-stimulus questions (no
relation
to the subject matter)-tendency to answer quickly; if stimulus
questions (related to subject matter)-tendency to delay
answer

Psychological Stress Evaluator

-detects, measures and graphically displays
the voice modulations that we cannot hear
-when not telling the truth-microtremor in
the voice utterance is suppressed; when
relaxed and responding honestly-the
inaudible frequencies are registered clearly
Administration of Truth Serum
-hyoscine hydrobromide is administered until a state of delirium
is induced
-feels compulsion to answer the questions truthfully; forgets his alibi
or may give details of his acts or may implicate others
Narcoanalysis/Narcosynthesis
-sodium amytal /sodium penthotal is used

Intoxication with Alcohol

-mask of sanity; in wine there is truth
-questioning must start during the excitatory
state-when subject has the sensation of his
well-being and his action, speech and
emotions are less strained due to lowering
of the inhibition
Hypnosis
-alteration of consciousness and concentration in which the
subject manifests a heightened of suggestibility while
awareness
is maintained
-may be used as a discovery procedure

Observation
Physiological and Psychological S/S of Guilt:
1.sweating-with flushed face indicates
anger, embarrassment or
extreme nervousness
-with pale face may indicate
shock or fear
-sweating hands-tension
2.color change-flushed face-anger, embarrassment, shame
-pale face-guilt
3.dryness of mouth-nervous tension
4.excessive activity of the Adams apple-nervous tension
5.fidgeting-nervous tension
6.peculiar feeling inside-troubled conscience
7.swearing to the truthfulness of his assertion
8.spotless past record
9.inability to look at the investigator straight n the eye
10.not that I remember expression

Scientific Interrogation
Sec.20, A.IV, Bill of Rights, Constitution
-No person shall be compelled to be a
witness against himself. Any person under
investigation for the commission of an
offense shall have the right to remain
silent and to counsel, and be informed of
such right. No force, violence, threat,
intimidation. or any other means which vitiates the free
will shall be used against him.
Some Techniques of Interrogation:
1.emotinal appeal
2.Mutt and Jeff technique
3.bluff on split-pair technique
4.stern approach
5.the subject is given the opportunity to make a lengthy narration

Confession
-Sec.33, R130,ROC-the declaration of an
accused acknowledging his guilt of the
offense charged, or of any offense
necessarily included therein, may be given
in evidence against him.
Admission
-Sec.25,R130,ROC-the act, declaration or
omission of a party as to a relevant fact may
be given in evidence against him.
Kinds of Confession:
1.extra-judicial confession-made outside of the court
2.judicial confession-made in court
Tokyo declaration-guidelines to be observed by physicians concerning torture
and
cruel, inhuman and degrading treatment in relation to
detention

MEDICO-LEGAL ASPECTS OF
IDENTIFICATION
Importance of Identification of Person:
1.prosecution of criminal offense-identity of
the offender and victim must be
established, otherwise, the case may be
dismissed
2.identification of a person missing or
presumed dead will facilitate settlement of
the estate, retirement, insurance and other
social benefits
3.resolves the anxiety of the relatives and friends over the
whereabouts of a missing person, victim of calamity or a
criminal act
4.needed in some transactions- cashing of check, sale of
property, etc.

Rules in Personal Identification:

1.The greater the number of points of
similarities and dissimilarities of 2 persons
compared, the greater is the probability
for the conclusion to be correct.
2.The value of the different points of
identification varies in the formulation of
conclusion.
-in fresh cadaver, fingerprints on file and those recovered from
the crime scene will positively establish the identity of person
3.The longer the interval between the death and the exam of the remains
for
purposes of identification, the greater is the need for experts in
establishing the
identity.
4.if the object to be identified is highly perishable, there is need to act in
the
shortest possible time.
5.There is no rigid rule to be observed in the procedure of identification.

Methods of Identification:
1.by comparison
2. by exclusion
Ordinary Methods of Identification:
A.Applicable to the Living Person only
1.characteristics which may easily be
changed
a)growth of hair, beard or mustache
b)clothing
c)frequent place of visit
d)grade of profession
e)body ornamentations
2. characteristics that may not easily be changed
a)mental memory
b)speech

c)gait
d)mannerism
e)hands and feet
f)complexion
g)changes in the eye
h)facies
i)left- or right-handedness
j)degree of nutrition
B.Applicable to both the living and dead
1. occupational marks
2.race-color of the skin, feature of the face, shape of the
skull,
wearing apparel
3.stature
methods of approximating the height of a person
4.tattoo marks

5.weight
6.deformities
7.birth marks
8.injuries leaving permanent results
9.moles
10.scars
Age of scars:
-recently formed scar-slightly raised, reddish or bluish and
tender to touch
-few weeks to 2 months- has inflammatory redness, soft
and sensitive
-2-6 months later-brownish or coppery red, free from
contraction and corrugation, and soft
-more than 6 months-white, glistening, contracted, tough

11.tribal marks
12.sexual organ
13.blood exam
Anthropometry (Bertillon system)
Basis of the Bertillon system of Identification
1.The human skeleton is unchangeable after the 20 th year.
2.It is impossible to find 2 human beings having bones exactly
alike.
3.The necessary measurement can easily be taken with the aid
of a simple instrument.
Portrait Parle (spoken picture)
-a verbal, accurate and picturesque description of the person
identified
-information may be given by witness, relatives, other persons

acquainted with the person to be identified.

If available, the investigator may look at the
rougues gallery or photographic files of
wanted or missing persons for comparison
with the cartographic sketch.
Light as a Factor in Identification:
1.clearest moonlight or starlight
-the best known person cannot be recognized at a distance
greater than 16-17y and by starlight any further than 10-13y
2.broad daylight
-a person can hardly recognize another person at a distance
farther than 100y if the person hasnt been seen before
3.flash of lightning produces sufficient light for identification of
person
provided that the persons eye is focused towards the person

Scientific Methods of Identification:

1.fingerprinting
2.dental identification
3.handwriting
4.identification of skeleton
5.identification of sex
6.identification of age
7.identification of blood and blood stains
8.identification of hair and fibers
Fingerprinting
-most valuable method of identification bec.a)there are no 2 identical fingerprints-the chances of 2
fingerprints
being the same are calculated to be 1 to 64,000,000,000
b)fingerprints are not changeable-fingerprints are formed in 4 th
mo. of fetal life

Uses of fingerprints:
1.help establish the identity of unknown or
missing or dead persons
2.associate a person or weapon to the crime
3.comparative purposes and knowledge of
previous criminal records
4.among illiterates, right thumbprint is a
substitute for signature on legal document
Dactylography-art and study of recording fingerprints as a
means of
identification
Dactyloscopy-art of identification by comparison of fingerprints
-study and utilization of fingerprints
Poroscopy-study of the pores in papillary ridges for identification

Can fingerprints be effaced?

-as long as the dermis of the bulbs of the
finger is not completely destroyed, the
fingerprints will always remain unchanged
and indestructible
Can fingerprints be forged?
-no case on record known or have been
been written that forgery of fingerprints
has been a complete success
Dental Identification
Reasons for importance of dental identification:
1.There is remote possibility that 2 persons have the same
dentition.
2.The enamel of the teeth is the hardest substance of the
body.

3.After death, the greater the degree of

tissue destruction, the greater is the
importance of dental characteristics as a
means of identification.
4.The more recent the ante-mortem records
of the person to be identified, the more
reliable is the comparative/exclusionary
mode of identification that can be done.
P.D. 1575-requiring dental practitioners to keep
the records of their patients for a period of 10yrs. After
which they shall be turned over to NBI for record purposes
Causes of unreliability of dental records:
1.The dentist may only concern himself with the affected teeth and
may not care to have a detailed exam of the other teeth.

2.There may be no uniformity in nomenclature of the location and condition in the

charting of the teeth.
3.The law did not mention the agency which
will enforce it.
4.The record may no longer be reliable due to
lapse of time.
Handwriting
Uses of handwriting examination:
1.financial crimes-bogus checks, credit card fraud,
embezzlement
2.death investigation-suicide note, hotel registration
card

3.robberies-pawnshop notes, cashing of

stolen checks
4.kidnapping with ransom-demand note,
threatening letter
5.anonymous threatening letter
6.falsification of documents
Purpose of handwriting examination:
1.whether the document was written by the suspect
2.whether the document was written by the person whose
signature it bears
3.whether the writing contains additions and deletions
4.whether the document such as bills, receipts, suicide
notes or checks
are genuine or a forgery

Bibliotics-science of handwriting analysis

-study of documents and writing
materials to determine its
genuineness or authorship
Graphology-study of handwriting for the
purpose of determining the writers
personality, character and aptitude
Disguised writing-deliberate attempt on the part of the writer
to alter
his writing habit by inventing a new writing style
or by
imitating the writing of another person
Signature forgery-a signature appearing on the document
and the
person has denied that he signed it

Types of signature forgery:

1.traced forgery-outlining of a genuine
signature from one document to
another
2.simulated forgery-attempt to copy in a
freehand manner the characteristics
of a genuine signature either from
memory or model
3.spurious forgery-prepared primarily in the forgers own
handwriting with little or no attempt to copy the
characteristics of the genuine writing
Classes of documents:
1.public
2.private

Sec.20,R132,ROC-Proof of private documentBefore any private document offered as

authentic is received in evidence, its due
execution and authenticity must be proved
either:
a)by anyone who saw the document
executed or written, or
b)by evidence of the genuineness of the
signature or handwriting of the maker.
Sec.22,R132,ROC-How genuineness of handwriting provedThe handwriting of a person may be proved by any witness
who
believes it to be the handwriting of such person because he
has
seen the person write, or has seen the writing purporting to
be

his upon which the witness has acted or

been charged, and has thus acquired
knowledge of the handwriting of such
person. Evidence respecting the handwriting may also be given by a comparison
made by the witness or the court, with
writings admitted or treated as genuine by
the party against whom the evidence is offered,
or proved to be genuine to the satisfaction of the judge.
Sec.50,R130,ROC-Opinion of ordinary witnesses-The opinion
of a witness for which proper basis is given, may be
received in
evidence regardinga)the identity of a person about whom he has adequate

knowledge;
b)a handwriting with which he has
sufficient familiarity; and
c)the mental sanity of a person with whom
he is sufficiently acquainted.
A witness may also testify on his impression
of the emotion, behavior, condition or
appearance of a person.
Identification of the Skeleton
Points that be determined approximately:
1.whether the remains are of human origin or not
2.whether the remains belong to one person or not
3.height

4.sex
5.race
6.age
7.length of interment or length of time from
the date of death
8.presence or absence of ante-mortem or
post-mortem bone injuries
9.congenital abnormalities
How to determine whether the remains are of human origin or
not:
-human-skull is oval or round with less prominent lower jaw
and
nasal bone
-presence of ornamentations, wearing apparel

How to determine whether remains comes

from a 1 person or not:
-a complete lay-out of bones in their exact
location is necessary
-any excess of bones means that the remains
belong to more than 1 person
-except-supernumerary fingers/toes
Height
-actual length of skeleton add 1-1 in. for soft tissues
-Pearsons formula, etc.

Determination of the sex of the skeleton

-bones to be studied-pelvis, skull, sternum,
femur, humerus
-pelvis-female-pubic arch wider & rounder
-diameter of true pelvis is
greater
-male-pubic arch narrow & less round
-diameter of true pelvis is lesser
Determination of the race of the skeleton
-bones to be studied-skull, pelvis, extremities

Determination of the age of the skeleton

1.appearance of ossification centers
2.union of bones and epiphyses
3.dental identification
4.obliteration of cranial sutures
Determination of the duration of interment
1.presence/absence of soft tissues still adherent to the bones
2.firmness and weight, brittleness, dryness of bones
3.degree of erosion of the surface of bones
4.changes in the clothings, coffin, painting
Determination of presence/absence of ante-mortem/post-mortem
injuries
-presence of fractures-sustained during life or during
exhumation?

Tests to Determine the Sex

1.social test
2.genital test
3.gonadal test
4.chromosomal test
-problems in sex determinationa)gonadal agenesis
b)true hermaphrodite
Evidences of sex:
1.presumptive evidence
2.highly probable evidences
3.conclusive evidence

Determination of Age
Legal Importance of Determination of Age:
1.aid in identification
2.determination of criminal liability
3.determination of right of suffrage
4.determination whether person can
exercise civil rights
5.determination of capacity to contract marriage
6.as requisite to certain crimes
Determination of the age of the fetus:
1.Hesss and Haases rule
2.exam of the product of conception
Age determination during infancy
1.height and weight
2.physical characteristics of infant

Age determination in childhood and

adulthood:
1.eruption of teeth
2.appearance of ossification centers
3.union of epiphysis with shaft of bones
4.obliteration of cranial sutures
Other points to consider in the determination of age:
1.appearance of secondary sexual characteristics
-growth of pubic hair
-changes of the breasts in female
2.develoment of the voice
3.changes in the hair color
4.grade or year in school
5.degree of mental development
6.manner off dressing, wrinkles of the skin, etc