LEGAL MEDICINE

LEGAL MEDICINE DEFINED

 branch of science which deals with application of

medical knowledge to the purposes of law and in
the administration of justice. It is the application of
basic and clinical, medical and paramedical
sciences to elucidate legal matters.
 Concept and practice of Legal Medicine in the
Philippines is of Spanish origin.
 LEGAL MEDICINE Vs. FORENSIC
MEDICINE
LEGAL MEDICINE FORENSIC MEDICINE

 Application of  Application of
medicine to legal medical science to
cases elucidate legal
problems
 MEDICAL JURISPRUDENCE

 knowledge of law in relation to the practice of

medicine. It concerns with the study of the rights,
duties and obligations of medical practitioner with
particular reference to those arising from doctor-
patient relationship.
NATURE OF THE STUDY OF LEGAL
MEDICINE

 Knowledge of legal medicine means the ability to

acquire facts, the power to arrange those facts in
their logical order, and to draw a conclusion from
the facts which may be useful in the administration
of justice.
 Medical Jurist (medical examiner, medico-legal
officer, medico-legal expert) – a physician who
specializes or is involved primarily with medico-
legal duties. They are mostly in the service of the
government.
NATURE OF THE STUDY OF LEGAL
MEDICINE

 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.
NATURE OF THE STUDY OF LEGAL
MEDICINE

 To be involved in medico-legal duties, a physician

must possess sufficient knowledge of:
 Pathology

 Surgery

 Gynecology

 Toxicology

 Other branches of Medicine germane to the issues

involved.
 ORDINARY PHYSICIAN/ MEDICAL
JURIST
ORDINARY PHYSICIAN MEDICAL JURIST

 Sees an injury or  Sees injury or disease

disease on the point of on the point of view of
view of treatment cause
 ORDINARY PHYSICIAN/ MEDICAL
JURIST
ORDINARY PHYSICIAN
 Purpose in examining  Purpose in examining
a patient is to arrive
at a definite diagnosis
so that appropriate
treatment can be
instituted

MEDICAL JURIST
a patient is to include
those bodily lesions in
his report and testify
before the court or
before an investigative
body
 ORDINARY PHYSICIAN/ MEDICAL
JURIST
ORDINARY PHYSICIAN
 Minor or trivial injuries  Records all bodily
are usually ignored
inasmuch as they do
not require usual
treatment.
MEDICAL JURIST
injuries even if they
are small or minor
because these injuries
may be proofs to
qualify the crime or to
justify the act.
 EXAMPLES

 Presence of PHYSICAL INJURIES of a victim of

sexual abuse = presumes that force was applied;
hence, crime committed must be RAPE.
 Presence of PHYSICAL INJURIES on the offender of
the crime of physical injuries= proof that the victim
acted in SELF-DEFENSE.
 OTHER DEFINITIONS

 LAW- rule of conduct, just, obligatory, laid by

legitimate power for common observance and
benefit.
 Characteristics of Law:
 It is a rule of conduct;
 It is dictated by legitimate power; and

 Compulsory and obligatory to all.

 OTHER DEFINITIONS

 Forms of Law:
 A. Written or Statutory Law (Lex Scripta)
composed of laws which are produced by the
country’s legislations and which are defined,
codified and incorporated by the law-making
body.
 Ex. Philippine Laws
 OTHER DEFINITIONS

 Forms of Law:
 B. Unwritten or Common Law (Lex non Scripta)
composed of unwritten laws based on immemorial
customs and usages. Sometimes referred to as case
law, common law, jurisprudence or customary law.
Ex. Laws of England.
 OTHER DEFINITIONS

 FORENSIC
 denotes anything belonging to the court of law or
used in court or legal proceedings or something
fitted for legal or public argumentations.
 OTHER DEFINITIONS

 MEDICINE
a science and art dealing with prevention, cure and
alleviation of disease.
 It is that part of science and art of restoring and
preserving health.
 It is the science and art of diagnosing, treating,
curing and preventing disease, relieving pain, and
improving the health of a person.
 OTHER DEFINITIONS

 LEGAL
 that pertains to law, arising out of, by virtue of or
included in law.
 Refers to anything conformable to the letters or
rules of law as it is administered by the court.
 OTHER DEFINITIONS

 JURISPRUDENCE
 scienceof giving a wise interpretation of the law
and making just application of them to all cases as
they arise.
 PRINCIPLE OF STARE DECISIS

 A principle that, when the court has once laid

down a principle of law or interpretation as
applied to a certain state of facts, it will
adhere to and apply to all future cases where
the facts are substantially the same.
 BRANCHES OF LAW WHERE LEGAL
MEDICINE MAY BE APPLIED
 In CIVIL LAW, knowledge of legal medicine may be
useful on the following:
 1. Determination and termination of civil personality
(Art.40-41);
 2. Limitation or restriction of a natural person’s capacity
to act (Art. 23 and 29);
 3. Marriage and legal separation

 4. Paternity and filiations

 5. Testamentary capacity of a person making a will.

 BRANCHES OF LAW WHERE LEGAL
MEDICINE MAY BE APPLIED
 In CRIMINAL LAW, legal medicine is applicable in
the following provisions of the Penal Code:
 1. Circumstances affecting criminal liability;
 2. Crimes against person;

 3. Crimes against chastity.

 BRANCHES OF LAW WHERE LEGAL
MEDICINE MAY BE APPLIED
 In REMEDIAL LAW, legal medicine is applied in the
following provisions of the Rules of Court:
 1. Physical and mental examination of a person (Rule
28);
 2. Proceedings for hospitalization of an insane person

(Rule 101); and

 3. Rules on evidences (Part IV).
 BRANCHES OF LAW WHERE LEGAL
MEDICINE MAY BE APPLIED
 In SPECIAL LAWS:
 1. Dangerous Drug Act (RA 6425, as amended)
 2. Youth and Child Welfare Code (PD 603)

 3. Insurance Law (Act No. 2427 as amended)

 4. Code of Sanitation (PD 856)

 5. Labor Code (PD 442)

 6. Employee’s Compensation Law

MEDICAL EVIDENCE
 EVIDENCE
 the means, sanctioned by the Rules of Court, of
ascertaining in a judicial proceeding the truth
respecting a matter of fact.
 If the means employed to prove a fact is medical in
nature then it becomes a medical evidence.
 TYPESOF MEDICAL EVIDENCE
 1. AUTOPTIC OR REAL EVIDENCE
 evidence made known or addressed to the senses
of the court.
 It is not limited to that which is known through the
sense of vision but is extended to what the sense of
hearing, taste, smell and touch is perceived.
 Limitations to the Presentation of
Autoptic Evidence
 a) Indecency and Impropriety
 presentation of evidence may be necessary to
serve the best interest of justice but the notion of
decency and delicacy may cause inhibition of its
presentation.
 Ex: Court may not allow exposure of the genitalia of an
alleged victim of sexual offense to show the presence
and degree of the genitalia and extra-genitalia injuries
suffered
 Limitations to the Presentation of
Autoptic Evidence
 b) Repulsive objects and those offensive to
sensibilities
 foul smelling objects, persons suffering from highly
infectious and communicable disease, or objects
which when touch may mean potential danger to
the life and health of the judge may not be
presented.
 Limitations to the Presentation of
Autoptic Evidence
 However, if such evidence is necessary in the
adjudication of the case, the question of indecency
and impropriety or the fact that such evidence is
repulsive or offensive to sensibilities, it may be
presented. This will depend on the sound discretion
of the court.
 TYPESOF MEDICAL EVIDENCE
 2. TESTIMONIAL EVIDENCE
 physician may be commanded to appear before a
court to give his testimony. His testimony must be
given orally and under oath or affirmation.

A physician may be presented in court as an

ordinary witness and/or as an expert witness:
 ORDINARY/ EXPERT WITNESS

ORDINARY WITNESS EXPERT WITNESS

 physician who testifies  A physician on account of

in court on matters
perceived from his
patient in the course of
physician-patient
relationship.
 (Sec. 20, Rule 130,
Rules of Court)
 (Sec. 48-49, Rule 130)
his training and experience
can give his opinion on a
set of medical facts. He can
deduce or infer something,
determine the cause of
death, or render opinion
pertinent to the issue and
medical nature.
 ORDINARY/ EXPERT WITNESS
ORDINARY WITNESS
 Exception: Privilege of  The probative value of the
Communication
between physician and
patient.
 (Sec. 24 c, Rule 130)
EXPERT WITNESS
expert medical testimony
depends upon the degree
of learning and experience
on the line of what the
medical expert is testifying,
the basis and logic of his
conclusion, and other
evidences tending to show
the veracity or falsity of his
testimony.
 TYPESOF MEDICAL EVIDENCE
 3. EXPERIMENTAL EVIDENCE
 A medical witness may be allowed by the court to
confirm his allegation or as a corroborated proof
to an opinion he previously stated.
 TYPESOF MEDICAL EVIDENCE
 4. DOCUMENTARY EVIDENCE
 Medical Documentary Evidence may be:
 a. Medical Certification or Report on:
 i. Medical examination
 ii. Physical examination
 iii. Necropsy/ autopsy
 iv. Laboratory
 v. Exhumation
 vi. Birth
 vii. Death
 b. Medical Expert Opinion
 c. Deposition
 TYPESOF MEDICAL EVIDENCE
 5. PHYSICAL EVIDENCE
 these are articles and materials which are 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 in general assist in the prosecution of a criminal.
 CRIMINALISTICS
 is the identification, collection, preservation and
mode of presentation of physical evidence.
 It is the application of sciences such as physics,
chemistry, medicine and other biological sciences in
crime detection and investigation.
 TYPES OF PHYSICAL EVIDENCE
 a. CORPUS DELICTI EVIDENCE
 objects or substances which may be a part of the
body of the crime.
 TYPES OF PHYSICAL EVIDENCE
 b. ASSOCIATIVE EVIDENCE
 these are physical evidence which link a suspect to
the crime.
 TYPES OF PHYSICAL EVIDENCE
 c. TRACING EVIDENCE
 these are physical evidence which may assist the
investigator in locating the suspect.
 PRESERVATION OF EVIDENCE
 The physical evidence recovered during medico-
legal investigation must be preserved to maintain
their value when presented as exhibits in court.
METHODS OF PRESERVING EVIDENCE

 1. Photographs, audio and/or video tape, micro-

film, Photostat, Xerox, voice tracing, etc.
 2. Sketching- rough drawing of the scene or object
to be preserve is done. It must be simple,
identifying significant items and with exact
measurement.
METHODS OF PRESERVING EVIDENCE

 Kinds of Sketch:
 Rough Sketch- made at the crime scene or during
examination of living or dead body.
 Finished Sketch- sketch prepared from the rough
sketch for court presentation.
METHODS OF PRESERVING EVIDENCE

 3. DESCRIPTION
 putting into words the person or thing to be
preserved. It must cause a vivid impression on the
mind of the reader, a true picture of the thing
described.
METHODS OF PRESERVING EVIDENCE

 3. DESCRIPTION
 Minimum Standard Requirements which must be
satisfied in the description of the person or thing to
make it complete:
 a. Skin Lesion
 b. Penetrating wound
 c. Hymenal Laceration
 d. Person
METHODS OF PRESERVING EVIDENCE

 4. MANIKIN METHOD
 miniature model of a scene or of a human body
indicating marks of a various aspects of the things
to be preserved
METHODS OF PRESERVING EVIDENCE

 5. PRESERVATION IN THE MIND OF THE

AUDIENCE
 Drawbacks of preserving evidence in the mind of
the witness:
 The capacity of a person to remember time,
place and event may be destroyed or modified
by the length of time, age of the witness,
confusion with other evidence, trauma or disease,
thereby making the recollection not reliable;
METHODS OF PRESERVING EVIDENCE

 5. PRESERVATION IN THE MIND OF THE

AUDIENCE
 Drawbacks of preserving evidence in the mind of
the witness:
 The preservation is co-terminus with the life of the
witness.
 Human mind can easily be subjected to too many
extraneous factors that may cause distortion of
the truth.
METHODS OF PRESERVING EVIDENCE

 6. SPECIAL METHODS
 Special way of treating certain type of evidence
may be necessary.
 Preservation may be essential from the time it is
recovered to make the condition unchanged up to
the period it reaches the criminal laboratory for
appropriate examination.
METHODS OF PRESERVING EVIDENCE

 6. SPECIAL METHODS
 Special ways of Preservation
 a. Whole human body- embalming.
 b. Soft tissues (skin, muscles, visceral organs) – 10%
formalin solution.
 c. Blood- refrigeration, sealed bottle container, addition
of chemical preservatives.
 d. Stains (blood, semen) – drying, placing in sealed
container.
 e. Poison- sealed container
MEDICO LEGAL ASPECTS OF
IDENTIFICATION
MEDICO- LEGAL ASPECTS OF
IDENTIFICATION
 Determination of the individuality of a person
 Importance of identifying of a person
 In the prosecution of crime, the identity of the
offender and victim
 Settlement of states, retirement, insurance

 In some transactions- sales release of dead body.

RULES IN PERSONAL IDENTIFICATION

 Law of multiplicity of evidence in identification-

greater the number of similarities
 Value of different points of identification-
fingerprint, moles. Visual recognition of relatives
lesser value than fingernails/ Dentition
 The longer interval between the death the more
experts are needed in establishing the identity
 The team to act in shortest time because it is
perishable
 No rigid rule in the procedure of identification of a
person
METHODS OF IDENTIFICATION
 By Comparison
 Latent fingerprints

 Dental findings

 By Exclusion
 If two or more persons have to be identified and
all but one is not yet identified, then the one whose
identity has not been established may be known by
the process of elimination
IDENTIFICATION OF A PERSON
 Ordinary Methods of Identification
 Characteristics which may easily change
 Growth of hair and beard
 Clothing
 Frequent place of visit
 Grade of profession
 Body ornamentations
IDENTIFICATION OF A PERSON
 Ordinary Methods of Identification
 Characteristics which may not easily change
 Mental memory
 Speech
 Gait
 Mannerisms
 Handedness-left/right
 Hands and feet
 Complexion
 Changes in the eyes
 Facies
 Degree of nutrition
ANTHROPOMETRY
 ANTHROPOMETRY (BERTILLON SYSTEM) Alphonse
Bertillon
 Uses anthropometrical measurement of the human
body for identification.
 Basis:
 Human skeleton is unchangeable after 20 years
 No two human beings have exactly the same bones
 Use of simple instruments
ANTHROPOMETRY
 ANTHROPOMETRY (BERTILLON SYSTEM) Alphonse
Bertillon
 Information:
 Descriptive
data- color of hair, eyes, shape of the nose
 Body marks
 Anthropometric measurement- height
 Measurement of the head limbs

 Portrait Parle (spoken picture)- picturesque

description of a person
SCIENTIFIC METHODS OF
IDENTIFICATION
 FINGERPRINTING
 Most valuable method of identification
 No two identical fingerprints
 Not changeable-4th month formed in the fetus

 Practical uses
 Identification of dead bodies
 Prints recovered from a crime scene
 Prints on file for comparison
 Right thumb print is substitute for signature
SCIENTIFIC METHODS OF
IDENTIFICATION
 DACTYLOGRAPHY
 Art and study of recording of fingerprints as a
method of identification
 DACTYLOSCOPY
 Art of identification by comparison of fingerprints

 POROSCOPY
 Study of pores found on the papillary friction
ridges of skin
 Fingers can’t be effaced
 As long as the dermis of the bulb of the finger is not
completely destroyed.
SCIENTIFIC METHODS OF
IDENTIFICATION
 DENTAL IDENTIFICATION
 Possibility of two person have the same is remote

 Enamel is the hardest substance of the body,

outlast other tissues in putrefaction
SCIENTIFIC METHODS OF
IDENTIFICATION
 HANDWRITING
 BIBLIOTIC
 Science of handwriting analysis
 GRAPHOLOGY
 Studyof hand writing for the purpose of determining
the writers personality, character and aptitude
SCIENTIFIC METHODS OF
IDENTIFICATION
 IDENTIFICATION OF SKELETON
 Human- shape, size, general feature

 Whether the remains belong to a single person or

not
SCIENTIFIC METHODS OF
IDENTIFICATION
 DETERMINATION OF THE SEX OF SKELETON:
 Pelvis

 Skull

 Sternum

 Femur

 Humerus
SCIENTIFIC METHODS OF
IDENTIFICATION
 IDENTIFICATION OF SEX
 Test to determine sex
 Socialtest
 Genital test
 Gonadal test
 Chromosomal test
SCIENTIFIC METHODS OF
IDENTIFICATION
 IDENTIFICATION OF SEX
 Evidences of Sex
 Presumptive Evidence
 General features- hair in some parts
 Transvestism- sexual deviation by desire to assume the
attire and be accepted as a member of the opposite
sex
 Highly probable
 Vagina, large breast
 Conclusive
evidence
 Ovary in females
SCIENTIFIC METHODS OF
IDENTIFICATION
 DETERMINATION OF AGE
 Legal importance
 Aid to identification
 Determination of criminal liability
 Determination of the right of suffrage
 Determination whether a person can exercise civil rights
 Determination of the capacity to marriage
 Requisites to certain crimes
SCIENTIFIC METHODS OF
IDENTIFICATION
 IDENTIFICATION OF BLOOD AND STAINS
 Legal importance
 Disputed parentage
 Circumstantial evidence against perpetrator of a crime
 Determination of the direction of the escape
 Determination of appropriate time crime was
committed
 Determination of the place of the crime
 Determination of the presence of certain disease.
SCIENTIFIC METHODS OF
IDENTIFICATION
 IDENTIFICATION OF HAIR AND FIBERS
 HAIR EXTRACTED FORCIBLY
 Bulb is irregular in form
 Shows an undulating surface
 Excrescences of different shapes and sizes

 NATURALY SHED BULB

 Rounded extremity
 Smooth surface
 Show signs of atrophic or fatty degeneration
MEDICO- LEGAL ASPECTS OF
PHYSICAL INJURY
 TYPES OF WOUND ( Medical
Classification)
 CLOSED WOUND- There is no break in he
continuity of the skin or mucous membrane
 SUPERFICIAL – Wound is just underneath the layers of
the skin or mucous membrane
 Petechiae
 Contusion
 Hematoma
 TYPES OF WOUND ( Medical
Classification)
PETECHIAE

 these are minute pin-

point circumscribed
extravasations of
blood in the sub-
cutaneous tissues or
underneath the mucous
membrane
 TYPES OF WOUND ( Medical
Classification)
CONTUSION OR BRUISE
 It is a wound in the
subcutaneous cellular tissues
characterized by swelling and
discoloration of tissues
because of extravasations of
blood. The shape of the
bruise 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.
 TYPES OF WOUND ( Medical
Classification)
HEMATOMA/ BLOOD CYST
“BUKOL”
 it is large extravasations
in a newly formed cavity
secondary trauma
characterized by swelling,
discoloration of tissues.
The hematoma maybe
absorbed spontaneously
or may complicate forming
abscess, cyst, gangrene or
tumor.
 TYPES OF WOUND ( Medical
Classification)
MUSCULOKETAL INJURIES
 SPRAIN-
 It is the straining or
tearing of the particular
tendons, ligaments and
muscles characterized
by the swelling,
discoloration of tissues
resulting from violence
or from some existing
pathology.
 TYPES OF WOUND ( Medical
Classification)
MUSCULOSKELETAL INJURIES

 DISLOCATION
 there is a displacement
of the bones but
without external
wound.
 TYPES OF WOUND ( Medical
Classification)
MUSCULOSKETAL INJURIES

 FRACTURE
 Solution of continuity
of bone resulting from
violence or some
existing pathology
 TYPES OF WOUND ( Medical
Classification)
MUSCULOSKELETAL INJURIES

 STRAIN
 The over- stretching,
instead of actual
tearing or rupture of
the muscle or ligament
which may not be
associated with the
joint
 TYPES OF WOUND ( Medical
Classification)
MUSCULOSKELETAL INJURIES

 SUBLUXATION
 Incomplete or partial
discolocation
 TYPES OF WOUND ( Medical
Classification)
CEREBRAL CONCUSSIONS
 Is the jarring or stunning of
the brain characterized by
more or less complete
suspensions of its functions ,
as a result of injury to the
head, which leads to some
commotions of the cerebral
substance.
 TYPES OF WOUND ( Medical
Classification)
 OPEN WOUND – there is a break in the overlying
skin or tissue
 Abrasion ( Scratch, graze, Impression mark, Friction
mark “ gasgas”)
 Incised wound( Cut, slice, slash, chopped, hacking
wound)
 Stab wound (saksak)

 Punctured wound ( tusok)

 Lacerated wound ( Tear, rupture, stretch “ putok”)

 TYPES OF WOUND ( Medical
Classification)
ABRASION

 Removal of the
superficial epithelial
layer of the skin
caused by a rub or
friction against a hard
rough surface.
 TYPES OF WOUND ( Medical
Classification)
TYPES OF ABRASION

 SCRATCH
 caused by sharp-
pointed object which
slides across the skin
like a pin, thorn or
finger nail
 TYPES OF WOUND ( Medical
Classification)
TYPES OF ABRASION

 GRAZE
 caused by forcible
contact with rough
hard objects resulting
to irregular removal of
the skin surface.
 TYPES OF WOUND ( Medical
Classification)
TYPES OF ABRASION
 IMPACT OR IMPRINT
ABRASION ( Patterned
abrasion)
 Those whose pattern
and location provides
objective evidence to
show, cause of the
wounding material or
instrument and the
manner of assault or
death
 TYPES OF WOUND ( Medical
Classification)
TYPES OF ABRASION
 PRESSURE OR FRICTION
ABRASION
 Caused by pressure
accompanied by a
movement usually
observed in hanging or
strangulation.
 TYPES OF WOUND ( Medical
Classification)
INCISED WOUND
 Produced by sharp-
edged( cutting) or sharp –
linear edge of the
instrument like a knife.
Razor, bolo, edge of oyster
cell metal sheet, glass etc.
 TYPES OF WOUND ( Medical
Classification)
INCISED WOUND
 CHOPPED OR HACKED
WOUND
 When the wounding
instrument is a heavy
cutting instrument, like
axe, and big bolo.
 TYPES OF WOUND ( Medical
Classification)
STAB WOUND
 Produced by the
penetration of sharp-
pointed and sharp- edged
instrument like a knife,
dagger, scissors. It may
involve the skin or mucous
membrane.
 TYPES OF WOUND ( Medical
Classification)
PUNCTURE WOUND
 Produced by the
penetration of sharp-
pointed and sharp- edged
instrument like a knife,
dagger, scissors. It may
involve the skin or mucous
membrane.
 TYPES OF WOUND ( Medical
Classification)
LACERATED WOUND
 is a tear of the skin and the
underlying tissues due to
forcible contact with blunt
instrument.
 Can be produced by a hit
with piece of wood, iron
bar, fist blow stone, butt of
a fire arm, or other objects
without harp edges.
MEDICO – LEGAL ASPECTS OF
DEATH
 IMPORTANCE OF DEATH
DETERMINATION

 1. The civil personality of a natural person is

extinguished by death;
 2. The property of a person is transmitted to his
heirs at the time of death;
 3. The death of the partner is one of the causes of
dissolution of partnership agreement
 IMPORTANCE OF DEATH
DETERMINATION

 4. The death of either the principal or the agent is a

mode of extinguishment of agency;
 5. The criminal liability of a person is extinguished
by death;
 6. The civil case for claims which does not survive is
dismissed upon the death of the defendant.
 DEFINITION OF DEATH

 is the termination of life.

 it is the complete cessation of all the vital functions
without possibility of resuscitation.
 it is an irreversible loss of the properties of living
matter.
 an event that takes place at a precise time.
 the ascertainment of death is a clinical and not a
legal problem.
 Based on the Criterion Used in its
Determination, death may be:
 BRAIN DEATH
 Death occurs when there is deep irreversible coma,
absence of electrical brain activity and complete
cessation of all the vital functions without possibility
of resuscitation.
 Based on the Criterion Used in its
Determination, death may be:
 CARDIO- RESPIRATORY DEATH
 Death occurs when there is a continuous and
persistent cessation of heart action and respiration.
 It is a condition in which the physician and the
members of the family pronounced a person to be
dead based on the common sense or intuition
 Based on the Criterion Used in its
Determination, death may be:
 BRAIN AND CARDIO- RESPIRATORY DEATH
 A person will be considered medically and legally
dead if in the opinion of a physician based on
ordinary standards of medical practice, there is:
 absence of spontaneous respiratory and cardiac function,
and because of the disease or condition which caused,
directly or indirectly, these functions to cease, or because
of the passage of time since these functions ceased,
attempts at resuscitation are considered hopeless;
 Based on the Criterion Used in its
Determination, death may be:
 BRAIN AND CARDIO- RESPIRATORY DEATH
 absence of spontaneous brain function and if based on
ordinary standards of medical practice during
reasonable attempts to either maintain or restore
spontaneous circulatory or respiratory function in the
absence of aforesaid brain function, it appears that
further attempts at resuscitation or supportive
maintenance will not succeed.
 KINDS OF DEATH
 SOMATIC OR CLINICAL DEATH
 State of the body when there is complete,
persistent and continuous cessation of the vital
functions of the brain, heart and lungs which
maintain, life and health.
 hardly impossible to determine the exact time of
death;
 KINDS OF DEATH
 SOMATIC OR CLINICAL DEATH
 immediately after death,
 the face and lips become pale
 the muscles become flaccid
 the sphincters are relax
 the lower jaw tends to drop
 the eyelids remain open
 KINDS OF DEATH
 SOMATIC OR CLINICAL DEATH
 immediately after death,
 pupils dilate
 skin loses its elasticity
 body fluids tend to gravitate to the most
dependent portions of the body
 body heat gradually assumes the temperature
of the surroundings.
 KINDS OF DEATH
 MOLECULAR OR CELLULAR DEATH
 After cessation of the vital functions, there is still
animal life among individual cells.
 About 3-6 hours later, there is death of individual
cells known as molecular or cellular death
 Exact occurrence cannot be definitely determined
due to several factors
 KINDS OF DEATH
 APPARENT DEATH OR “ STATE OF SUSPENDED
ANIMATION.
 The condition is not really death but merely a
transient loss of consciousness or temporary
cessation of the vital functions of the body on
accounts of the disease, external stimulus or other
forms of influence.
 Itmay arise especially hysteria, uremia, catalepsy and
electric shock
SIGNS OF DEATH
 CESSATION OF HEART ACTION AND CIRCULATION
 Methods of Detecting the Cessation of Heart action and
circulation
 Examination of the heart
 Palpation of the pulse

 Auscultation of the heart sound at the precordial

area
 Fluoroscopic examination
 By the use of ECG
SIGNS OF DEATH
 CESSATION OF HEART ACTION AND CIRCULATION
 Methods of Detecting the Cessation of Heart action and
circulation
 Examination of the peripheral circulation
 Magnus test
 Opening of small artery
 Icard’s test
 Pressure on the fingernails
 Diaphanous test
 Application of heat on the skin
 Palpation of the Radial pulse
 Dropping of melted wax
SIGNS OF DEATH
 CESSATION OF RESPIRATION
 Methods of Detecting the Cessation of Respiration

 Expose the chest and observe the movement during

inspiration and expiration
 Examine with the aid of stethoscope
 Examination with a mirror
 Examination with a feather or cotton fibers.
 Examination with a glass of water
 Winslow’s test
SIGNS OF DEATH
 ALGOR MORTIS- COOLING OF THE BODY
 The rate of cooling of the body is not uniform

 It is rapid during the first two hours after death

 As the temperature of the body gradually

approaches the temperature of surroundings , the
rates becomes slower
SIGNS OF DEATH
 ALGOR MORTIS- COOLING OF THE BODY
 After the first hour, the rate of cooling is dependent
upon:
 Body factors
 Body size
 Age
 Infectious disease
 Death from asphyxia

 Environmental Factors
 Effects of clothing
 Air temperature and Movement
 Environmental and Room temperature
SIGNS OF DEATH
 INSENSIBILITY OF THE BODY AND LOSS OF POWER
TO MOVE
 After death the whole body is insensible. No kind
of stimulus is capable of letting the body to have
voluntary movement
SIGNS OF DEATH
 CHANGES IN THE SKIN
 Skin may be observed to be pale and waxy-
looking due to the absence of circulation
 Loss of Elasticity of the Skin

 Opacity of the skin

 Effect of the application of heat

SIGNS OF DEATH
 CHANGES IN AND ABOUT THE EYE
 Loss of corneal reflex

 Clouding of the cornea

 Flaccidity of the eyeball

 The pupil is in the position of rest

 Ophthalmoscope findings

 Tache noir de la sclerotique

Tache noir de la sclerotique
SIGNS OF DEATH
 ACTION OF HEAT ON THE SKIN
 The heat is applied to a portion of the leg or arm.
If death is real, only a blister is produced.
MUSCULAR CHANGES IN THE BODY
FOLLOWING DEATH
 Importance- Help us determine the approximate
time of death
 Stage of Primary flaccidity
 AKA-” post mortem irritability
 The muscles are relaxed and capable of contracting
when stimulated
 Died less than six (6) hours
MUSCULAR CHANGES IN THE BODY
FOLLOWING DEATH
 Importance- Help us determine the approximate
time of death
 Stage of post- mortem rigidity
 AKA-” rigor mortis”
 The whole body becomes rigid due to contraction of the
muscle
 Died less six (6) hours- twenty four (24) hours
MUSCULAR CHANGES IN THE BODY
FOLLOWING DEATH
 Importance- Help us determine the approximate
time of death
 Stage of secondary flaccidity
 AKA-”commencement of putrefaction”
 The whole body is relax and soft but with foul odor
 Died less than twenty four (24)- thirty six (36) hours
and above
MUSCULAR CHANGES IN THE BODY
FOLLOWING DEATH
 RIGOR MORTIS- RIGIDITY OF THE BODY
(Cadaveric rigidity, death stiffening , death struggle
of muscles)
 is a condition in which muscles of the body become
hardened as a result of chemical changes within the muscle
fibers
 Usually start with the muscles of the neck and lower jaw
and spreads downwards to the chest, arms and lower limbs.
 There is increase of lactic acid and phosphoric content of
the muscles.
MUSCULAR CHANGES IN THE BODY
FOLLOWING DEATH
 RIGOR MORTIS- RIGIDITY OF THE BODY
(Cadaveric rigidity, death stiffening , death struggle
of muscles)
 Small muscles are affected first
 Detected in 3-6 hours

 Complete in 6-12 hours

 Remains 12-18 hours

 Begins to leave in 24-36 hours

 Gone in 40-60 hours

MUSCULAR CHANGES IN THE BODY
FOLLOWING
 RIGOR MORTIS- RIGIDITY OF THE BODY
(Cadaveric rigidity, death stiffening , death struggle
of muscles)
 However, onset and departure of rigor is greatly
affected by the environment as noted earlier
 Outward visual indication of rigor mortis is “goose
bumps” or “goose flesh” on skin
MUSCULAR CHANGES IN THE BODY
FOLLOWING DEATH
 RIGOR MORTIS- RIGIDITY OF THE BODY
(Cadaveric rigidity, death stiffening , death struggle
of muscles)
 Factors Influencing the time of onset of Rigor Mortis
 State of the muscles
 Age
 Temperature
 Integrity of the nerve
MUSCULAR CHANGES IN THE BODY
FOLLOWING DEATH
 RIGOR MORTIS- RIGIDITY OF THE BODY
(Cadaveric rigidity, death stiffening , death struggle
of muscles)
 Conditions Stimulating Rigor Mortis:
 Heat Stiffening – A condition characterized by hardening
of the muscles due to coagulation of muscle proteins when
the dead body is exposed to intense heat as by burning
or immersion in a hot liquid.
MUSCULAR CHANGES IN THE BODY
FOLLOWING DEATH
 RIGOR MORTIS- RIGIDITY OF THE BODY
(Cadaveric rigidity, death stiffening , death struggle
of muscles)
 Conditions Stimulating Rigor Mortis:
 Cold Stiffening – A condition characterized by hardening
of the muscles due to solidification of fats, muscles and
fluid when the dead body is exposed to extremely cold
or freezing temperature.
MUSCULAR CHANGES IN THE BODY
FOLLOWING DEATH
 RIGOR MORTIS- RIGIDITY OF THE BODY
(Cadaveric rigidity, death stiffening , death struggle
of muscles)
 Conditions Stimulating Rigor Mortis:
 Cadaveric Spasm or Instantaneous Rigor- It is the instant
stiffening of a certain group of muscles which occurs
immediately at the moment of death and although its
cause is unknown is associated with the violent death due
to extreme nervous tension, fatigue and injury to the
nervous system.
CHANGES IN THE BLOOD
 POST MORTEM LIVIDITY
 It occurs in most extensive areas of the most
dependent portions of the body
 Importance- to determine the position of the body
when the person died.
CHANGES IN THE BLOOD
 LIVOR MORTIS- POST MORTEM LIVIDITY ( Post –
mortem suggillation or post- mortem hypostasis)
 Isa reddish purple discoloration of body and organ
surfaces
 Results when blood settles to the lower parts of the
body
 Becomes visible in the skin 3-6 hours after death

 This pooling of blood begins immediately after death

and becomes fixed in approximately 8-12 hours
SIGNS OF DEATH
 LIVOR MORTIS- POST MORTEM LIVIDITY ( Post –
mortem suggillation or post- mortem hypostasis)
 The color of lividity may indicate the cause of death:
 Carbon monoxide poisoning/ cyanide
 cherry red to pinkish color
 Carbon dioxide poisoning
 bright pink
 Asphyxia
 Dark lividity
 Phosphorous poisoning
 Dark brown
 Potassium chlorate
Blood settles to lower
extremities of body
 LIVOR MORTIS
 Areas of skin in contact
with a surface may
prevent livor from
discoloring the skin at
the point of contact
SIGNS OF DEATH
 TYPES OF LIVIDITY
 Hypostatic-
 Blood is still in fluid from inside blood vessel
 Change as position of the body changes
 Blood remains fluid in the blood vessels for 6-8 hours

 Diffusion
 Coagulated inside blood vessels
 Change in position will change its location
AUTOLYTIC OR AUTODIGESTIVE
CHANGES AFTER DEATH
 PUTREFACTION OF THE BODY
 Complex protein breaks down into simpler components
associated with fouls-smelling gases accompanies by
change of body color.
 CHANGES:
 Changes in the color of the tissue
 Evolution of gases in the tissue
 Liquefaction of the soft tissue
FACTORS MODIFYING THE RATE
OF PUTREFACTION
 Internal factors
 Age

 Condition of the body

 Causes of death

 External Factors
 Free air

 Earth

 Clothing
PRESUMPTIONS OF DEATH
 Rule 131 Section 5 Rules of Court
 Article 390 Civil Code
 Disputable Presumption: not heard from for 7
years = DEAD
 Dead for all purposes. EXCEPT: SUCCESSION
 Absentee shall not be presumed dead for the
purpose of opening his succession till after
absence of 10 years.
 If he disappeared after 75 years old: Absence
of 5 years SUFFICIENT to open succession.
PRESUMPTIONS OF DEATH
 Article 391 Civil Code
 Presumed DEAD FOR ALL PURPOSES
 Lost on board a vessel lost during sea voyage,
missing airplane, not been heard of for 4 years
since loss of vessel or airplane.
 Person in armed forces who has taken part in
war, missing for 4 years
 Person in danger of death other circumstances
and his existence not known 4 years.
PRESUMPTIONS OF SURVIVORSHIP
 Rule 131 Section 5(jj) Rules of Court
 When 2 persons die in same calamity, such as:
 Wreck
 Battle
 Conflagration
PRESUMPTIONS OF SURVIVORSHIP
 Not shown who died first; there are no particular
circumstances from which it can be inferred, the
survivorship is presumed from the probabilities
resulting from the strength and age of the sexes,
according to the following:
 1. Both UNDER 15: Older presumed survived
 2. Both ABOVE 60: Younger presumed survived

 3. One UNDER 15, Other ABOVE 60: UNDER 15

presumed survived
PRESUMPTIONS OF SURVIVORSHIP
 Not shown who died first; there are no particular
circumstances from which it can be inferred, the
survivorship is presumed from the probabilities
resulting from the strength and age of the sexes,
according to the following:
 4. One OVER 15, Other UNDER 60,
 a. Different Sex: Male presumed survived
 b. Same Sex: Older

 5. One UNDER 15, or ABOVE 60, the other BETWEEN

those ages: latter presumed survived