UNIVERSITY OF BAGUIO

Baguio City

Prepared by
DR. JEZREEL B. VICENTE
National Reviewer on Criminalistics
Email – jezreel_vicente@yaho.com
Facebook – Jezreel Vicente

LEGAL MEDICINE
 branch of medicine which deals with the application of medical knowledge to the
purpose of law and in the administration of justice
 it is the application of basic and clinical, medical and paramedical sciences to
elucidate legal matters
 Originally the terms legal medicine, forensic medicine and medical
jurisprudence are synonymous and in common practice are used
interchangeably.
 Strictly speaking, legal medicine is primarily the application of medicine to legal
cases while forensic medicine concerns with the application of medical science
to elucidate legal problems.
 Medical Jurisprudence denotes knowledge of law in relation to the practice of
medicine. It concerns with the study of the rights, duties and obligations of a
medical practitioner with particular reference to those arising from the doctor-
patient relationship.
Scope of Legal Medicine
 It is the application of medical and paramedical sciences as demanded by law
and administration of justice.
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 a conclusion from the facts
which may be useful in the administration of justice.
Brief History of Legal Medicine
 Imhotep: earliest recorded medico-legal expert
 Hippocrates: discussed the lethality of wounds
 Antistius: the “first police surgeon” or forensic pathologist
 Paulus Zacchias: a papal physician, regarded as the “father of forensic
medicine”
 Orfila: introduced chemical methods in toxicology
On December 23, 1975, Presidential Decree 856 was promulgated and Sec 95
provides:
 Persons authorized to perform autopsies:
 health officers
 medical officers of law enforcement agencies
 members of the medical staff of accredited hospitals
 Autopsies shall be performed in the following cases:
  whenever required by special laws
 upon order of a competent court, a mayor and a provincial or city fiscal
 upon written request of police authorities
 whenever the Solicitor General, provincial, or city fiscal deem it necessary
to disinter and take possession of the remains for examination to
determine the cause of death
 whenever the nearest kin shall request in writing the authorities concerned
to ascertain the cause of death
MEDICAL EVIDENCE
 Evidence is the means, sanctioned by the Rules of Court, of ascertaining in a
judicial proceeding the truth respecting a matter of fact (Sec1, Rule128, Rules of
Court)
 It is the species of proof, or probative matter, legally presented at the trial of an
issue by the act of the parties and through the medium of witnesses, records,
documents, concrete objects, etc, for the purpose of inducing belief in the minds
of the court as to their contention.
Methods of Preserving Evidences
 A: Photographs, audio and/or video tape, micro-film, Photostat, Xerox, voice
tracing, etc
 Photography is considered to be the most practical, useful and reliable means of
preservation.
1. Sketching
2. Description
3. Manikin Method
4. Preservation in the Mind of the Witness
5. Special Methods
whole human body
 soft tissues (skin, muscle, visceral organs)
 blood
 stains (blood, semen)
 poison
Rules in Personal Identification
a. The greater the number of points of similarities and dissimilarities of two persons
compared, the greater is the probability for the conclusion to be correct. This is
known as the Law of Multiplicity of Evidence in Identification.
b. The value of the different points of identification varies in the formulation of
conclusion.
c. The longer the interval between the death and the examination of the remains for
purposes of identification, the greater is the need for experts in establishing
identity.
d. In as much as the object to be identified is highly perishable, it is necessary for
the team to act in the shortest possible time especially in cases of mass disaster.
e. There is no rigid rule to be observed in the procedure of identification of persons.
Methods of Identification
1. by comparison
a: latent fingerprints
 b: dental findings
2. by exclusion

Points of Identification Applicable to the Living Persons Only

1. Characteristics which may be changed
 growth of hair, beard or mustache
 clothing
 frequent place of visit
 grade of profession
 body ornamentations
2.Characteristics that may not easily be changed
 mental memory
 speech
 gait (ataxic, cerebellar, cow’s gait)
 mannerism
 hands and feet
 complexion
 changes in the eyes
 facies
Scientific Methods of Identification
 fingerprinting
 dental identification
 handwriting
 identification of skeleton
 determination of sex
 determination of age
 identification of blood and blood stains
 identification of hair and fibers

MEDICO-LEGAL ASPECTS OF DEATH

Importance of Death Determination
 civil personality of a natural person is extinguished by death
 property of a person is transmitted to his heirs at the time of death
 death of a partner is one of the causes of dissolution of partnership
agreement
 criminal liability of a person is extinguished by death
 civil case for claims which does not survive is dismissed upon death of the
defendant
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.
Kinds of Death
a. Somatic Death or Clinical Death
 it is the state of the body in which there is complete, persistent and continuous
cessation of the vital functions of the brain, heart and lungs which maintain life
and health
  it occurs the moment a physician or the other members of the family declare a
person has expired, and some of the early signs of death are present
 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, pupils dilate and the skin losses its elasticity
 the body fluid tends to gravitate to the most dependent portions of the body and
the body heat gradually assumes the temperature of the surroundings
b: Molecular or Cellular Death
 after cessation of vital functions of the body there is still animal life among
individual cells
 this is evidenced by the presence of excitability of muscles and ciliary
movements and other functions of individual cells
 about 3-6 hours later, there is death of individual cells
c: Apparent death or state of suspended animation
 is not really death but merely a transient loss of consciousness or temporary
cessation of the vital functions of the body on account of disease or external
stimulus
 it may arise especially in hysteria, uremia, catalepsy and electric shock
 there are records of cases wherein a person was pronounced dead, placed in a
coffin and later angrily rise from it and walk unaided
Signs of Deaths
1. cessation of heart action and circulation
2. cessation of respiration
3. cooling of the body (algor mortis)
a: After death the metabolic process inside the body ceases. No more heat is produced
but the body loses slowly its temperature by evaporation or by conduction to the
surrounding atmosphere
b: It is rapid during the first 2 hours after death and as the temperature of the body
gradually approaches the temperature of the surroundings, the rate becomes slower
4. Insensibility of the body and loss of power to move
5. Changes in the skin
6. Changes in and about the eye
7. Action of heat on the skin
Changes in the Body Following Death
1. Changes in the muscle
a. After death, there is complete relaxation of the whole muscular system
b. The entire muscular system is contractile for 3-6 hours after death, and later
rigidly sets in
c. Secondary relaxation of the muscles will appear just when decomposition has
set in
3 Stages of Muscle Tissue after Death
a. Stage of primary flaccidity
The muscles are relaxed and capable of contracting when stimulated. The pupils
are dilated, the sphincters are relaxed, and there is incontinence of urination and
defecation.
b. Stage of post-mortem rigidity (cadaveric rigidity or death struggle of muscles or rigor
mortis)
The whole body becomes rigid due to the contraction of the muscles. This
develops 3-6 hours after death and may last from 24-36 hours.
c. Stage of secondary flaccidity or commencement of putrefaction (decay of the
muscles)
The muscles become flaccid, no longer capable of responding to mechanical or
electrical stimulus and the reaction becomes alkaline.
2. Changes in the blood
a. coagulation in the blood
b. post-mortem lividity or cadaveric lividity, or post-mortem suggillation or post-
mortem hypostasis or livor mortis.
3. Autolytic or autodigestive changes
4. Putrefaction of the body

MEDICO-LEGAL INVESTIGATION OF DEATH

Inquest Officer:
 an official of the state charged with the duty of inquiring into certain matters
 charged with the duty of investigating the manner and cause of death of a person
 authorized to summon witnesses and direct any person to perform or assist in
the investigation when necessary
The following officials of the government are authorized to make death
investigation:
 Provincial and City Fiscals
 Judges of the Courts of the First Instance (now Regional Trial Courts)
 Justice of the Peace (now Municipal Trial Courts)
 Director of the National Bureau of Investigation
 Chief of Police of the city of Manila
 Solicitor General
Stages of Medico-Legal Investigation
1. crime scene investigation: investigation of the place of commission of the crime
 The crime scene is the place where the essential ingredients of the
criminal act took place.
 It includes the setting of the crime and also the adjoining pieces of entry and exit
of both offender and victim.
Autopsy: investigation of the body of the victim
 An autopsy is a comprehensive study of a dead body, performed by
a trained physician employing recognized dissection procedure and
techniques
 It includes removal of tissues for further examination
Autopsy vs. Post-Mortem Examination
 Post-mortem examination: refers to an external examination of a dead body
without incision being made, although blood and other body fluids may be
collected for examination
 Autopsy: indicates that, in addition to an external examination, the body is
opened and an internal examination is conducted
Kinds of Autopsies
a. hospital or non-official autopsy
b. medico-legal or official autopsy
Distinction between Pathological (Non-official) and Medico-Legal (Official) Autopsies

Pathological Medico-Legal

It is the law that gives the consent.

Must have the consent of the
a. Requirement Consent of relatives not
next of kin.
needed.

Confirmation of clinical findings Correlation of tissue changes to the

b. Purpose
of research. criminal act.

Emphasis laid on effect of wrongful

Notation of all abnormal act on the body. Other findings
c. Emphasis
findings. may only be noted in mitigation
of the criminal responsibility.

Summation of all abnormal

Must be specific for the purpose of
findings irrespective of its
d. Conclusion determining whether it is in
correlation with clinical
relation to the criminal act.
findings.

e. Minor or Non- If the investigator things it will be

Need not be mentioned in the
pathologica useful in the administration of
report.
l justice, it must be included.

The Following Manner of Death should be Autopsied:

 death of violence
 accidental death
 suicides
 sudden death of persons who are apparently in good health
 death unattended by physician
 death in hospitals or clinics (DOA) wherein a physician was not
able to arrive at a clinical diagnosis as the cause of death.
 death occurring in an unnatural manner
CAUSES OF DEATH
The primary purpose of a medico-legal autopsy is the determination of the
cause of death.
The cause of death is the injury, disease or the combination of both injury and disease
responsible for initiating the trend or physiological disturbance, brief or prolonged, which
produce the fatal termination.
a. immediate (primary) cause of death
 applies to cases when trauma or disease kill quickly that there is no
opportunity for sequelae or complications to develop
 example: extensive brain laceration as a result of vehicular
accident
b. proximate (secondary) cause of death
 the injury or disease was survived for a sufficiency prolonged
interval which permitted the development of serious sequelae which
actually caused the death
 example: stab wound in the abdomen later caused generalized
peritonitis, then peritonitis is the proximate cause of death
mechanism of death
 is the physiological derangement or biochemical disturbance
incompatible with life which is initiated by the cause of death
 it may be hemorrhagic shock, metabolic disturbance, respiratory
depression, toxemic condition, cardiac arrest, tamponade, etc
manner of death
 the explanation as to how the cause of death came into being or
how the cause of death arose
 it maybe:
natural death: fatality is caused solely by disease
violent or unnatural death: due to injury of any sort (gunshot, stab, fracture, traumatic
shock)
Instantaneous Physiological Death (Death from Inhibition, Death from Primary
Shock, Syncope with Instantaneous Exitus)
 this is sudden death which occurs within seconds or a minute or 2
(no more) after a minor trauma or peripheral stimulation of relatively
simple and ordinarily innocuous nature
 examples: a blow to the larynx, a kick in the scrotum, pressure on
the carotid sinus
Medico-Legal Classification of the Cause of Death
a. Natural death
b. Violent death
1. accidental death
2. negligent death
3. infanticidal death
4. parricidal death
5. Murder
6. homicidal death
Penal Classification of Violent Deaths
a. accidental death
 death due to misadventure or accident
 an accident is something that happens outside the sway of our will, and although
it comes about through some act of will, lies beyond bound of human foreseeable
consequences
b. negligent death
  death due to reckless imprudence, negligence, lack of skill or lack of foresight
c. suicidal death
 destruction of one’s self
d. parricidal death (killing of one’s relative)
• Art246, Revised Penal Code
• Any person who shall kill his father, mother or a child whether legitimate or
illegitimate, or any of his ascendants or descendants, or his spouse, shall
be guilty of parricide and be punished by the penalty of reclusion
perpetua to death.

e. infanticide death (killing of a child less than 3 days old)

 Art255, Revised Penal Code
 The penalty provided for parricide in Art246, and for murder in Art248 shall be
imposed upon any person who shall kill any child less than 3 days of age
f. murder
 Art248, Revised Penal Code
 Any person who, not falling within the provisions of Art246 shall kill another, shall
be guilty of murder and shall be punished of death, if committed with any of the
following circumstances:
 with treachery, taking advantage of superior strength, with the aid of armed men,
or employing means to weaken the defense or of means or persons to insure or
afford impunity
 in consideration of a price, reward or promise
 by means of inundation, fire, poison, explosion, shipwreck, stranding of a vessel,
derailment or assault upon a street car or locomotive, fall of an airship or with the
use of any other means involving great waste and ruin.
 on occasion of any of calamities.
 with evident premeditation.
 with cruelty, by deliberately inhumanly augmenting the suffering of the victim, or
outraging or scoffing at his person or corpse
g. homicidal death
 Art249, Revised Penal Code
 Any person who, not falling within the provisions of Art246 shall kill another, shall
be deemed guilty of homicide and be punished by reclusion temporal
Pathological Classification of the Causes of Death
a. death from syncope
 due to sudden and fatal cessation of the action of the heart with circulation
included
b. death from asphyxia
 asphyxia is a condition in which the supply of oxygen to the blood or to the
tissues or to both has been reduced below normal working level
c. death from coma
 coma is the state of unconsciousness with insensibility of the pupil and
conjunctivae, and inability to swallow, resulting from the arrest of the functions of
the brain
SPECIAL DEATHS
Methods of Judicial Death
1. death by electrocution
 A person is made to sit on a chair made of electrical conducting materials with
straps of electrodes on both wrists, ankles and head. An alternating current
voltage of more than 1,500 volts is put on until the convict dies.
2. death by hanging
 The convict is made to stand in an elevated collapsible flat-form with a black
hood on the head, a noose made of rope around the neck and the other end of
which is fixed in an elevated structure above the head.
 Without the knowledge of the convict, the flat-form suddenly collapses which
causes the sudden suspension of the body and the tightening of the noose
around the neck.
 Death may be due to asphyxia or injury of the cervical portion of the spinal cord.
3. death by musketry
 The convict is made to face a firing squad and is put to death by a volley of fire.
The convict may be facing or with his back towards the firing squad.
4. death by gas chamber
 The convict is enclosed in a compartment and an obnoxious or asphyxiating gas
is introduced. The most common gas used is carbon monoxide.
Euthanasia
 or mercy killing
 deliberate and painless acceleration of death of a person usually suffering from
an incurable and distressing disease
Death from Starvation
 Starvation or inanition is the deprivation of a regular and constant supply of food
and water which is necessary to normal health of a person.
Types of Starvation
1. acute starvation: is when necessary food has been suddenly and completely
withheld from a person
2. chronic starvation: is when there is a gradual or deficient supply of food
Length of Survival
The human body without food loses 1/24th of its weight daily, and a loss of 40% of the
weight results to death.
The length of survival depends upon the presence or absence of water. Without food
and water, a person cannot survive more than 10 days, but with water a person may
survive without food for 50 to 60 days.
Factors that Influence the Length of Survival
a. age
b. condition of the body
c. sex
d. environment
DISPOSAL OF THE DEAD BODY
Methods of Disposal of the Dead Body
1. embalming
  artificial way of preserving the body after death by injecting 6-8 quarts of
antiseptic solution of formalin, perchloride of mercury or arsenic, which is carried
into the common carotid and the femoral arteries
2. burial or inhumation
 Body must be buried within 48 hours after death (Sec 1092, Rev Admin
Code) except:
a. when it is still a subject matter of legal investigation
b. when it is specifically authorized by the local health authorities that the
body may be buried more than 48 hours after death
c. impliedly when the body is embalmed
 If the person died of communicable disease, the body must be buried within 12
hours unless the local health officer permits otherwise.
 If the body is not buried within 48 hours after death, the permit previously issued
is deemed cancelled and there is a need for a new permit.
 Considering the climatic conditions in the Philippines, the time limit provided by
the law regarding burial time should be reduced to 24 hours instead of 48 hours.

3. disposing of the dead body in the sea

 Some dead bodies are not buried, embalmed or cremated but thrown over board
in an open sea provided that the deceased is not suffering from dangerous
communicable disease.
 Such manner of disposal may be the will of the deceased or a part of religious
practice.
4. cremation
 pulverization of the body into ashes by the application of heat
5. use of the body for scientific purposes
 use of remains for medical studies and scientific research
Exhumation
 The deceased buried may be raised or disinterred upon the lawful order of the
proper authorities.
 The order may come from the provincial or city fiscals, from the court, and from
any entity vested with authority to investigate.
Physical injury is the effect of some forms of stimulus on the body.
 The effect of the application of stimulus may be immediate or may be delayed. A
thrust to the body of a sharp pointed and sharp edged instrument will lead to the
immediate production of a stab wound, while a hit by a blunt object may cause
the delayed production of a contusion.
Causes of Physical Injuries
a. physical violence
b. heat or cold
c. electrical energy
d. chemical energy
e. radiation by radio-active substances
f. change of atmospheric pressure (barotrauma)
g. infection
Classification of Wounds
1. as to severity
a. mortal wound: caused immediately after infliction or shortly thereafter that is
capable of causing death
b. non-mortal wound: not capable of producing death immediately after infliction
or shortly thereafter
2. as to kind of instrument used
a. wound brought about by blunt instrument (contusion, hematoma, laceration)
b. wound brought about by sharp instrument (incision, puncture, stab)
c. wound brought about by tearing force (laceration)
d. wound brought about by change of atmospheric pressure (barotrauma)
e. wound brought about by heat or cold (frostbite, burns, scald)
f. wound brought about by chemical explosion (gunshot, shrapnel)
g. wound brought about by infection
3. as to the manner of infliction
a. hit (bolo, blunt instrument, axe)
b. thrust or stab (bayonet, dagger)
c. gunpowder explosion (projectile or shrapnel wound)
d. sliding or rubbing or abrasion
4. as regards to the depth of the wound
a. superficial: when the wound involves only the layers of the skin
b. deep: when the wound involves the inner structure beyond the layers of the skin
1. penetrating: one in which the wounding agent enters the body but did not
come out or the mere piercing of a solid organ or tissue of the body (example:
punctured, stab and gunshot)
2. perforating: when the wounding agent produces communication between the
inner and outer portion of the hollow organs (point of entry and exit of instrument)
5. as regards to the relation of the site of the application of force and the location of
injury
a. coup injury: physical injury which is located at the site of the application of force
b. contre-coup injury: physical injury found opposite the site of the application
force
c. coup contre-coup injury: physical injury located at the site and also opposite
the site of the application of force
d. Locus Minoris Resistencia: physical injury located not at the site nor opposite
the site of the application of force but in some areas offering the least resistance
to the force applied
e. extensive injury: physical injury involving a greater area of the body beyond the
site of the application of force
6. special types of wounds
a. defense wound: result of a person’s instinctive reaction of self-protection
b. patterned wound: wound in the nature and shape of an object or instrument and
which infers the object or instrument causing it
c. self-inflicted wound: wound produced on oneself. Person has no intention to
end his life
Legal Classification of Physical Injuries
1. mutilation (Art 262, Revised Penal Code)
  act of looping or cutting off any part or parts of the living body
 in order to be punishable under the Code, it must be intentional, otherwise it will
be considered as a physical injury
2. serious physical injuries
 Any person who shall wound, beat, or assault another, shall be guilty of the crime
of serious physical injuries.
 The crime of serious physical injuries may be due to:
a. wounding
b. beating
c. assaulting
d. administering injurious substances without the intent to kill
3. administering injurious substances or beverages (Art 264, Revised Penal Code)
 Any person who, without the intent to kill, shall inflict upon another any serious
physical injury, by knowingly administering to him any injurious substances or
beverages or by taking advantages of his weakness of mind or credulity
4. less serious physical injuries (Art 265, Revised Penal Code)
 Any person who shall inflict upon another physical injuries but which shall
incapacitate the offended party for labor 10 days or more, or shall require
medical attendance for the same period, shall suffer the penalty of arresto
mayor.
5. slight physical injuries and maltreatment (Art 266, Revised Penal Code)
Kinds of Slight Physical Injuries Punishable by the Code
a. physical injuries which incapacitate the victim for labor from 1-9 days, or require
medical attendance for the same period
b. physical injuries which did not prevent the offended party from engaging in his
habitual work or which did not require medical attendance
c. ill-treatment of another by deed without causing any injury
6. physical injuries inflicted in a tumultuous affray (Art 252, Revised Penal Code)
Elements of the Crime:
a. there is a tumultuous affray
b. participant(s) suffered from serious physical injuries
c. the person(s) who inflicted such serious physical injuries cannot be
identified
d. all those who appear to have used violence upon the person of the
offended party shall be penalized by arresto from 5-15 days
Fatality of Wounds
1. wound may be directly fatal by reason of:
a. hemorrhage
b. mechanical injuries on the vital organs
c. shock
2. wound may be indirectly fatal by reason of:
a. secondary hemorrhage following sepsis
b. specific infection
c. scarring effect
Complications of Trauma or Injury
a. Shock
 b. hemorrhage
c. infection
d. embolism
1. fat embolism
2. air embolism
MEDICO-LEGAL INVESTIGATION OF WOUNDS
The following rules must always be observed by the physician in the examination of
wounds:
1. All injuries must be described, however small for it may be important later.
2. The description of the wounds must be comprehensive, and if possible a sketch
or photograph must be taken.
3. The examination must not be influenced by any other information obtained others
in making a report or a conclusion.
Outline of the Medico-Legal Investigation of Physical Injuries
1. General Investigation of the Surroundings
a. examination of the place where the crime was committed
b. examination of the clothing, stains, cuts, hair and other foreign bodies that
can be found in the crime scene
c. investigation of those persons who may be the witnesses to the incident or
those who could give light to the case
d. examination of the wounding instrument
e. photography, sketching, or accurate description of the crime scene for the
purpose of preservation
b. examinations that are applicable only to the living
(1.) determination whether the injury is dangerous to life
(2.) determination whether the injury will produce permanent deformity
(3.) determination whether the wound(s) produced shock
(4.) determination whether the injury will produce complication as a
consequence
c. examinations that are applicable to the dead victim
(1.) determination whether the wound is ante-mortem or post-mortem
(2.) determination whether the wound is mortal or not
(3.) determination whether death is accelerated by a disease or some abnormal
developments which are present at the time of infliction of the wound
(4.) determination whether the wound was caused by accident, suicide or
homicide
3. Examinations of the Wound
a. character of the wound
1. description must first state the type of wound (abrasion, contusion,
hematoma, incised, lacerated, stab)
2. must include the size, shape, nature of the edges, extremities and other
characteristic marks
3. must also state the presence of contusion collar in case of gunshot wound
of entrance, scab formation in abrasion and other open wounds, infection,
surgical intervention, etc
b. location of the wound
 1. the region of the body where the wound is situated must be stated
 it is advisable to measure the distance of the wound from some fixed point of the
body prominence to facilitate reconstruction (to determine the course of wound
inside the body)
c. depth of the wound
1. determination of the exact depth must not be attempted in a living subject if in so
doing it will prejudice the health or life
2. depth is measurable if the outer wound and the inner end is fixed
3. no attempt must be made in measuring a stabbed wound of the abdomen because of
the movability of the abdominal wall
d. condition of the surroundings
1. in gunshot wound near or contact fire will produce burning or tattooing of the
surrounding skin
2. in suicidal incised wound, there may be superficial tentative cuts (hesitation cuts)
3. lacerated wound may show contusion of the neighboring skin
e. extension of the wound
1. extensive injury may show marked degree of force applied in the production of
the wound
2. in homicidal cut-throat cases, it is generally deeper than in cases of suicide
3. homicidal wounds are extensive and numerous

f. direction of the wounds

1. is material in the determination of the relative position of the victim and the
offender when such wound has been inflicted
2. the direction of the incised wound of the anterior aspect of the neck may
differentiate whether it is homicidal or suicidal
g. number of wounds
 several wounds found in different parts of the body are generally indicative
of murder or homicide
h. conditions of the locality
(1.) degree of hemorrhage
(2.) evidence of struggle
(3.) information as to the position of the body
(4.) presence of letter or suicide note
(5.) conditions of the weapon
Determination Whether the Wounds were inflicted During Life or After Death