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    LEGAL MEDICINE PEDRO P. SOLIS, M.D., LLB. Diploma in Criminology, University of Cambridge Medico-Legal Officer, National Bureau of Investigation Professorial Lecturer in Legal Medicis and Medical Jurisprudence, University of the Philippines, Far Eastern University and Manila Central University; Professor in Legal Medicine and Criminal Phenomet , Philippine College of Criminology PRINTED BY R. P. GARCIA Publishing Co. 811 Quezon Blvd. Ext. Q. C. C—O Copyright 1964 By Pepro P. SoLis All rights reserved PREFAGE Legal medicine occupies a unique position among the medical gpecialties. The interest of justice is its prime consideration rather than the life and health of the people. It is a courtroom application of medical science rather than the bedside of the patient. Although the basic principles of legal medicine is uni- form throughout the world, it lacks universality of application jn as much it must be tempered by the existing local laws. The purpose of this book is to correlate as much as pos- sible the principles of medicine to our substantive and procedural laws. The ideas are expressed in simple language so as to afford understanding by students and practitioners of medicine, law, police science and criminology. It is made in concise form be- cause of the limited period of instructions as prescribed in the curriculum. The book only include fundamentals of legal medicine. It is not the intention of the author to include. intricate problems and their solutions. Whenever specific problems arise in the legal proceedings, it is recommended that textbooks on medical specialties involved must be consulted. (CHAPTER Page » CONSIDE 5 nar a 2 of Legal Medicine 1 Some Principles Governing Application and Effec 5 _ Tiranches of Law Where Legal Medicine Is Applied ..... 7 Recommendations for Instruction of Legal Medicine in Medical Schools . v8 Reasons for the Insufficiency of Medico-Legal Investigation in the Philippines . oe 10 History of Legal Medicine in the Philippines 1 Medico-Legal Systems Commonly Adapted in Different Countries 13 fedical Evidence . 16 Forms of Medical Evidence 16 Methods of Preserving Evidence . 19 Degree of Proof in the Court of Justice . 20 Medical Aspect of Criminal Investigation - 22 Criminal Interrogation ... 22 Deception Detection Methods 26 Confession ~ 81 I, MEDICO-LEGAL ASPECT OF IDENTIFICATION Identification of Person and Remains . 34 Identification of Person .. 85 Points Applicable to the Living . 35 Points Applicable to the Living an 37 Extrinsic Factors in Identification . 41 thropometry a ingerprinting 42 Handwriting 44 (/Adentification of Ske 49 Light Facior in Identi 58 Determination of Sex 68 Identification of Age 60 [dentification of Blood and Blood Stains . 65 Identification of Hair and Other Fibers 1 Ul. MEDICO-LEGAL ASPECT OF DEATH Anis of Death . 81 igns of Death . 83 thangs in the Body Following Death . 98 Changes in the Muscles . 98 Changes in the Blood . 98 Autolytic or Autodigestive Changes - 102 Putrefactive Changes ae Special Modifications to e + A TABLE OF CONTENTS vi me age car Duration of Death .. . * . tee - He -TPresumption of Death .._ - . . se. 119 Presumption of Survivorship : seeee 120 Euthanasia . oo ae sseee 120 Causes of Death « . te eeeee 121 (Medico-Legal Cla: ation of the Causes of Death 122 Pathological Classification of the Causes of Death . 136 Judicial Death .. ceveeeees sees 140 Medico-Legal Investigation of Death .-. ee tag) Medico-Legal Post-mortem Examination seeeeeee MB Methods of Disposal of the Dead Body ............ 153 IV. MEDICO-LEGAL ASPECT OF PHYSICAL INJURIES Physical Injuries Brought about by Physical Violence .... 169 Classification of Wounds ee Type of Wounds . a Effects and Complications of Wounds 191 Medico-Legal Investigation of Wounds - 197 Physical Injuries in Different Parts of the Body - 209 Firearm Wound ........... ood Nature of the Gunshot Wound . = 240. Gunshot Wound in Different Parts of the Body . 253 Shot-gun .........-. cece sees 257 Gunpowder Examination ... 259 Firearm Identification 261 Thermal Injuries or Deaths .... 268 Death or Injury from Cold ... = 268 Death or Injury from Heat ..... = oo 270 Physical Injuries or Death by Lightning and Electrici 285 Death or Physical Injuries by Lightning - 285 Death or Physical Injuries from Electricity . + 288 Death or Physical Injuries Due to Radiation by Radio-active Substances ..... . 294 Atomic Bomb Explosion ...... . 295, X-ray Radiation ...... Death by Asphyxia ....... Asphyxia by Hanging ... 297 sense 298 - 300 Asphyxia by Strangulation ....... ener t 507 Asphyxia by Suffocation .........6.... + 312 Asphyxia by Submersion or Drowning .. - 818 Asphyxia by Compression or Crush Asphyxia ........ 820 Asphyxia by Breathing Irrespirable Gases ...... Death or Physical Injuries from Changes in Atmospheric P¥essure .eeeeee ee eeee Caison’s Disease .... Mountain Sickness 321 326 326 Brees 82t eoncee 328 to Vehicular Accidents ... 330 lo ceceseeneceees BBE Aireraft Injuries and Fatalities Death or Physical Injuries Due Death from Starvation enn CHAPTER v. VI. vu. vit. Ix, XI. TABLE OF CONTE: vii Page MEDICO-LEGAL ASPECT OF SEXUAL CRIMES Virginity and Defloration sees 838 Rape | sc: ieaeenseess pase acon ; ++ 846 Examination of Seminal Fluid and Spermatozoa .....--++. 354 Other Crimes against. Chastity cesses 859 Seductions = ruitarsses 809 Acts of Lasciviousness - 362 Abductions es 363 Corruption of Minors . 265 White Slave Trade . 365 Adultery. aoe 366 Coneubinage 367 Unnatural Sexual Offenses PREGNANCY Legal Importance’ of the Determination . 376 Medical Evidences of Pregnancy .... 378 DELIVERY ‘Methods of Delivery Signs of Recent Delivery . Signs of Remote Delivery Gocsg Post-mortem Findings in Recent Delivery . ABORTION Legal Provision ... ‘Methods of Inducing Abortion .... 391 391 Complications of Abortion 400 Medical Evidence of Abortion 402 Therapeutic Abortion ..... 404 Problems in Abortion ......... 406 BIRTH Legal Importance of the Study of Birth 409 Proof of Live Birth ..... 410 Proof of Length of Survival after Birth 414 Signs of Maturity of a Child at Birth 415 Causes of Still-birth .. eee 415 INFANTICIDE Penal Provision ........+ ee nopecsogao tt) Methods of Committing the Crime of Infanticide .......+ 416 Other Allied Crimes .. sees 418 PATERNITY AND FILIATION Legal Importance of Determining Paternity and Filiation .. 420 Legitimate Children . seeeee 421 Legitimated Children ceeees 428 Adopted Children ..... —_ Illegitimate Children 430 Artificial Insemination ...... 482 Evidences of Paternity and Filiation 435 ee oa er a VABLE OF CONTE viii cuartet oe SUL MEDLCOT ASPECT OF MARITAL UNION AND DISSOL! UUTION As to Requisites of a Valid Marria; + 437 s to Marital Relation . + 439 s to Annulment of Marriage + 442 As to Legal Separation . + 448 XU IMPOTENCY AND STERILITY Impotency ~ 445 Sterility .. + 448 XIV. MEDICO-LEGAL ASPECT OF DISTURBANCE OF MENTALITY Legal Importance of the Determination pane Hospitalization of Insane .. - a8e Manifestation of Mental Disorder - = £o7 Mental Deficiency + 460 Methods of Measuring the Degree of Intelligence + 462 Alcoholism .....0...... + 404 Prohibited Drugs and Opium Addiction ~ 479 Malingering . = 4 Other Conditions Manifesting or Simul of Mentality .. XV. MEDICO-LEGAL ASPECT OF POISONING Definition and Site of Action of Poisons . 491 Circumstances Affecting Action of Poison 492 Signs and Symptoms that Lead One to Suspect Poisoning . Differential Diagnosis of Poisoning . Treatment of Acute Poisoning Medical Evidences in Cases of Poisoning . Classification 6f Poisons Food Poisoning Laws on Poisons . Post-mortem Findings in Some Chemical Poisoning 494 495 496 ++ 498 501 APPENDIX — Basie Principles of Philippine Criminal Law ........ 519 REFERENCES 535 Aur Juy ¥ Chaplers 1-3 GENERAL CC INSIDERATION LAEGAL MEDICINE is a branch of medicine which deals ith ihe application of medical knowledge to the purposes of law wit justice, It is the application of the basic and clinical, redi- cal and paramedical sciences to elucidate legal matters. - ‘orensic medicine are synonymous and in common practice are used interchangeably, although legal medi- cing strictly speaking means medicine applied to legal cases, while forensic medicine refers to the use of medical science to elucidate legal_problems. (Herzorg, p. 1). MEDICAL JURISPRUDENCE, on the other hand, is that branch of law which deals with the organization and regulation of the medical profession, with the contractual obligations exist- ing between practitioner and his patient, and with the duties im- posed on the practitioner by the State. Though a branch of law it is nonetheless a subject for him to know what is his status as « member of -the profession, what are the rights pertaining to the status, and his concomitant obligations. (Lyon’s Medical Juris- prudence by S. D. S. Greval, 10th ed. p. 1, 1953). For example, the testimony of a physician in court during the trial of violent death by stabbing, utilizing his knowledge of surgery and traumatic pathology, is an application of legal medicine, while the conduct of a medical practitioner in his rela- tion with the patient on matters regarding his duties and obliga- tions is within the scope of medical jurisprudence. Distinctions between Legal Medicine and Medical Jurisprudence: A; Legal_medicine is a branch of medical science, while medical jurisprudence is a branch of law. e applied to law and administration | jurisprudence is law applied to the Legal medicine and ft \ practice of medicine. 8. Legal _medicine basically originate from the development. of medical science, it being a branch of medicine, while medical jurisprudence emanates from acts of Congress, executive_or- ders, administrative circulars, customs and usages, and deci- 1 LEGAL MEDICINE, 2 sions of tribunals which have relation lo the practice of medi- cine. 4, Legal medicine is based on the principles of coordination ; that legal medicine coordinate medicine to law and jus On the other hand, medical jurisprudence is based on the prin- ciples.of subordination; that it is the duty of a physician to obey the laws in as much as our government is established on the principle of government of laws and not of men and that no one is considered above the law. It is the duty of a physician to make himself a subordinate of the superior be- ing, the sovereign people, from whom the law emanates. PURPOSES OF THE STUDY: 1. To give students and practitioners of medicine a theoretical and practical knowledge of the subject in his relation to law. (Principles and Practice of Medical Jurisprudence by Taylor, 10th ed. p. 2). 2. To give information to physicians of his rights and duties and the manner in which the law expect him to act under certain circumstances. 3. To enable a lawyer find the principles which apply, and the laws and decisions which may govern, in any case involving medical questions, as well as the points upon which medical experts should be examined. (Herzorg, p. 2). Sec. 5, Par. 2, Rule 188, Rules of Court: No applicant shall be admitted to the bar examination unless he has satisfactorily completed the following courses in a law school or university duly recognized by the govern- ment: civil law, commercial law, remedial law, political law, labor and social legislation, medical jurisprudence, taxation and legal ethics. 4. To acquaint medical and law students and practitioners of the recent advances of forensic medicine and the medico-legal sys- tem and procedure adapted in different countries. Students of criminology and police sciences must be acquainted with the medical aspect of criminal investigation, their signifi- cance, interpretation and probative value in court. Scope of Legal Medicine: ___ The scope of legal medicine is quite broad. It is the applica- tion of all branches of medicine and other allied sciences to law and administration of justice. The knowledge of wounds has been \ i i | | GENERAL CONSIDERATION 3 i 4 en deaths in jved in suryery, abortion in gynecology, sudden h acquired in surge \ ; ‘ medicine, effects of trauma in pathology, ele., although viewed in a different angle. ; In as much as the knowledge of medicine is that one, which applied in law, it is also necessary for the students and prac- titioners to have a working knowledge of law wherein branches of medicine is applied for they will encounter certain difficulty in the appreciation of the subject matter without basically know- ing where it is applied. It is necessary for them to know the elementary principles of our substantive and procedural laws. Nature of Legal Medicine: knowledge of legal medicine means tnDapiity to acquire fact{{fhe power to arrange those facts in the logical order, and he application for purposes of law the conclusion: which they lead. (Coy’s Medico-Legal Companion, by Bhattacharyya, 2nd ed., p. 7). A physician should be an impartial observer, intent only or seeking the truth of a case in relation to its circumstances; the conscience with which he discharges his duties is but a corollary to his putting into practice the medico-legal knowledge he has acquired. (Taylor’s Principles and Practice of Medical Jurisprud- ence, 11th ed., p. 2). It is not only necessary that a physician should have-an im- partial and accurate observation of the facts but also must possess the power to impart in words or in writing all of his observations to others. He must convey all the facts he has observed and be able to give his logical opinion. Some members of the medical profession have been inclined to regard medico-legal matter with abhorence. They consider it as an addition to their usual duties. while others refuse to handle medico-legal cases because of fear, and waste of material time when being summoned in court. But, no physician in practice can ignore nor refuse to face the problem of legal responsibility and his duties to the court. A Medical Jurist (Medico-Legal Expert) is a physician who ecializes in the science of legal-medicine. He must possess a sufficient knowledge of pathology, surgery, toxicology, and other branches of medicine in its application to law and justice. Abitferences between an Ordinary Physician and a Medical ee 1. An ordinary physician sees an injury or disease on the poin of view of ¢reatment while a medical jurist sees injury or disease as revards tatSiuae™. LEGAL MEDICINE 4 phe purpose of an ordinary physician’s examination of a 4b patient is to institute remedy or treatment, while the purpose ak of a medical jurist in examining the patient is for law and justice to one where justice is due. or bodily lesions may be insignifi nt lo an ordinary phy- cant attention for they n ay not ni sical injuries of whatever nature, size and location preciated and de: It may prove force e the nature of the crime, or it may prove jus x1 on the part of the offender to inflict injuries on the Small abvasions on the hand of the victim of multiple ay not be worth the physician’s attention, but to the medical jurist, those small abrasions may be necessary to prove that the victim offered some degree of resistance, there- by modifying the nature of the crime committed. xvother Definitions: Autatd “1._Law is a rule of conduct, just, obligatory, laid by legitimate power for common observance and benefit. It is a science of moral laws founded on the rational nature of man which regu- late free activity for the realization of his individual and social ends under the aspect of mutual demandable independ- ence. (1 S-R.) The word “law” includes regulations and circulars which are issued to implement a law and have therefore the effect of law. » Characteristics of Law: a. It is a rule of conduct; b. It is dictated by legitimate power; and c. Compulsory and obligatory to all. (Padilla, Civil Code) Forms of Law: a. Written or Statutory Law (Lex Seripta) This is composed of laws which are produced by the country's legislations and which are defined, codified and incorporated by the law-making body. Example: Laws of the Philippines b. Unwritten or Common Law (Lex non Scripta) This is composed of the unwritten laws based on im- memorial customs and usages. It is sometimes referred Primer ned as ate nd GENERAL CONSIDERATION to as case law, common law jurisprudence or customary 19 as case law, jaw, law. Example: Laws of England 2. Medicine Medicine is a science ion of di nd_art dealing with prevention, se. It is that part of seience and cure and alle art of restoring and p: ‘The term medicine is als diagnosing, treating, curing and preventing di pain, improving the health of a person. plied to a science and art of , relieving Legal: Legal is that which or pertains to Jaw, arising out of by virtue of or included in law. It also refers to anything confermable to the letters or rules of law as it is administered by the court. te 4 Q u phe « Jurisprudence: Wim 4 aa Ay Laybh ~ It is a practical scfoncd whlch ‘Thvestigates*the nature, origin, development and functions of law. It is a science of giving a wise interpretation of the law and making just application of them to all cases as they arise. Judicial decisions applying or interpreting the laws shall form a part of the Philippine jurisprudence. The decisions contemplated are those rendered by the Supreme Court which is the final arbiter on legal issues. However, the decisions of the Court of Appeals may serve as precedent for inferior courts on points of law not covered by Supreme Court decisions. Principle of Star _ A principle that, when the court has once laid down a prin- ciple of law as applied to a certain state of facts, it will adhere to that principle, and apply it to all future cases where the facts are substantially the same. (Ad law The principle is one of policy, grounded on the theory that security and certainty require that accepted and established legal principles, under which right may accrue, be recognized and followed, though later found to be not legally sound, but whether previous holding of court shall be adhered to, modified or over-ruled is within the court's discretion under the cireum- stance of the case before it. (Black, Law Dictionary). Ci a a me Ignorance of the laeexcuses 00m from compliance there- with. (Art. 8, C. C.) (Ignorancia legis nominem excusat) : fad L MEDICINE 6 The main reason for the rule is to prevent ignorance of the law as a means of defense for violation of the law. Other. rN wise mere ignorance in fact of the law would furnish im- munity from punishment for violation of the penal code and jmmunity from liability for actual loss for violation of per- sonal and property right, The maxim is not inflexible. It is only applicable to a nifest and truly inexcusable ignorance of the law. A physician must not be held liable or penalized for having committed an honest error in the interpretation of the law Laws shall_have no retroactive effect, unless the contrary is provided. (Art. 4,C. C.) The general rule is that all laws have a prospective effect. It will be unjust if a law will be given a retroactive effect because it impairs vested rights and not in accord with sound legislation or with social compact. Exceptions: A law may have retroactive effects in the following instances? C, (atic Las how a. When the law provides the contrary (Art. 4, C. C.) b. Penal laws shall have retroactive effect if favorable to the accused who is not_a habitual delinquent. (Art. 22, R.P.C.) c. When the statute is remedial in nature because there is no vested right in the rules of procedure and evidence. d. When the law creates new substantive rights. 3. Rights, may be taived,unless the waiver is contrary to law, “public order, public policy, morals, good customs, or prejudicial to a third person with a right recognized by law. (Art. 6, aC.) Example: A physician has the right to demand compensation for the services rendered to patient, but the physician may waive his right to demand professional fee from patient thereby making his services gratuitous. Such waiver is not contrary to law, public order, public policy or prejudicial to a third person. A physician has the right to refuse emergency calls but in as much as such refusal is contrary to good customs, morals and prejudicial to a third person, he must ethically answer to the call of emergency, GENERAL CONSIDERATION 7 Customs which are contrary to law, public order or public policy shall not be countenaneed. (Art. 11, C. Cc.) A custom is an unwritten law, established by long usage and with the consent of our ance Usage is the legal evi- dence of custom and is defined as an established method of dealing, adopted in a particular place, which acquires legal force because people makes contract in re to it. In the Philippines, the Civil Code expr: customs should be applied in case there is no codal prov’ applicable. incipally Applied: (Bianches of Law Where Legal Medicine is P: 1. Civil Law: vil law is a mass of precepts that determines or regulates the relations of assistance, authority and obedience between members of a family, and those that exist between members of a society for the protection of private interest. (S. R.) It covers rules governing persons and family regulations to society for the protection of private interest. The civil law of the Philippines is embodied in the Civil Code which is divided into the following books: Book I. — Persons (Art. 87-413) Book II — Property, Ownership and its Modification (Art. 414-711) Book III — Different Modes of Acquiring Ownership (Art. 712-1155) Book IV — Obligations and Contracts (Art. 1156-1430) Miscellaneous Provisions (1481-2270) 2. Criminal Law: Criminal law is that branch or divisiop of law which de- ‘ines crime, “Yreats_of their nature, andUprovides for their punishments. shay Penal laws and those of public security and safety shall be obligatory upon all who live or sojourn in Philippine territory, subject to the principles of public international law and to treaty stipulation. (Art. 14, Civil Code) ‘The Philippine criminal law is codified in the “Revised Penal Code” and may also be found in the penal provisions of special laws. LEGAL MEDICINE . IEDICINI Remedial Law: Remedial law is that branch of Jaw which deals with the rules concerning pleadings, practice and procedure in all courts of the Philippines. Our remedial 1 e embodied in the “Rules of Court of the Philippines” and also the re laws. edial provisions of specis 4, Speciat Laws: a. Insurance Law (Act 2427 as amended) b. Workman’s Compensation Act ce. Employer's Liability Act d. Magna Carta of Labor RECOMMENDATIONS FOR INSTRUCTION OF LEGAL MEDI- CINE IN MEDICAL SCHOOLS: The Committee on Medico-Legal Problems of the American Medical Association has approved the publication of the follow- ing report of Louis J. Regan and Consultants: The Committee recommends that: 1. A strong department or division of legal medicine be developed in every medical school. 2. The department or division of legal medicine in each med- ical school incorporates in its curriculum a required course in legal medicine, a course dealing with basic material or general interest and importance to all physicians. 3. More detailed treatment of forensic specialties, or of par- ticular areas of interest, be developed as special (elective) courses. 4. Teaching should not be restricted to undergraduate medical students but opportunity should be provided for the train- ing of graduate physicians in the special techniques of medico-legal investigation, in forensic pathology, toxicol- ogy, hematology, immunology, etc. with fundamental re- search emphasized and encouraged. 5. Post-graduate seminars should be provided to meet the need of those engaged in medico-legal work, such as coro- ners, medical. examiners, pathologists, interested prac- ticing physicians, technicians in police science laboratories, and representative members of district attorney’s staff. GENERAL CONSIDERATION 9 6. The staff of the department or division of legal medicine should encourage the development, and participate in the conduct, or courses in the neighboring law schools. 7. There should be a direct and immediate relationship be- tween the staff of the department or division of legal medicine in the medical school and the local office of the coroner or the medical examiner. Further, it is de- sirable that the chief autopsy surgeon in that office and perhaps his first assistant, should have appointment on the teaching staff of the department. The Same Committee Recommends: 1. That, in the practice of medicine, no physician can avoid contact with the law and that no medical student should be permitted to receive his degree without instruction on his legal duties to his patients, community and govern- ment. 2. That formal instruction in the pathology of trauma is neglected in the average medical school; that, commonly, the material from autopsies of victim of trauma is siphoned into official channels divorced from academic sponsorship; and that consequently, not only the material is lost for scientific study but the presentation and interpretation in court of sound documented medical evidence is frequent. (Published in the Journal of the American Medical Asso- ciation, Oct. 18, 1952). METHODS OF INSTRUCTION: The students and practitioners of medicine has already re- ceived instructions on the fundamental and clinical aspect of medical science. Emphasis must only be given on the medico- legal significance and its application in investigation and in judi- cial and administrative proceedings. Law and jurisprudence as related to certain aspects of medicine must not be ignored in the instruction. Students will not very well appreciate the subject matter without proper instruction of the inter-relationship be- tween medicine and law. Most of the medical institutions in the Philippines offer legal medicine two hours a week during the first and second semesters of the fourth year. The whole of the first semester may be de- voted to legal medicine proper while medical laws, jurisprudence and ethics may be taken during the second semester. EDICINE 10 To the students of law, instruction must be limited to the medical aspect of the subject matter, with proper emphasis on atters of certain legal principles. They must be trained “On the different points a medical expert witne’ examined zn trial in order that justice may be given to the one where it is due. On account of the limited time allotted to legal medicine in the law course, students in most instances can not bi 1 trained of the medical aspect of investigation. Students of criminology and police sciences must be given instructions on medico-legal procedures, especially in the investiga- tion of death, physical injuries and sexual offenses. They must be informed of the importance of forensic medicine in the solution of crimes. Preparation, presentation and appreciation of medical evidences must not be overlooked. Reasons for the Insufficiency of Medico-Legal Investigation in the Philippines: 1. Lack of sufficient training of our physicians in medico-legal work: It is quite lamentable indeed that a major portion of our government physicians in the rural areas are still unprepared to undertake medico-legal investigations. There is a limited period of medico-legal instruction in medical schools. Legal medicine, although a part of the med- ical college curriculum, has been allotted a limited number of hours of instruction. Most of the present medical institution do not give practical training in the field of legal medicine. Whatever knowledge the graduate has, are merely theoretical so that oftentimes they cannot apply what they have learned in college. A practitioner of medicine cannot escape medico- legal cases in the course of his practice. 2. Lack of adequate facilities: Most of the physicians in the remote areas are not pro- vided with the proper equipments and supplies necessary in the performance of their medico-legal duties. . Untrained police investigators: Most of the peace officers do not know in what phase of the investigation they need the services of a physician. They do not appreciate the value of medical evidence in the solution of crimes. They often rely too much on testimonial evidences. ‘They are not yet conscious of the value of scientific evidences. GENERAL CONSIDERATION i 4. Inadequacy of our om of transportation and communication: Most medical e re destroyed by time because of the difficulty of pr ion. A ph in may make his in- vestigation after © of certain period because of the dif- ficulty of transpor ion and communication HISTORY OF LEGAL MEDICINE IN THE PHILIPPINES 1858 — First medical textbook printed including pertinent in- structions related to medico-legal practice by Spanish phy- sician, Dr, Rafael Genard y Mas, Chief Army Physician, entitled “Manual de Medicina Domestica”. 1871 — Teaching of legal medicine, included as an academic sub- ject in the foundation of the School of Medicine of the Real y Pontifica Universidad de Santo Tomas. March 31, 1876 — By virtue of the Royal Decree No. 188, of the King of Spain, the position of “Medico Titulares” was created and made in charge of public sanitation and at the same time medico-legal aid in the administration of justice. 1894 Rules regulating the services of those “Medico Titular y Forences” published. 1895 — Medico-legal laboratory was established in the City of Manila and extended at the same time its services to the provinces. 1898 — American Civil government preserved the Spanish forensic medicine system. 1901 — Philippine Commission created the provincial, insular and municipal Board of Health (Act Nos. 157, 307 and 308) in the Philippines and assigned to the respective inspectors and presidents of the same, medico-legal duties of the “Medico Titulares” of the Spanish regime. The Philippine Legislature maintained the pre-existing medico-legal system in full force in the Administrative Code. 1808 — The Philippine Medical School incorporated the teaching of Legal Medicine, one hour a week to the fifth year medical students. 1919 — The University of the Philippines created the Department of Legal Medicine and Ethics with the head having the salary of P4,000.00 per annum, half-time basis, with Dr. Sixto de los Angeles as the chief. 12 LEGAL MEDICINE January 10, 1922 —The head of the Department of Legal Medicine and Ethics beeame the Chief of the Medico-Legal Depart. ment of the Philippine General Hospital without pay. March 10, 1922—The Philippine Legislature enacted Act No. 1043 which heeame incorporated in the Administrative Code as section 2465 and provides that the Department of Legal Medicine, University of the Philippines, a branch of the Department of Justice. December 10, 1937 — Commonwealth Act No. 181 was passed creat- ing the Division of Investigation under the Department of Justice. The Medico-Legal Section was made as an integral part of the Division with Dr. Gregorio T. Lantin as the chief. March 8, 1939 — The Department of Legal Medicine of the Col- lege of Medicine, University of the Philippines was abol- ished and its functions transferred to the Medico-Legal Section of the Division of Investigation. July 4, 1942 — The City of Manila created the Medico-Legal Sec- tion under the Manila Police Department with Dr. Pablo Anzures as the chief. July 1, 1944 — President Jose P. Laurel consolidated by executive order all the different law-enforcing agencies and created the Bureau of Investigation on July 8, 1944. 1945 — Immediately after liberation of the City of Manila, the Provost Marshal of the United States Army created the Criminal Investigation Laboratory with the Office of the Medical Examiner as an integral part and with Dr. Ma- riano Lara as Chief Medical Examiner. June 28, 1945 —The re-activation of the Division of Investiga- tion, under the Department of Justice. June 19, 1947— Republic Act No. 157 creating the Bureau of Investigation was passed. The Bureau of Investigation was made the National Bureau of Investigation by virtue of an executive order of the President of the Philippines. Under the bureau, a Medico-Legal Division was created with Dr. Enrique V. de los Santos as the Chief. There exists a Medico-Legal Division in the Criminal Lab- oratory Branch of the G-2 of the Philippine Constabulary. All provincial, municipal and city health officers, phy- sicians of hospitals, health centers, asylums, penitentiaries and colonies are ex-officio medico-legal officers. ecome RAL CONSIDERATION 13 srvices of a registered phy- ano Ministrante” may per- where the In remote place sician is not 4 De form medicolegal work TEMS COMMONLY ADAPTED ERENT COUNTRIES AL S IN DIF! MEDICO-1 The three medico-legal systems commonly adapted especially by English-speaking countries are: the medico-legal officer, the medical examiner, and the coroner systems. The coroner is a very ancient officer in England and he represents the king, espe- cially in investigating the discovery of treasures and in crimes punishable by fines. There are thirty-five states in the United States wherein the office of the coroner still exists. The other states adapt the medical examiner system. For purposes of com- parative study, the medico-legal officer in the Philippines, the medical examiner of New York and the officer of the coroner of England shall be considered in the discussion. 1. MEDICO-LEGAL OFFICER: a. Qualifications of a medico-legal officer: . He must be a physician duly qualified to practice medi- cine in the Philippines. To qualify him as an expert witness, he must haveGufficient experience and training in all branches of medico-legal work. b. How the medico-legal officer gets his office: All municipal, provincial and city health officers, med- ical staffs of hospitals, asylum, schools, colonies and peni- tentiaries, and other charitable institutions are ex-officio medico-legal officers. They are appointed by the com- petent authorities provided for by law. The medical exam- iners of the city of Manila are appointed by the Mayor. The medico-legal officers of the National Bureau of In- vestigation are appointed by the Secretary of Justice. They are governed by the civil service rules and regulations in matters of conduct and discipline of a public officer. ¢. Duties of the medico-legal officer: The medico-legal officer investigates death upon re- quest, expressed or implied, from competent authorities. Usually that person who has primarily the power to in- vestigate has also the right to request for medical investi- gation. He does all that a physician could do within the er lll f 4 LEGAL MEDICINE scope of med administ ience that will be of value in the proper tion of justice, MEDICAL EXAMINER: a. Qualifications He must approved ins of a@ medical examiner ave received the degree of M.D. from an itution of recognized standing. He must be a skilled_pathologist, learned in the field of legal medicine, both with regards to the literature and the present state of science. He must_have connection with .a_pathological laboratory for atleast ten _years/ He must possess theoret- ical and practical knowledge of bacteriology and toxicology. He must have experience in preparing and presenting evi- dences in court. b. How the medical examiner gets his office: The chief medical examiner is appointed by the mayor from the classified civil service list. He is authorized to make appointments of the qualified deputies, assistants, and other employees as may be provided by law. ¢. Duties of the medical examiner: ‘The medical examiner investigates the circumstances of -death and if necessary performs the necessary autopsy. He is supposed to write a report of his findings. He has the right to subpoena witnesses and hold hearing concerning any matter within the jurisdiction of the office. 4. Procedure of investigation: The police officer informs the medical examiner of an alleged violent death. The medical examiner goes to the scene of the crime, takes names of witnesses and examines the body. He may or may not perform the autopsy de- pending upon the result of his investigation. He summons witnesses and holds hearings concerning the case. At the actual trial in court, the medical examiner is summoned to testify as to his findings and opinion of the case. 3. CORONER: a. Qualifications of a coroner: He must be a barrister, a solicitor or a legally qualified medical practitioner for not less than five years. b. How the coroner gets his office: . _ The coroner is elected by popular votes and any in- dividual eligible to the office may run for the position. He GENERAL CONSIDERATION 15 is elected by the county council or the borough council. In some places he is appointed for life. ce. Duties of the coroner: The coroner is clothed with investigative and judicial functions. ‘The coroner is the inquest officer of every death, violent in nature. He is notified of such death by the local police, parish officer, registrar of death or by any private in- dividual. The coroner also appreheni who are at the th ged with murder and assures their attendai ize or magistrate courts. d. Procedure of inquest: (1) In case of violent death, the authorities concerned will inform the coroner. (2) The coroner may summon the doctor and directs him to make examination of the body. (3) The coroner may summon a jury for the Coroner’s court. (4) The medical practitioner who made the examination is called in court. The proceedings here is less formal than the ordinary court of law and the rules of evid- encé are not enforced. (5) The case is then elevated to the magistrate if it is a minor case, or to the Court of Assize for serious cases. The medical witness is again asked to be present for direct and cross examinations. Practically, the medico-legal officer and the medical examiner have the same qualifications, powers, and duties, unlike that of the coroner who is clothed with judicial functions. There seems to be a growing tendency for the gradual disappearance of the coroner’s system among the-English-speaking countries. REASONS FOR THE GRADUAL DISAPPEARANCE OF THE CORONER’S SYSTEM: 1. The position of the coroner is extremely political and the tenure of office is short in as much as he secures his office by election. 2. In most cases the coroners are not trained for medico-legal investigations and do not take interest in the work. Fre- quently, the coroners are undertakers who are resentful to 4 LEGAL MEDICINE 1 post-mortem examination on account of its interference in the Rmbalming of the body. the coroner their principal sou to make known the ‘© poorly paid and they derive ne from concealing or refusing use of death. of ine; MEDICAL EVIDENCE EVIDENCE is the means, sanctioned by law, of ascertaining in a judicial proceeding the truth respecting a matter of fact (Model Code of Evidence) / Alone Section 1, Rule 128, Rules SABE tht ae t means sanctioned by this rule, (Rules of Court) of ascertaining in a judicial proceeding the truth respecting a matter of fact. Sec. 2, Rule 128, Rules ‘of Court—The rules of evidence shall be the same in all courts and on all trials and hearings, whether civil or criminal. See. 3, Rule 128, Rules of Court—Evidence is admissible when it is relevant to the issue-and.is not excluded by this rule. Sec. 4, Rule 128, Rules of Court—Evidence must correspond with the substance of. the issue and, therefore, collateral matters shall not be allowed, except’ when they tend in any reasonable degree to establish the probability or improbability of a fact in issue, ical Evidence, therefore, is the means, sanctioned by law, of ascertaining in a judicial proceeding that truth respecting a a matter of fact wherein scientific medical knowledge is necessary. Such medical evidence must be relevant to’ the issue and not excluded by the Rules of Court of the Philippines. It is also necessary that such medical ovisenee must correspond to the sub- stance of the issue. Wg > Q bin a - CL: Bee OF MEDICAL EVIDEN¢E S41“ elontte SF Real or Autoptic Bvidence: — iN{ «wHfiis form of evidence is made known or addressed to the senses of the court. Sec. 1, Rule 130, Rules of Court: View of an Object — Whenever an: object has such a rela- an to the fact in dispute as to afford reasonable grounds lief respecting it; such object may be exhibited to or Re i tf * Epa diebs Albums —— dirty fod hed th SNERAL CONSIDERATION 17 viewed by the court, or ils existence, situation, or character proved by witnes the court in its discretion may deter- mine. Example: The court may require the ph: n to bring the skeleton exhumed and examined to show the presence and the degree of ante-mortern fractures, Real or autoptic evidence is be known by the sense of vi ceived by the senses of hearin, (a) Indecency and impropriety are exceptions to this rule of a» . evidence, but when exhibition is necessary for the end oo of justice, notions of decency and delicacy of feeling will not be allowed to prevail. Example: not limited to that which can ‘ion but extend to what is per- ; taste, smell or touch. The court may not allow to expose her genital organs to show the presence and degree of Physical injuries. It is because of decency. However if it is very necessary to prove a certain matter of fact at issue, the court may_ compel exposure, but with caution and with the least injury to the sense of decency. (b) Repulsive objects and those offensive to sensibilities should also be excluded if they are not absolutely neces- sary for the proper administration of justice. Example: The court will not aliow or permit a portion of a decomposed body be brought to the court just to show how long the body has been mur. dered, because it is repulsive and offensive to the senses. However, it is with the sound discretion of the court whether those evidences shall be brought to the senses of the same. 6) Testimonial Evidence: — A physician may be placéd at the wi d to answer questions propounded to him by counsels of parties or by the Presiding officer of the court. His testimony must be given orally in open court and under oath or affirmation. Qualification of an ordinary witness: Sec. 18, Rule 180, Rules of Court: | . fr oe Except as provided in the next succeeding section, all per- sons who, having organs of sense, can perceive, and perceiving, can make known their ar to others, may be witnesses, . ONY to, Prssubidipy toners © OA2 ta rbowt om 7 ie a nn a ae wpirne Aas to. AO we MO yy a ue erage Janda wit Uartiy the a ee t LEGAL M SINE ns interested in the outcome of ; nor those who have been convicted ount of his opinion on matters 1 Qualification of an expert witne Sec 42, Rule 130, Rules of Court: The opinion of a witness regarding a question of science, art or trade, when he is skilled therein, may be received in evidence. ® Experimental Evidence: A medical witness may be required to perform certain ex- periments to prove a certain matter_of fact. Again, such evidence must not.be offensive to decency, sensibilities, and propriety. The court, however, in its discretion may or may not allow experimental evidence. Example: A guinea pig may be injected with fatal dose of potassium cyanide to prove that the drug can pro- duce death almost instantaneously. Z./Documentary Evidence: ~ pj, ‘Any written evidence presented by a physician in court which is relevant to the subject matter in dispute and not excluded by the Rules of Court is documentary evidence. Medical Documentary Evidence consists of the following: a. Formal Written Reports: (1) Medical examination report (2) Physical examination report (8) Necropsy report (4) Laboratory examination report (5) Exhumation report (6) Medical investigation report b. Written Opinions: A medical witness or medico-legal officer may be re- quired to make a written opinion of the case under in- vestigation. Such written opinion during the stage of the trial is presented as one of the supposing documentary evidence of a party. ©. Certificates; (1) Medical certificate (2) Certificate of physical health (8) Death certificate ! Vilyped — Undy dus taideew!— mosryram a ye furs ol & duty wad A alu Unt died en ety be >) ome fe pode, wales re | ee cunnian, Condbnatation 16 (4) Birth certificate ~. (5) Certificate of phys (@) Deposition: A deposition is a written record of evidence given or: and tr: cal injurie nscribed in writing in the form of questions by the interrogatgr and the answer of the deponent and signed by the latter. e. Duing Declar tion: The declaration of a dying person, made under a con- sciousness of an impending death, may be received in a criminal case wherein his death is the subject of inquiry, as evidence of the cause and surrounding circumstances of such death. (Sec. 81, Rule 130, Rules of Court) The dying statement of a patient in the emergency ward to the physician or surgeon on duty may be re- duced in writing for purposes of preservation. Such @) Written declaration is a dgum tary evidence. 2 tha RVING EVIDENCE: Pep Sometimes it is necessary to preserve the evidences gathered by a physician in the course of his investigation. The evidences at the hands of the police authorities may not be sufficient to warrant filing of the charge in court, or the accused is still at large, or the judge may-be in vacation. In these instances it is necessary to preserve the medical evidence for some future time. 1. Photography and Sound Recording: This includes photostats, microfilms, movie films, sound mirrors, phonography, telephotos, X-ray records, ete., This way of preserving evidence will not change the normal pro- portion and condition of the objects or sound. It could last for a longer time in the file of records, 2. Sketching: If photography is not available, the investigator may draft an outline of the scene or object to be preserved. A oust representation as to the size, relation, position, location | sf the identifying marks may be placed in paper. In most cas proportion, natural configuration, and details are ign 3. Desoription: giles Beotiuies i ‘A descriptive narration of the evidence apresarvod is made. The investigator must use the rE eibed for the location, size, shape and color of the thing LEGAL MEDICINE, 20 estimony of witne Sec. 18, Rule 130, Rule of Court (Supra) Preservation of evidence in the mind of a person is not an ideal method beeause a. Human mind may later be influenced by some external factors, especially by another person, in a way that evi dence will not exactly manifest the truth. b. The preservation will only last during the lifetime of the evidence preserved in his mind. DS OF EVIDENCE NECESSARY FOR CONVICTION: 1. Direct Evidence: That which proves the fact in dispute without the aid of any inference or presumption. The evidence presented cor- responds to the precise or actual point at issue, 2. Circumstantial Evidence: The proof of fact or facts from which, taken either singly or collectively, the existence of a particular fact in dispute may be inferred as a necessary or probable consequence. When is Circumstantial Evidence Sufficient to Produce Con- viction?: Ex a,/When there is more than one circumstance; b, When the facts from which the inferences are derived are proven; and ¢. When the combination of all the circumstances is such as to produce a conviction beyond a reasonable doubt. (Sec. 4, Rule 133, Rules of Court) DEGREE OF PROOF REQUIRED IN THE COURT OF JUSTICE: 1, In CIVIL CASES, preponderance of evidence only is required. Preponderance of evidence means the greater weight of evidence that will outweigh the evidence of the other party. It means that the evidence adduced as a whole by one side is Superior to that of the other. Whenever the evidences pre- sented by both parties are placed in a balance the beam in- clines towards the prevailing party. Whenever the evidences presented by both parties are in equilibrium or equally balanced, the decision must be made against the party holding the affirmative fact. GENERAL CONSIDERATION 21 Factors to be considered in the determination which party's evidence preponderate: Sec. 1, Rule In civil cases, 'y having the burden of proof must establish his ease by a prepondei In deter mining where the preponderance or superior weight of evi- dence on the issues involved lies, the court may consider all the facts and circumstances of the case, the witnesses’ manner of testifying, their intelligence, their means and opportunity of knowing the facts to which they testify, the nature of th facts to which they testify, the probability or improbability of their testimony, their interest or want of interest, and also their personal credibility so far as the same may legitimately appear upon the trial. The court may also consider the num- ber of witnesses, though the preponderance is not necessarily with the greatest number. From the foregoing provision of the Rules of Court, the following factors must be considered which party's evidence preponderate: . a. All the facts and circumstances of the case. b. The witnesses’ manner of testifying, their intelligence, their means and opportunities of knowing the facts to which they are testifying. c. The nature of the facts to which the witnesses testify. d. The probability and improbability of the witnesses’ tes- timony. e. The interest or want of interest of the witnesses. f. Credibility of the witness so far as the same may le- gitimately appear upon the trial. g. The number of witnesses presented, although prepon- derance is not necessarily with the greatest number. 2. In CRIMINAL CASES, Proof beyond a reasonable doubt is re- quired: Sec, 2, Rule 183, Rules of Court: In a criminal case, the defendant is entitled to an acquittal, unless his gui't is shown beyond a reasonable doubt. Proof beyond a reasonable doubt does not mean such a degree of proof as, excluding possibility of error, produces absolute cer- tainty. Moral certainty only is required or that degree of proof which produces conviction in an unprejudiced mind. 33, Rules of Cou the pa nee of evide GAL MEDICINE 2 LEGAL MEDICINE It is presumed that a person is innocent of a crime until the contrary is proven beyond a ble doubt. The doubt, the benefit of which an accuse i case, is a reasonable doubt, and not a whimsical ‘ul doubt, based on imagined and wholely improbable possibilities and unsupported by evidence. MEDICAL ASPECT OF CRIMINAL INV! ‘ESTIGATION ‘There are certain aspects of criminal investigation which in- yolve psychologic and neurologic consideration, especially in the process of interrogation and deception detections. The human instinct of self-preservation makes it difficult to obtain informa- tion from witnesses or from prospective informants. 1. CRIMINAL INTERROGATION The principal psychological, physical and’ medi a successful interrogation is privacy. In interrogation, it is an inherent mental process that a suspect or witness is more apt to divulge his secret in a private room occupied by only the subject and interrogator than in the presence of other persons. The room where the investigation is to be conducted must have a limited number of things which may distract the atten- tion of the subject. It must contain no ornaments, pictures or ~ other objects and the lighting fixture must not be excessive or glaring the subject’s facial features. No telephone should be present in the room for its ringing constitutes serious distraction. ‘Before actual interrogation is done, the investigator must be thoroughly familiar with all the facts and circumstances of the case which are krown to that time. It is important to know the past life and history of the subject. ‘A good interrogator must have the capacity to (1) “size-up” the subject ‘and (2) select and effectively apply tactics and tech- niques most appropriate for the occasion. Kinds of Offenders: 1. “Emotional Offenders”—These are persons who commit crimes in the heat of passion, ane or revenge, and also persons whose offenses are of an /accidental nature. Emotional of- fenders usually have feelings of remorse, mental anguish or compunction as a result of their acts, They have a sense of oneal GENERAL CONSIDERATION 23 moral guilt. ‘Their conscience “bother” them and they have difficulty resting or sleeping because of their feeling of guilt. The most effective interrogation approach to use on them is based upon sympathetic consideration regarding their of- fense and present difficulty. “Non-K motional Offenders”—These are persons who commit crimes for financial gain and particularly offenders who are vists or repeaters. This type of offender usually has no trouble in their conscience. Sympathetic approach is not ef- fective. The interrogator should make a factual analysis of the suspect’s predicament and appeal to his common sense and ‘reasoning rather than to his emotions. (Imbau) Symptoms of Entotional Tension: Emotional tension is usually manifested by emotional of- fenders in the course of an interrogation but may also be mani- fested by accidental offenders and those who commit crime for the first time. The following are the symptoms of emotional tension: 1. Sweating: Sweating is accompanied with flushed face indicating anger, embarrassment or extreme nervousness. Sweating with pallid face, cold sweat may indicate shock or fear. Sweating hands may indicate tension. 2+ Color change: ‘A ruddy, flushed face may indicate shame, anger, embar- rassment. A pale, blanched face indicates fear and’ may be an index of guilt, although not conclusive. 8« Dry_mouth: ° Continuous swallowing by the subject, licking the lips, and drinking excessive amounts of water are indicative of tension. 4¢ Clenching of hands: The clenching of hands indicates tension and may be coupled with anger. The wringing of the hands, rubbing against the clothings, twisting and knotting of handkerchief, or manipulating objects are indicators of tension. 5y Elbows: Close watch of the elbows may reveal whether or not the approach is having its effect. If the elbow is hanging, the subject is relaxed. If they are held closely to the sides or become tense, the manner under discussion is critical and affecting the subject strongly. ae AL MEDICINE 6. e are not visible, close observation may re- an increa te. The neck vessels may stand out. When knees are crossed, there is a tendency for the free foot to move with the heart. beat. {~ Breathing: Controlled breathing indicates a critical question. It may be betrayed by a slight gasp, a sudden intake of breath, a holding of breath, or a sudden explosion of the breath 8. Kidgeting, general nervous symptoms: Subject constantly moving about in the chair, pulling of the ears, rubbing of the face, picking and tweaking the nose, crossing and uncrossing the knees or legs, shifting the feet (there is a tendency to brace the feet on critical question) rubbing the hair, eyes, or eyebrows, biting or snapping of fingernails, all may indicate tension. (From:—Technic for the Crime Investigator by William Dien- stein, Ist ed., p. 109). Physiological and Psychological “Symptoms” of Guilt of the Subject: The appearance of a subject may be betraying his guilt. His attitude may place him tiearer the confession stage. The following “symptoms” may be utilized by the interrogator as pre- sumptive manifestation of guilt: 1. Pulsation of the carotid artery: A person who is telling a lie may. show acceleration of the pulsation of the carotid artery in the neck. This May be seen also in an innocent subject Excessive activity of the “Adam’s apple”: The amount of drying of the°mouth and throat depends on the degree and rate of acceleration of the upward and downward movement of the laryngeal box. The reaction is due to a reflex inhibition of the salivary secretion when a person is not telling the truth. This is not conclusive of guilt because nervous reaction is not the same in different persons. 3. Dryness of the mouth: Due to the reflex inhibition of the salivary secretion, there is dryness of the mouth. There will be repeated attempts on the part of the subject to wet his lips. This is observed in a majority of guilty subjects, x GENERAL CONSIDERATION 25 4. Inability to look at the interrogator “straight in the eye”: The subject do not like to look at the interrogator for fear that his guilt may be seen in his eye chair, ete.: 5. Swinging one leg over the other; Tapping the These are all due to the disturbed mental condition of the subject 6. The “peculiar feeling inside”: The subject is feeling unusual as a result of his troubled conscience. re) - Swearing to the truthfulness of his assertion: Usually a guilty subject always utter such expressions as “TI swear to God I am telling the truth” or “I hope my mother drops dead if I am lying,” “I swear to God”....ete. Such expressions are made to make forceful and convincing his as- sertion of innocence. ° 8. “Not that I remember” expression: The subject will resort to the use of “not that I remember” expression when answering some questions to be evasive and to avoid committing something prejudicial to him, (Imbau) Attitude and Conduct of an Interrogator: To the course of an interrogation of a suspect or witness, the interrogator must observe the following: 1. The interrogator should avoid creating an impression that he is an investigator secking a confession or conviction. It is better for him to appear in the role of one who is merely seek- ing the truth. 2. Such realistic words or expressions as “kill”, “steal”, “confess” your crime, ete. should not be used by the interrogator. It is more desirable, from the psychological standpoint, to employ milder terminology like “shoot”, “take”, “tell the truth”, etc. 8. The interrogator should sit fairly close to the subject and be- tween the two, there should be no table, or other piece of furniture. The distance or the presence of an obstruction of any sort seems to afford the subject a certain degree of relief and confidence not otherwise attainable. 4. The interrogator should avoid pacing about the room. To give an undiverted attention to the person being interrogated, make it such that it is more difficult for him to evade detection of deception or conceal his guilt, AL MEDICINE the interrogator should avoid or at least minimize and he 0 ref smoking, in from fumbling with a pencil, pen or other room s, for all these tend to create an im- sion of lack of interest or confider ‘The interrogator should adapt his language to that used and understood by the subject himself. In dealing with an un- | educated and ignorant subject, the interrogator should use | simple words and sentences. 7. Since the interrogator should always occupy a fearless posi tion with regards to his subject and to the condition and ci cumstances attending the interview, the subject should not be handcuffed or shackled during his presence in the interroga- tion room. The interrogator should face the subject as “man to man” and not as a policeman to prisoner. 1. DECEPTI ETECTION METHODS ‘The following are the different methods of deception detec- tion based on medical science and which are of value in criminal investigation: SE OF THE LIE_DETECTOR OR KEELER’S POLY- GRAPH: Principles: ‘When a person lies, there is blushing, dryness of the throat, change of his blood pressure, respiration and change in the activity of the sweat pores. Apparatus Used: ‘A polygraph which records continuously the blood pres- sure, pulse and respiration, and the psycho-galvanic reflex or variation in skin electrical phenomena. Procedure: The subject is seated in a comfortable chair; the blood pressure cuff, pneumograph and electrodes are placed on the subject and the apparatus is set in motion. These bodily re- actions (blood pressure, respiration, and skin resistance) are recorded in ink on the graph operated in the machine. The subject is instructed to remain quiet as much as possible, to . answer all questions by “yes” or “no” and to refrain from other verbal response during the test. If any explanation is to be made the subject is instructed to wait until after the conclu- 7S rare aA UN Wn ety A wR Aa PRT lon pg oy Ten @ dha at quetana |, GENERAL CONSIDERATION (A dala ghecal — ataalisn The test Cin not be conducted without co operation of the subject. A truthful subject, us to offer further proof of the truthfuln The gr: as ord of the examination and it may serve of the examination by the operator for future reference. th a re This te is many drawbacks and may not be absolutely relied upon. Factors Responsible for the 25% Failure of the Use of the Lie Detector: The factors responsible for the 25% failure of the lie de- tector as listed by Fred EB. Imbau, Professor of Law, North- western University are: 1, Nervousness or extreme emotional tension experienced by a subject who és telling the truth regarding the offense in question but who is nevertheless affected by: a. Apprehension induced by the mere fact that suspicion or accusation has been directed against him; b. Apprehension over the possibility of an inaccurate lie- detector test result; ¢. Over-anxiety to cooperate, in order to assure an accurate test result; d. Apprehension concerning possible physical hurt from the instrument; e. Anger and resentment over having to take a lie-detector test; | f. Over-anxiety regarding serious personal problems unrelated to the offense under investigation ; g. Previous extensive interrogation, especially when accom- panied by physical abuse; h. A guilt complex or fear of detection regarding some other offense which he had committed. 2. Physiological abnormalities, such as: a. Excessively high or excessively low blood pressure; b. Diseases of the heart; c. Respiratory disorders. 6 1 fe rae 8. Mental abnormalities, such as: a. Feeblemindedness, as in idiots, imbeciles and morons; noi b, Eatin or insanities, as in manic depres: "5 pur “ey 4 ‘izophrenics, paretics, etc.; a crouse aUhy wh aa gine impacd OH MO tu Ap hs tearm * ft al rp OO iat Canaan, ld LEGAL MEDICINE and psyeho emotionally u neither psychotic or no} between these two groups. as among so-called “pecu- persons—those who are , and who form the borderline 4. Unresponsiveness in a lying or guilty subject, becau: a. No fear of detection; b. Apparent ability to consciously control responses by means in mental sets or attitudes; ion of “sub-shock” or “adrenal exhaustion” at the time of the test; d. Rationalization of the crime in advance of the test to such an extent that lying about the offense arouses little or no emotional disturbances; 5. Attempts to “beat the machine” by controlled breathing or by muscular flexing. 6 of: 6. Unobserved application of muscular pressures which produce ambiguities or misleading indications in the blood pressure tracings. (Lie Detection and Criminal Interrogation by Imbau, 8rd ed., p 65). Admissibility of the Result of the Lie Detector Test in Court: In a series of decisions of the staté supreme courts in United States, (Fyre v. U.S., State v. Bohner (Wis.), People v. Becker (Mich:), People v. Forte, State v. Cole, (Mich.), Beech v. State (Neb.), People v. Wechnick, (Calif.) ete. uniformly ruled non- admissibility of the lie detector test. The common reason given is that the test has not gained among physiological and psycho- logical authorities a degree of development beyond the experi- mental stage. Until it is established that reasonable certainty follows from such test, it would be an error to admit in evidence | the result. The test is useful in investigation of crime but it has no place in the courtroom. However, it may be admitted conditionally in the following instances: a. When there is expressed stipulations of the parties to a case to subject a person to such test and also the person who will make the examination. The parties may also stipulate expressly that the result will be binding among parties. . When the other party interposes no objection to the pres- entation of the result of the test, there is implied waiver. GENERAL CONSIDERATION 29 be Compelled to Be Subjected to the Lie Detector Can a Pers Test? the test requires the subject to answer ques- , il may infer the use of intelligence ntal faculties which is self-incriminatory, not be compelled to be subjected to the a) 2. ADMINISTRATION OF “TR' i Hyoscing romide is Fodermically in repeat- ed doses until a state of delirium is induced. When the proper point is reached, the questioning begins and the patient has forgetfulness of any ‘alibi he may have built up to cover his guilt. Consequently, under such circum- stances, he is apt to tell the truth and give details or may implicate others. The use of hyoscine hydrobromide for the purpose is not without the element of danger and should not be attempted except by a physician who has experience in using the drug. Statement taken from a subject under the influence of the truth serum is not admissible because its very nature is it voluntary. Although not admissible, it is quite useful in crim- cc investigation because of its psychological effect. 4. bhroxicarrow: The person whose statement is to be taken is allowed to take alcoholic beverages to intoxication point. When under the influence of alcohol, the power of control is diminished and the investigator begins propounding questions, Interrogation must only be made during the excitatory ef- fect of alcohol. During the excitatory stage there is a sensa- tion of well-being. The actions, speech and emotions are less’ strained due to lowering of the inhibition normally exercised by the higher brain centers. . There is lack of self-control. When the subject is already in the depressive state, he will not be able to answer any question. Confession made by the subject while intoxicated is ad- missible if he is physically able to recollect the facts and state them truly after the influence of alcohol has disappeared. But in most instances, the subject cannot recall his utterances or usually refuses to admit the truth of the statement given. or piven ¥y % 30, 4 ae E X RCOANALYSIS OR NARCOSYNTHES! ey Keneds UA CAL aU) + LEGAL MEDICINE WORD ASSOCIATION ‘TEST: ‘A list of stimulus words i peen instructed to respond read to the # quickly as pos interval between the stimulus word and the ans corded. A person will not answer quickly que ing words which has relation to the crime committe A person may be asked of his name, address, ci 5 or other personal circumstance and the answer is made in a short time. But when asked whether he recognized a weapon presented to him which was allegedly used in the commission of the offense, he will hesitate for sometime before an answer is given if it was really the weapon he used against the victim such that the time interval between the question and answer is prolonged. Like the use of the lie detector, the subject uses his in- tellect and attention and other mental faculties in answering the question. It is therefore also considered that the test is violative of the right of a person not to be a witness against Narcoanalysis or narcosynthesis does not include the use of the truth serum, but rather a process of inducing a state of mind by the application of a drug whereby the individual’s capacity to unite thoughts and choose those to which he de- sides to give utterance is inhibited. This method of deception detection utilizes the administration of anesthesia or hypnotics and psychiatry in criminal interrogation. When. the subject is under the influence of narcotics or anesthetics, interrogation should be made by, a trained psycho- logist. The drugs commonly used are scopolamine, “psychi- atric” sodium amytal and sodium pentothal, The test is not admissible in court because by its nature it is involuntary. y “Ceunitul ‘ HYPNOTISM: 9) @~o tty wervottuw ‘The subject is made to be under the influence of hypnosis by a qualified hypnotist. While fully hypnotized, questions are asked relating to the subject-matter of the investigation. This method of deception detection is not as dangerous as the use of the truth serum, however, authorities doubt its value because the subject’s answers are under the control and - suggestion of thé hypnotist. Oburvatun A) Yalun damp GENERAL CONSIDERATION 31 SSION knowledgement by the of the truth of his guilt as to the tials. thereof. Jal Confession it criminal. ¢: Conf includes as_on¢ ment of (quilt,) while admission is usually a by the actuséd which-do not directly involve an of guiltof the accused. The defendant stated in the preliminary investigation that he had inflicted upon the deceased the wounds in question. It was held that such statement is, not a confession of guilt but only an admission, in as much as the defendant might have inflicted the wound in self-defense. (U.S. v. Team, 23 Phil. 64). An admission by one accused of rape that he had carnal intercourse with the complaining witness at the time and place mentioned in the information is not a confession of guilt of the crime charged unless the accused further admits that he co- habited with the woman without her consent, or by the use of force or threat. (U.S. v. Flores, 26 Phil. 262). nowledgement Kinds of Confession: 1, Extrajudicial Confession: This is a confession made outside of the court prior to the trial of the case. Sec. 8, Rule 138, Rules of Court: An extra-judicial confession made by an accused, shall not be a sufficient ground for conviction, unless corroborated by evidence of corpus delicti, Corpus delicti means the body of the crime or fact of specific loss or injury sustained. It may not necessarily be the body of the crime but may consist of facts and cireum- stances tending to corroborate the confession. The reason for the above rule is to guard against conviction upon false confession of guilt. It is possible that a person might have confessed his guilt regarding an offense which someone has committed and when asked of his victim or the nature of the injuries inflicted by him, it coincides with the identity or nature of the injuries received by the victim. Extra-judicial confession may be: a. Voluntary extra-judicial confession: 32 lis LEGAL MEDICINE Phe confession is voluntary when the accused speaks of his free will and accord, without inducement of any kind, and with a full and complete knowledge of the nature and consequence of the confession, and when the speaking is so free from influences affecting the will of the accused, at the time the confession was made that it tenders it admissible in evidence against him. b. Involuntary extra-judicial_confession: Confession obtained through fotee, threat, intimidation, duress or anything influencing the voluntary act of the confessor. Confession obtained from the defendant by means of foree and violence is null and void, and can not be used against him at the trial. (U.S. v. Lozada, 4 Phil. 266; USS. v. Felipe, 5 Phil. 383). A confession made when threat or promise was made by, or in the presence of a person in authority, who has, or is supposed by the accused to have power or opportunity to fulfill the threat or promise, the confession of the accused will be presumed to be exclusive effect of induce- ment and therefore inadmissible. (Early v. Com., 86 Va. 921). ‘A confession made under the influence of spiritual advice or exhortation is not admissible. ‘A confession made under the influence of parental senti- ment is not admissible. (People v. Martinez, 42 Phil. 853. ‘A confession although involuntary is admissible when it is conformed by subsequent fact. Example: If a person through force and threat’ ad- mitted that he killed the victim and confessed that after the killing he disposed the dead body in a well. If upon investigation of the well the body of the victim was seen, then the confession even if obtained through “third degree” is admissible. In confession through “third degree” it is the duty of the physician to determine the ee ee and extent of A physician must i . ; een erica acre aan Se concluding at te course of a “third degrec”. Tt could be tomste that tne - It could be possible that the \ j Crm ign cis ae a3 3.4 zs 2,3 23 24 44a an Triangular face Side-view shapes of nose GENERAL CONSIDERATION 33 elf-inflicted those wounds in the guise that the ion was not voluntary. 2. Judicial Conf This is the confession of an acéused in court. It clusive upon the court and may be considered to be a mi gating circumstance to criminal liability. A plea of guilty when formally entered on arraignment is sufficient to sustain a conviction of any offense, even a capital one, without further proof. Sec. 2, Rule 129, Rules of Court: Judicial Admission :— Admission made by the parties in the pleadings, or in the course of the trial or other proceedings do not require proof and can not be contradicted unless previously shown to have been made through palpable mistake. ion: iS con ; F Chapter 2 /MEDICO-LEC sAL, ASPECT OF IDENTIFICATION J. IENTWICATION OF PERSON AND REMAINS instances Showing Importance of Identification of Person and Remains: 1. A person disappeared under suspicious circumstances and the body of a person is found. It is necessary to identify the dead body and determine whether he is the missing person. 2. A certain person.has. been arrested by. police authorities. _The person arrested claimed he is not the person wanted. His identity must be proved before he can be released. 3. A man died leaving a vast estate. Someone claimed that “he is the legal heir of the deceased, He must prove his identity and also his right over the estate. 4. A certain remains was exhumed. It is necessary to iden- tify whether the remains is of human origin, the height, sex, race, age, approximate date of interment, and pres- ence or absence of physical injuries during life. When an unknown body i , the following should be noted by the investigator to facilitate identification: . Place where the body was found . Time when found . Cause of death Time when, death, occurred . Approximate age

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