Death and its Legal Implications

Importance of Death Determination

• The civil personality of a natural person ceases upon death.
• The property of the deceased goes to their heirs upon death.
• A partner's death leads to the dissolution of a partnership agreement.
• Death of a principal or agent terminates agency.
• The individual's criminal liability ends.
• Civil cases for claims are dismissed if the defendant dies.

Death

• It is the termination of life.
• It is the complete stopping of vital functions with no resuscitation possible
• It is the irreversible loss of living matter properties.
• Death happens at a specific moment.
• Ascertaining it is a clinical, not legal, issue.

Brain Death

• Occurs with deep coma, no electrical brain activity, and complete cessation of all vital functions without resuscitation.
• Harvard Report of 1968 lists characteristics of irreversible coma:
• Unreceptivity and unresponsivity.
• No movements or breathing.
• No reflexes.
• Flat electro-encephalogram.
• All tests must be repeated after 24 hours with no changes.
• In 1969, the Ad Hoc Committee of Human Transplantation convened under the auspices of the Institute of Forensic Sciences, Duquesne University School of Law adopted the Philadelphia Protocol:
• Lack of responsiveness to internal and external environment.
• Absence of spontaneous breathing movements for 3 minutes, without hypocarbia and while breathing room air.
• No muscular movements with generalized flaccidity or shivering.
• No reflexes and response.
• Failing arterial pressure without drug support.
• Iso-electric electro-encephalogram recorded spontaneously, and during auditory and tactile stimulation.
• Criteria must be present for 2 hours and certified by 2 physicians.

Kinds of Death

• Somatic (clinical) death.
• Molecular (cellular) death.
• Apparent death (suspended animation).

Signs of Death

• Cessation of heart action and circulation.
• Detected via physical examination of the heart
• Palpation of the pulse
• Listening to the heart at the precordial area
• Fluoroscopic examination
• Use of electrocardiograph
• Examination of peripheral circulation.
• Magnus test
• Opening a small artery.
• Icard's test
• Pressure on fingernails.
• Diaphanous test.
• Applying heat to the skin.
• Palpating the radial pulse.
• Dropping melted wax.
• Cessation of respiration: must be continuous and persistent.
• Suspension may occur without death in divers/swimmers, but no longer than 2 minutes.
• In Cheynes-Stokes respiration, apneic interval cannot exceed 15-20 seconds.
• Also, in cases of apparent drowning.
• Newborn infants may delay breathing after birth until stimulated.

Internal Hypostasis in Visceral Organs

• Post-mortem lividity: irregular staining in dependent parts
• Simple Congestion: uniform staining all over the body
• Post-mortem lividity: dull, lusterless mucus membrane
• Simple Congestion: Not applicable
• Post-mortem lividity: no exudates, redness alternates with pale areas in hollow viscus
• Simple Congestion: no exudates

Post-Mortem Lividity vs Hemorrhage of Scurvy vs Phosphorus Poisoning

• Post-Mortem Lividity: presence cannot be revealed in history, and skin lesion are visible only after death concentrated on dependent portions of the body
• Hemorrhage of Scurvy: Presence can be revealed by history, and lesion present before death, may be found all over the skin and organs
• Phosphorus Poisoning: Presence can be revealed by history, and lesion present before death, may be found all over the skin and organs

Autolytic/Autodigestive Changes After Death

• After death, proteolytic, glycolytic, and lipolytic ferments act on glandular tissues leading to self-digestion of organs.
• This action is sped up by weak acid and higher temperature, and delayed by the alkaline reaction of tissues and low temperature.
• This early appearance is observed in the parenchymatous and glandular tissues

Putrefaction of the Body

• Putrefaction is the breakdown of complex proteins into simpler components, releasing foul-smelling gases, with color changes.

Tissue Changes in Putrefaction

• Changes in tissue color.
• Evolution of gases.
• Gas pressure effects: blood displacement, bloating, fluid from nostrils/mouth, fetus expulsion in gravid uterus, floating.
• Liquefaction of soft tissues.

Factors Modifying the Rate of Putrefaction

• Internal Factors:
• Age.
• Body condition.
• Cause of death.
• External Factors:
• Free air.
• Earth.
• Water.
• Clothing.

Factors Influencing Changes in the Body After Burial

• Body state before death.
• Time between death/burial and environment.
• Coffin effect.
• Clothing/coverings.
• Burial depth.
• Soil condition/type.
• Grave inclusions hastening decomposition.
• Air access.
• Mass grave.
• Trauma.

Chronological Sequence of Putrefactive Changes (Temperate Regions)

• 1-3 days: Greenish discoloration over the iliac fossae, eyeballs soften.
• 3-5 days: Greenish discoloration spreading, frothy blood from mouth/nostrils.
• 8-10 days: Abdomen distends with gas, cornea falls in and concave, purplish red streaks of veins prominent, sphincters relax, nails become firm.
• 14-20 days: Body greenish-brown, blisters form, skin peels, features unrecognizable, scrotum distends, body swells, maggots appear, nails/hair loosen.
• 2-5 months: Soft parts become a thick, semi-fluid black mass.

Chronological Sequence of Putrefactive Changes (Tropical Regions)

• 12 hours: Rigor mortis present, hypostasis well-developed/fixed, greenish discoloration over the casturn.
• 24 hours: Rigor mortis absent, green discoloration spreads, abdomen distends with gases.
• 48 hours: Fly ova seen, trunk bloated, face discolored, blisters present, moving maggots seen.
• 72 hours: Whole body grossly swollen, tissues soft/discolored, hair/nails loose.
• 1 week: Soft viscera putrefied.
• 2 weeks: Only resistant viscera distinguishable, soft tissue largely gone.
• 1 month: Body skeletonized.

Chronological Sequence of Putrefactive Changes (Submerged Body)

• 4-5 days: Very little change if water is cold, rigor mortis may persist.
• 5-7 days: Skin on hands/feet become sodden/bleached, face softens and fades white.
• 1-2 weeks: Face is swollen and red, Greenish discoloration on eyelids, lips, neck and sternum, hands/feet wrinkle, upper surface of brain greenish in color.
• 4 weeks: Skin wrinkled, scrotum/penis distended with gas, nails/hair intact, lungs emphysematous and covered over the heart.
• 6-8 weeks: Abdomen distended, skin from hands/feet come off like gloves.

Factors Influencing Floating of a Body in Water

• Age
• Sex
• Conditions of the body
• Season of the Year
• Water
• External Influence
• Order of Putrefaction

Influence of Bacteria in Decomposition

• Decomposition occurs due to bacterial action in tissues.
• Aerobic bacteria are active early on.
• Anaerobes become prominent later, producing gases.
• Softening of tissues is due to bacterial action and proteolytic/autolytic ferments.
• Clostridium welchii plays an important role, growing in parenchymatous organs, causing cytoplasm disintegration, nuclei destruction, and gas generation.
• Other destructive agents exist that include flies, maggots, reptiles, rodents, other mammals, fishes, carbs and molds

Special Modification of Putrefaction

• Mummification.
• Saponification or adipocere formation.
• Maceration.

Mummification

• The whole body dehydrates, shrivels and is preserved.
• It usually happens in warm countries, where body fluid evaporation occurs quickly
• Natural: body dehydrates and becomes mummified due to natural forces.
• Artificial: tissue fluid evaporation is accelerated before decomposition onset with addition of preservatives.

Saponification / Adipocere Formation

• It is the transformation of fatty tissues into a soft, brownish-white substance called adipocere.
• Factors influencing this formation:
• Health before death.
• Time between death and burial.
• Coffin's effect.
• Clothing presence.
• Soil type.
• Air access after burial.
• Mass grave.

Maceration

• Softening of tissues in a fluid medium without putrefactive microorganisms, often seen in the death of a fetus in utero.

Duration of Death

• Presence of Rigor Mortis
• Sets in 2-3 hours after death in warm countries and is fully developed after 12 hours.
• Lasts from 18-36 hours.
• Disappearance accompanies putrefaction onset.
• Presence of post-mortem lividity.
• Usually develop 3-6 hours after death.
• Appears as small, red spots that merge over time, in most dependent portions of the body.
• Onset of decomposition.
• In tropical areas, decomposition happens early and in 24-48 hours.
• Stage of decomposition.
• Approximate time of death can be known looking at decomposition.
• Entomology of the cadaver.
• Presence of certain insects can used to assess when the person died.
• Stage of digestion in the stomach.
• It normally takes 3-4 hrs for the stomach to evacuate contents after a meal
• Approximate time of death known relative last content in the persons stomach
• Amount of urine in the bladder.
• Urine volume is analyzed relative to if the person recalled voiding/or not
• State of Clothing
• This is circumstantial proof
• Post-mortem clotting and decoagulation of blood
• Blood clots inside blood vessels 6-8 hours after death
• Presence or absence of soft tissues in skeletal remains
• Soft tissues disappear 1-2 years after burial under normal conditions
• Conditions of the bones
• Degree of erosion of epiphyseal ends, pulverization of flat bones, loss of animal matter is analysed
• Presence of live flies in the clothing (drowning cases)
• The survival time of the species is then used to determine approximate submersion time

Presumption of Death

• Rule 131 Section 5 Rules of Court
• Article 390 Civil Code:
• Disputable presumption: absent and unheard of for 7 years = Dead, but with exception pertaining to succession
• If the disappeared is over 75 years old, an absence of 5 years is enough to open succession
• Article 391 Civil Code:
• Presumed DEAD FOR ALL PURPOSES
• When vessel or airplane is lost for 4 years from incident
• Missing veteran for 4 years
• Person in danger of death and missing for 4 years

Presumption of Survivorship

• Rule 131 Section 5 (jj) Rules of Court