Legal vs Forensic Medicine

General Considerations and Definitions

• Legal Medicine applies medical knowledge to law and justice administration
• Uses basic, clinical, and paramedical sciences to clarify legal issues
• Synonyms: Legal Medicine, Forensic Medicine, and Medical Jurisprudence
• Legal Medicine strictly applies medicine to legal cases
• Forensic Medicine uses medical knowledge to solve legal problems
• Curran defines legal medicine as medicine related to substantive law and legal institutions
• Forensic Medicine focuses on evidence investigation, preparation, preservation, and presentation in legal settings
• Dr. Henry C. Lee defines forensic medicine broadly, encompassing pathology, anthropology, odontology, toxicology, and entomology, applying to legal, historical, environmental, and socio-political issues
• Legal Medicine relates to substantive law, defining relationships between doctors, hospitals and patients
• Forensic Medicine addresses punishable acts under local laws

Medical Jurisprudence and Expertise

• Medical Jurisprudence requires knowledge of law for medical practice
• It includes studies of the rights, duties, and obligations of medical practitioners in doctor-patient relationships
• Medical Jurisprudence is a subject in law courses for Bar exam admission
• Forensic Medicine expertise encompasses all branches of medicine, seen as a subspecialty of a medical specialty

Scope and Application

• Forensic Medicine involves collecting, preserving, and presenting evidence in legal forums, including serology, chemistry, and toxicology
• Knowledge of wounds integrates surgery with physics, physiology, and pharmacology
• Physics of Wound Production: Wound = Kinetic Energy x Time x Area x "other factors"
• Kinetic Energy relies on mass and squared velocity; velocity is the key damage factor
• Time: Shorter transfer = greater damage; stationary body = less injury
• Area: Larger contact lessens damage; stabbing exceeds blunt force damage
• "Other Factors": Less elastic tissue = more lacerations; internal injuries from body part movement; fluid-filled tissue lacerations from force

Legal & Medico-legal Practitioners

• Medico-legal work involves legal duties connected to health care
• A medical jurist specializes in medico-legal duties. Common public misconception is that a medico legal practitioner must be a lawyer
• Forensic medicine applies to both the living and the dead
• Forensic Pathologists document the cause of death
• Medicolegal practitioners are connected with law enforcement or legitimate investigative branches, and are in government or private practice
• They may be municipal or provincial health officers for medicolegal cases and autopsies
• Private practitioners consult in private hospitals and testify in court regarding patient injury, treatment, and cause

Autopsies, Physician Roles, and Medico-legal Cases

• Health officers, medical officers of law enforcement agencies and members of accredited medical staff are authorized to perform autopsies
• It's every physician's duty, when called upon by judicial authorities, to assist in justice administration on medico-legal matters
• An ordinary physician treats injuries or illnesses and makes diagnoses
• A medical jurist focuses on bodily lesions and testimonies to qualify crimes
• Medical jurists must record all injuries, both trivial and significant
• Medicolegal cases include injuries or deaths of unidentified persons, or those pronounced DOA (dead on arrival)
• Medico legal cases include deaths within 24 hours of admission with unknown cause, sudden deaths, death from violence, accident, suicide or poisoning and death due to negligence
• Physical injuries from gunshot wounds, stabs, vehicular accidents, asphyxia, electrocution, and poisoning are medico legal cases
• Also includes child abuse, domestic violence, rape, alcoholism, drug addiction, cases involving mental competency and iatrogenic causes
• Medicolegal deaths require mandatory autopsies even without consent, a death certificate requires the autopsy
• Cases without autopsy authority are referred to the PNP, NBI, or a health officer
• If autopsy is refused, death certificate states "undetermined" as cause, effectively voiding it

Medico-legal Officer

• A major capability of a medicolegal officer is that they conduct autopsies
• Examination of victims of sexual or physical crimes is a major capability
• A Medico legal officer can conduct examinations of skeletal remains
• A medicolegal officer conducts blood and blood stain testing to look for body fluids, seminal fluid, etc
• Exhumation of bodies and histopathological examinations are major capabilities

Civil, Criminal, and Remedial Law & Autopsies

• Legal medicine applies to paternity and filiation cases, determination of civil status, adoption, nullity of marriage and legal seperation
• Legal medicine applies to circumstances affecting criminal liability and crimes against persons, chastity
• Legal medicine applies to rules on evidence, proceedings for hospitalization and physical/mental examinations
• Autopsies must be performed when required by law, by court order, by written request from police or when deemed necessary by a City Fiscal

Forensic Science Disciplines

• Forensic Science is a broad field
• Includes hair analysis, fiber analysis, DNA analysis, forensic anthropology, archeology and pathology
• Also includes forensic odontology, questioning document analysis, psychiatry, psychology and blood splatter analysis

Medical Evidence Intro & Types

• Evidence is the means sanctioned by the Rules of Court to ascertain the truth in court proceedings
• Medical evidence is medical in nature
• Autoptic or Real Evidence is addressed to the court's senses and not limited to vision
• Limitations include indecency and impropriety, repulsive objects and offense to sensibilities
• Testimonial Evidence requires a physician appearance in court either as an ordinary or expert witness
• An ordinary witness is a physician testifying on patient matters, the 24(c) rule of exemption applies here relating to patient privacy
• Expert Witness provides opinion on medical facts based on training and experience

Experimental, Documentary & Physical Evidence

• Experimental Evidence uses demonstrations, like lethal injections on animals
• Documentary Evidence often is a Medico-legal certificate
• It includes Medical Examinations Necropsies, Exhumations, Birth and Death Certificates
• May also include Medical Expert Opinions and Depositions
• Physical Evidence are materials connecting to an investigation to identify perpetrators or circumstances of a crime
• Includes Corpus Delicti Evidence of objects part of the crime body and Associative Evidence linking suspects to a crime
• Tracing evidence helps investigators locate suspects, like drops of blood going towards the suspect fleeing.

Preservation of Evidence

• The necessity and vitality of evidence and proper medico-legal investigation for this, must be stressed
• Done through photography, rough and finished sketches and word description
• Manikin Method uses miniature models to indicate aspects of what should be preserved
• Witness memory can be destroyed or modified
• Witness testimony preservation is limited to the life of the witness
• Special methods needed to treat and preserve special types of evidence

Qualities if expert witness

• Reputable professional background with solid education
• Personal integrity and good judgement
• Objective, neutral, independent and sincere
• Credibility hinges on not just "what" was said but "how" it was said
• Able to clearly communicate complex ideas
• Recognizes that contrary opinions will not necessarily discredit him
• Informs the counsel of all information
• Is aware of all courtroom procedures
• Entitled to funding during travel
• Is not compensated on contingent fee basis
• Is willing to disagree with so called authorities if wrong

Deception Detection and Psycho-physiological Responses

• The knowledge of truth is an essential tool in legal administration
• The knowledge and application of detecting deception is what counts
• Use polygraphs (lie detector machine)
• Use a word association test

Polygraphs & Word Association Tests

• Polygraph records physiological changes assciated withlying
• Fear related to deception activates the sympathetic nervous system, causing automatic physiological changes
• Inadmissibility factors in court include Experimental Stage, judge factors, no qualified examiner guarantees
• The Examiner may unwittingly waive his or her right against self-incrimination without knowing and in a non quantifiable measure

Use of drugs to extract the truth

• Use of a "Truth Serum", which is a misnomer because it is not actually a serum
• Use a hyoscine hydrobromide through injection
• Repeated doses can get someone in a delirium state to tell the truth
• It depreases the CNS functions
• Not admissible in court
• Narcoanalysis or Narcosynthesis uses Sodium amytal/ Sodium penthotal
• Drug can depress inhibatory functions
• In Vino Veritas allows drinking of person untill a state of intoxication to extract information
• Must be able to recollect statements for them to be used

Hypnotism & Physiological Symptoms

• Subject may not recall or admit truth, is a risk
• In this state of consiocuness , subjects exhibit a heightened state of suggestibility with maintained awareness
• Not all people are likely to be hypnotized
• Hypnotism lacks general scientific acceptance of reliability and the state can lead to fabricate information
• Confessions while under a hyponic spell are not admissible as they are involuntary
• Good investigators must be good observers and psychologist Sweating with a flushed face indicates anger. Embarrassment or extreme nervousness and a pallid face indicates shock or fear
• A Dryness of the Mouth and swallowing occurs Subject is constantly moving indicates nervous tension
• Swearing the a claim expresses guilt
• Unwillingness to look eye to eye means they are afraid to be viewed as guilty

Interogattion & Criminal Attitudes

• Interogation may be done on suspects and witnesses
• Active Agresasive offenders are the types to commit crime with passion
• Passive agressive offenders are the state of mind with Rational Offenders
• Irration offenders are those who are kill without knowing their actions
• Professionals are highly skilled and have the ability to perform with minimum risk
• Emotions may be used to leverage info

Techniques of interoggation

• Build relations
• Mutt and Tech techinuqes use one person is aggressive, the other sympathetic

Identification Techniques

• Identification determines individuality
• In legal cases, it must be done to determine an acquittal can occur
• If missing then death applies
• If can't find then it will be 7 year wait from death
• Multipliciuty of evidence and greater evidence determines a better determination

Scientific Method and Identification

Methods used

• Comparision the available records and comparing them
• Exclusion eliminate the the possibilities to figure out the actual person
• Can grow beard for can change hair
• memory a good indication to determine people

Approximting Height

Methods to approx

Tattoo easy to be seen but other parts are weight easily gain or lose but deformities and birth mark are key to note Scars the way they heled will determine how they were wounded and what action had lead Blood tests good indicator for testing

Anthroometry & Face identification

• skeleton is is the only good measure Face time has to the be way the person descries them Photos can be used it can also determine the location of the images

Fingerprinting & Forensics

• No identical fingerprints will pop up the way its stated
• Can be used to help indentify in bodies or missing persons
• Used to tell the crime scenes
• Dactyleography recording the fingerprint test dactile-ocopy what to do with comparison of fingerprint

Dental identification & More

• Possiblilty for people to have same teeth is almost zero but need to be consistent
• Forensic odontologist dentist in the system
• Handwriting can used it goes into the type of way the person writes What is found, and where the bodies found and etc...

Skeleton Identification

• whether their remains are there
• Size shape in this location the way is stored
• whether they one person or not

Determination of the time

• look for time they were around
• Gonadil aagenesisi for the people
• Detmerination of age and what they do with this
• Heess and ass rule

Blood and Bodily testing

• to identify
• Blood type and blood stains used
• Cases of stray children is done to deteminrte this and can used blood for to see
• Look for wounds and how far

Different methods of the process

What degree the article has been state the way the peron looks

• Posiitive vs negative

Blood characteristics

• Atricatial bright level
• Venous blood will stay inside look and Menustrul clots
• Not good to detemert the the person is a women

DNA test

• What to do dna test and make suer to see

DNA Analysis

• Make usre to check blood type and dna sequence
• A witht g works with c to connect dna
• the one thing they all have
• Dna profile helps detemr the the dna

DNA Profile

• Look into the dna to know if the person is in there