Introduction to Legal Medicine PDF

**OUTLINE** I. **Introduction** A. **Forensic** B. **Definition of Terms** C. **Forensic Medicine/Legal Medicine** D. **Role of PNP Medico-Legal Officer. Forensic Medical Specialist/ Medical Jurist/ Medical Examiner/ Coroner** II. **Coroner Vs Medical Examiner** I...

**OUTLINE** I. **Introduction** A. **Forensic** B. **Definition of Terms** C. **Forensic Medicine/Legal Medicine** D. **Role of PNP Medico-Legal Officer. Forensic Medical Specialist/ Medical Jurist/ Medical Examiner/ Coroner** II. **Coroner Vs Medical Examiner** III. **Distinction between Ordinary physician and Medico-legal Officer** IV. **Branches of Law where Legal Medicine maybe Applied** A. **Civil Law** B. **Criminal Law** C. **Remedial Law** D. **Special Laws** +-----------------------+-----------------------+-----------------------+ | **LEGEND** | | | +=======================+=======================+=======================+ | ⭐ | 🖊️ | 📖 | | | | | | Must | Lecture | Book | | | | | | Know | *\[lec\]* | *\[bk\]* | +-----------------------+-----------------------+-----------------------+ I. INTRODUCTION TO LEGAL MEDICINE ================================= A. ETYMOLOGY OF FORENSIC {#a.-etymology-of-forensic.TransSubtopic1} ------------------------ Latin adjective **"forensis"** Meaning: public debate or forum Anything belonging to the court of law or used in legal proceedings (Solis) Used to describe the debates that occur in courts of law and is even more broadly defined as any matter that is "pertaining to the law." (Evans, Wells, 1999) Early years: When one accuses somebody of a crime, one has to produce evidence, usually done in a **public** assembly. Nowadays: Refers to debates or arguments that occur **inside the courtroom.** B. DEFINITION OF TERMS {#b.-definition-of-terms.TransSubtopic1} ---------------------- LEGAL MEDICINE {#legal-medicine.TransSub-subtopic2} -------------- Primarily the application of medicine to legal cases 📖 Branch of medicine which deals with the application of medical knowledge to the purposes of law and in the administration of justice 📖 Application of basic and clinical, medical, and paramedical sciences to elucidate legal matters FORENSIC MEDICINE {#forensic-medicine.TransSub-subtopic2} ----------------- Concerns with the application of medical science to elucidate legal problems. MEDICAL JURISPRUDENCE {#medical-jurisprudence.TransSub-subtopic2} --------------------- Denotes knowledge of law in relation to the practice of medicine, concerns with the rights, duties, and obligations of a medical practitioner with particular reference to those arising from the doctor-patient relationship. FORENSIC PATHOLOGY {#forensic-pathology.TransSub-subtopic2} ------------------ Application of knowledge of Pathology to aid in the administration of justice (in relation to the courts of law) Investigation of sudden, unnatural, unexplained, or violent deaths A branch of medicine that applies the principles and knowledge of the medical sciences in the field of forensics Investigate and determines the cause and manner of death PATHOLOGY {#pathology.TransSub-subtopic2} --------- The study of the essential nature of disease (includes trauma); Examines and analyzes tissue samples to identify irregularities and diseases. C. FORENSIC MEDICINE/LEGAL MEDICINE. {#c.-forensic-medicinelegal-medicine..TransSubtopic1} ------------------------------------ Originally, the terms legal medicine, forensic medicine, and medical jurisprudence were synonymous in common practice and are used interchangeably. Prevailed among countries under the Anglo-American influence The concept and practice of Legal Medicine in the Philippines is of Spanish origin. According to Solis: A branch of medicine that deals with the application of medical science for the purposes of law and in the administration of justice. According to Simpson: Deals with the interaction of medical science with the law. According to Gradwohl: The application of medical knowledge to the administration of law and to the furthering of justice and, in addition, the legal relations of the medical man. Medical aspects of law and medical jurisprudence; the medicine of the forum; or the law of courts. **Legal Medicine** **Forensic Medicine** ----------------------------------------- ------------------------------------------------------------- Application of medicine to legal cases. Application of medical science to elucidate legal problems. **Table 1.** Difference of Legal Medicine and Forensic Medicine D. ROLE OF PNP MEDICO-LEGAL OFFICER/ FORENSIC MEDICAL SPECIALIST {#d.-role-of-pnp-medico-legal-officer-forensic-medical-specialist.TransSubtopic1} ---------------------------------------------------------------- Philippines PNP Medico-legal officers, but there are also NBI medico-legal officers Asian countries called medico-legal officers United States Medical Examiner/Coroner Europe, England Forensic Medical Specialist or Medical Jurist ⭐ **ROLE OF PNP MEDICO-LEGAL OFFICER:** **Conducts autopsies** determine the cause, manner, and mechanism of death approximation of the time of death **Conducts examination of victims of physical injuries** determining if it is slight, less serious, or serious physical injuries **Examination of victims of sexual abuse** **Example: rape** **Examination of arrested persons/suspects for detention or release** to avoid violation of human rights **Conducts** exhumations the disinterring/removing of the body from its burial place and performing autopsies **Examines skeletal remains** determine the race, sex, approximate height, age, and probable cause of death **Serological examinations** blood or other bodily fluids **Histopathological examination** conducted by forensic pathologists human tissue sections that are recovered from the body of the victim during the autopsy and processed for microscopic examination **DNA Analysis** last resort to specifically identify specimens or individuals **Disaster Victim Identification (DVI)** medicolegal officers are requested to join the different agencies to handle the DVI during natural or manmade disasters; Also known as mass casualty identification **Attend court duties when summoned** presents as an expert witness to testify prepare medicolegal reports, and submit them to the prosecutors and law enforcement agencies **Conducts lectures/trainings/seminars in the field of forensic medicine** training for police investigators and health officers under DOH for them to be familiar **Act as a member of the SOCO team during the death investigation** the medicolegal officer is the first to handle the body and search for physical evidence as a source of identification, describe injuries sustained, and the probable cause of death II. CORONER VS MEDICAL EXAMINER =============================== +-----------------------------------+-----------------------------------+ | **Table 2. Difference of Coroner | | | and Medical Examiner** | | +===================================+===================================+ | **Coroner** | **Medical Examiner** | +-----------------------------------+-----------------------------------+ | Used in the U.S since the 1600s | Used in the US since the 1900s | +-----------------------------------+-----------------------------------+ | Elected to office | Appointed by the government | | | | | | Can also be elected/appointed as | | | a coroner which will be | | | advantageous to the county or | | | state | +-----------------------------------+-----------------------------------+ | Holds a 2--4-year term | Has no specific term length | | | | | | can hold office for as long as | | | the circumstances allow | +-----------------------------------+-----------------------------------+ | Does not need a medical | Usually, a licensed physician. | | background | | | | usually has a background in | | | forensic pathology | +-----------------------------------+-----------------------------------+ | **In charge of:** | Conducts death investigations in | | | a similar process to that of a | | judicial inquiries on bodies of | coroner | | those who seem to have died | | | because of violence or harm. | **also performs:** | | | | | confirms the death, identifies | medical autopsies, | | the body, | | | | toxicological and pathological | | notifies the next of kin or | tests, | | relatives, | | | | DNA | | handles personal belongings | | | found, | | | | | | identifies the cause and manner | | | of death, maintains death records | | | and files for death certificates | | | | | | Handles personal belongings found | | +-----------------------------------+-----------------------------------+ III. DISTINCTION BETWEEN ORDINARY PHYSICIAN AND MEDICO-LEGAL OFFICER ==================================================================== +-----------------------------------+-----------------------------------+ | **Table 3. Ordinary Physician vs. | | | Medico-Legal Officer** | | +===================================+===================================+ | **Ordinary Physician** | **Medico-Legal Officer** | +-----------------------------------+-----------------------------------+ | Sees an injury or disease on the | Sees injury or disease on the | | **[point of view of | **[point of view of the | | treatment]** | cause]** | +-----------------------------------+-----------------------------------+ | Purpose in examining the patient: | Purpose of examining the patient: | | | | | to arrive at a definite diagnosis | to include bodily lesions in his | | so that appropriate treatment can | report | | be instituted | | | | testify before the court or an | | | investigative body | | | | | | gives justice to whom justice is | | | due | +-----------------------------------+-----------------------------------+ | Minor or trivial injuries are | Records all bodily injuries, even | | usually ignored | if they are small or minor. | | | | | not included in the medical | Because these injuries may be | | report | proofs to qualify the crime or | | | justify the act. | | | | | | - 📖 Example: | | | | | | Presence of PHYSICAL INJURIES | | | of a victim of sexual abuse = | | | presumes that force was | | | applied; hence, crime | | | committed must be RAPE. | | | | | | Presence of PHYSICAL INJURIES | | | on the offender of the crime | | | of physical injuries= proof | | | that the victim acted in | | | SELF- DEFENSE. | +-----------------------------------+-----------------------------------+ IV. BRANCHES OF LAW WHERE LEGAL MEDICINE MAY BE APPLIED ======================================================= A. CIVIL LAW {#a.-civil-law.TransSubtopic1} ------------ - A mass of precepts that determines and regulates the relation of assistance, authority, and obedience between members of a family and those that exist among members of a society for the protection of private interest. - Determination of civil personality. - Limitation or restriction of a natural person's capacity to act. - Marriage and legal separation. - Paternity and Filiation. - Testamentary capacity of a person making a will. B. CRIMINAL LAW {#b.-criminal-law.TransSubtopic1} --------------- - A branch or division of law that defines crimes, treats their nature and provides for their punishment. - Circumstances affecting criminal liability. - Crimes against person - homicide, physical injuries, or murder - Crimes against chastity - involves sexual crimes C.REMEDIAL LAW {#c.remedial-law.TransSubtopic1} -------------- - Deals with the rules concerning pleadings, practices, and procedures in all courts of the Philippines. - A designed law, which redresses an existing grievance or introduces regulation conducive to public good. - Physical and mental examination of a person. - Proceedings for hospitalization of an insane person. - Rules on evidence. D. SPECIAL LAWS {#d.-special-laws.TransSubtopic1} --------------- - Dangerous Drug Act - Youth and Child Welfare Code - Child abuse - Insurance Law - Code of Sanitation - Deals with autopsies and disposal of a dead body - Labor Code - Employees Compensation Law - If the injury or death is service-related or related to the job that he is doing GUIDE QUESTIONS =============== 1. **What is the coroner and medical examiner death investigation system, and how do they compare to the Philippine system of death investigation?** +-----------------------------------+-----------------------------------+ | **Table 2. Difference of Coroner | | | and Medical Examiner** | | +===================================+===================================+ | **Coroner** | **Medical Examiner** | +-----------------------------------+-----------------------------------+ | Used in the U.S since the 1600s | Used in the US since the 1900s | +-----------------------------------+-----------------------------------+ | Elected to office | Appointed by the government | | | | | | Can also be elected/appointed as | | | a coroner which will be | | | advantageous to the county or | | | state | +-----------------------------------+-----------------------------------+ | Holds a 2--4-year term | Has no specific term length | | | | | | can hold office for as long as | | | the circumstances allow | +-----------------------------------+-----------------------------------+ | Does not need a medical | Usually, a licensed physician. | | background | | | | usually has a background in | | | forensic pathology | +-----------------------------------+-----------------------------------+ | **In charge of:** | Conducts death investigations in | | | a similar process to that of a | | judicial inquiries on bodies of | coroner | | those who seem to have died | | | because of violence or harm. | **also performs:** | | | | | confirms the death, identifies | medical autopsies, | | the body, | | | | toxicological and pathological | | notifies the next of kin or | tests, | | relatives, | | | | DNA | | handles personal belongings | | | found, | | | | | | identifies the cause and manner | | | of death, maintains death records | | | and files for death certificates | | | | | | Handles personal belongings found | | +-----------------------------------+-----------------------------------+ The same mechanism can also be applied in the Philippine setting except that the majority of the professionals who are qualified to conduct an autopsy are those with medical backgrounds (A Coroner has no medical background). Of course, the cases conducted here in the Philippines are conducted much more different manner with less complex cases than in US (more on death in natural calamities, pathologic death and more). \[BATCH 2025\] These systems differ from the Philippine death investigation system, which can combine elements of both approaches. The Philippine system involves organizations like the National Bureau of Investigation and the Philippine National Police in investigating deaths, with varying levels of expertise and resources. Differences include qualifications, autopsy procedures, legal frameworks, and resource availability, all of which influence the effectiveness of death investigations. **\[BATCH 2024\] [Philippine System of Death Investigation]** (This is **OPINION based**, from CNN Philippines Life) (✍ sorry not sure about this + can't find other sources) [The Philippines employs a police-led Medicolegal Death Investigation (MLDI) system, whereby the police initiate, lead, and define the scope of both the criminal investigation and death investigation.] Related to conflicts of interest, the jurisdictional boundaries of who is in charge of a case are also unclear. The Philippine National Police (PNP), with its large workforce and wide geographic spread, conducts the majority of "day-to-day" MLDIs in the country, while the National Bureau of Investigation (NBI) under the Department of Justice (DOJ) takes on high-profile cases as it sees fit. However, it is unclear what "high profile" even means, and how a case is determined to be as such. The boundary has never been clearly drawn except in the context of mass fatality incidents.  Proper MLDI requires a science-first, multidisciplinary approach that employs a cadre of vetted, qualified, and impartial experts and focuses on fact-finding surrounding the death event. [Currently, initial employment as a medicolegal officer in the Philippines only requires passing the general physician licensure exam. Once hired, they are internally trained in MLDI, including conducting autopsies and collecting biological samples.] However, autopsy is a complex procedure that requires years of formalized study and training. Autopsies and the conclusions drawn thereof should only be conducted by a pathologist that is board-certified by an accredited specialty board. (✍ This is based on **opinion** of Dr. Matthew Go, a forensic anthropologist working at US Department of Defense Agency. If you want to read more about this: ) 2. **How is death classified?** 📖 Complete cessation of vital functions w/o resuscitation **according to its manner of determination** [Natural Death:] This refers to deaths that occur due to natural causes, such as diseases (heart disease, cancer, etc.), old age, or other medical conditions. [Accidental Death:] Accidental deaths result from unintentional and unforeseen events, such as car accidents, falls, drowning, or drug overdoses. [Suicidal Death:] Suicidal deaths occur when an individual intentionally takes their own life. [Homicidal Death:] Homicidal deaths involve one person causing the death of another person. These deaths are the result of intentional actions by another individual. [Undetermined:] In cases where the evidence is insufficient to conclusively determine the manner of death, it may be classified as \"undetermined.\" **according to forensic pathology** [Natural Cause:] This classification indicates that the death resulted from a disease or medical condition. It is determined through a thorough examination of the body\'s organs, tissues, and medical history. [Traumatic Cause]: Traumatic deaths result from physical injuries, such as those caused by accidents, falls, assaults, or other violent events. [Toxicological Cause]: Deaths caused by the ingestion, inhalation, or exposure to toxic substances, such as drugs, chemicals, or poisons. [Asphyxial Cause]: Asphyxial deaths occur when the body is deprived of oxygen, which can happen due to suffocation, strangulation, drowning, or other causes. [Thermal Cause]: Deaths resulting from extreme temperatures, either heat (hyperthermia) or cold (hypothermia). [Infectious Cause:] Deaths caused by infections or diseases, often involving pathogens such as bacteria, viruses, or parasites. [Combined Causes]: In some cases, multiple factors contribute to the cause of death, and it may be classified as a combination of different causes. REFERENCES {#references.TransOutline} ========== - Solis PP: Legal Medicine. Quezon City: R.P. Garcia Publishing Co., 1987 - Powerpoint: Villasenor, V.(2024). Introduction to Forensics - Previous Trans: Batch 2024 - Institute of Medicine (US) Committee for the Workshop on the Medicolegal Death Investigation System. Medicolegal Death Investigation System: Workshop Summary. Washington (DC): National Academies Press (US); 2003. 6, COMPARING MEDICAL EXAMINER AND CORONER SYSTEMS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK221913/ - Go, M,(2021). OPINION: Why we need an independent, science-based medicolegal death investigation system. Available from: https://www.cnnphilippines.com/life/culture/Current-Events/2021/1/13/medicolegal-death-investigation-system.html APPENDIX ======== - No appendices