Lec 1 - Gen Considerations

7/17/2019 Lec 1 - Gen Considerations

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GeneralGeneral

ConsiderationsConsiderations

Atty Molly Cr Abiog,Atty Molly Cr Abiog,

MD, LlBMD, LlBUniversity of theUniversity of the

CordillerasCordilleras

Baguio CityBaguio City

Lecture 1:



Defnition o TermsDefnition o Terms

• Legal MedicineLegal Medicine

• Branch of Medicine which deals withBranch of Medicine which deals with

the application of edical !nowledgethe application of edical !nowledgeto the purposes of law and in theto the purposes of law and in the

adinistration of "usticeadinistration of "ustice

• Legal Medicine, #orensic Medicine andLegal Medicine, #orensic Medicine and

Medical $urisprudenceMedical $urisprudence -- synonyoussynonyouswith each other, and in coonwith each other, and in coon

practice are used interchangeablypractice are used interchangeably



Defnitions &Defnitions &

DierencesDierences• %trictly spea!ing%trictly spea!ing

• Legal MedicineLegal Medicine is priarily theis priarily the

application of edicine to legal casesapplication of edicine to legal cases• Forensic MedicineForensic Medicine concerns withconcerns with

the application of edical !nowledgethe application of edical !nowledge

to elucidate legal probles&to elucidate legal probles&



Dierences in ScopesDierences in Scopes

• William J. CurranWilliam J. Curran • a proinent 'arvard professor of legala proinent 'arvard professor of legal

edicine de(nesedicine de(nes

• Legal MedicineLegal Medicine as encopassing thoseas encopassing thosespecialty areas of edicine concerned withspecialty areas of edicine concerned withrelations to substantive law and legalrelations to substantive law and legalinstitutionsinstitutions

• #orensic Medicine#orensic Medicine deals with investigation ,deals with investigation ,

preparation, preservation and presentation ofpreparation, preservation and presentation ofevidence and edical opinion in courts andevidence and edical opinion in courts andother legal, correctional and other law)other legal, correctional and other law)enforceent settingsenforceent settings



ccording to Dr !enr"ccording to Dr !enr"

C. LeeC. Lee• an einent U&%& forensic e*pert who claisan einent U&%& forensic e*pert who claisthatthat Forensic MedicineForensic Medicine has a broaderhas a broaderde(nition than Lde(nition than Legal Medicineegal Medicine• #M encopasses a variety of (elds in forensic#M encopasses a variety of (elds in forensic

science such as, pathology, anthropology,science such as, pathology, anthropology,odontology, to*icology, entoology, et alodontology, to*icology, entoology, et al

• +ts application is liited not only to legal issues but+ts application is liited not only to legal issues butalso covers historical, environental and socialalso covers historical, environental and socialpolitical issuespolitical issues

• Legal MedicineLegal Medicine refers to substantive law de(ningrefers to substantive law de(ningthe relationship between and aong hospitals,the relationship between and aong hospitals,doctors, patients, whereas #orensic Medicine dealsdoctors, patients, whereas #orensic Medicine dealswith activities or acts punishable under our localwith activities or acts punishable under our locallawslaws



• Dr. !enr" C. LeeDr. !enr" C. Lee,,

• Medical JurisprudenceMedical Jurisprudence denotes thedenotes the

!nowledge of law in relation to the!nowledge of law in relation to thepractice of edicinepractice of edicine

• +t concerns with the study of the+t concerns with the study of the

rights, duties and obligations of arights, duties and obligations of a

edical practitioner with particularedical practitioner with particularreference to those arising fro areference to those arising fro a

doctor)patient relationshipdoctor)patient relationship



ature of the %tudy of Legalature of the %tudy of Legal

MedicineMedicine##

• -nowledge of legal edicine eans.-nowledge of legal edicine eans.

• ability to ac/uire factsability to ac/uire facts

• power to arrange those facts in theirpower to arrange those facts in their

logical orderlogical order

• draw a conclusion fro the facts whichdraw a conclusion fro the facts which

ay be useful in the adinistration ofay be useful in the adinistration of

"ustice "ustice• power to ipart to others verbally or inpower to ipart to others verbally or in

writing all those he has observed&writing all those he has observed&



Facts & FallaciesFacts & Fallacies

• Misconceptions among t$eMisconceptions among t$e

pu%licpu%lic

• Medicolegal practitioners mustMedicolegal practitioners mustalso %e la"ersalso %e la"ers

• 'ne $as to %e a pat$ologist to %e'ne $as to %e a pat$ologist to %e

in(ol(ed in t$is line o or) in(ol(ed in t$is line o or)



W$o is $o*W$o is $o*

• A physician who speciali0es or is involvedA physician who speciali0es or is involved

priarily with edico)legal duties is !nownpriarily with edico)legal duties is !nown

as aas a Medical JuristMedical Jurist ++a!aa!a ,Medical,Medical

aminer/0 ,Medico-legal '1cer/0aminer/0 ,Medico-legal '1cer/0,Medico-legal pert/2,Medico-legal pert/2

• e&g& Dr 1&1& 1illasenor 233 Crie Laboratory4e&g& Dr 1&1& 1illasenor 233 Crie Laboratory4

Dr& 5onaldo Bandonill 2B+4Dr& 5onaldo Bandonill 2B+4

• tt". Moll" Cr. %iog0 M.D.tt". Moll" Cr. %iog0 M.D. is a doctor andis a doctor and

a lawyer, buta lawyer, but notnot aa Medico-legal '1cer3Medico-legal '1cer3



W$o are t$e Medico-LegalW$o are t$e Medico-Legal

4ractitioners*4ractitioners*

• Can either be in the service of the governentCan either be in the service of the governent

or in private practice&or in private practice&

• +n governent+n governent•

Connected with law enforceent agencies such as the policeConnected with law enforceent agencies such as the police

departentsdepartents

• Legitiate investigative bodies such as the 33 CrieLegitiate investigative bodies such as the 33 Crie

LaboratoryLaboratory

• Medicolegal division of the ational Bureau of +nvestigationMedicolegal division of the ational Bureau of +nvestigation

• 3hysicians eployed by the governent as they are3hysicians eployed by the governent as they are

andated by law to perfor autopsies on edicolegal casesandated by law to perfor autopsies on edicolegal cases• Municipal 'ealth 67cerMunicipal 'ealth 67cer

• 3rovincial 'ealth 67cers3rovincial 'ealth 67cers



W$o are t$e Medico-LegalW$o are t$e Medico-Legal

4ractitioners*4ractitioners*

• As private practitionersAs private practitioners

• Consultants in private hospitals to whoConsultants in private hospitals to who

are referred edicolegal patients&are referred edicolegal patients&

• As part of the 'ospital 8ea that onitors theAs part of the 'ospital 8ea that onitors thepatient9s condition while con(ned at thepatient9s condition while con(ned at the

'ospital& :hen the patient9s case goes to'ospital& :hen the patient9s case goes to

court, the edicolegal practitioner is called tocourt, the edicolegal practitioner is called to

testify on the fact of the in"ury, the treatenttestify on the fact of the in"ury, the treatent

the patient received in the 'ospital, his e*pertthe patient received in the 'ospital, his e*pertopinion as to the cause of the patienty9opinion as to the cause of the patienty9



:ho are authori0ed by law:ho are authori0ed by law

to perfor autopsiesto perfor autopsies**• %ec& ;<, 3&D& =<>, Code of %anitation.%ec& ;<, 3&D& =<>, Code of %anitation.

• 'ealth 67cers'ealth 67cers

• Medical 67cers of Law enforceent agenciesMedical 67cers of Law enforceent agencies

• Mebers of the Medical %ta? of Accredited hospitalsMebers of the Medical %ta? of Accredited hospitals• Code of Medical @thics of the Medical 3rofessionCode of Medical @thics of the Medical 3rofession

of the 3hilippines& %ec& & Art& +++ states.of the 3hilippines& %ec& & Art& +++ states.

• 'owever, it is the duty of every physician, when'owever, it is the duty of every physician, when

called upon by the "udicial authorities, to assist in thecalled upon by the "udicial authorities, to assist in the

adinistration of "ustice on atters which areadinistration of "ustice on atters which areedico)legal in characteredico)legal in character



Distinction between anDistinction between an

ordinary physician and aordinary physician and a

medical jurist:medical jurist: Ordinary PhysicianOrdinary Physician

&& %ees an in"ury or%ees an in"ury or

illness on the point ofillness on the point of

view of 85@A8M@8view of 85@A8M@8

&& 3urpose in3urpose in

e*aining patiente*aining patientis to arrive at ais to arrive at a

de(nite Diagnosis)de(nite Diagnosis)

5* 5*5* 5*

Medical Jurist Medical Jurist

&& %ees an in"ury or%ees an in"ury or

illness on the point ofillness on the point of

view of CAU%@view of CAU%@

&& include thoseinclude thosebodily lesions in hisbodily lesions in his

report and testifyreport and testifybefore the courtbefore the courtbefore anbefore an

investigation bodyinvestigation body

result. "usticeresult. "usticewhere ustice is



Ordinary PhysicianOrdinary Physician

E& Minor or trivialE& Minor or trivial

ignored Fthey doignored Fthey do

not re/uirenot re/uire

Medical Jurist Medical Jurist

E& Medical "urists ustE& Medical "urists ust

record all bodilyrecord all bodily

in"uries even if theyin"uries even if theyare inor becauseare inor because

these in"uries aythese in"uries ay

be proofs to /ualifybe proofs to /ualify

the crie or tothe crie or to "ustify an act "ustify an act



:hat are these so)called:hat are these so)called

M@D+C6L@GAL CA%@%M@D+C6L@GAL CA%@%• +n"uries or deaths involving persons who have no+n"uries or deaths involving persons who have no

eans of being identi(edeans of being identi(ed

• 3ersons pronounced as dead on arrival 2D6A43ersons pronounced as dead on arrival 2D6A4• Deaths under the following circustances.Deaths under the following circustances.

• Deat$ occurring it$in 56 $ours o admission $en t$eDeat$ occurring it$in 56 $ours o admission $en t$eclinical cause o deat$ is un)non or undetermina%le7clinical cause o deat$ is un)non or undetermina%le7

• 8nepected sudden deat$ especiall" $en t$e8nepected sudden deat$ especiall" $en t$edeceased is in apparent good $ealt$7deceased is in apparent good $ealt$7

• Deat$ due to natural disease %ut associated it$Deat$ due to natural disease %ut associated it$p$"sical e(idence suspicious o oul pla"7p$"sical e(idence suspicious o oul pla"7

• Deat$ as a result o (iolence0 accident0 suicide orDeat$ as a result o (iolence0 accident0 suicide orpoisoning7poisoning7

• Deat$ due to improper o negligent act o anot$erDeat$ due to improper o negligent act o anot$erperson7person7



• 9ictims o p$"sical in:uries caused %"9ictims o p$"sical in:uries caused %"t$e olloing#t$e olloing#• 4$"sical (iolence suc$ as guns$ot ound04$"sical (iolence suc$ as guns$ot ound0

sta% ound0 mauling0 etc.7sta% ound0 mauling0 etc.7

• 9e$icular accident9e$icular accident

• sp$"iasp$"ia

• lectrocutionlectrocution

• C$emical or t$ermal insultC$emical or t$ermal insult

• ccidentccident• ttempted !omicide or suicidettempted !omicide or suicide

• 4oisoning4oisoning



• Cases o c$ild a%use0 domestic (iolence0Cases o c$ild a%use0 domestic (iolence0

rape0 alco$olism and drug addiction7rape0 alco$olism and drug addiction7

• Cases in(ol(ing t$e mental competenc"Cases in(ol(ing t$e mental competenc"

o t$e patient7o t$e patient7• ;atrogenic causes %roug$t a%out %";atrogenic causes %roug$t a%out %"

negligent acts or omissions o t$enegligent acts or omissions o t$e

$ospital sta resulting in (iolation o$ospital sta resulting in (iolation o

rig$ts o patients or leading to $isrig$ts o patients or leading to $isp$"sical and mental incapacitation0p$"sical and mental incapacitation0

p$"sical in:ur" and deat$.p$"sical in:ur" and deat$.



• 8nder 4$ilippine las0 medico-legal8nder 4$ilippine las0 medico-legal

deat$s must undergo mandator"deat$s must undergo mandator"

autops"autops"

• <o consent is re=uired or t$e autops"<o consent is re=uired or t$e autops"alt$oug$ t$e net o )in is inormed oalt$oug$ t$e net o )in is inormed o

t$is re=uirement and $is signed consentt$is re=uirement and $is signed consent

o%tained as a matter o courtes"o%tained as a matter o courtes"

• Deat$ certifcate cannot %e completedDeat$ certifcate cannot %e completedit$out t$e autops".it$out t$e autops".



• +f the hospital has no authority to conduct+f the hospital has no authority to conductautopsy, it refers the case to a governentautopsy, it refers the case to a governentbody which can do itHeither to the 33 or thebody which can do itHeither to the 33 or theB+ or top a Municipal or 3rovincial 'eathB+ or top a Municipal or 3rovincial 'eath

67cer67cer• +f the 'ospital has the authority to conduct+f the 'ospital has the authority to conduct

autopsy but the relatives refuse to cooperate,autopsy but the relatives refuse to cooperate,the death certi(cate is erely (lled up bythe death certi(cate is erely (lled up by

putting as the cause of death undeterinedputting as the cause of death undeterined• +n e?ect, it is also as if no death certi(cate has been+n e?ect, it is also as if no death certi(cate has beenissued because legally the body cannot be buriedissued because legally the body cannot be buriedwithout a cause of deathwithout a cause of death



Ma"or capabilities of aMa"or capabilities of a

edico)legal o7cer.edico)legal o7cer.

• ConductsConducts• autopsyautopsy

• e*aination of victis of se*ual criese*aination of victis of se*ual cries

• e*aination of victis of 3hysical in"uriese*aination of victis of 3hysical in"uries

• e*aination of s!eletal reainse*aination of s!eletal reains

• blood and blood stain, seinal IuidJstain)blood and blood stain, seinal IuidJstain)e*aination of body Iuidse*aination of body Iuids

• @*huation of bodies@*huation of bodies

• 'istopathological e*ainations'istopathological e*ainations



Case Discussion.Case Discussion.

• n >? "ear old emale0 single0 came to a medical clinicn >? "ear old emale0 single0 came to a medical cliniccomplaining t$at s$e $as %een raped.complaining t$at s$e $as %een raped.

• !istor" o t$e 4resent Complaint#!istor" o t$e 4resent Complaint#• 'ne +>2 mont$ 4TC0 Mr. @ %" use o orce and intimidation $ad'ne +>2 mont$ 4TC0 Mr. @ %" use o orce and intimidation $ad

carnal )noledge it$ $er at Aurn$am 4ar) B 5# p.m. For earcarnal )noledge it$ $er at Aurn$am 4ar) B 5# p.m. For earo $er parents rat$0 s$e )ept $at $appened to $ersel ando $er parents rat$0 s$e )ept $at $appened to $ersel and

came or medical eamination onl" toda".came or medical eamination onl" toda".• amination results#amination results#• Eecentl" $ealed $"meneal lacerations at 6 and ocloc)7Eecentl" $ealed $"meneal lacerations at 6 and ocloc)7• <o signs o recent application o orce at t$e perineal area7<o signs o recent application o orce at t$e perineal area7• ;nternal amination0 admits 5 eamining fngers it$ ease7;nternal amination0 admits 5 eamining fngers it$ ease7

s$allo (aginal rugosities7s$allo (aginal rugosities7

• La%orator" aminations# 4ositi(e or spermatoGoa0 no gramLa%orator" aminations# 4ositi(e or spermatoGoa0 no gramnegati(e cocci.negati(e cocci.

• Conclusions#Conclusions# -non-(irgin state7-non-(irgin state7

-$ealed lacerations at 6 and ocloc) -$ealed lacerations at 6 and ocloc)

-presence o SpermatoGoa0-presence o SpermatoGoa0• Conclusion# recent seual intercourse it$in t$e last 56 $rs.Conclusion# recent seual intercourse it$in t$e last 56 $rs.

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Lec 1 - Gen Considerations