CHAPTER 3: Medico-legal aspects of identification Importance of Identification of Person 1) 2) In the prosecution of the criminal offense, the identity of the

offender and that of the victim must be established; otherwise it will be a ground for the dismissal of the charge or acquittal of the accused. The identification of a person missing or presumed dead will facilitate settlement of the estate, retirement, insurance and other social benefits. It vests on the heirs the right over the properties of the identified person. If identity cannot be established, then the law on presumption of death must be applied which requires the lapse of seven years before a person can be presumed dead. In special instances, the seven years period may be reduced to four years; 3) 4) Identification resolves the anxiety of the next-of-kin, other relatives and friends as to the whereabouts of a missing person or victim of calamity or criminal act. Identification may be needed in some transactions, like cashing of check, entering a premise, delivery of parcels or registered mail in post office, sale of property, release of dead bodies to relatives, parties to a contract, etc.

ORDINARY METHODS OF IDENTIFICATION 1) Characteristics which may easily be changed: a. Growth of hair, beard or mustache b. Clothing c. Frequent place of visit d. Grade of profession e. Body ornamentations Characteristics that may not easily be changed a. Mental memory b. Speech-identification can be achieved through the sound spectrographic analysis c. Gait i. Ataxic gait-as seen in persons suffering from tabes dorsalis ii. Cerebellar gait-staggering movement iii. Cows gait- a swaying movement due to knock-knee iv. Spastic gait-a gait in which the legs are held together/move in stiff manner v. Festinating gait-involuntary movement in short accelerating steps vi. Frog gait-a hopping gait resulting from infantile paralysis vii. Waddling gait-similar to the movement of the duck d. Mannerism i. Way of sitting ii. Movement of the hand iii. Movement of the body iv. Movement of the facial muscles v. Expression of the mouth while articulating vi. Manner of leaning e. Hands and feet i. Foot or hand impression ii. Foot or handprint f. Complexion g. Changes in the eyes h. Facies i. Hippocratic facies-the appearance of the face is indicative of approaching death ii. Mongolian facies- almond eys, pale complexion, prominence of cheek bones iii. Facies leonine- a peculiar,lion-like appearance, observed in leprosy. Etc iv. Myxedemic facies-pale face,slow monotonous speedh, muscular tremor i. Left or Right handedness-can be determined while watching him in unguarded time j. Degree of nutrition-a person may be thin, normal or stout

2)

POINTS OF IDENTIFICATION APPLICABLE TO BOTH LIVING AND DEAD BEFORE ONSET OF DECOMPOSITION: 1) 2) Occupational marks Race a. Color of the skin i. Caucasian-fair ii. Malayan-brown iii. Mongolian-fair iv. Negro-black b. Feature of the face

i. ii. iii. iv. 3) Stature a.

Caucasian-prominent sharp nose Malayan-flat nose with round face Mongolian-almond eyes and prominent cheek bone Negro-thick lips and prominent eyes

4) 5) 6) 7)

Methods of approximating the height of a person i. Measure the distance between the tips of the middle fingers of both hands with the arms extended laterally and it will approximately be equal to the height. ii. Two times the length from the vertex of the skull to the pubic symphysis is the height. Tattoo marks Deformities-congenital or acquired Sexual organ-male organ may show previous circumcision. In female the uterus and breasts may show signs of previous pregnancy Blood examination-blood type, disesase;

SCIENTIFIC METHODS OF IDENTIFICATION 1) Fingerprinting a) Dactylography-art and study of recording fingerprints as a means of identification b) Dactyloscopy-art of identification by comparison of fingerprints. It is the study and utilization of fingerprints c) Poroscopy-is the study of the pores found on the papillary or friction ridges of the skin; Dental Identification a) The enamel of the teeth is the hardest substance of the human body. It may outlast all other tissues during putrefaction or physical destruction; Handwriting a) Bibliotics- is the science of handwriting analysis; an expert is a bibliotist or qualified document examiner; b) Graphology- is the study of handwriting for the purpose of determining the writers personality, character and aptitude

2)

3)

Movements in writing: 1) 2) 3) 4) Finger movement- the letters are made entirely by the action of the thumb, the pointing and middle fingers. Seen in illiterates, children, those to whom writing is unfamiliar; Hand movement-letters are produced by the action of the hand as a whole. With the wrist as the center of action and with some action of the fingers Arm movement- the movement in writing is made by the hand and arm supported with the elbow at the center of the lateral swing; good writings are written in this manner; Whole arm movement- the action is produced by tbhe entire arm without any rest. Blackboard writing is an example;

4)

5)

Identification of the skeleton a) Whether the remains are of human origin or not b) Whether the remains belong to a single person or not c) Humphreys table-used to determine height when living d) Differences between a male and a female pelvis i) Male is heavier construction wall more pronounced; female is lighter construction wall less pronounced ii) Male-Diameter of the true pelvis less; Female- diameter of the true pelvis greater; Determination of sex a) As an aid in identification b) To determine whether an individual can exercise certain obligation vested by law to one sex only; c) Marriage or the union of a man and a woman; d) Rights granted by law are different to different sexes; e) There are certain crimes wherein a specific sex can only be the offender or victim i) Rape ii) Prostitution iii) Adultery is woman; concubinage offender is a man

tests to determing the sex: 1) 2) 3) 4) social test genital test gonadal test chromosal test

problems in sex determination

1)

presumptive evidence a. clothes and other wearing apparel , but not in a transvestite

The important distinguishing presumptive characters between the two sexes are as follows: Female Hips are broader in relation to shoulders Breasts developed Adams apple not prominent Striae present Male Shoulders are broader than hips Generally not developed Adams apple prominent Striae absent

2) 3)

highly probable evidences of sex a. possession of vagina, uterus and accessories in female, and penis in male conclusive evidence a. presence of ovary in female and testis in males

CHAPTER 4: Medico Legal aspects of death Importance of death determination 1) 2) the death of either the principal or agent is a mode of extinguishment of agency the civil case for claims which does not survive is dismissed upon death of the defendant

KINDS OF DEATH 1) 2) 3) Somatic death or clinical death-there is complete, persistent and continuous cessation of the vital functions of the brain, heart and lungs which maintain life and health; Molecular or cellular death- about three to six hours later, there is death of individual cells. This is known as molecular or cellular death Apparent death or state of suspended animation- this condition is not really death but merely a transient loss of consciousness or temporary cessation of the vital function of the body on account of disease, or external stimulus;

SIGNS OF DEATHS (1) Cessation of heart action and circulation Methods of detecting the cessation of heart action and circulation 1) Examination of the heart a. Palpation of the pulse b. Auscultation for the heart sound at the precordial area; c. Flouroscopic examination d. By the use of electrocardiograph Examination of the peripheral circulation a. Magnus test b. Opening of small artery c. Icards test d. Pressure on the fingernails e. Diaphanous test f. Application of heart on the skin g. Palpation of the radial pulse h. Dropping of melted wax (2) CESSATION OF RESPIRATION LIKE HEART ACTION, CESSASTION OF RESPIRATION IN ORDER TO BE CONSIDERED AS A SIGN OF DEATH MUST BE CONTINUOUS AND PERSISTENT. A person can hold his breath for a period not longer than 3 minutes. In case of electrical shock, respiration may cease for sometime but may be restored by continuous artificial respiration

2)

1)

In the following conditions there may be suspension of respiration without death ensuing 1) 2) 3) 4) In a purely voluntary act, as in divers, swimmers, etc (but it cannot be longer than 2 minutes) In some peculiar condition of respiration, like cheyne-stokes respiration; but not longer than 15-20 seconds In cases of apparent drowning; Newly born infants may not breathe for a time after birth and may commence only after stimulation or spontaneously later.

METHODS OF DETECTING CESSATION OF RESPIRATION

1)

WINLOWS TEST- there is no movement of the image formed by reflecting artificial or sun light on the water or mercury contained in a saucer and placed on the chest or abdomen if respiration is not taking place.

COOLING OF THE (ALGOR MORTIS) The progressive fall of the body temperature is one of the most prominent signs of death The rate of cooling of the body is not uniform. It is rapid during the first two hours after death and as the temperature of the body gradually approaches the temperature of the surroundings , the rate becomes slower; Post-mortem Contact Flattening On account of the loss of elasticity of the skin and of the post-mortem flaccidity of muscles, the body becomes flattened over areas which are in contact with the surface it rests. This is observed at the region of the shoulder blades, buttocks and calves if death occurs while lying on his back. Certain degree of pressure may be applied on the face immediately after death and may be mistaken for traumatic deformity Tache Noir de la sclerotique- after death a spot may be found in the sclera. The spot which may be oval or round or may be triangular with the base towards the cornea and may appear in the sclera a few hours after death. At the beginning it is yellowish but later it becomes brown or black. This is believed to be due to the thinning of the sclera thereby making the pigmented choroid visible; CHANGES IN THE BODY FOLLOWING DEATH

1.

Changes in the muscle a. Stage of primary flaccidity- the muscles are relaxed and capable of contracting when stimulated; b. Stage of post mortem rigidity- the whole body becomes rigid, this develops three to six hours after death and may last from twenty-for to thirty-six hours; c. Stage of secondary flaccidity or commencement of putrefaction (decay of the muscles)

Stage of post-mortem rigidity, or cadaveric rigidity or death stiffening or rigor mortis- three to six hours after death the muscles gradually stiffen; usually the whole body becomes stiff after twelve hours. 2) in the medico-legal view point, post mortem rigidity may be utilized to approximate the length of time the body has been dead;

stages 1) Internal factors a. State of the muscles b. Age c. Integrity of the nerves External factors a. Temperature b. Moisture

2)

Conditions simulating rigor morts 1) 2) 3) Heat stiffening Cold stiffening Cadaveric spasm or instantaneous rigor

Distinction between rigor mortis and cadaveric spasm

Rigor mortis Time of appearance

Appears 3-6 hours after death

Cadaveric spasm
Appears immediately after death Involves only a certain muscle or group of muscles and are asymmetrical May or may not appear on a person at the time of death May be useful to determine the nature of the crime

Muscles Involved
Involves all the muscles of the body

Occurrence
Natural phenomena

Medico-legal significance
May be utilized by a medical jurist to approximate the time of death

Stage of secondary flaccidity or secondary relaxation

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After the disappearance of rigor mortis, the muscle becomes soft and flaccid. It does not respond to mechanical or electrical stimulus;

Distinctions between ante-mortem from post mortem clot ANTE-MORTEM CLOT (before death) Firm in consistency Surface of the blood vessel raw after the clots are removed Clots homogenous in construction so it cannot be stripped into layers Clot with uniform color POST-MORTEM CLOT(after death) Soft in consistency Surface of the blood vessels smooth and healthy after the clots are removed Clots can be stripped off in layers Clot with distinct layer

POST MORTEM LIVIDITY or cadaveric lividity Characteristics of post-mortem lividity 1. 2. 3. 4. 5. It occurs in the most extensive areas of the most dependent portions of the body It only involves the superficial layer of the skin It does not appear elevated from the rest of the skin The color is uniform but the color may become greenish at the start of decomposition There is no injury of the skin

KINDS OF POST MORTEM LIVIDITY 1) 2) Hypostatic lividity- blood merely gravitates into the most dependent portion of the body Diffusion lividity-blood has coagulated inside the

blood

vessels

MARBOLIZATION It is the prominence of the superficial veins with reddish discoloration during the process of decomposition which develops on both flanks of the abdomen, root of the neck and shoulder which makes the area look like a marbled reticule of branching veins; this is observed easily among dead persons with fair complexion; CHAPTER 5: MEDICO LEGAL INVESTIGATION OF DEATH Stages of medico-legal investigation a) b) Crime scene investigation- investigation of the place of commission of the crime Autopsy

PERSONS TO COMPOSE THE SEARCH 1) 2) 3) A Physician A photographer An assistant

Methods conducting a search 1) 2) 3) 4) 5) Strip method Double strip or grid method Spiral method Wheel method Zone method

DISPOSAL OF THE COLLECTED EVIDENCE- All evidences collected must be protected, identified and preserved. Examination of the dead body in the crime scene a) Thorough inspection of the dead body; special consideration must be made on the following; a. Evidences which will tend to prove identity b. Position of the victim c. Condition of the apparel worn d. Approximate time of death e. Presence of wounding instrument and the approximate distance from the body f. Potential cause of death

AUTOPSIES- An autopsy is a comprehensive study of a dead body, performed by a trained physician employing recognized dissection procedure and techniques. It includes removal of tissues for further examination; Autopsies vs. post-mortem examination 1) 2) Post mortem examination- refers to an external examination of a dead body without incision being made, although blood and other body fluids may be collected for examination; In autopsy, in addition to an external examination, the body is opened and an internal examination is conducted;

Kinds of Autopsies 1) Hospital on non-official autopsy-this is an autopsy done on a human body with the consent of the deceased persons relatives for the purposes of: a. Determining the cause of death b. Providing correlation of clinical diagnosis and clinical symptoms c. Determining the effectiveness of therapy d. Studying the natural course of disease process e. Educating students and physicians

The consent shall be obtained from a) Spouse b) Descendants of the nearest degree c) Ascendants , also of the nearest degree d) The brothers and sisters e) The eldest and the paternal shall have a better right Medico legal or official autopsy a. Determining the cause, manner(mode), and time of death b. Recovering, identifying, and preserving evidentiary material c. Providing interpretation circumstances related to death d. Providing a factual report for law enforcement e. Separating death due to disease from death due to external cause Distinction between pathological(non-official) a0nd medico-legal(official) autopsies PATHOLOGICAL AUTOPSY Must have the consent of the next of kin Confirmation of clinical findings of research Notation of all abnormal findings MEDICO LEGAL AUTOPSY It is the law that gives the consent. Consent of relatives are not needed Correlation of tissue changes to the criminal act Emphasis laid on effect of wrongful act on the body. Other findings may only be noted in mitigation of the criminal responsibility Must be specific for the purpose of determining whether it is in relation to the criminal act If the investigator thinks it will be useful in the administration of justice, it must be included.

2)

3)

Requirement Purpose Emphasis

Conclusion

Minor or non-pathological

Summation of all abnormal findings irrespective of its correlation with clinical findings Need not to be mention in the report

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The following manner of death should be autopsied a. Death by violence b. Accidental death c. Suicides d. Sudden death of persons who are apparently in good health e. Death unattended by physician f. Death in hospitals or clinics g. Death occurring in an unnatural manner GUIDELINES IN THE PERFORMANCE OF AUTOPSIES a. Be it an official or non official autopsy, the pathologist must be properly guided by the purposes for which autopsy is to be performed. b. The autopsy must be comprehensive and must not leave some parts of the body unexamined c. Bodies which are severely mutilated, are still suitable for autopsy d. All autopsies must be performed in a manner which show respect of the dead body e. Proper identity of the deceased autopsied must be established in a non-official autopsy. An autopsy on a wrong body may be a ground for damages f. A dead body must not be embalmed before the autopsy. g. The body must be autopsied in the same condition when found at the crime scene.

6) 7)

The true identity of the decease must be ascertained. If no one claims the body, a complete data to reveal his identity must be taken; Religious objections to autopsies- there is no place in the bible, in the Talmudic or post Talmudic writings, is there evidence that post-mortem examination is prohibited. where the decendants gave consent

a. According to traditional interpretation, autopsies and transplantation of organs are permitted only in those cases