CHAPTER 1 LEGAL MEDICINE

- testamentary capacity of a person making

a will
- the right to hereditary succession

Legal Medicine
- Is that branch of medicine that applies, medical
and surgical concepts, scientific knowledge and
skills to medico legal issues, in order to assist the
trier of facts in the proper dispensation of justice.
Medical Jurisprudence
- is the study of the Medical Law and its applicable
Jurisprudence that governs, regulates and
defines the practice of medicine.

2. Criminal Law
- Felonies and circumstances which affect criminal
liability
- Civil liability ex delictu
- Crimes relative to opium and prohibited drugs
- Crimes against persons
- Crimes against chastity
- Crimes against civil status of persons
- Quasi offenses

In the Philippines, Legal Medicine is the appropriate

name for Forensic Medicine.
Modern Legal medicine has a broad range of
applications, it is used in civil cases such as paternity
and filiation, annulment of marriage, DNA testing , etc.
In all cases the medical examiner must conduct an
investigation of the crime scene and also an autopsy.

3. Remedial Law
- Physical and Mental Examination of a person
- Hospitalization of insane persons
- Rules of Evidence
4. Special Laws
- Dangerous Drug Act
- Youth and Child Welfare Code
- Sanitation Code
- Insurance law
- Labor Code
- Employees Compensation Law

TECHNIQUES OF LEGAL MEDICINE:

- Legal Medicine uses sophisticated laboratory
techniques to detect the presence of substances
in the victim, in the suspected criminal, or at the
crime scene.
- Forensic examination of substances found at a
crime scene can often establish the presence of
the suspect at the crime scene.

5. CORPUS DELICTI
- Is the body or substance of the crime and
is defined as the fact that a crime actually has been
committed. In all criminal prosecutions, the burden is
on the prosecution to prove the corpus delicti.

LEGAL MEDICINE AND THE LEGAL SYSTEM

- Courts routinely call upon physicians to give
expert testimony in a trial, especially concerning
the findings of an autopsy and the results of
laboratory tests.
- As an expert witness he is allowed to express an
opinion about the validity of the evidence in a
case and may quote the statements of other
experts in support of an opinion.
- Ordinary testimony is restricted to statements
concerning what the witness actually saw or
heard.
- The evidence to be presented by the legal
medicine expert must signify a relation between
the facts called the Factum Probandum or
proposition to be established and the factum
Probans which is the material evidencing the
proposition.
- The Physician must present RELEVANT,
MATERIAL AND COMPETENT EVIDENCE.

QUANTUM OF PROOF
1. In Civil Cases the quantum of proof necessary to
prove a civil complaint is a PREPONDERANCE OF
EVIDENCE. The party filing or bringing a civil
complaint has the burden of proof and must establish
the truth and righteousness of his allegations by a
preponderance of the evidence admitted by a
competent court.
2. In Criminal Cases
the quantum is proof beyond reasonable doubt.
- In a criminal case the accused is entitled to an
acquittal, unless his guilt is shown beyond
reasonable doubt
- Presumption of INNOCENCE is a conclusion
drawn by the constitution and the law in favor of
the accused , while REASONABLE DOUBT, is a
condition of mind produced by proof resulting
from evidence in the case.

HISTORY OF LEGAL MEDICINE:

- Paulus Zacchias ( 1584 1659 ) is the Father of
Forensic Medicine. He was the first to describe
the importance and application of medicine to the
proper administration of justice.

3. To establish matters of defense

- The doctrine of reasonable doubt applies
only to incriminative facts.

In the Phil. , the father of Legal Medicine can be

rightfully bestowed to Dr. Pedro P. Solis. His book
on Legal Medicine copyrighted in 1987, contains
the most extensive treatise and teachings in
Philippine Legal Medicine.
APPLICATION OF LEGAL MEDICINE TO LAW:
Legal Medicine is Applied to Law
1. Civil law
- the determination and termination of civil
personality
- the limitation or restriction of a natural
persons capacity to act
- marriage and legal separation
- paternity and filiation

4. To establish self defense

- One who sets up SELF DEFENSE must
rely on the strength of his own evidence and not on
the weakness of that of the prosecution.
5. To establish Alibi
- It must be proved by positive, dear and
satisfactory evidence. Oral Evidence of alibi is so
easily manufactured and usually unreliable that it can
rarely be given credence.
6. In Administrative Complaints

- In cases filed before administrative or

quasi judicial bodies, a fact maybe deemed
established if it supported by substantial evidence
which means that amount of relevant evidence which
a reasonable mind might accept as adequate to justify
a conclusion.

7. The right to privacy and confidentiality.

8. The right to a second or third opinion.
9. The right to leave.
10. The right to information.
11. The right to self determination.
12. The right to refuse participation in medical research
13. The right to express grievance
14. The right to be informed of his rights and obligations.

CHAPTER 2 MEDICAL AND HOSPITAL

JURISPRUDENCE
Medical Jurisprudence:
- Is the study of the Medical Law and its applicable
Jurisprudence, that governs, regulates, and
defines the practice of medicine.
- It includes the rights, duties, obligations and
liabilities of both physician and patient to each
other in a physician patient professional contract.

SOCIATAL RIGHTS OF THE PATIENTS FROM THE

GOVERNEMNT ( Refer to Book )
RIGHTS INHERENT IN THE PRACTICE OF MEDICINE:
1. The right to choose his patients
2. The right to limit the practice of his profession
3. The right to determine appropriate treatment procedures
in the discretion and judgment of the physician.
4. The right to avail of hospital privileges after being
qualified.
5. The right to receive just and fair compensation from his
patients.

The Following Acts Constitute the Practice of

Medicine:
1. To physically examine and diagnose a patient.
2. To physically examine and treat a patient
3. To physically examine and perform surgery in a
patient
4. To physically examine and prescribe any remedy to
a patient.

Liabilities of a Physician Which May Arise from His

Negligent or Wrongful Acts or Omissions:
1. Administrative Liability
- A complaint under oath can be filed before the
Professional Regulation Commission Board of Medicine,
for reprimand, of the license to practice medicine.
2. Criminal Liability
- When an act or omission constitutes a crime, the
physician can be imprisoned or fined or both, as any other
profession.
3. Civil Liability
- The aggrieved party can be awarded monetary
damages for any wrongful or negligent act or omission,
when the professional is found guilty.

Any person who practice any of the above acts

enumerated, without any valid certificate of
registration as a physician, is practicing illegal
medicine.

The Nature of the Physician Patient Professional

Relationship is
1. Consensual:
- based on mutual consent of both patient and
physician.
- Contracts that are consensual in nature, are
perfected upon mere meetings of the minds
2. Fiduciary:
- founded in trust, faith, and confidence reposed by
one person in the integrity and fidelity of another.

CASES ( Refer to Book )

Ex. Negligent or Wrongful Act
Medical malpractice is a particular form of negligence
which consists in the failure of a physician or surgeon
to apply to his practice of medicine that degree of care
and skill which is ordinarily employed by the
profession generally, under similar conditions, and in
like surrounding circumstances

DUTIES AND OBLIGATIONS OF THE PHYSICIAN

TOWARDS HIS PATIENTS:
1. He must possess that knowledge and skill possessed by
an average physician.
2. He must use such knowledge and skill with ordinary care
and due diligence.
3. He is obliged to exercise his best judgment
in good faith.
4. He has the duty to keep the secrets and confidentialities
of his patients.

The Terms and Conditions not included in the

Physician Patient Professional Relationship Contract (
refer to book )

The only promise or guaranty that the law requires is

that, the physician will treat the patient in accordance
with the standards of medical care.

Obligations of the Patients to their Physicians ( Refer

to Book )

There are Four Elements involved in medical

negligent cases:
1. Duty
2. Breach
3. Injury
4. Proximate Causation It has been recognized that
expert testimony is usually necessary to support the
conclusion as to causation.

PATIENTS RIGHTS RESPECTED BY PHYSICIANS:

1. The right to appropriate medical care and humane
treatment.
2. The right to his religious belief.
3. The right to refuse treatment.
4. The right to Informed Consent.
5. The right to choose his physician.
6. The right to medical records.

Ex. Whether A Hospital may be Held Liable for the

Negligence of Physicians Consultants allowed to
Practice in its Premises.
CHAPTER 3 DEATH
Legal Presumption of Death:
- If absent without explanation from his or her
usual or last place of residence for a long
continuous period.
- Circumstantial proof of death

Ex. a passenger on an airplane that crashed is

considered to have died even if no remains can
be recovered.

Rules of Evidence in Rule 131, section 5 paragraph X,

paragraph JJ, and paragraph KK.
In common law the presumption of death does not
arise until the expiration of seven years of continuous
absence.

CRITERIA FOR DIAGNOSING BRAIN STEM DEATH.

( refer to textbook )
Persistent Vegetative State ( PVS )
- This condition exists, when irreversible
destruction of the Cortex of the brain occurs
without damage to the vital centers, and there
are permanent eyes open state of
unconsciousness, but cardio respiratory functions
continue, sometimes without respiratory
assistance, but most often with respiratory
support.
- They do not however match the clinical criteria of
Brain Death, in as much as they have elicitable
reflexes, spontaneous respirations and reactions
to external stimuli.

DEATH IS THE COMPLETE CESSATION OF ALL THE VITAL

FUNCTIONS OF THE BODY WITHOUT POSSIBILITY OF
RESUSCITATION. THE ASCERTAINMENT OF DEATH IS A
MEDICAL AND NOT A LEGAL PROBLEM.
Death maybe
A. Brain Death occurs when there is a deeply irreversible
coma, and absence of electrical brain activity.
B. Cardio Respiratory Death occurs when there is continuous
and persistent cessation of heart action and respiration.
4 Kinds of Death:
1. Clinical or Somatic Death
2. Brain Death
3. Biological Death
4. Cellular Death

HARVARD CRITERIA OF WHOLE BRAIN DEATH:

1. Unreceptivity and Unresponsitivity
2. No spontaneous movements or breathing
3. No reflexes
4. Flat EEG of Confirmatory value

Clinical or Somatic Death

- This particular kind of death occurs when in the
judgment of the physician with the use of his
clinical eye the bodys vital signs of life cease to
exist continuously and permanently.
- The clinical death is verifiable only by a physician
after he observes that the patient no longer has a
heart beat no pulse rate, no spontaneous
breathing and movement, with the pupils of the
eye widely dilated and not reactive to light and
accommodation.
- When a clinically dead person is brought to the
morgue the generalized contraction of the
muscles or Rigor Mortis of the body within 3 to 6
hours, may simulate a return to life, because of
the motion or movement of the body.

WHOLE BRAIN DEAD

- When the brain ceased all functions, even though
the heart continues to beat. As a rule doctors can
legally declare whole brain death twelve hours
after they have corrected all treatable medical
problems, but the brain still doesnt respond even
to induced pain , they eyes do not react to light
and the person doesnt breath without a
respirator.
BIOLOGICAL DEATH
- All the components of the brain are dead
- There is also permanent extinction of bodily life.
- It is cardiorespiratory and brain death altogether
with permanent cessation of all the anatomic and
physiological functions of the body organs.

BRAIN DEATH
- This kind of death follows clinical death almost
immediately unless resuscitative procedures are
started promptly, because the human brain under
normal conditions cannot survive loss of oxygen
for more than 6 to 10 minutes.
- Brain Death may occur in the
Stage 1 Cerebral Cortex- the highest center of
the brain that is most sensitive to changes in the
supply of oxygen and blood to the brain. When
the cerebral cortex dies, the patient is in cortical
death.

CELLULAR DEATH:
- The death of the different parts of the body
occurs at different times and stages.
- This is the reason why such organs as the
corneas and the kidneys can be removed
immediately after biological death and
transplanted successfully.
SIGNS OF DEATH:
1. Cessation of heart action and circulation
2. Cessation of respiration
3. Cooling of the body ( Algor Mortis )
- The temperature of 15 20 degrees
Fahrenheit is considered as a certain sign of death.
4. Loss of motor power
5. Loss of sensory power
6. Changes in the skin
7. Changes in and about the eye
- There is loss of corneal reflex

Stage 2 - Cerebellum It deals with the function

of equilibrium. It follows the death of the cerebral
cortex.

Death Certificate, even though the heart is still

beating, and make arrangements to harvest
donor organs and tissues at this stage.
Further, in the presence of brain stem death,
artificial respirators only achieve the maintenance
of an oxygenated circulation through a corpse or
cadaver.

Stage 3 Brainstem and Vital centers These

centers controlling respiration, heart rate and
blood pressure, ultimately die. When it does, the
patient is, Brain Stem Dead.
If the brain stem is damaged, then the vital
centers in the medulla maybe destroyed, causing
the respiratory center to fail.
The occurrence of brain stem death is equivalent
to Legal Death, so that Doctors can now issue a

CHANGES IN THE BODY FOLLOWING DEATH

1. Changes in the Muscle
a. Stage of primary flaccidity
b. Cadaveric rigidity or rigor mortis

- muscular contraction which

develops 3 6 hours after death
and may last for 24 36 hours.
- may also be utilized to
approximate the length of time the
body has been dead from 3 to 36
hours
c. Stage of secondary flaccidity or
commencement of putrefaction

suicidal, murderous, homicidal, sudden or

unexpected, or unexplained, need medico legal
investigation.
The Death Certificate
- The death certificate is a legal document
necessary for burial of the dead, as it certifies the
occurrence of death. It is a document from the
Office of the Civil Registrar General, listing the
particulars of an individuals death.
- It contains the Immediate Cause or Primary
cause of death, the antecedent causes and
underlying cause of death

Cadaveric Spasm- is the immediate or instantaneous spasm or

rigidity of the skeletal muscles occurring at the moment of death
due to exhaustion, etc.
Medico legal Importance of Cadaveric Spasm
( Refer to Book )

Immediate Cause or Primary Cause of Death

Ex. Suffocation due to drowning
Asphyxia
Cardio Respiratory Arrest

2. Changes in the Blood

a. Coagulation of the blood
b. Postmortem lividity or Livor Mortis
3. Autolytic or Auto Digestive Changes After Death
4. Putrefaction of the Body

Antecedent Cause of Death are events or

conditions that substantially contribute to the
immediate cause of death
Ex. Acute peritonitis, Acute Hypovolemic shock,
Acute Septic Shock,

PUTREFACTIVE CHANGES OCCURING AFTER DEATH

( Refer to Book )
Kinds of Putrefaction:
1. Mummification
2. Saponification This is also called Adipocere Formation.
3. Maceration

Underlying Cause of Death is the basic cause or

bottom line cause of death. It is the diagnosis of
the patients or victims illness or sickness that
resulted to his death
Ex. Acute Appendicitis, Hepatocarcinoma, Pelvic
Fracture, Stab or Gunshot Wound to the chest.

Factors to Consider in Approximating the Duration of Death in a

Cadaver
1. Entomology The presence of maggots in the cadaver
indicates duration of death for more than 24 hours
2. Presence of live Fleas in clothing in death by drowning, a
flea can survive for about 24 hours submerged in water. After 24
hours submersion in water the fleas die.
3. Blood vessel clots blood clotting occurs in 6 -8 hours after
death.
4. Post Mortem lividity develops in 3 to 6 hours after death.
5. Rigor Mortis- begins to develop in 3 to 6 hours after death
and may last for 24 to 36 hours after death.
6. Onset of decomposition Decomposition takes place within
24 48 hours after death.
7. Food in the stomach
8. Skeletal soft tissues soft tissues may disappear from 1.5
years to 2 years after burial.

Non Natural Causes of Death

Ex. Murder, Homecide, Suicide, Accident
Death Warrant is a warrant from the proper executive authority
appointing the time and place for the execution of the sentence
of death upon a convict judicially condemned to suffer death.
Manner of Death
- Is the explanation as to how the cause of death
arose, and maybe either Natural Death or Violent
Death
Lazarus Syndrome
- Is also called Lazarus Phenomenon is the
spontaneous return of circulation after failed
attempts at resuscitation.

Position of the Body at the time of Death

1. Post Mortem lividity
2. Cadaveric spasm Death due to violence or inflicted physical
injuries, usually manifest the position of the body at the time of
death.
Ex. In suicide by gunshot wound, the gun maybe tightly grasped
in the hand of the deceased
In drowning, the victim maybe holding objects that
come in contact with his hands to cling to life.

Implications of Lazarus Syndrome

- raise ethical and legal issues for doctors, who
must determine when medical death has
occurred, when resuscitation efforts should end,
and post mortem procedures such as autopsies
and organ harvesting may take place.
Lazarus Sign
- Lazarus sign or Lazarus reflex is a reflex
movement in brain dead patients, which causes
them to briefly raise their arms and drop them
crossed on their chests.
- The phenomenon has been observed to occur
several minutes after the removal of medical
ventilators used to pump air in and out of brain
dead patients to keep their bodies alive.

MEDICOLEGAL IMPORTANCE OF RIGOR MORTIS AND

CADAVERIC SPASM:
Rigor mortis is utilized to approximate the time of death.
Generalized muscular contractions occur from 3 to 6 hours until
36 hours.
Cadaveric spasm occurs immediately after death and is useful
to ascertain the circumstances of death.

NEAR DEATH EXPERIENCE

- Refers to a broad range of personal experiences
associated with impending death, encompassing
multiple possible sensations including

Medico Legal Investigation of Death

- Deaths which are not obviously due to natural
causes, but are criminal, suspicious, accidental,

detachment from the body; feelings of levitation

etc.

4. Abdomen
Types of Injuries:
a. Penetrating
- Gunshot wounds of the abdomen carry
95% probability of significant visceral injury
- A bullet when it hits the abdomen will
penetrate the abdominal wall, enter the
abdominal cavity and most likely injure more
than one organ.
- The incidence of abdominal injury is
strikingly higher in gunshot wounds than in
stab wounds.
- The major cause of death is hemorrhage
and this occurs within the first 24 hours
- In stab wounds of the abdomen , only 2/3
penetrate the peritoneal cavity; of these only
cause significant visceral injury that
requires surgical repair.
b. Blunt
- The spleen and liver are the most
commonly injured organs due to blunt
trauma.
- Their frequent incidence also explains why
the mortality rate following blunt trauma is
higher than that of penetrating injury.

EUTHANASIA
- Meaning good death ( well or good )
- Refers to the practice of ending life in a painless
manner.
- Deliberate intervention undertaken with the
express intention of ending life, to relieve
intractable suffering
Classification of Euthanasia:
1. Voluntary euthanasia is euthanasia conducted with consent
2. Involuntary euthanasia
is euthanasia conducted without consent.
-is conducted where an individual makes a decision for another
person incapable of doing so.
- also known as physician assisted death, physician assisted
suicide or mercy killing.
3. Passive euthanasia entails withholding of common
treatments
4. Active euthanasia entails the use of lethal substances or
forces to end life and is the most controversial means.

5. Fractures and Dislocations

The word fracture comes from the Latin word
fractura which means a break in the continuity of the bone. It is
also a combination of a break in the bone and soft tissue injury

CHAPTER 4 REGIONAL TRAUMA

Trauma
is the leading cause of death in the first four decades of life
and the 3rd leading cause of death in all age groups today.
-Penetrating trauma particularly handguns is becoming common
in nearly all areas of the country.

A. Open Fractures - 90% of open fractures are caused

by vehicular accident.
B. Hip fractures are very common in elderly people
and are usually caused by minor falls. It is the most common
cause of traumatic death after the age of 75.

Trimodal Distribution of Death from Trauma:

1. Seconds to minutes of injury due to the injury to the brain,
high spinal cord, heart, aorta and other large vessels. These
patients can rarely be salvaged.
2. Minutes to Few hours from injury ( The Golden Hour )
- It is in this period that Advanced Trauma Life Support9
( ATLS ) techniques are important.
3. Several days to weeks of Injury these are due to sepsis or
organ failure.

6. Urologic
- Hematuria following trauma
- Blunt kidney injury is usually due to motor
vehicular accidents which account for 70
90 % of kidney trauma.
- Penile injury:
The erect penis is usually 6 8 inches long
and 1 -2 inches in diameter.
- Avulsion of the prepuce this may follow
accidents where the foreskin called prepuce
is detached or lacerated by a blunt force.
- Fracture of the penis this is the traumatic
rupture of the corpora cavernosa penis
resulting from a forceful trauma to the
flaccid organ.
- Amputated penis the penis of an avid
womanizer is sometimes intentionally cut or
amputated by a jealous derange wife or
lover.

SPECIFIC INJURIES
1. Head
a. Types of Head Injuries:
a.1 Hematoma
a.2 Contusions
a.3 Skull fractures
a.4 Hemorrhage
2. Spine and Spinal Cord Injuries
The most common causes of severe spinal trauma
are motor vehicular accidents, falls, diving accidents, and
gunshot wounds.
3. Chest
a. Life Threatening Injuries
Pnumothorax
Hemothorax
Flail chest as in multiple rib fractures
Cardiac tamponade due to penetrating
injuries
b. Potentially Lethal Injuries
b.1. Pulmonary Contussion with or without
flail chest
b.2. Thoracic Aortic Tear or Rupture the
most common cause of sudden death after
a vehicular accident or fall ( major
decelaration injury )
c. Serious Chest Injuries

7. Arterial trauma
8. Burns
CLASSIFICATION OF WOUNDS
1.
AS TO LEGAL CLASSIFICATION
Chapter 1
DESTRUCTION OF LIFE
a. Article 246. Parricide
b. Article 247. Death or Physical Injuries Inflicted Under
Exceptional Circumstances
c. Article 248. MURDER
- Any person who, not falling within the provisions of
Article 246 shall kill another, shall be guilty of murder and shall

be punished by Reclusion Perpetua, to death if committed with

any of the following attendant circumstances;
1. With treachery
2. In consideration of a price , reward or promise
3. By means of inundation etc.
4. On occasion of any of the calamities etc.
5. With evident premeditation
6. With cruelty etc

b.2 Perforating there is a communication between the outside,

inner and the outer side. There is both a point of entry and exit.

Article 249 HOMICIDE

Article 251. Death Caused in a Tumultous Affray
Article 252. Physical Injuries Inflicted In a Tumultuous Affray
Article 253. Giving Assistance to Suicide
Article 254. Discharge of Firearms
Article 255. Infanticide
Article 256. Intentional Abortion
Article 257. Unintentional Abortion who shall caused an
abortion by violence but not intentional.
Article 258. Abortion Practiced by the Woman Herself or By Her
Parents
Article 259. Abortion Practiced by a Physician or Midwife and
Dispensing of Abortives
Article 260. Responsibility of Participants in a Duel
Article 261. Challenging to a Duel

b. Non Deadly Wounds Does not result to death immediately,

after the wound is inflicted. A non deadly wound may cause
death later, due to complications i.e. tetanus, septicemia

Classification of Wounds
3. AS TO MORTALITY
a. Deadly Wound- Death results immediately, after the infliction
of the wound. Deadly wounds though mortal, maybe prevented
with prompt medical treatment.

Classification of Wounds:
4. AS TO THE WOUNDING INSTRUMENTS USED:
a. Sharp Instruments Ex. incised wound, punctured wound,
stab wound dagger or kitchen knife
b. Blunt Instruments A block of wood or iron produces
contusion, hematoma, abrasions, lacerated wound when used
to strike, attack, wound, beat or assault another
Classification of Wounds:
5. AS TO THE CONSEQUENTIAL INJURY AFTER THE
APPLOCATION OF FORCE
a. Coup Injury b. Coup Centre Coup Injury
c. Contre Coup Injury
d. Locus Minoris resistancia
e. Extensive injury

CHAPTER 2
PHYSICAL INJURIES
a. Article 262. Mutilation Any person who shall intentionally
mutilate another by depriving him, either totally or partially , of
some essential organ of reproduction.
b. Article 263. Serious Physical Injuries Any person who shall
wound, beat, or assault another, shall be guilty of the crime of
serious physical injuries
c. Article 264. Administering Injurious Substances or Beverages
d. Article 265. Less Serious Physical Injuries Any person who
shall inflict upon another physical injuries which shall
incapacitate the offended party for labor for 10 days or more, or
shall require medical attendance for the same period
e. Article 266. Slight Physical Injuries and Maltreatment.
- When the offender has inflicted physical injuries which shall
incapacitate the offended party for labor from one to nine days,
or shall require medical attendance during the same period.

Classification of Wounds:
6. AS TO THE INTEGRITY OF THE SKIN
A. CLOSED WOUNDS Presents no break in the integrity or
continuity of the skin. There maybe only outward manifestations
of injury internally.
Ex. of closed wounds:
1. petechiae a circumscribe extravasation of blood in the
subcutaneous tissue.
2. contusion effusion of blood into the tissues underneath the
skin as a result of a blunt force. Ex. black eye
3. Hematoma
4. Blunt injury
5. Musculoskeletal injuries
Ex. Sprain, Dislocation, Fracture, Strain

Chapter 3, RAPE When and How rape is committed

1. By a man who shall have carnal knowledge of a woman
under any of the circumstances
a. Through force, threat, or intimidation
b. When the offended party is deprived of reason or
otherwise unconscious
c. By means of fraudulent machinations or grave
abuse of authority
d. When the offended party is under twelve ( 12 )
years of age or is demented, even though none of the
circumstances mentioned above is present.

Cerebral Concussion there is a brief loss of consciousness

and sometimes memory after a head injury that doesnt cause
obvious physical damage.
Cerebral Contusion they are bruises to the brain, usually
caused by a direct, strong blow to the head. They are more
serious than concussions.
B. OPEN WOUNDS
- There is a break in the continuity of the skin
Examples:
1. Abrasion
2. Bruise
3. Incised wound
4. Stab wound
5. Punctured wound
6. Perforating wound
7. Lacerated wound
8. Bites
9. Gunshot wounds

2. By any person who, under any of the circumstances

mentioned in paragraph 1 hereof, shall commit an act of sexual
assault by inserting his penis into another persons mouth or
anal orifice or any instrument or object into the genital or anal
orifice of another person.
Classification of Wounds
2. AS TO THE DEPTH OF THE WOUND
a. Superficial When the wound involves only the layer of the
skin
b. Deep When the wound involves the structures beyond the
layers of the skin.

B. OPEN WOUNDS there is a break in the continuity of the

skin
B.1. Abrasion Scratch, friction mark

b.1 Penetrating the wound enters the body but does not come
out. Punctured, stab and gunshot wounds usually belong to this
type of wound.

B.2. Bruise cause by a blunt injury to the tissues which

damage blood vessels beneath the surface, allowing blood to
extravasate or leak into the surrounding tissues.
B.3. Incised wound
B.4. Stab wound
B.5. Punctured wound
B.6. Perforating wound
B.7. Lacerated wound result of an injury from a blunt
instrument. In cerebral laceration, the brain tissue is torn often
with an accompanying visible head wounds and skull fractures.
B.8. Bites they maybe abraded, bruised or rarely lacerated.
They are usually seen in sexual assaults and in child abuse and
also by animal bites
B.9. Gunshot wounds

The Dangerous Drug Act of 1972, include the following

Dangerous Drugs as follows:
A. PROHIBITED DRUGS
1. Opium and its active components and derivatives
such as heroin and morphine.
2. Coca leaf and its derivatives, principally cocaine.
3. Hallucinogenic drugs such as mescaline, lysergic
acid diethylamide ( LSD ) and other substances
producing similar effects.
4. Other drugs whether natural or synthetic with the
physiological effects of a narcotic drug.
B. REGULATED DRUGS
1. Self inducing sedatives such as secobarbital,
phenobarbital, pentobarbital, barbital and any drug
which contains salt or derivative of a salt of barbituric
acid.
2. Any salt of amphetamine such as Benzedrine or
any drug which produces a physiological action similar
to amphetamine.
3. Hypnotic drugs, such as methaqualone producing
similar physiologic effects.

TEST FOR THE PRESENCE OF POWDER RESIDUES:

1. Paraffin test or Dermal Nitrate test present on the skin of
the hand dorsum or site of the wound of entrance. This test is
not conclusive because fertilizers, cosmetics, cigarettes, urine
and other nitrogenous compounds with nitrates will give a
positive reaction. A negative test is also not conclusive . The test
usually gives a positive result even after a lapse of 3 days or
even if the hands are subjected to ordinary washing

IMPORTANT TERMS in the DANGEROUS DRUG

ACT OF 2002
1. Drug Syndicate
2. Illegal Trafficking
3. Chemical Diversion
4. Planting Evidence
5. Drug Dependence

2. Use of Scanning Electron Microscope with a linked X ray

analyzer. This method appears to be more specific but seldom
used because the instrument is expensive.
SPECIAL TYPES OF WOUNDS
1. Assailants wounds these wounds are sustained by the
assailant from the victim, while the former is in the process of
attacking, wounding, assaulting, beating or killing his victim.
2. Defense wounds in the process of defending himself from
the attacks, assault, wounding, beating or violence of the
assailant, the victim sustains defensive wounds usually in the
upper extremities.
3. Victims wounds these are wounds sustained by the victim,
from the assailant, the former not having the chance or
opportunity to defend himself. The victims wounds maybe
located in any part of the body.
4. Self Inflicted wounds these are wounds self inflicted by
the person on himself. The wounds are usually found on the
accessible parts of the body, usually with no intention to kill
himself. Unless the victim is insane, self inflicted wounds are for
a fraudulent or self serving purpose.
5. Homicidal wounds these are the serious wounds sustained
by the victim resulting to his death, from the criminal assailant.
Usually the wounds are situated in the areas of the neck, chest,
the abdomen and the skull.
6. Accidental wounds these wounds are sustained by the
victim, without any fault or intention whatsoever on the part of
the accused to inflict the wounds on the victim. The wounds are
usually located on any part of the victims body.
7. Suicidal wounds these are wounds self inflicted by the
victim on himself, and usually seen on the temple, the roof of
the mouth, and other fatal body areas, accessible to the hand of
the victim.

Two Classes of Drug Dependence:

a. Drug Addiction is a state of periodic or chronic
intoxication produced by the repeated consumption of
a drug, whether synthetic or natural and found to be
detrimental to the individual and to the society.
Characteristics of Drug Addiction:
A. An overpowering desire or need to
continue taking the drug or to obtained it by any
means.
- a tendency to increase the dose.
-a psychological and physical dependence
on the effects of the drug.
- a detrimental effect to the society and to
the individual
B. Drug Habituation is the desire to have a
continuous use of the drug but with the capacity to
refrain physically from using it.
Characteristics of Drug Habituation:
- The desire to use the drug is not
compulsive but merely psychical.
- There is little or no tendency to increase
the dose

CHAPTER 5 COMPREHENSIVE DANGEROUS DRUGS ACT

OF 2002

- The detrimental effect if any, is primarily on

the individual.

REPUBLIC ACT 9165

6. Protector
7. Pusher
8. Controlled Delivery
9. Den, Dive or Resort
10. PDEA The Philippine Drug Enforcement Agency,
which is the implementing arm of the Dangerous
Drugs Board.

A DANGEROUS DRUG is a drug whose use is attended by risk

and therefore is unsafe, perilous and hazardous to people and
society.
A DRUG is any substance , vegetable, mineral or animal in
origin, used in the composition or preparation of medicines or
any substance used as medicines.

UNLAWFUL ACTS AND PENALTIES IN THE

DANGEROUS DRUGS ACT OF 2002 ( R.A. 9165:
1. Importation of Dangerous Drugs and or Controlled
Precusors and Essential Chemicals.
2. Sale, Trading, Administration, Dispensation,
Delivery, Distribution and Transportation of Dangerous
Drugs and or Controlled Precursors and essential
Chemicals.
3. Maintenance of a Den, Dive or Resort
4. Employees and Visitors of a Den, Dive or Resort
5. Manufacture of Dangerous Drugs and or Controlled
Precursors and Essential Chemicals
6. Illegal Chemical Diversion of Controlled Precursor
and Essential Chemicals
7.Manufacture or Delivery of Equipment , Instrument,
Apparatus and Other paraphernalia for Dangerous
Drugs and or Controlled Precursors and Essential
Chemicals
8. Possession of Dangerous Drugs
9. Possession of Equipment, Instrument , Apparatus
and Other Paraphernalia for Dangerous drugs.
10. Possession of Dangerous D During Parties, Social
Gatherings or Meetings
11. Possession of Equipment, Instrument, Apparatus
and Other Paraphernalia for Dangerous Drugs During
Parties, Social Gatherings or Meetings
12. Use of Dangerous drugs
13. Cultivation or Culture of Plants Classified as
Dangerous Drugs or are Sources thereof
14. Failure to Maintain and Keep the Original Records
of transactions on Dangerous drugs and or Controlled
Precursors and Essential chemicals
15. Unnecessary Prescription of Dangerous Drugs
16. Unlawful Prescription of Dangerous drugs

Section 56. Temporary Release from the Center; After

Care and Follow up Treatment Under the Voluntary
Submission Program
Section 58. Filing of Charges Against a Drug
Dependent who is not rehabilitated Under the
Voluntary Submission Program.
Section 61. Compulsory Confinement of a drug
dependent who refuses to apply under the Voluntary
Submission Program
Section 62. Compulsory Submission of a Drug
Dependent Charged with an Offense, to Treatment
and Rehabilitation
Section 70. Probation or Community Service for a
First Time Minor Offender In Lieu of Imprisonment
Section 73. Liability of a Parent, Spouse or Guardian
Who refuses to Cooperate with the Board or any
Concerned Agency
Section 77. The Dangerous Drugs Board
Section 82. Creation of the Philippine Drug
Enforcement Agency ( PDEA )
Section 85. The PDEA Academy
Section 90. Jurisdiction
Section 91. Responsibility and Liability of Law
Enforcement Agencies and Other Government
Officials and Employees in Testifying as Prosecution
Witnesses in Dangerous Drug Cases
Section 92. Delay and Bungling in the Prosecution of
Drug Cases
PHARMACOLOGIC
CLASIFICATION
DANGEROUS DRUGS
1.Hypnotics
2. Sedatives and Tranquilizers
3. Hallucinogens and Psychomimetics
4. Stimulants
5. Depressants
6. Deliriants and Intoxicants

THE
CUSTODY AND
DISPOSITION
OF
CONFISCATED, SEIZED AND OR SURRENDERED
DANGEROUS DRUGS, PLANT SOURCES OF
DANGEROUS
DRUGS,
CONTROLLES
PRECURSORS AND ESSENTIAL CHEMICALS,
INSTRUMENTS AND PARAPHERNALIA AND OR
LABORATORY EQUIPMENT The PDEA shall take
charge and have custody of all dangerous drugs, plant
sources of dangerous drugs, controlled precursors
and essential chemicals, as well as Instruments
paraphernalia and laboratory equipment so
confiscated, seized and or surrendered, for proper
disposition in the following manner ( Refer to Book ).

OF

A.Hypnotics:
Opiates and Their Derivatives Opium is obtained
from the milky exudates of the unripe seed capsules
of the poppy plant, Papaver Sornoiferum.
Derivatives of opium commonly used are morphine,
heroin, and codeine.
Its synthetic preparation are Demerol and Methadone.
Narcotics that have a legitimate medical used as
powerful pain relievers are called Opioids, and include
codeine, oxycodone, meperidine, morphine and
hydromorphone.

IMPORTANT PROVISIONS OF R.A. 9165 OR THE

COMPREHENSIVE DANGEROUS DRUGS ACT OF
2002
Section 22. Grant of Compensation, Reward and
Award
Section 23. Plea Bargaining Provision
Section 36. Applicants for Drivers License
Section 38. Laboratory Examination or test on
Apprehended / Arrested Offenders
Section 39. Accreditation of Drug Testing Centers and
Physicians
Section 40. A physician, dentist, veterinarian or
practitioner authorized to prescribe any dangerous
drug shall issue the prescription therefore in one
original and 2 duplicate copies.
Section 54. Voluntary Submission of a Drug
Dependent to Confinement, Treatment and
Rehabilitation
Section 55 Exemption from Criminal Liability
Under the Voluntary Submission Program

Heroin which is prohibited is a very strong pain

reliever and narcotic
Signs and Symptoms of Opium Administration:
1. Stage of Excitement
2. Stage of Stupor
3. Stage of Narcosis
B. SEDATIVES:
Barbiturates: - are the products of malonic acid and
urea, synthesized on St. Barbara day.
- Used to treat anxiety and to induce sleep can
cause both psychologic and physical
dependence.
C. HALLUCINOGENS
DRUGS:

OR

PSYCHOMIMETIC

Marijuana ( Cannabis Sativa ) is a Mexican term for

pleasurable feeling. Marijuana is not addictive.
Physical dependence and dose tolerance do not
develop with its use. Psychic dependence may occur.

SEXUAL DYSFUNCTIONS ( Classification )

A. As to choice of sexual partners
1. Homosexual
2. Infanto sexual
3. Besto sexual
4. Auto sexual
5. Gerontophilia
6. Necrophilia
7. Incest

Subjective effects of Marijuana:

- There is a feeling of lightness of the extremities
followed by rushes of warmth and well being that
eventually lead to a sense of relaxation, mild
euphoria and a dreamy state where ideas are
disconnected.
Objective Effects of Marijuana:
- Moderate increase in resting pulse rate,
reddening of the eyes due to dilatation of the
conjunctival blood vessels. Difficulty of speech
and of remembering of the logical trend of what
was being said.

B. As to instinctual strength of the sexual urge:

1. Over sex
2. Under sex or sexual frigidity
a. Sexual anesthesia
b. Dyspareunia
c. Vaginismus
d. Old age
C. As to the mode of sexual expression
1. Oralism
a. Fellatio
b. Cunnilingus
c. Analism

Lysergic Acid Dsethylamide ( LSD )

- These drugs are false hallucinogens.
- It produces impaired judgement so that a user
might think that he can fly, and may even jump
out a window to prove it, resulting in severe injury
or death.

2. Sado masochism
a. Sadism
b. Masochism
3. Fetishism
a. Anatomic
b. Clothing

D.STIMULANTS:
Amphetamines methamphetamines ( Shabu,
speed ); methylenedioxymethamphetamine ( MDMA,
ecstasy or Adam )
- Acts on the cerebral cortex causing alertness,
excessive self confidence and feeling of well
being. Physical performance may to some
degree temporarily improve.

.
c. Necrophilic
d. Odor ( ospresiophilia )
Kinds of Ospresiophilia
1. Urolagnia
2. Coprolagnia
3. Mysophilia
a. Narcissism
b. Saboteur Fetish
c. Vampirism

Untoward Effects:
- They increase the blood pressure and heart rate.
Fatal heart attacks have occurred even in
healthy, young athletes. The blood pressure
maybe so high that a blood vessel in the brain
ruptures causing a stroke.
Coccaine is an alkaloid from the leaves of the coca
shrub cultivated in Bolivia and Peru.
- It produces effects similar to amphetamines, but
is a much more powerful stimulant.
- Is used to excite the undersexed.
- Is a euphoriant and readily relieves fatigue

D. As to the part of the body

1. Sodomy
2. Uranism
3. Frottage
4. Partialism
E. As to visual stimulus
1. Voyeurism
2. Scoptophilia
F. As to number
1. Troilism
2. Pluralism
G. Other sexual deviates.
1. Don Juanism
2. Indecent exposure
3. Coprolalia
H. Disorders of sexual function:
1. Premature ejaculation
2. Retarded ejaculation
3. Low sexual desire disorder
4. Sexual aversion disorder
5. Sexual arousal disorder in women
6. Inhibited orgasm
7. Dyspareunia
8. Vaginismus
I. Sexual reversal
1. Transvertism
2. Transexualism
3. Intersexuality

Untoward Effects:
- Same as amphetamine
E. DEPRESSANTS:
- Angel dust
- Depresses the brain and abusers usually
become confused and disoriented shortly after
taking the drug.
- Can be combative and because they dont feel
the pain they may continue fighting even when hit
hard.
CHAPTER 6 SEXUAL DYSFUNCTIONS AND SEXUAL
CRIMES
SEXUALITY IS A NORMAL BIOLOGICAL URGE AND AN
IMPORTANT PART OF THE HUMAN EXPERIENCE.
4 Stages of a Sexual Response:
1. Desire
2. Arousal
3. Orgasm
4. Resolution

SEXUAL CRIMES:
Chaste An unmarried woman who has had no carnal
knowledge with men or that she never voluntarily had unlawful
sexual intercourse. These also denotes purity of mind and
innocence of heart.

J. Marriage Contracted Against the Provisions of

Law
K. Premature Marriage
L. Performance of Illegal Marriage Ceremony
M. Prostitution
N. Corruption of Minors
O. White Slave Trade
P. Abuse Against Chastity

Virgin A woman who has had no carnal knowledge of man.

Her genital organs have not been altered by carnal connection.
Kinds of virginity
1. Moral virginity the state of not knowing the nature of sexual
life and not having experience sexual relation.
2. Physical virginity A condition whereby a woman is
conscious of the nature of sexual life but has not experienced
sexual intercourse.
3. Demi virginity This term refers to a condition of a woman
who permits any form of sexual liberties as long as they abstain
from rupturing the hymen by sexual act. The woman allows
sexual intercourse, but only inter femora or even inter labia, but
not to the extent of rupturing the hymen.
4. Virgo intacta A truly virgin woman. There is no structural
change in her organ, notwithstanding the fact of a previous
sexual intercourse.

PROVISIONS OF THE REVISED PENAL CODE

APPLICABLE TO UNNATURAL SEXUAL OFFENSES

DEFLORATION This is the laceration or rupture of the hymen,

as a result of sexual intercourse. All other lacerations which are
not due to coitus are not considered defloration.

Mental Health Disorders include disturbances in thinking,

emotion, and behavior. There is a complex interaction between
the physical, psychologic, social, cultural and hereditary
influences.

1. Grave Scandal ( Art. 200 )

2. Immoral Doctrines, Obscene Publications and Exhibitions
( Art. 201 )
3. Vagrants and Prostitutes ( Art. 202 )
4. Grave Threats ( Art. 282 )
5. Light Threats ( Art. 283 )
6. Other Light Threats ( Art. 285 )
7. Grave Coercions
8. Unjust Vexation or Any Other Coercion ( Art. 287 )
CHAPTER 7 MENTAL HEALTH DISORDERS

SEMEN AND SPERMATOZOA:

Factors that Contribute to the Development of Mental Disorders:
ERECTILE DYSFUNCTION ( Impotence )
- The diagnosis of Erectile Dysfunction is important
especially in complaints of rape. It must be
proven convincingly that the accused is
permanently impotent, so that the crime of rape
cannot be proved beyond reasonable doubt.
-

1. Heredity the most frequent factor that contributes to insanity

and a good history will reveal the ascendants afflicted with the
same.
2. Incestous Marriage The mental illness is accentuated when
they are blood relatives.
3. Impaired Vitality Stress, tension, worry, grief may
predispose to insanity
4. Poor Moral Training and Breeding Corrupt moral upbringing
in the family due to immorality of the parents
5. Psychic Factors Factors like love, hate, rage, anger,
passion disappointments
6. Physical Factors
a. Non toxic factors exhaustion resulting from
severe physical and mental strain and traumatic injuries to the
head.
b. Toxic factors drug addiction, infections of the brain

Impotence usually results from vascular

impairment, neurologic disorders, drugs,
abnormalities of the penis or psychological
problems that interfere with sexual arousal.
These includes injury, diabetes mellitus, stroke
and drugs like all antihypertensive and
psychotics, antidepressants and some sedatives.
Alcohol can also cause impotence and also low
levels of testosterone
SEX CRIMES IN THE REVISED PENAL CODE:
A. Rape
B. Carnal Knowledge
- is the act of a man in having sexual bodily
connection with a woman. There is carnal
knowledge if there is the slightest penetration in
the sexual organ of the female by the sexual
organ of the male.

KINDS OF MENTAL HEALTH DISORDERS:

1. Psychosomatic disorders physical disorders caused by
psychologic factors.
2. Somatiform disorders encompasses several psychiatric
disorders in which people report physical symptoms but deny
having psychiatric problems.
3. Generalized Anxiety Disorders
4. Panic Attacks and Panic Disorder

C. Seduction
- is the art of a man enticing women to have
unlawful intercourse with him by means of
persuasion, solicitation, promises, bribes or other
means without employment of force

5. Phobic Disorders
a. Agoraphobia
b. Specific phobias
c. Social phobia
6. Obsessive Compulsive Disorder
7. Post Traumatic Stress Disorder
8. Depression and Mania
9. Bipolar Disorder
10. Suicidal Behavior
11. Eating Disorders
a. Anorexia nervosa
b. Bulimia nervosa
c. Binge eating disorder
12. Personality Disorders

D. Acts of Lasciviosness
E. Acts of Lasciviousness with Consent of the
Offended Party
F. Abduction
1. Forcible Abduction
2. Consensual Abduction
G. Adultery
H. Concubinage
I. Bigamy

10

a. Paranoid
b. Schizoid
c. Histrionic
d. Narcissistic
e. Antisocial
f. Borderline
g. Avoidant
h. Dependent

1. True insanity develops insidiously usually with the

existence of some predisposition to an exciting cause
if careful history is taken, while false insanity develops
suddenly with no existing predisposition.
2. In true insanity, there is a peculiar facial expression,
which is absent in false insanity
3. In true insanity, there is a continuous and persistent
manifestation of insanity, which is only present in false
insanity when the pretender is under observation, and
absent when not under observation.

i. Obsessive Compulsive
j. Passive Aggressive
k. Dissociative
13. Schizophrenia a serious mental disorder characterized by
loss of contact with reality ( psychosis ) , hallucinations,
delusions ( false beliefs ) , abnormal thinking, disrupted work
and social functioning

4. In true insanity, there is a clinical entity of a specific

mental disorder, which is absent in false insanity.
5. In true insanity, the patient can endure a violent or
stressful activity without fatigue, which is not present
in false insanity

Types of Schizophrenia:
a. Paranoid
b. Hebephrenic
c. Catatonic

6. In true insanity, the patient does not observe

personal hygiene, in false insanity, the pretender
observes hygiene

14. Delusional Disorder

15. Psychological Incapacity a waste basket diagnosis
because it is so broad a term, that it covers all possible Mental
Disorders.

Insanity or Mental Illness is an exempting or mitigating

circumstance to Criminal Liability as provided in the
following:
1. As an exempting Circumstance
Article 12 of the Revised Penal Code
provides, When the imbecile or an insane person
has committed an act which the law defines as felony,
the court shall order his confinement in one of the
hospitals or asylums established for persons thus
afflicted and he shall not be permitted to leave without
first obtaining the permission of the same court.

SOME MANIFESTATIONS OF MENTAL DISORDERS:

1. Disorders of Cognition ( Knowing )
a. Illusion
b. Hallucination
2. Disorders of Memory
a. Dementia
3. Disorders in the Content of Thought
A. Delusion
a. Delusion of grandeur
b. Delusion of persecution
c. Delusion of reference
d. Delusion of Self Accusation
e. Delusion of infidelity
f. Nihilistic delusion
g. Delusion of poverty
h. Delusion of control
i. Delusion of depression
B. Obsession
4. Disorders in the trend of thought
Types:
a. Mania
b. Melancholia

2. As a mitigating Circumstance
Article 13, of the Revised Penal Code
provides, the following are mitigationg circumstances:
a. That the offender is deaf and dumb, blind
or otherwise suffering from physical defect which thus
restricts his means of action, defense or
communication with his fellow beings
The American Law Institute formulated the following
Rules on Criminal Responsibility and states that;
1. A person is not responsible for his criminal conduct
if at the time of such conduct as a result of mental
illness or defect, he lacks essential capacity to
appreciate the criminality of his conduct or to conform
his conduct to the requirement of the law.

5. Disorders of Emotions or Feelings a disorder in the state of

mind, fervor, or sensibility, not in accord with reality.
6. Disorders of volition or conation ( doing )
Kinds of Conation:
A. Impulsion or Impulse ( Compulsion ) a sudden
and irresistible force compelling a person to the
conscious performance of some action without motive
or forethought.

2. The term mental disease or defect does not

include an abnormality manifested only by repeated
criminal or otherwise anti social conduct
Fundamental Principles of Insanity and Criminal
Responsibility:
1. A sane man is assumed to be wholly responsible for
the consequence of his crime.
2. A person who commits a criminal act is presumed
to be sane.
3. Crime is always considered as an affair of the mind
as well as the body and to make an act or omission a
crime, there must be a criminal act ( actus reus ) and
an criminal mind ( mens rea ) . Actur facit reum, nisi
mens sit rea.

Types of Compulsion:
a. Pyromania
b. Kleptomania
c. Dipsomania
d. Homicidal impulse
e. Sex impulse
f. Suicidal impulse
DISTINCTIONS BETWEEN TRUE AND FALSE
INSANITY:

Mental Deficiency or mental retardation, is sub

average intellectual ability present from birth or early
infancy. Intelligence is both determined by heredity

11

and environment. In most cases of mental deficiency,

the cause is unknown.
Classification of mental deficiency:
1. Idiot The idiots intelligence never exceeds that of
a normal child over 2 years old. The IQ is between 0
20. This is usually congenital.
2. Imbecile the imbeciles intelligence is compared
to a normal child from 2 7 years old and the IQ is 20
40.
3. Feeble Minded his mentality is similar to that of a
normal child between 7 12 years old and an IQ of 40
70.
The Legal Importance of determining the persons
state of mind are the following
In Criminal law, insanity exempts a person from
criminal liability
In Civil law, Insanity is a restriction of the capacity of a
natural person to act as provided in Article 38 of the
Civil Code.
Insanity modifies or limits the capacity of a natural
person to act as providedin Article 39, also of the Civil
Code.
Insanity at the time of marriage of any or both parties
is a ground for the annulment of marriage.

12