Legal medicine Branch of forensics Application of scientific theories concerning death or injury applying the principles of medicine Forensic

pathology = legal medicine; to answer questions of legal medicine involving death or injury Death: parricide or murder cases Questions asked 1. Cause of death 2. Manner of death 3. Identity of the deceased 4. Time of death 5. Evidence from the body of the deceased 6. Injuries suffered 7. How was injuries inflicted 8. Natural dismissal 9. Factors that affected death -You need an expert witness in court USA office of the coroner whose function is to determine whether somebody should be charged in court Coroner says whether it is murder or suicide Philippines = medico legal officers in various law enforcement agencies e.g NBI PNP medico legal officers or city medico legal officer , no coroner system if they happen to treat patients with suspicious death they will answer Q: Is there a need to prove death A: presumptive death has been dead for period provided for by law No cadaver Situations where it is allowed 1. For purposes of succession 2. To marry 3. To convict persons Accused was seen bringing the victim in his banka. You can presume death. In all other cases you have to prove death Cadaver is the best proof of death Death according to law biological inevitable cessation of the circulatory system and respiratory system including the death of the brain and all other body functions Death; situation where a person is dead for all intents and purposes Legal death declaration or pronouncement by qualified person that further medical care is not appropriate and patient should be considered dead for all intents and purposes Q: what kinds of death is the object of proceedings or case in court 1. violent death: accidents, suicide or homicide 2. suspicious death 3. sudden and unexpected death 4. death without physician-in-attendance 5. death in an institution 6. death with physician-in-attendance 1. Cause of death: same as manner of death Any injury or disease w/c causes physiological derangement & injury Physiological derangement causes injury to the body and alters its physical context e.g. stabbed in the heart, gunshot wound in the brain = cause of death note: injury as cause of death is wrong 2. Mechanism of death: physiological derangement produced by injury . massive haemorrhage Manner of death: how cause of death came about or how disease or injury was produced

e.g. natural, when he fell down, buried by the landslide, somebody stabbed him or undetermined manner of death is the legal opinion of the medico legal e.g. solid material hit his head sometimes the officer gives opinion as to the manner of death but does not jive with testimony of the witness court will not believe expert testimony but if it jives court will give credence court is not bound by the expert testimony Time of death: when is it necessary 1. Succession 2. Murder for aggravating circumstances of cruelty 3. Alibi as a defense e.g between 12-12:30 hospital time of death or situations where no one saw the person died Factors for time of death 1. Livor mortis purple coloration in the areas of body, accumulation of blood Those part which are lowered occurs within 30 mins or 2 hours after death reddish purple coloration develops slowly and gradually after 8 hours Cadaver lying in his back Important only to know whether the body has been moved 2. Rigor mortis stiffening of the body, the body stiffens usually 2-4hrs after death it fully develops within 6-12hrs stiff as a wood if dead for more than 12hrs trouble with this is that it is affected by cold or freezing weather cold v hot regions = rigor mortis will not be the same 3. Body temperature Relevant only if the temperature of the body is known at the time of death 4. Decomposition Internal organs of the body decompose first petrification process when the body starts to decay caused by the bacteria found in the stomach it will slowly eat the body affected by the environment or climate Contents of stomach: Depending on the food person ate Extent of digestion shows time of death e.g. sandwich 1-2hrs, dead body autopsy meat digested 4rhs dead or fresh not beyond 4hrs activity taken by the victim alcohol Insect activity Analyze the eggs of the flies As the body decomposes the insects attack the body Lay eggs-maggots- how many days or how long does the eggs hatch = proximate time of death Injuries which may cause death RPC: Serious physical injuries, less serious and slight physical injuries Medical Parlance 1. Blunt weapon 2. Sharp or pointed weapon or object Weapon includes not only solid objects but also parts of the body capable of causing injury Severity of the injury extent and appearance Amount of force used and delivered The greater the force the greater the injury or the more serious the injury Type of force delivered

3.

1.

Part of the body struck Extent of the body surface over which force is delivered Nature of the weapon

1.

Weapon breaks or deforms upon coming contact with the body less energy is delivered the lesser injury e.g. Ruler energy is less it will break while bat it will not it will give greater injury 2. Body moves the lesser the injury It will move along with the blow Greater area of the body the lesser severity would be the wound Depend upon the nature of the body A weapon with a flat surface it will give lesser injury than a narrow weapon Wider the weapon the lesser than the narrow If theres any object that projects form the surface of weapons force will concentrate on the projectile the greater the injury caused something projects greater the injury Blow to a rounded portion of the human body will create greater than flat surface Head greater injury than back

3.

Stab wounds: goes beyond the surface of the skin Depth is longer or longer than its width Entry wound length is more than edges of the wound = sharp and ragged Pointed object knife, ballpen or ice pick Penetrates & breaks the surface of the skin Physician what is possible weapon was used Look into the point of entry of wound depth and edges of the wound 2 edged knife or single bladed knife What is the width of the wound length of the wound and direction of the wound Relative position of victim & accused Trajectory facing each other the assailant was right handed Basis for the physician Is it possible that the victim was lying = yes Incise wounds: cuts on the body produced by sharp objects or sharp edged Comes in contact with the body Resulting to incise wounds Edges of incise wounds are clean Width is bigger than the length Where: expanded parts of the body, neck, head Stab wounds = abdomen and breast May incise wounds be self inflicted = arm wrist Chopped wounds or hacking wounds By blows of axe , wider surface and skin opens Arms is sliced, extremes of the body is removed hacking wounds Victim of physical injuries may suffer all this kind of wounds Significance; several wounds are aggravating circumstances of cruelty Accused sets up self defense may negate a claim of self defense

2.

Medical science categories of wounds: 1. Abrasions: injury to skin, removal of the epidermal part of the skin. Epidermis is removed due to friction Gasgas Cadaver how will you know if it was caused prior or after the death Ante mortem is reddish brown scar produced Post mortem is yellow and translucent and wont heal anymore Scraped or bruised abrasions: scratch or linear Impact abrasions: blunt force is directed to skin crushing it or moment the skin comes in contact with solid surface Patterned abrasions: clothing is left in the skin, imprint of object like grills Contusions: or bruises Present not only in surface of the skin but also internal organs, blood vessel is broken, haemorrhage , concentrated on small portion of the body like blood clot Post mortem contusion: yes if after striking blow is delivered to the cadaver with short period after death Lacerations: tear in the tissue either by causing force which among will cause a crime in the RPC abrasions or contusions is slight physical injuries if the ACL occurs on the face and leaves scar or permanent deformity it is serious other parts it is slight Fracture of the skeletal system: bones is broken Mandible up to nose fracture in the face ACL if at the back of the hands defensive wounds Causes of fracture victim injury becomes serious physical Blunt object like rocks, wood or bat Sharp object like knife

3.

a. b. c.

2.

Autopsy term came from the Greek word autopsia Seeing with ones own eyes or sight Standardize dissection of the body or corpse Procedure is followed system progression of what to do 2 kinds: 1. Standard hospital autopsy Conducted because the physician requested it The physician does it with prior consent of relatives Hospital autopsy must be with the permission of the relatives 2. Medico legal autopsy Conducted pursuant to the need of investigation of death for legal purposes Q: when is it proper When person dies unexpectedly Naturally Under suspicious circumstances Cause and manner of death There can be primary cause or secondary cause Primary cause: Primary Cause 3 conditions closely linked to one another A person died 12 pm We go back bypass surgery Next oldest condition why was there a necessity for bypass surgery

3.

4.

Common wounds a. Stab wounds b. Incise wounds c. Chop wounds d. Therapeutic or diagnostic wounds

Oldest condition because victim was suffering from artery disease is the direct cause death 2.

Cannot immediately determine by autopsy and must take circumstances into consideration

Secondary Cause Factors not related to primary cause Extreme heat or temperature Autopsy to determine whether manner of death Manner say which cause of death came to be rd Due to homicide is act of 3 person Suicide, accident or natural Due to act of another 4 ways or manner of death Cause of death = fell down Autopsy alone may strengthen evidence or weaken trace

Smothering Mechanical destruction of external airways, breath mouth or nose Can it be suicide or homicidal or accidental Homicidal by another person Accidental is to babies Choking Air passages are blocked Natural choking abnormal growth or cancer More often it is suicidal Bad fitting of dentures, alcohol or food, senility on part of the victim Mechanical Asphyxia When pressure is applied on outside of the body which prevents respiration Most are accidental Traumatic Asphyxia heavy object in the chest which makes breathing impossible Python wraps around the body Homicidal when someone intentionally places something heavy on the chest of the victim Positional asphyxia Riot crush or stampede when a person is pressed against the wall

3.

Who conducts autopsy In the Philippines any person authorized Medico legal officer (NBI, PNP or City) If medico legal officer is not available any physician can testify to the result of the autopsy How is autopsy conducted 1. External: This involves the careful examination and description Whatever is seen it is placed in autopsy report Note the clothing and photograph it Height possible weight any marks on the body Describe cuts, contusions or haemorrhage, lacerations Anything which is foreign 2. Internal: They cut body Go into and exam body organs one by one Lung injury if any, if yellowish in color Depth of the wound, what organs were hit and present it in court Requisites for Autopsy 1. Request to conduct an autopsy in order to conduct autopsy Either from relatives or law enforcement agency Note when it was received date and time of request 2. Autopsy report 3. Anatomical presentation of the body 4. Main autopsy of the body Cause of death is hematoma Manner of death is homicide Specific reasons why people die: Asphyxia: results when there is failure of cells to receive or utilize toxins or lack of oxygen Maybe partial hypoxia or total deprivation anoxia How caused: 1. Strangulation 2. Suffocation 3. Chemical Asphyxia Due to accident, suicide or homicide Suffocation: 1. Entrapment or environmental There is inadequate oxygen in place Air tight enclose of oxygen Some children die in refrigerator = entrapment Environmental = area where there is a deficiency in oxygen Areas where there is depletion of oxygen like underground holes and mines

4.

Asphyxia with smothering Maybe accidental, like when you roll over your baby Buried in a landslide burking came from burke; when someone intentionally sits on your chest 6. Asphyxia due to suffocating gases Carbon dioxide and methane

5.

Strangulation Characterized by closure of blood vessels, neck is applied air passages 3 kinds: 1. Hanging: loss of oxygen because there is compressions of neck or bond is tightened by weight of the body of victim most often suicidal and maybe homicidal, suicidal or judicial suicidal material used like rope or electrical chords what will tighten is the body weight occurs in private areas presence of suicide note Is not suicide per se homicidal hanging if the victim was unconscious or rendered helpless by drugs accidental common to children and babies judicial is form of sentence imposed by court like England ligature strangulation pressure is on the neck applied to constructing bond pressure is outside force which tightens bond homicidal at most tools which constrict neck usually it is the person who tightens manual strangulation pressure is by use of hands or feet or legs or forearm all homicidal

2.

3.

Sexual Asphyxia and erotic asphyxia

Evidence of similar conduct- exceptions to prove modus operandi plan system design Estafa- put up what they claim is a good business and ask people to deal with them and then run away with the money Illegal recruiters Put up office giving advice applicant gives money Shows style to prove the public Identity- akyat bahay gang Robed a house- lock all the occupants inside the room Cook all their food Tunnel in the ground Habit custom- prove aggravating circumstance of drunkenness- if habitual, if not by introducing evidence of past acts Or a recidivist previous acts of committed crimes and convicted for it Prove battered woman syndrome- previous acts of the victim Habit on the part of the accused to hurt the woman Person is a habitual smoker- refer to the previous acts Prove a habit of a party in a case allowed to introduce evidence of similar previous acts and habits Person filed a civil case against business- ordered goods but never paid Businessman that whenever he transacts he pays in the form of a cheque Show the cheque- did not produce any cheque, case dismissed habitual Owners of bag or transport for hire sufferd an accident charge owner for negligence- habit that before any vehicle is brought out undergoes check up- so it is the fortuitous event Charged for snatching- he never sits inside of the jeep Always clinging at the back or the top load Unaccepted offer Death or injury by motor vehicle accident General causes of motor vehicles accidents into 3: 1. Impairment of the driver Driver is under alcohol or drug influence or both Drug may refer to those taken in by medication or prohibited Under influence of alcohol- vehicular accident, reason for driving under the influence of liquor Here in the Philippines- level of alcohol in your blood before under influence? none In the US there is breathalyzer- exceed the amount liable Charge only when you meet and accident No legal level in the Philippines Driver should not be under the influence of liquor that impairs the senses while driving 2. General causes- due to human error couple with speed Human error of the driver resulting from reckless driving King of the road- over speeding never mind the rules and regulations Drivers who were driving while drowsy lack of sleep Drivers who are distracted- lack of concentration Do not talk to the driver while driving Music- effect on you? Depends on how you take it 3. Environmental hazards Like weather

More accidents during rainy season Slippery roads Poorly marked roads Slides Poorly constructed roads Miscellaneous causes: defective vehicles- brakes, wheels Natural disease Heart attack while driving Categorize injuries based on vehicular accidents: Into 4 depending how it occurred 1. Front impact crashes 2. Side impact crashes 3. Roll overs 4. Rear impact crashes w/n there will be death or serious injuries will be dependent on the size and type of the vehicles involved in the crash small vehicles- greater possibility of death or injury because these vehicles because of size less able to absorbed the impact from the crash, metal just like a can size type model older model vehicles are less sturdy than the new ones occupants of the utility vehicles less likely to suffer injuries than drivers and occupants of automobiles multiple vehicle crashes and single vehicle crash more deaths and injuries in multiple vehicle crashes than single vehicle crashes also in the single vehicle crashes the frequency of the type of crash which causes death, front impact side impact roll overs or rear impact front crush impact either there is a head on collision with another vehicle or the front vehicle crashes to a solid object injuries that may result: distinguish driver or passenger (front or back) or that the occupant is restraint or not restraint or if there is an airbag or not serious if unrestraint and no airbag one who sustains greater injury is the one in front than the one at the back if the passenger is unrestraint and the vehicle is involved in the frontal crash but the movement of the passenger continues forwardinertia causes body to still move forward possible injuries1. Knee impact with the instrumental panel Knee impact to the instruments in front 2. Chest impact with steering wheel 3. Head impact- windshield sunvisor Physically by the law of physics in a frontal impact you move forward then at the back Head face chest knees Passengers in front- the same injuries the impact of the chest is in the dashboard- force with the dashboard not steering wheel If restraint- usual impact but no airbag The knees impact with the instruments But the head will reflex move there is a limited distance that the head may move but may still hit the instrument in front- straight forward, not as far as when you have no seatbelt Passengers in the back- the backseat if there is no seatbelt- front injury, face, neck chest depending on size and height of the person

Head injuries More are the external injuries- you can see Internal injuries- fractures especially if there is a strong impact with the head and the solid object Dislocation of bones like the neck Chest with dashboard or steering wheel- external abrasions contusions There is also internal injuries esp if the impact is very strong Fracture of the sternum or the ribs If there is a fracture of the ribs it may impale the lungs which may cause death Also rapture of the heart Lacerations of the liver and the spleen- because of the fractures that may result Knee fracture- comes in contact with the instruments Or the patella- bone on the knee cap Femur- bone from the knee up to the ? Dislocation of the hip joint In head on collision or crashes that the dash board be driven backwards and inward And twist the foot or ankle and cause fractures Possibilities that the seat may move forward so that the foot be trapped beneath the seat resulting to breaking of the ankle- other injuries, dicing injuries or superficial injuries due to fragments of glass and hit the victim There may be instant death due to a head on collision if the speed is such that the vehicles are pinned between the wreckage or slams into the solid object- pinned between vehicle car and backseat 1. Side impact crashes Occurs at intersections Road is struck on the side which is going in the intersection at right angles or possible that the car slid side wards striking a fixed object Can be accidental- also homicidal Impacting car are the bigger and heavier ones Possible injuries that we can find- dicing injuries either in one or both sides of the driver caused by the shreds of glasses depending if the side glass impacts the face of the driver or thrown to the glass In a car to car side impact crash where the impact is on the drivers side of the car, the force of the impact is from the shoulder level downward because the front of the car is lower it hits the car so the force is in the shoulder level or downward- most injuries found here In the head, can flex laterally- can move side wards Impact is so great and driver is restraint the lateral movement may cause dislocate on the neck and may also be that if unrestraint be thrown to the right side of the vehicle Force delivered from the roof of the ground to the floor collision between a truck and a car In such a situation the usual external injuries if impact not that strongabrasions dicing lacerations on the left side of the driver Strong fractures found on the left side of the driver The direction of the force, source Applies only to left hand driving not to right side driving, the reverse will happen Same if there is passengers- more on the left side depending on the source of the impacting vehicle 2. Roll overs From side to side And possible to roll front Depend whether roll is sideward or frontward

More force if front roll Impact of head hitting roof of the car and the arms protruding on the window and being rolled over If the windows are closed and the driver is not restraint- thrown in every direction as the car rolls over Dents on all sides caused by the head striking the roof or interior parts that are dented If the window is having glasses that are hard to break, it will have shatter marks Victim may be ejected if window is opened 3. Rear impact crashes Least kind of injuries- passenger or driver are protected by the trunk of the car the rear portion of the vehicle Impacting vehicle- the front persons are injured but the vehicle in front will be protected If the force is so great and the impacting vehicle is very big if there is any injury the vehicle that was hit may crash or roll over but the impact itself will force the passenger to move forward or backward the face may sustain external injuries as it comes contact with the steering wheel or hit the backseat but unless intentional, resulting to a smashing the car in front. Other kinds of deaths associated with vehicles: Pedestrian death Hit by a motor vehicle pattern seriousness will depend on four factors: 1. Speed of the vehicle which hit the pedestrian The faster the more serious the injury to the pedestrian Most serious injury- spinal fracture and if the speed is 67.5km or higher there will always be a spinal fracture 38km not necessary to have spinal injury 2. Type and size of the vehicle Truck v. Volkswagen 3. Location of the injury Fast moving or braking at the point of impact- no attempt to stop, the pedestrian frontally will be thrown forward and ran over If there was an attempt to brake, the victim will be lifted carried into the hood and impact to the mirror of the driver Examine the hoods- dents on the hood trying to brake or stop Front mirror being broken or blood splattered on the front mirror Extent nature of the injury 4. Whether the child or adult Same kind of vehicle the child will sustain more injury Most common are the spinal fracture and rapture of the thoracic aorta- thorax (breast) Speed is 85KM rapture of the thoracic aorta Assuming the pedestrian was hit frontally Side- fracture of the ribs Another kind of injury- dismemberment Amputation of the arms, legs and the necks itself- if speed is at least 55KM per hour Whenever a person dies as a result of a vehicular accident- factors medical examiner takes into consideration Injury will defer if hit by the front fender than when side swiped by the vehicle Side swipe, thrown away but injuries impacted with another object not necessary from the car But of hit frontally, 99% caused by the force of the car Victim is ran over happen if the victim is not standing

Find tire marks on the body Injuries due to fire, How to categorize burns Medically legally- flame burns Actual contact between body and part of the body with the flame There is scorching of the skin and if the contact is prolonged it will lead to charring For purposes of flame burns, you have refer to as flash burnsphysical contact with burn, burns are due to initial ignition or flash from flash fires from the sudden ignition or explosion Lighters flash of fire Put on the gas stove- flash fire burns Electric sparkMatch As distinguished from Fire kept burning over a period of time Flash fire of short duration Flash burns only the exposed surfaces that are burned and the burning is uniform Contact burns- physical contact between body and the hot object/ heated object Contact with hot surfaced metals Radiant heat burns Due to heat waves No body contact between burn and flames or hot surfaces Prolonged exposure may result to skin becoming brown Bonfires-heat wave from the bonfire- stay from a distance Too near result to radiant heat burns Scalding burns- burns due to contact with hot liquids Most commonly with boiling water Maybe due to immersion burns, whole body or a part is immersed into the boiling liquid- maybe intentional or accidental or negligence Put fingers to feel if ok, intentionally, test temperature Cause of scalding burns- negligence for babies and small children when you bathe then in hot water Burns affected by the age of the victim There may be burns due to splash or spill burns Cooking in a frying pan- the oil that hits the fingers or skin Splash burns Do not immerse the body but the boiling liquid travels and hit your body, most often the oil Tendency to pop up- boiling frying oil Most often unintentional unless boiling water is intentionally thrown at the victim- happens usually in domestic violence and the victim is the husband Spill burns- liquid poured over the body, may be intentional or accidental Pour boiling water on one of the sons for being gay Accidental also, spills and causes burning on the skin Children usually sustain these burns Exposed part that usually get burned- hands neck etc People who are sadistic Chemical burns The injuries burns are due to agents like acid- splashed in the face

Chemical burning- physical injuries Agents which cause: acids alkaline compounds wherein prolonged contact would produce injury similar to burns like gasoline Same thing with cement- chemical in cement that will holes in the skin, the effect because of chemical component of the skin- burn the skin Microwave burns Death Person dies because of fire If a person killed by means of fire, Intention to kill the person inside the building- murder Without intention arson resulting to homicide Separate crime of arson and homicide- to hide body Murder- reason why the legal problem solved by experts is the corpse there are fire burns important to determine whether the fire was before the death or after the death Legal significance- if fire was burns were inflicted prior to death, consequence, fire was the cause of death then it is murder if the burning was intentional, but if the cause of death is other than the burning but the it is cruelty not cause of death but if after death fire, or scoffing or ignominy Immediate died victim because of direct thermal injury Refers to heat, or a vital organ was burned or that there may be immediate death by fire even if no part was burned but by smoke inhalation- a building burned find persons died but were not burned, death is not by fire, but medically, yes it is by fire Inhaling the smoke- smoke inhalation If there find in the mouth or nose- soot , coloring matter that results from fire or smoke If they find that there is soot they will say that he died because of smoke inhalation but it is possible that there may not be soot the best way to determine is analysis of the blood Inhales carbon monoxide- can be found in the blood Death by fire may also be delayed not immediate If the individual dies between the first 2-3 days death due to shock fluid loss or acute respiratory failure due to inhalation of poisonous gasses- if the individual survives but later dies the death traced to thermal injury of the body or due to respiratory insufficiency, inhaled too much carbon dioxide Likewise categorize burns according to the extent of area burned severity of the burn age of the victim presence of inhalation injuries 9% rule- the whole body is 100% and they assign of the 100% there are of the head is 9% The upper extremities other than the head is assigned 9% as the area, the front of the torso is 18% the back is 18% Each of the lower extremity legs 18% each Perineum is given 1% allocation depending on what percentage burned According to severity or degree of first degree burns etc Superficial burns- outer skin epidermis Skin peels off 2 degree burn- partial thickness burn Thickness of skin- most outer portion, goes a bit deeper than the third degree burn 3 degree- full thickness may result to fatal injury Flesh below skin burned 4 degree burn Full thickness burn
th rd nd

Magnifying glass- that burn under radiant heat burn- not flame burn because of energy by radiant When body burned reduced into size Reduced in size liquid is evaporated Steam burn

If no findings n hymen- reddish, sexual abuse cannot be discounted Blunt object was inserted Erect penis, finger or hard object Medical certificate merely corroborative to the testimony of the victim even without medical certificate- in case the doctor already graduated No semen found not necessary that there was no rape- not an element to the crime of rape

Closed doors trial- of sex crimes General rule public excluded Hearings and trial done in chambers of the judge or in court but public is excluded Women in presenting in hearings- make sure that the woman or girl who is in the witness stand will not have eye contact with the perpetrator Accused can intimidate the victim cannot fully relate the incident to the court if she sees the accused looks at her menacingly Ask victim sit sideways Accused sit at the back Use blackboard Children Minors Mental retarded Establish rapport Do not touch them without their permission Do not be bribing them To make them comfortable- let them draw making feel comfortable Use the words of the child Do not say it with malice Leading questions allowed for child questions But do not feed him everything Make sure questions are brief Answer not limited to yes no yes no Do not let the child be pointing to her private parts When to use the dolls, if the witness will not be able to relate it correctly in court better to demonstrate Distinguish Male doll and female doll- ask the parts of the body Support group- mother father social worker (psychotherapy) May have a toy Child does not know distances Do not have concept of distances Time cannot ask Make sure to have slept or have eaten Do not let the child or mental retarded demonstrate in court Psychotherapy coping up mechanism not the incident- absolutely confidential Child witness- rule- present the child Doctor Social worker Prosecutor Physician Consent necessary for examination Interview corroborate statement of the victim Hymen-estrogenized Consummated rape Medical/ physician findings- sexual abuse is not discounted blunt penetrated trauma

Face of the clock Does not be a precise date- on or about Identity of accused must be established Child presumed to be competent Mental retarded can testify Make sure present psychiatrist and psychologist to prove mental age of the child Go down to level of the child Birth certificate of the victim Used best evidence which is the NSO copy not certification from the LCR Government physicians psychologists Sex crimes 1. It is in rape that it is required the testimony of the physician 2. Also when substance is given for woman to sleep 3. And sexual assault 4. Usually it is male organ that is classic rape Note: No need for physician if it is sexual harassment In view to the amendment of rape it is necessary to consider whether it is the male organ or an object It is sufficient that the testimony of the woman raped be given But the physician (specialist) will also corroborate the testimony in giving medical services 1. Ask the general appearance, 2. Victims conduct, 3. Outer clothing (in detail of whether there were torn) Standard from in Baguio medico legal certificate of the victim name, age, sex of the victim (sexual assault), patients address, civil status (not necessary), occupation and nationality, and the requesting party (maybe the police or friend), place and date of examination -finding is different if the examination is conducted a day after or 1 hour after Acute conducted within 72 hours or non-acute A. B. C. D. General survey: he could be happy, ambulatory, nervous, conversant Mental Status Pertinent physical findings: (corroborate physical findings of bite marks or imprints on the body or to corroborate force) External genital: is there any injury on the external (phase of the clock)

Q: can there be rape without injury on the genital A: when woman is not sexually aroused there is resistance because penetration is hard But if she is aroused the lubricating oil is present that is why no injury is possible Note: Purpose of pubic hair according to Elmer is serve as cushion and prevent possible injury on contact on skin If there are no injuries rape is still possible like married woman

What are to be examine for injuries: 1. urethral or peri urethral area to find out if there are injuries 2. peri hymenal areas or foxal 3. discharge: semen (coming from male organ if aroused, it is the whole liquid part of it is the sperm) you can always conclude that there is arousal or other fluids coming out from woman 4. anal examination 5. other matters found it will part of forensic examination this does not discount possibility of the crime of rape Slightest penetration in labia it is consummated rape, mere touching is not penetration If no full penetration it is only the victim that can say such, if not the discharge

Note: always found out the time when it was committed Acute evidentiary examination Rape with Homicide Best evidence is the medical examination specially the male discharges found in the genitals of the woman and eye witness as well