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CHAPTER 1 LEGAL MEDICINE - testamentary capacity of a person making

a will
Legal Medicine - the right to hereditary succession
- Is that branch of medicine that applies, medical
and surgical concepts, scientific knowledge and 2. Criminal Law
skills to medico legal issues, in order to assist the - Felonies and circumstances which affect criminal
trier of facts in the proper dispensation of justice. liability
Medical Jurisprudence - Civil liability ex delictu
- is the study of the Medical Law and its applicable - Crimes relative to opium and prohibited drugs
Jurisprudence that governs, regulates and - Crimes against persons
defines the practice of medicine. - Crimes against chastity
- Crimes against civil status of persons
 In the Philippines, Legal Medicine is the appropriate - Quasi – offenses
name for Forensic Medicine.
 Modern Legal medicine has a broad range of 3. Remedial Law
applications, it is used in civil cases such as paternity - Physical and Mental Examination of a person
and filiation, annulment of marriage, DNA testing , etc. - Hospitalization of insane persons
 In all cases the medical examiner must conduct an - Rules of Evidence
investigation of the crime scene and also an autopsy.
4. Special Laws
TECHNIQUES OF LEGAL MEDICINE: - Dangerous Drug Act
- Legal Medicine uses sophisticated laboratory - Youth and Child Welfare Code
techniques to detect the presence of substances - Sanitation Code
in the victim, in the suspected criminal, or at the - Insurance law
crime scene. - Labor Code
- Forensic examination of substances found at a - Employees Compensation Law
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
LEGAL MEDICINE AND THE LEGAL SYSTEM is defined as the fact that a crime actually has been
- Courts routinely call upon physicians to give committed. In all criminal prosecutions, the burden is
expert testimony in a trial, especially concerning on the prosecution to prove the corpus delicti.
the findings of an autopsy and the results of
laboratory tests. QUANTUM OF PROOF
- As an expert witness he is allowed to express an
opinion about the validity of the evidence in a 1. In Civil Cases – the quantum of proof necessary to
case and may quote the statements of other prove a civil complaint is a PREPONDERANCE OF
experts in support of an opinion. EVIDENCE. The party filing or bringing a civil
- Ordinary testimony is restricted to statements complaint has the burden of proof and must establish
concerning what the witness actually saw or the truth and righteousness of his allegations by a
heard. preponderance of the evidence admitted by a
- The evidence to be presented by the legal competent court.
medicine expert must signify a relation between
the facts called the “ Factum Probandum” or 2. In Criminal Cases
proposition to be established and the “ factum – the quantum is proof beyond reasonable doubt.
Probans” which is the material evidencing the - In a criminal case the accused is entitled to an
proposition. acquittal, unless his guilt is shown beyond
- The Physician must present RELEVANT, reasonable doubt
MATERIAL AND COMPETENT EVIDENCE. - Presumption of INNOCENCE is a conclusion
drawn by the constitution and the law in favor of
HISTORY OF LEGAL MEDICINE: the accused , while REASONABLE DOUBT, is a
- Paulus Zacchias ( 1584 – 1659 ) is the ‘ Father of condition of mind produced by proof resulting
Forensic Medicine”. He was the first to describe from evidence in the case.
the importance and application of medicine to the
proper administration of justice. 3. To establish matters of defense
- The doctrine of reasonable doubt applies
- In the Phil. , the father of Legal Medicine can be only to incriminative facts.
rightfully bestowed to Dr. Pedro P. Solis. His
book on Legal Medicine copyrighted in 1987, 4. To establish self defense
contains the most extensive treatise and - One who sets up SELF DEFENSE “ must
teachings in Philippine Legal Medicine. rely on the strength of his own evidence and not on
APPLICATION OF LEGAL MEDICINE TO LAW: the weakness of that of the prosecution”.
Legal Medicine is Applied to Law
1. Civil law 5. To establish Alibi
- the determination and termination of civil - It must be proved by positive, dear and
personality satisfactory evidence. “ Oral Evidence” of alibi is so
- the limitation or restriction of a natural easily manufactured and usually unreliable that it can
person’s capacity to act rarely be given credence.
- marriage and legal separation
- paternity and filiation 6. In Administrative Complaints

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- In cases filed before administrative or 7. The right to privacy and confidentiality.
quasi judicial bodies, a fact maybe deemed 8. The right to a second or third opinion.
established if it supported by “ substantial evidence” 9. The right to leave.
which means that amount of relevant evidence which 10. The right to information.
a reasonable mind might accept as adequate to justify 11. The right to self determination.
a conclusion. 12. The right to refuse participation in medical research
13. The right to express grievance
CHAPTER 2 MEDICAL AND HOSPITAL 14. The right to be informed of his rights and obligations.
JURISPRUDENCE

Medical Jurisprudence:  Obligations of the Patients to their Physicians ( Refer


- Is the study of the Medical Law and its applicable to Book )
Jurisprudence, that governs, regulates, and
defines the practice of medicine.  SOCIATAL RIGHTS OF THE PATIENTS FROM THE
- It includes the rights, duties, obligations and GOVERNEMNT ( Refer to Book )
liabilities of both physician and patient to each RIGHTS INHERENT IN THE PRACTICE OF MEDICINE:
other in a physician patient professional contract. 1. The right to choose his patients
2. The right to limit the practice of his profession
The Following Acts Constitute the Practice of 3. The right to determine appropriate treatment procedures
Medicine: in the discretion and judgment of the physician.
1. To physically examine and diagnose a patient. 4. The right to avail of hospital privileges after being
2. To physically examine and treat a patient qualified.
3. To physically examine and perform surgery in a 5. The right to receive just and fair compensation from his
patient patients.
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:
 Any person who practice any of the above acts 1. Administrative Liability
enumerated, without any valid certificate of - A complaint under oath can be filed before the
registration as a physician, is practicing illegal Professional Regulation Commission Board of Medicine,
medicine. for reprimand, of the license to practice medicine.
2. Criminal Liability
The Nature of the Physician Patient Professional - When an act or omission constitutes a crime, the
Relationship is physician can be imprisoned or fined or both, as any other
1. Consensual: profession.
- based on mutual consent of both patient and 3. Civil Liability
physician. - The aggrieved party can be awarded monetary
- Contracts that are consensual in nature, are damages for any wrongful or negligent act or omission,
perfected upon mere meetings of the minds when the professional is found guilty.

2. Fiduciary: CASES ( Refer to Book )


- founded in trust, faith, and confidence reposed by  Ex. Negligent or Wrongful Act
one person in the integrity and fidelity of another.
Medical malpractice is a particular form of negligence
DUTIES AND OBLIGATIONS OF THE PHYSICIAN which consists in the failure of a physician or surgeon
TOWARDS HIS PATIENTS: to apply to his practice of medicine that degree of care
1. He must possess that knowledge and skill possessed by and skill which is ordinarily employed by the
an average physician. profession generally, under similar conditions, and in
2. He must use such knowledge and skill with ordinary care like surrounding circumstances
and due diligence.
3. He is obliged to exercise his best judgment There are Four Elements involved in medical
in good faith. negligent cases:
4. He has the duty to keep the secrets and confidentialities 1. Duty
of his patients. 2. Breach
3. Injury
 The Terms and Conditions not included in the 4. Proximate Causation – It has been recognized that
Physician Patient Professional Relationship Contract ( expert testimony is usually necessary to support the
refer to book ) conclusion as to causation.

 The only promise or guaranty that the law requires is  Ex. Whether A Hospital may be Held Liable for the
that, the physician will treat the patient in accordance Negligence of Physicians – Consultants allowed to
with the standards of medical care. Practice in its Premises.

PATIENTS RIGHTS RESPECTED BY PHYSICIANS: CHAPTER 3 DEATH


1. The right to appropriate medical care and humane
treatment. Legal Presumption of Death:
2. The right to his religious belief. - If absent without explanation from his or her
3. The right to refuse treatment. usual or last place of residence for a long
4. The right to Informed Consent. continuous period.
5. The right to choose his physician. - Circumstantial proof of death
6. The right to medical records.
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Ex. a passenger on an airplane that crashed is Death Certificate, even though the heart is still
considered to have died even if no remains can beating, and make arrangements to harvest
be recovered. donor organs and tissues at this stage.
- Further, in the presence of brain stem death,
 Rules of Evidence in Rule 131, section 5 paragraph X, artificial respirators only achieve the maintenance
paragraph JJ, and paragraph KK. of an oxygenated circulation through a corpse or
 In common law the presumption of death does not cadaver.
arise until the expiration of seven years of continuous
absence. CRITERIA FOR DIAGNOSING BRAIN STEM DEATH.
( refer to textbook )
DEATH – IS THE COMPLETE CESSATION OF ALL THE Persistent Vegetative State ( PVS )
VITAL FUNCTIONS OF THE BODY WITHOUT POSSIBILITY - This condition exists, when irreversible
OF RESUSCITATION. THE ASCERTAINMENT OF DEATH IS destruction of the Cortex of the brain occurs
A MEDICAL AND NOT A LEGAL PROBLEM. without damage to the vital centers, and there
are permanent eyes – open state of
Death maybe unconsciousness, but cardio respiratory functions
A. Brain Death – occurs when there is a deeply irreversible continue, sometimes without respiratory
coma, and absence of electrical brain activity. assistance, but most often with respiratory
support.
B. Cardio Respiratory Death – occurs when there is continuous - They do not however match the clinical criteria of
and persistent cessation of heart action and respiration. Brain Death, in as much as they have elicitable
reflexes, spontaneous respirations and reactions
4 Kinds of Death: to external stimuli.
1. Clinical or Somatic Death
2. Brain Death HARVARD CRITERIA OF WHOLE BRAIN DEATH:
3. Biological Death 1. Unreceptivity and Unresponsitivity
4. Cellular Death 2. No spontaneous movements or breathing
3. No reflexes
Clinical or Somatic Death 4. Flat EEG of Confirmatory value
- This particular kind of death occurs when in the
judgment of the physician with the use of his WHOLE BRAIN DEAD
clinical eye the body’s vital signs of life cease to - When the brain ceased all functions, even though
exist continuously and permanently. the heart continues to beat. As a rule doctors can
- The clinical death is verifiable only by a physician legally declare whole brain death twelve hours
after he observes that the patient no longer has a after they have corrected all treatable medical
heart beat no pulse rate, no spontaneous problems, but the brain still doesn’t respond even
breathing and movement, with the pupils of the to induced pain , they eyes do not react to light
eye widely dilated and not reactive to light and and the person doesn’t breath without a
accommodation. respirator.
- When a clinically dead person is brought to the
morgue the generalized contraction of the BIOLOGICAL DEATH
muscles or Rigor Mortis of the body within 3 to 6 - All the components of the brain are dead
hours, may simulate a return to life, because of - There is also permanent extinction of bodily life.
the motion or movement of the body. - It is cardiorespiratory and brain death altogether
with permanent cessation of all the anatomic and
BRAIN DEATH physiological functions of the body organs.
- This kind of death follows clinical death – almost
immediately unless resuscitative procedures are CELLULAR DEATH:
started promptly, because the human brain under - The death of the different parts of the body
normal conditions cannot survive loss of oxygen occurs at different times and stages.
for more than 6 to 10 minutes. - This is the reason why such organs as the
- Brain Death may occur in the corneas and the kidneys can be removed
Stage 1 – Cerebral Cortex- the highest center of immediately after biological death and
the brain that is most sensitive to changes in the transplanted successfully.
supply of oxygen and blood to the brain. When
the cerebral cortex dies, the patient is in cortical SIGNS OF DEATH:
death. 1. Cessation of heart action and circulation
2. Cessation of respiration
Stage 2 - Cerebellum – It deals with the function 3. Cooling of the body ( Algor Mortis )
of equilibrium. It follows the death of the cerebral - The temperature of 15 – 20 degrees
cortex. Fahrenheit is considered as a certain sign of death.
4. Loss of motor power
Stage 3 – Brainstem and Vital centers – These 5. Loss of sensory power
centers controlling respiration, heart rate and 6. Changes in the skin
blood pressure, ultimately die. When it does, the 7. Changes in and about the eye
patient is, Brain Stem Dead. - There is loss of corneal reflex
- If the brain stem is damaged, then the vital
centers in the medulla maybe destroyed, causing CHANGES IN THE BODY FOLLOWING DEATH
the respiratory center to fail. 1. Changes in the Muscle
- The occurrence of brain stem death is equivalent a. Stage of primary flaccidity
to Legal Death, so that Doctors can now issue a b. Cadaveric rigidity or rigor mortis
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- muscular contraction which suicidal, murderous, homicidal, sudden or
develops 3 – 6 hours after death unexpected, or unexplained, need medico legal
and may last for 24 – 36 hours. investigation.
- may also be utilized to
approximate the length of time the The Death Certificate
body has been dead from 3 to 36 - The death certificate is a legal document
hours necessary for burial of the dead, as it certifies the
c. Stage of secondary flaccidity or occurrence of death. It is a document from the
commencement of putrefaction Office of the Civil Registrar General, listing the
particulars of an individual’s death.
Cadaveric Spasm- is the immediate or instantaneous spasm or - It contains the Immediate Cause or Primary
rigidity of the skeletal muscles occurring at the moment of death cause of death, the antecedent causes and
due to exhaustion, etc. underlying cause of death

Medico legal Importance of Cadaveric Spasm Immediate Cause or Primary Cause of Death
( Refer to Book ) Ex. Suffocation due to drowning
Asphyxia
2. Changes in the Blood Cardio – Respiratory Arrest
a. Coagulation of the blood
b. Postmortem lividity or Livor Mortis Antecedent Cause of Death are events or
3. Autolytic or Auto Digestive Changes After Death conditions that substantially contribute to the
4. Putrefaction of the Body immediate cause of death
Ex. Acute peritonitis, Acute Hypovolemic shock,
PUTREFACTIVE CHANGES OCCURING AFTER DEATH Acute Septic Shock,
( Refer to Book )
Kinds of Putrefaction: Underlying Cause of Death is the basic cause or
1. Mummification bottom line cause of death. It is the diagnosis of
2. Saponification – This is also called Adipocere Formation. the patients or victim’s illness or sickness that
3. Maceration resulted to his death
Ex. Acute Appendicitis, Hepatocarcinoma, Pelvic
Factors to Consider in Approximating the Duration of Death in a Fracture, Stab or Gunshot Wound to the chest.
Cadaver
1. Entomology – The presence of maggots in the cadaver Non Natural Causes of Death
indicates duration of death for more than 24 hours Ex. Murder, Homecide, Suicide, Accident
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. Death Warrant – is a warrant from the proper executive
3. Blood vessel clots – blood clotting occurs in 6 -8 hours after authority appointing the time and place for the execution of the
death. sentence of death upon a convict judicially condemned to suffer
4. Post Mortem lividity – develops in 3 to 6 hours after death. death.
5. Rigor Mortis- begins to develop in 3 to 6 hours after death
and may last for 24 to 36 hours after death. Manner of Death
6. Onset of decomposition – Decomposition takes place within - Is the explanation as to how the cause of death
24 – 48 hours after death. arose, and maybe either Natural Death or Violent
7. Food in the stomach Death
8. Skeletal soft tissues – soft tissues may disappear from 1.5
years to 2 years after burial. Lazarus Syndrome
- Is also called Lazarus Phenomenon is the
Position of the Body at the time of Death spontaneous return of circulation after failed
1. Post Mortem lividity attempts at resuscitation.
2. Cadaveric spasm – Death due to violence or inflicted physical
injuries, usually manifest the position of the body at the time of Implications of Lazarus Syndrome
death. - raise ethical and legal issues for doctors, who
Ex. In suicide by gunshot wound, the gun maybe tightly grasped must determine when medical death has
in the hand of the deceased occurred, when resuscitation efforts should end,
In drowning, the victim maybe holding objects that and post mortem procedures such as autopsies
come in contact with his hands to cling to life. and organ harvesting may take place.
MEDICOLEGAL IMPORTANCE OF RIGOR MORTIS AND Lazarus Sign
CADAVERIC SPASM: - Lazarus sign or Lazarus reflex is a reflex
movement in brain dead patients, which causes
Rigor mortis is utilized to approximate the time of death. them to briefly raise their arms and drop them
Generalized muscular contractions occur from 3 to 6 hours until crossed on their chests.
36 hours. - The phenomenon has been observed to occur
several minutes after the removal of medical
Cadaveric spasm occurs immediately after death and is useful ventilators used to pump air in and out of brain
to ascertain the circumstances of death. dead patients to keep their bodies alive.
Medico Legal Investigation of Death NEAR DEATH EXPERIENCE
- Deaths which are not obviously due to natural - Refers to a broad range of personal experiences
causes, but are criminal, suspicious, accidental, associated with impending death, encompassing
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multiple possible sensations including c. Serious Chest Injuries
detachment from the body; feelings of levitation 4. Abdomen
etc. Types of Injuries:
a. Penetrating
EUTHANASIA - Gunshot wounds of the abdomen carry
- Meaning good death ( well or good ) 95% probability of significant visceral injury
- Refers to the practice of ending life in a painless - A bullet when it hits the abdomen will
manner. penetrate the abdominal wall, enter the
- Deliberate intervention undertaken with the abdominal cavity and most likely injure more
express intention of ending life, to relieve than one organ.
intractable suffering - The incidence of abdominal injury is
strikingly higher in gunshot wounds than in
Classification of Euthanasia: stab wounds.
1. Voluntary euthanasia – is euthanasia conducted with consent - The major cause of death is hemorrhage
and this occurs within the first 24 hours
2. Involuntary euthanasia - In stab wounds of the abdomen , only 2/3
– is euthanasia conducted without consent. penetrate the peritoneal cavity; of these only
-is conducted where an individual makes a decision for another ½ cause significant visceral injury that
person incapable of doing so. requires surgical repair.
- also known as physician assisted death, physician assisted b. Blunt
suicide or mercy killing. - The spleen and liver are the most
commonly injured organs due to blunt
3. Passive euthanasia – entails withholding of common trauma.
treatments - Their frequent incidence also explains why
the mortality rate following blunt trauma is
4. Active euthanasia – entails the use of lethal substances or higher than that of penetrating injury.
forces to end life and is the most controversial means.
5. Fractures and Dislocations
CHAPTER 4 REGIONAL TRAUMA The word fracture comes from the Latin word
“fractura” which means a break in the continuity of the bone. It is
Trauma also a combination of a break in the bone and soft tissue injury
– 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. A. Open Fractures - 90% of open fractures are caused
-Penetrating trauma particularly handguns is becoming common by vehicular accident.
in nearly all areas of the country. B. Hip fractures are very common in elderly people
and are usually caused by minor falls. It is the most common
Trimodal Distribution of Death from Trauma: cause of traumatic death after the age of 75.
1. Seconds to minutes of injury – due to the injury to the brain,
high spinal cord, heart, aorta and other large vessels. These 6. Urologic
patients can rarely be salvaged. - Hematuria following trauma
2. Minutes to Few hours from injury ( The Golden Hour ) - Blunt kidney injury is usually due to motor
- It is in this period that Advanced Trauma Life Support9 vehicular accidents which account for 70 –
( ATLS ) techniques are important. 90 % of kidney trauma.
3. Several days to weeks of Injury – these are due to sepsis or - Penile injury:
organ failure. The erect penis is usually 6 – 8 inches long
and 1 -2 inches in diameter.
SPECIFIC INJURIES - Avulsion of the prepuce – this may follow
1. Head accidents where the foreskin called prepuce
a. Types of Head Injuries: is detached or lacerated by a blunt force.
a.1 Hematoma - Fracture of the penis – this is the traumatic
a.2 Contusions rupture of the corpora cavernosa penis
a.3 Skull fractures resulting from a forceful trauma to the
a.4 Hemorrhage flaccid organ.
2. Spine and Spinal Cord Injuries - Amputated penis – the penis of an avid
The most common causes of severe spinal trauma womanizer is sometimes intentionally cut or
are motor vehicular accidents, falls, diving accidents, and amputated by a jealous derange wife or
gunshot wounds. lover.
3. Chest
a. Life Threatening Injuries 7. Arterial trauma
Pnumothorax 8. Burns
Hemothorax
Flail chest as in multiple rib fractures CLASSIFICATION OF WOUNDS
Cardiac tamponade due to penetrating 1. AS TO LEGAL CLASSIFICATION
injuries Chapter 1
b. Potentially Lethal Injuries DESTRUCTION OF LIFE
b.1. Pulmonary Contussion with or without a. Article 246. Parricide
flail chest b. Article 247. Death or Physical Injuries Inflicted Under
b.2. Thoracic Aortic Tear or Rupture – the Exceptional Circumstances
most common cause of sudden death after c. Article 248. MURDER
a vehicular accident or fall ( major - Any person who, not falling within the provisions of
decelaration injury ) Article 246 shall kill another, shall be guilty of murder and shall

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be punished by Reclusion Perpetua, to death if committed with b.2 Perforating – there is a communication between the outside,
any of the following attendant circumstances; inner and the outer side. There is both a point of entry and exit.
1. With treachery
2. In consideration of a price , reward or promise Classification of Wounds
3. By means of inundation etc. 3. AS TO MORTALITY
4. On occasion of any of the calamities etc. a. Deadly Wound- Death results immediately, after the infliction
5. With evident premeditation of the wound. Deadly wounds though mortal, maybe prevented
6. With cruelty etc with prompt medical treatment.

Article 249 HOMICIDE b. Non Deadly Wounds – Does not result to death immediately,
Article 251. Death Caused in a Tumultous Affray after the wound is inflicted. A non deadly wound may cause
Article 252. Physical Injuries Inflicted In a Tumultuous Affray death later, due to complications i.e. tetanus, septicemia
Article 253. Giving Assistance to Suicide
Article 254. Discharge of Firearms Classification of Wounds:
Article 255. Infanticide 4. AS TO THE WOUNDING INSTRUMENTS USED:
Article 256. Intentional Abortion a. Sharp Instruments – Ex. incised wound, punctured wound,
Article 257. Unintentional Abortion – who shall caused an stab wound dagger or kitchen knife
abortion by violence but not intentional. b. Blunt Instruments – A block of wood or iron produces
Article 258. Abortion Practiced by the Woman Herself or By Her contusion, hematoma, abrasions, lacerated wound when used
Parents to strike, attack, wound, beat or assault another
Article 259. Abortion Practiced by a Physician or Midwife and
Dispensing of Abortives Classification of Wounds:
Article 260. Responsibility of Participants in a Duel 5. AS TO THE CONSEQUENTIAL INJURY AFTER THE
Article 261. Challenging to a Duel APPLOCATION OF FORCE
a. Coup Injury -
CHAPTER 2 b. Coup Centre Coup Injury
PHYSICAL INJURIES c. Contre Coup Injury
a. Article 262. Mutilation – Any person who shall intentionally d. Locus Minoris resistancia
mutilate another by depriving him, either totally or partially , of e. Extensive injury
some essential organ of reproduction.
b. Article 263. Serious Physical Injuries – Any person who shall Classification of Wounds:
wound, beat, or assault another, shall be guilty of the crime of 6. AS TO THE INTEGRITY OF THE SKIN
serious physical injuries A. CLOSED WOUNDS – Presents no break in the integrity or
c. Article 264. Administering Injurious Substances or Beverages continuity of the skin. There maybe only outward manifestations
d. Article 265. Less Serious Physical Injuries – Any person who of injury internally.
shall inflict upon another physical injuries which shall Ex. of closed wounds:
incapacitate the offended party for labor for 10 days or more, or 1. petechiae – a circumscribe extravasation of blood in the
shall require medical attendance for the same period subcutaneous tissue.
e. Article 266. Slight Physical Injuries and Maltreatment. 2. contusion – effusion of blood into the tissues underneath the
- When the offender has inflicted physical injuries which shall skin as a result of a blunt force. Ex. black eye
incapacitate the offended party for labor from one to nine days, 3. Hematoma
or shall require medical attendance during the same period. 4. Blunt injury
5. Musculoskeletal injuries
Chapter 3, RAPE – When and How rape is committed Ex. Sprain, Dislocation, Fracture, Strain
1. By a man who shall have carnal knowledge of a woman
under any of the circumstances Cerebral Concussion – there is a brief loss of consciousness
a. Through force, threat, or intimidation and sometimes memory after a head injury that doesn’t cause
b. When the offended party is deprived of reason or obvious physical damage.
otherwise unconscious
c. By means of fraudulent machinations or grave Cerebral Contusion – they are bruises to the brain, usually
abuse of authority caused by a direct, strong blow to the head. They are more
d. When the offended party is under twelve ( 12 ) serious than concussions.
years of age or is demented, even though none of the
circumstances mentioned above is present. B. OPEN WOUNDS
- There is a break in the continuity of the skin
2. By any person who, under any of the circumstances Examples:
mentioned in paragraph 1 hereof, shall commit an act of sexual 1. Abrasion
assault by inserting his penis into another person’s mouth or 2. Bruise
anal orifice or any instrument or object into the genital or anal 3. Incised wound
orifice of another person. 4. Stab wound
5. Punctured wound
Classification of Wounds 6. Perforating wound
2. AS TO THE DEPTH OF THE WOUND 7. Lacerated wound
a. Superficial – When the wound involves only the layer of the 8. Bites
skin 9. Gunshot wounds
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 Penetrating – the wound enters the body but does not come B.1. Abrasion – Scratch, friction mark
out. Punctured, stab and gunshot wounds usually belong to this
type of wound.

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B.2. Bruise – cause by a blunt injury to the tissues which The Dangerous Drug Act of 1972, include the following
damage blood vessels beneath the surface, allowing blood to Dangerous Drugs as follows:
extravasate or leak into the surrounding tissues. A. PROHIBITED DRUGS
B.3. Incised wound 1. Opium and its active components and derivatives
B.4. Stab wound such as heroin and morphine.
B.5. Punctured wound 2. Coca leaf and its derivatives, principally cocaine.
B.6. Perforating wound 3. Hallucinogenic drugs such as mescaline, lysergic
B.7. Lacerated wound – result of an injury from a blunt acid diethylamide ( LSD ) and other substances
instrument. In cerebral laceration, the brain tissue is torn often producing similar effects.
with an accompanying visible head wounds and skull fractures. 4. Other drugs whether natural or synthetic with the
B.8. Bites – they maybe abraded, bruised or rarely lacerated. physiological effects of a narcotic drug.
They are usually seen in sexual assaults and in child abuse and
also by animal bites B. REGULATED DRUGS
B.9. Gunshot wounds 1. Self inducing sedatives such as secobarbital,
phenobarbital, pentobarbital, barbital and any drug
TEST FOR THE PRESENCE OF POWDER RESIDUES: which contains salt or derivative of a salt of barbituric
1. Paraffin test or Dermal Nitrate test – present on the skin of acid.
the hand dorsum or site of the wound of entrance. This test is 2. Any salt of amphetamine such as Benzedrine or
not conclusive because fertilizers, cosmetics, cigarettes, urine any drug which produces a physiological action similar
and other nitrogenous compounds with nitrates will give a to amphetamine.
positive reaction. A negative test is also not conclusive . The 3. Hypnotic drugs, such as methaqualone producing
test usually gives a positive result even after a lapse of 3 days similar physiologic effects.
or even if the hands are subjected to ordinary washing
IMPORTANT TERMS in the DANGEROUS DRUG
2. Use of Scanning Electron Microscope with a linked X – ray ACT OF 2002
analyzer. This method appears to be more specific but seldom 1. Drug Syndicate
used because the instrument is expensive. 2. Illegal Trafficking
3. Chemical Diversion
SPECIAL TYPES OF WOUNDS 4. Planting Evidence
1. Assailant’s wounds – these wounds are sustained by the 5. Drug Dependence
assailant from the victim, while the former is in the process of
attacking, wounding, assaulting, beating or killing his victim. Two Classes of Drug Dependence:
2. Defense wounds – in the process of defending himself from a. Drug Addiction – is a state of periodic or chronic
the attacks, assault, wounding, beating or violence of the intoxication produced by the repeated consumption of
assailant, the victim sustains defensive wounds usually in the a drug, whether synthetic or natural and found to be
upper extremities. detrimental to the individual and to the society.
3. Victim’s wounds – these are wounds sustained by the victim,
from the assailant, the former not having the chance or Characteristics of Drug Addiction:
opportunity to defend himself. The victim’s wounds maybe A. An overpowering desire or need to
located in any part of the body. continue taking the drug or to obtained it by any
4. Self – Inflicted wounds – these are wounds self inflicted by means.
the person on himself. The wounds are usually found on the
accessible parts of the body, usually with no intention to kill - a tendency to increase the dose.
himself. Unless the victim is insane, self inflicted wounds are for -a psychological and physical dependence
a fraudulent or self serving purpose. on the effects of the drug.
5. Homicidal wounds – these are the serious wounds sustained - a detrimental effect to the society and to
by the victim resulting to his death, from the criminal assailant. the individual
Usually the wounds are situated in the areas of the neck, chest,
the abdomen and the skull. B. Drug Habituation – is the desire to have a
6. Accidental wounds – these wounds are sustained by the continuous use of the drug but with the capacity to
victim, without any fault or intention whatsoever on the part of refrain physically from using it.
the accused to inflict the wounds on the victim. The wounds are
usually located on any part of the victim’s body. Characteristics of Drug Habituation:
7. Suicidal wounds – these are wounds self inflicted by the - The desire to use the drug is not
victim on himself, and usually seen on the temple, the roof of compulsive but merely psychical.
the mouth, and other fatal body areas, accessible to the hand of
the victim. - 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
A DANGEROUS DRUG is a drug whose use is attended by risk 7. Pusher
and therefore is unsafe, perilous and hazardous to people and 8. Controlled Delivery
society. 9. Den, Dive or Resort
10. PDEA – The Philippine Drug Enforcement
A DRUG is any substance , vegetable, mineral or animal in Agency, which is the implementing arm of the
origin, used in the composition or preparation of medicines or Dangerous Drugs Board.
any substance used as medicines.

7
UNLAWFUL ACTS AND PENALTIES IN THE Section 56. Temporary Release from the Center; After
DANGEROUS DRUGS ACT OF 2002 ( R.A. 9165: Care and Follow up Treatment Under the Voluntary
1. Importation of Dangerous Drugs and or Controlled Submission Program
Precusors and Essential Chemicals. Section 58. Filing of Charges Against a Drug
2. Sale, Trading, Administration, Dispensation, Dependent who is not rehabilitated Under the
Delivery, Distribution and Transportation of Voluntary Submission Program.
Dangerous Drugs and or Controlled Precursors and Section 61. Compulsory Confinement of a drug
essential Chemicals. dependent who refuses to apply under the Voluntary
3. Maintenance of a Den, Dive or Resort Submission Program
4. Employees and Visitors of a Den, Dive or Resort Section 62. Compulsory Submission of a Drug
5. Manufacture of Dangerous Drugs and or Controlled Dependent Charged with an Offense, to Treatment
Precursors and Essential Chemicals and Rehabilitation
6. Illegal Chemical Diversion of Controlled Precursor Section 70. Probation or Community Service for a
and Essential Chemicals First Time Minor Offender In Lieu of Imprisonment
7.Manufacture or Delivery of Equipment , Instrument, Section 73. Liability of a Parent, Spouse or Guardian
Apparatus and Other paraphernalia for Dangerous Who refuses to Cooperate with the Board or any
Drugs and or Controlled Precursors and Essential Concerned Agency
Chemicals Section 77. The Dangerous Drugs Board
8. Possession of Dangerous Drugs Section 82. Creation of the Philippine Drug
9. Possession of Equipment, Instrument , Apparatus Enforcement Agency ( PDEA )
and Other Paraphernalia for Dangerous drugs. Section 85. The PDEA Academy
10. Possession of Dangerous D During Parties, Social Section 90. Jurisdiction
Gatherings or Meetings Section 91. Responsibility and Liability of Law
11. Possession of Equipment, Instrument, Apparatus Enforcement Agencies and Other Government
and Other Paraphernalia for Dangerous Drugs During Officials and Employees in Testifying as Prosecution
Parties, Social Gatherings or Meetings Witnesses in Dangerous Drug Cases
12. Use of Dangerous drugs Section 92. Delay and Bungling in the Prosecution of
13. Cultivation or Culture of Plants Classified as Drug Cases
Dangerous Drugs or are Sources thereof
14. Failure to Maintain and Keep the Original Records PHARMACOLOGIC CLASIFICATION OF
of transactions on Dangerous drugs and or Controlled DANGEROUS DRUGS
Precursors and Essential chemicals 1.Hypnotics
15. Unnecessary Prescription of Dangerous Drugs 2. Sedatives and Tranquilizers
16. Unlawful Prescription of Dangerous drugs 3. Hallucinogens and Psychomimetics
4. Stimulants
THE CUSTODY AND DISPOSITION OF 5. Depressants
CONFISCATED, SEIZED AND OR SURRENDERED 6. Deliriants and Intoxicants
DANGEROUS DRUGS, PLANT SOURCES OF
DANGEROUS DRUGS, CONTROLLES A.Hypnotics:
PRECURSORS AND ESSENTIAL CHEMICALS, Opiates and Their Derivatives – Opium is obtained
INSTRUMENTS AND PARAPHERNALIA AND OR from the milky exudates of the unripe seed capsules
LABORATORY EQUIPMENT – The PDEA shall take of the poppy plant, Papaver Sornoiferum.
charge and have custody of all dangerous drugs, plant
sources of dangerous drugs, controlled precursors Derivatives of opium commonly used are morphine,
and essential chemicals, as well as Instruments heroin, and codeine.
paraphernalia and laboratory equipment so
confiscated, seized and or surrendered, for proper Its synthetic preparation are Demerol and Methadone.
disposition in the following manner ( Refer to Book ).
Narcotics that have a legitimate medical used as
IMPORTANT PROVISIONS OF R.A. 9165 OR THE powerful pain relievers are called Opioids, and include
COMPREHENSIVE DANGEROUS DRUGS ACT OF codeine, oxycodone, meperidine, morphine and
2002 hydromorphone.

Section 22. Grant of Compensation, Reward and Heroin which is prohibited is a very strong pain
Award reliever and narcotic
Section 23. Plea Bargaining Provision
Section 36. Applicants for Driver’s License Signs and Symptoms of Opium Administration:
Section 38. Laboratory Examination or test on 1. Stage of Excitement
Apprehended / Arrested Offenders 2. Stage of Stupor
Section 39. Accreditation of Drug Testing Centers and 3. Stage of Narcosis
Physicians
Section 40. A physician, dentist, veterinarian or B. SEDATIVES:
practitioner authorized to prescribe any dangerous Barbiturates: - are the products of malonic acid and
drug shall issue the prescription therefore in one urea, synthesized on St. Barbara day.
original and 2 duplicate copies. - Used to treat anxiety and to induce sleep can
Section 54. Voluntary Submission of a Drug cause both psychologic and physical
Dependent to Confinement, Treatment and dependence.
Rehabilitation
Section 55 Exemption from Criminal Liability C. HALLUCINOGENS OR PSYCHOMIMETIC
Under the Voluntary Submission Program DRUGS:

8
Marijuana – ( Cannabis Sativa ) is a Mexican term for 4. Resolution
pleasurable feeling. Marijuana is not addictive.
Physical dependence and dose tolerance do not SEXUAL DYSFUNCTIONS ( Classification )
develop with its use. Psychic dependence may occur. A. As to choice of sexual partners
1. Homosexual
Subjective effects of Marijuana: 2. Infanto sexual
- There is a feeling of lightness of the extremities 3. Besto sexual
followed by rushes of warmth and well being that 4. Auto sexual
eventually lead to a sense of relaxation, mild 5. Gerontophilia
euphoria and a dreamy state where ideas are 6. Necrophilia
disconnected. 7. Incest
Objective Effects of Marijuana:
- Moderate increase in resting pulse rate, B. As to instinctual strength of the sexual urge:
reddening of the eyes due to dilatation of the 1. Over sex
conjunctival blood vessels. Difficulty of speech 2. Under sex or sexual frigidity
and of remembering of the logical trend of what a. Sexual anesthesia
was being said. b. Dyspareunia
c. Vaginismus
Lysergic Acid Dsethylamide ( LSD ) d. Old age
- These drugs are false hallucinogens. C. As to the mode of sexual expression
- It produces impaired judgement so that a user 1. Oralism
might think that he can fly, and may even jump a. Fellatio
out a window to prove it, resulting in severe injury b. Cunnilingus
or death. c. Analism

D.STIMULANTS: 2. Sado – masochism


Amphetamines – methamphetamines ( Shabu, a. Sadism
speed ); methylenedioxymethamphetamine ( MDMA, b. Masochism
ecstasy or Adam ) 3. Fetishism
- Acts on the cerebral cortex causing alertness, a. Anatomic
excessive self confidence and feeling of well b. Clothing
being. Physical performance may to some .
degree temporarily improve. c. Necrophilic
d. Odor ( ospresiophilia )
Untoward Effects:
- They increase the blood pressure and heart rate. Kinds of Ospresiophilia
Fatal heart attacks have occurred even in 1. Urolagnia
healthy, young athletes. The blood pressure 2. Coprolagnia
maybe so high that a blood vessel in the brain 3. Mysophilia
ruptures causing a stroke. a. Narcissism
b. Saboteur Fetish
Coccaine – is an alkaloid from the leaves of the coca c. Vampirism
shrub cultivated in Bolivia and Peru.
- It produces effects similar to amphetamines, but D. As to the part of the body
is a much more powerful stimulant. 1. Sodomy
2. Uranism
- Is used to excite the undersexed.
3. Frottage
- Is a euphoriant and readily relieves fatigue
4. Partialism
E. As to visual stimulus
Untoward Effects:
1. Voyeurism
- Same as amphetamine 2. Scoptophilia
F. As to number
E. DEPRESSANTS: 1. Troilism
- Angel dust 2. Pluralism
- Depresses the brain and abusers usually G. Other sexual deviates.
become confused and disoriented shortly after 1. Don Juanism
taking the drug. 2. Indecent exposure
- Can be combative and because they don’t feel 3. Coprolalia
the pain they may continue fighting even when hit H. Disorders of sexual function:
hard. 1. Premature ejaculation
2. Retarded ejaculation
CHAPTER 6 SEXUAL DYSFUNCTIONS AND SEXUAL 3. Low sexual desire disorder
CRIMES 4. Sexual aversion disorder
5. Sexual arousal disorder in women
SEXUALITY – IS A NORMAL BIOLOGICAL URGE AND AN 6. Inhibited orgasm
IMPORTANT PART OF THE HUMAN EXPERIENCE. 7. Dyspareunia
8. Vaginismus
4 Stages of a Sexual Response: I. Sexual reversal
1. Desire 1. Transvertism
2. Arousal 2. Transexualism
3. Orgasm 3. Intersexuality

9
I. Bigamy
SEXUAL CRIMES: J. Marriage Contracted Against the Provisions of
Chaste – An unmarried woman who has had no carnal Law
knowledge with men or that she never voluntarily had unlawful K. Premature Marriage
sexual intercourse. These also denotes purity of mind and L. Performance of Illegal Marriage Ceremony
innocence of heart. M. Prostitution
N. Corruption of Minors
Virgin – A woman who has had no carnal knowledge of man. O. White Slave Trade
Her genital organs have not been altered by carnal connection. P. Abuse Against Chastity

Kinds of virginity PROVISIONS OF THE REVISED PENAL CODE


1. Moral virginity – the state of not knowing the nature of sexual APPLICABLE TO UNNATURAL SEXUAL OFFENSES
life and not having experience sexual relation.
2. Physical virginity – A condition whereby a woman is 1. Grave Scandal ( Art. 200 )
conscious of the nature of sexual life but has not experienced 2. Immoral Doctrines, Obscene Publications and Exhibitions
sexual intercourse. ( Art. 201 )
3. Demi – virginity – This term refers to a condition of a woman 3. Vagrants and Prostitutes ( Art. 202 )
who permits any form of sexual liberties as long as they abstain 4. Grave Threats ( Art. 282 )
from rupturing the hymen by sexual act. The woman allows 5. Light Threats ( Art. 283 )
sexual intercourse, but only inter femora or even inter labia, but 6. Other Light Threats ( Art. 285 )
not to the extent of rupturing the hymen. 7. Grave Coercions
4. Virgo intacta – A truly virgin woman. There is no structural 8. Unjust Vexation or Any Other Coercion ( Art. 287 )
change in her organ, notwithstanding the fact of a previous
sexual intercourse. CHAPTER 7 MENTAL HEALTH DISORDERS

DEFLORATION – This is the laceration or rupture of the hymen, Mental Health Disorders – include disturbances in thinking,
as a result of sexual intercourse. All other lacerations which are emotion, and behavior. There is a complex interaction between
not due to coitus are not considered defloration. the physical, psychologic, social, cultural and hereditary
influences.
SEMEN AND SPERMATOZOA:
Factors that Contribute to the Development of Mental Disorders:
ERECTILE DYSFUNCTION ( Impotence )
- The diagnosis of Erectile Dysfunction is important 1. Heredity – the most frequent factor that contributes to insanity
especially in complaints of rape. It must be and a good history will reveal the ascendants afflicted with the
proven convincingly that the accused is same.
permanently impotent, so that the crime of rape 2. Incestous Marriage – The mental illness is accentuated when
cannot be proved beyond reasonable doubt. they are blood relatives.
3. Impaired Vitality – Stress, tension, worry, grief may
- Impotence usually results from vascular predispose to insanity
impairment, neurologic disorders, drugs, 4. Poor Moral Training and Breeding – Corrupt moral upbringing
abnormalities of the penis or psychological in the family due to immorality of the parents
problems that interfere with sexual arousal. 5. Psychic Factors – Factors like love, hate, rage, anger,
- These includes injury, diabetes mellitus, stroke passion disappointments
and drugs like all antihypertensive and 6. Physical Factors
psychotics, antidepressants and some sedatives. a. Non toxic factors – exhaustion resulting from
- Alcohol can also cause impotence and also low severe physical and mental strain and traumatic injuries to the
levels of testosterone head.
b. Toxic factors – drug addiction, infections of the
SEX CRIMES IN THE REVISED PENAL CODE: brain
A. Rape
B. Carnal Knowledge KINDS OF MENTAL HEALTH DISORDERS:
- is the act of a man in having sexual bodily 1. Psychosomatic disorders – physical disorders caused by
connection with a woman. There is carnal psychologic factors.
knowledge if there is the slightest penetration in 2. Somatiform disorders – encompasses several psychiatric
the sexual organ of the female by the sexual disorders in which people report physical symptoms but deny
organ of the male. having psychiatric problems.
3. Generalized Anxiety Disorders
C. Seduction 4. Panic Attacks and Panic Disorder
- is the art of a man enticing women to have
unlawful intercourse with him by means of 5. Phobic Disorders
persuasion, solicitation, promises, bribes or other a. Agoraphobia
means without employment of force b. Specific phobias
c. Social phobia
D. Acts of Lasciviosness 6. Obsessive Compulsive Disorder
E. Acts of Lasciviousness with Consent of the 7. Post Traumatic Stress Disorder
Offended Party 8. Depression and Mania
F. Abduction 9. Bipolar Disorder
1. Forcible Abduction 10. Suicidal Behavior
2. Consensual Abduction 11. Eating Disorders
G. Adultery a. Anorexia nervosa
H. Concubinage b. Bulimia nervosa

10
c. Binge eating disorder DISTINCTIONS BETWEEN TRUE AND FALSE
12. Personality Disorders INSANITY:
a. Paranoid 1. True insanity develops insidiously usually with the
b. Schizoid existence of some predisposition to an exciting cause
c. Histrionic if careful history is taken, while false insanity develops
d. Narcissistic suddenly with no existing predisposition.
e. Antisocial
f. Borderline 2. In true insanity, there is a peculiar facial expression,
g. Avoidant which is absent in false insanity
h. Dependent
3. In true insanity, there is a continuous and persistent
i. Obsessive – Compulsive manifestation of insanity, which is only present in false
j. Passive Aggressive insanity when the pretender is under observation, and
k. Dissociative absent when not under observation.

13. Schizophrenia – a serious mental disorder characterized by 4. In true insanity, there is a clinical entity of a specific
loss of contact with reality ( psychosis ) , hallucinations, mental disorder, which is absent in false insanity.
delusions ( false beliefs ) , abnormal thinking, disrupted work
and social functioning 5. In true insanity, the patient can endure a violent or
stressful activity without fatigue, which is not present
Types of Schizophrenia: in false insanity
a. Paranoid
b. Hebephrenic 6. In true insanity, the patient does not observe
c. Catatonic personal hygiene, in false insanity, the pretender
observes hygiene
14. Delusional Disorder
15. Psychological Incapacity – a waste basket diagnosis Insanity or Mental Illness is an exempting or mitigating
because it is so broad a term, that it covers all possible Mental circumstance to Criminal Liability as provided in the
Disorders. following:
1. As an exempting Circumstance
SOME MANIFESTATIONS OF MENTAL DISORDERS: Article 12 of the Revised Penal Code
1. Disorders of Cognition ( Knowing ) provides, “ When the imbecile or an insane person
a. Illusion has committed an act which the law defines as felony,
b. Hallucination the court shall order his confinement in one of the
2. Disorders of Memory hospitals or asylums established for persons thus
a. Dementia afflicted and he shall not be permitted to leave without
3. Disorders in the Content of Thought first obtaining the permission of the same court.
A. Delusion
a. Delusion of grandeur 2. As a mitigating Circumstance
b. Delusion of persecution Article 13, of the Revised Penal Code
c. Delusion of reference provides, the following are mitigationg circumstances:
d. Delusion of Self – Accusation a. That the offender is deaf and dumb, blind
e. Delusion of infidelity or otherwise suffering from physical defect which thus
f. Nihilistic delusion restricts his means of action, defense or
g. Delusion of poverty communication with his fellow beings
h. Delusion of control
i. Delusion of depression The American Law Institute formulated the following
B. Obsession Rules on Criminal Responsibility and states that;
4. Disorders in the trend of thought 1. A person is not responsible for his criminal conduct
Types: if at the time of such conduct as a result of mental
a. Mania illness or defect, he lacks essential capacity to
b. Melancholia 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. 2. The term “ mental disease or defect “ does not
6. Disorders of volition or conation ( doing ) include an abnormality manifested only by repeated
Kinds of Conation: criminal or otherwise anti social conduct
A. Impulsion or Impulse ( Compulsion ) – a sudden
and irresistible force compelling a person to the Fundamental Principles of Insanity and Criminal
conscious performance of some action without motive Responsibility:
or forethought. 1. A sane man is assumed to be wholly responsible
for the consequence of his crime.
Types of Compulsion: 2. A person who commits a criminal act is presumed
a. Pyromania to be sane.
b. Kleptomania 3. Crime is always considered as an affair of the mind
c. Dipsomania as well as the body and to make an act or omission a
d. Homicidal impulse crime, there must be a criminal act ( actus reus ) and
e. Sex impulse an criminal mind ( mens rea ) . Actur facit reum, nisi
f. Suicidal impulse mens sit rea.

11
Mental Deficiency – or mental retardation, is sub
average intellectual ability present from birth or early
infancy. Intelligence is both determined by heredity
and environment. In most cases of mental deficiency,
the cause is unknown.

Classification of mental deficiency:


1. Idiot – The idiot’s 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 imbecile’s 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 person’s


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.

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