CHAPTER 1: LEGAL MEDICINE - Instruments used for determining blood alcohol
level: a) Breath Alcohol Analyzer – measuring the
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.
- chromatography and mass spectrometry, to
Medical Jurisprudence
- is the study of the Medical Law and its applicable
Jurisprudence that governs, regulates and
defines the practice of medicine.
· 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.
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.
amount of alcohol exhaled in the breath of an
individual, which reflects the concentration of
alcohol in the person’s blood; b) Gas
chromatography – mass spectrometry – the “Gold
Standard”. It is an analytical method that
combines the features of gas-liquid
identify different substances within a test sample.
(EX: drug detection, fire investigation,
environmental analysis, explosives investigation,
and identification of unknown samples, airport
baggage checks)
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.
- Generally, a licensed physician is an expert in
Legal Medicine and his testimony in a court of
law is admissible as evidences. 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.
- Expert testimony is that given by a physician
who has been recognized by the court as having
expert knowledge about evidence in the case.
Ordinary testimony is restricted to statements
 concerning what the witness actually saw or
heard.
- An expert is a person who is so qualified either,
by actual experience or by a careful study, as to
enable him to form a definite opinion of his wn
respecting any division of science, branch of art
about which, persons having no particular training
or special study are incapable of forming accurate
opinions or of deciding correct conclusions. 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.
(MATERIAL: that quality of evidence, which tends
to influence the trier of facts because of its logical
connection with the issue.)
- REQUISITES FOR THE ADMISSIBILITY OF
EXPERT TESTIMONY:
- 1) Subject under examination must be one that
requires that the court has the aid of knowledge
and experience such as men not especially skilled
do not have, and therefore, cannot be obtained
from the ordinary witnesses;
- 2) The expert witness called must possess the
knowledge, skill, or experience needed to inform
the court about the particular case under
consideration;
- 3) Expert testimony is not admissible as to a
matter not in issue.
- GR: Expert opinions are not received, if all the
facts can be ascertained and made intelligible to
the court, or if it is such as men in general are
capable of comprehending.
HISTORY OF LEGAL MEDICINE:
- Paolo 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.
- In the Phil., the father of Legal Medicine can be
rightfully is 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:
1. Civil law
- the determination and termination of civil
personality
- the limitation or restriction of a natural
person’s capacity to act
- marriage and legal separation
- paternity and filiation
 - testamentary capacity of a person making also used to describe the evidence that proves the
a will crime has been committed.
- the right to hereditary succession
QUANTUM OF PROOF
2. Criminal Law
- Felonies and circumstances which affect 1. In Civil Cases – the quantum of proof necessary to
criminal liability prove a civil complaint is a PREPONDERANCE OF
- Civil liability ex delictu EVIDENCE. The party filing or bringing a civil complaint
- Crimes relative to opium and prohibited has the burden of proof and must establish the truth and
drugs righteousness of his allegations by a preponderance of the
- Crimes against persons evidence admitted by a competent court.
- Crimes against chastity
- Crimes against civil status of persons 2. In Criminal Cases - the quantum is proof beyond
- Quasi – offenses reasonable doubt.
- In a criminal case the accused is entitled to an
3. Remedial Law acquittal, unless his guilt is shown beyond
- Physical and Mental Examination of a person reasonable doubt
- Hospitalization of insane persons - Presumption of INNOCENCE is a conclusion drawn
- Rules of Evidence by the constitution and the law in favor of the accused,
while REASONABLE DOUBT is a condition of mind
4. Special Laws produced by proof resulting from evidence in the case.
- Dangerous Drug Act
- Youth and Child Welfare Code 3. To establish matters of defense
- Sanitation Code - The doctrine of reasonable doubt applies only
- Insurance law to incriminative facts. The accused is not required to
- Labor Code establish matters in mitigation or defense beyond
- Employees Compensation Law reasonable doubt. It is sufficient if he satisfies the court
of their truth, by credible or preponderant evidence.
5. CORPUS DELICTI
- Is the body or substance of the crime and is 4. To establish self defense
defined as the fact that a crime actually has been - One who sets up SELF DEFENSE “must rely on the
committed. In all criminal prosecutions, the burden is strength of his own evidence and not on the
on the prosecution to prove the corpus delicti. It is 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.
CHAPTER 2: MEDICAL AND HOSPITAL
JURISPRUDENCE
Medical Jurisprudence:
- It 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.
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.
5. To offer or undertake by any means or method to
diagnose, treat, operate or prescribe any remedy for any
human disease, injury, deformity, physical, mental, or
physical condition; or
6. To falsely use the title of M.D., after one’s name.
NOTE: 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:
1. Consensual: based on mutual consent of both
patient and physician whereby the latter binds himself to
treat the former for a given consideration.. Contracts that
are consensual in nature, are perfected upon mere
meetings of the minds There is expressed consent, when
the patient seeks the professional services of the physician
and the physician treats the patient.
2. Fiduciary: founded in trust, faith, and confidence
reposed by one person in the integrity and fidelity of
another. Neither party may exert influence or pressure
upon the other, take selfish advantage of his trust, or deal
with the subject matter of the trust in such a way as to
benefit himself or prejudice the other except in the exercise
of the utmost good faith and with full knowledge and
consent of that other.
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.
Terms and Conditions NOT included in the Physician
Patient Professional Relationship Contract: It does not
include provisions that promise or guaranty that-
1) The treatment by the physician will be successful;
2) The treatment will benefit the patient;
3) The treatment will produce certain results;
4) The treatment will not harm the patient;
5) The doctor will cure the patient;
6) The doctor will not commit honest mistakes of
judgment.
NOTE: 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.
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.
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.
Obligations of the Patients to their Physicians:
1) To provide accurate and complete information;
2) To know and understand the terms and
conditions that are not included in the contract;
3) To understand the purpose and cost of
treatment;
4) To settle their financial obligations;
5) To accept the consequences of his own
Informed Consent;
6) The obligation to himself and others;
7) To exhaust grievance mechanism;
8) To report unexpected health changes
SOCIETAL RIGHTS OF THE PATIENTS FROM THE
GOVERNMENT: the rights included are the right to-
1) To health from the government;
2) To access quality public health care;
3) To a healthy and safe workplace;
4) To prevention and education programs;
5) To participate in policy decisions regarding their
health’
6) To essential goods, health and other social
services available to all people at affordable cost;
7) To a priority for the needs of the underprivileged,
sick, elderly, disabled, women, and children.
RIGHTS INHERENT IN THE PRACTICE OF
MEDICINE:
 1. The right to choose his patients – the physician is not
duty bound to accept or render treatment to any patient
who solicits his professional services. A physician may
arbitrarily and legally refuse to render medical services
to a patient even if there are no other physicians
available in the locality.
2. The right to limit the practice of his profession – “He
cannot be a jack of all trades and master of none in a
very litigious and demanding society.
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. – When a physician has been qualified to
practice in a hospital, he deserves the same hospital
privileges granted to other physicians in the same class.
5. The right to receive just and fair compensation from his
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.
GROUNDS FOR REPRIMAND, SUSPENSION, OR
REVOCATION OF THE PHYSICIAN’S LICENSE:
• Conviction by a court of competent jurisdiction of
any criminal offense involving moral turpitude;
• Immoral or dishonorable conduct;
• Insanity;
• Fraud in the acquisition of the certificate of
registration;
• Gross negligence, ignorance, or incompetence in
the practice of his profession;
• Addiction rendering him or her incompetent to
practice his or her profession;
• False or extravagant or unethical advertisements;
• Performance of or aiding in any criminal abortion;
• Knowingly issuing any false medical certificate;
• Issuing any statement or spreading any derogatory
rumor that destroys another physician’s reputation
without justifiable motive;
• Aiding or acting as a dummy of an unqualified r
unregistered person to practice medicine;
• Violation of any provision of the Code of Ethics.
NOTE: Mere refusal of a physician to attend to a patient in
danger of death is not a sufficient ground for revocation or
suspension of his registration certificate.
➢ To hold a doctor responsible for liability, it is not
sufficient to show that his diagnosis is incorrect or
that he adopted one of the several recognized
methods of treatment than the other, or that
complications followed an operation, unless in each
instance, it is also shown that he failed to exercise
the degree of skill and care required by law.
CHAMPERTY: the “maintenance” of a person in a lawsuit Ex. Whether A Hospital may be Held Liable for the
or condition that the subject matter of the action is to be Negligence of Physicians
shared with the maintainer. – Consultants allowed to Practice in its Premises.

MAINTENANCE: the intermeddling of a disinherited party

to encourage a lawsuit.

BARRATRY: the bringing of vexatious litigation. It is

creating a legal business by stirring up disputes and
quarrels, generally for the benefit of the lawyer who sees
fees in the matter.

AMBULANCE CHASER: a person who is hired by an

attorney to seek out Negligence cases at the scenes of
accidents or in hospitals where injured parties are treated,
in exchange for a percentage of the damages that will be
recovered in the case.

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

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.