LEGAL MEDICINE

I. INTRODUCTION:

This handout is intended to familiarize the participants with the principles of medicine as
applied to law, and to correlate the same to other scientific investigative procedures leading to
the solution of crimes.

HISTORICAL BACKGROUND (Philippines):

1858 – The first textbook in Legal Medicine and its practice by Dr. Rafael Genard Y Mas,
who is a Spanish chief army physician was published and is entitled “Manual
deMedecina Domestica.”
1871 – Legal medicine was included in the curriculum of the college of medicine in the
University of Santo Thomas.
March 31, 1876 – The “ medico titulares” which took charge of the public sanitation and
medico-legal aid for the purpose of justice was created by the King of Spain in his Royal Decree
No. 188.
1894 – The “Medico Titulares of Forensic” which is about the regulation and its practice
was published.
1895 – A medico-legal laboratory was wstablished in Manila to handle medico-legal
cases.
1898 – During the American regime, the Spanish Forensic Medicine System was
preserved.
1901 – The provincial, insular and municipal board of health (Acts 157, 307, 308) were
created by the Philippine Commission which are about the medico-legal duties of “medico
titulares” of the Spanish regime and its assignment to the health officers of the respective areas.
1908 – Legal Medicine was taught in all medical schools in the Philippines.
1919 – The Department of Legal Medicine and Ethics of the University of the Philippines
was created under Dr. Sixto de Los Angeles as the chief.
January 10, 1922 – The Department of Legal Medicine and Ethics of the University of the
Philippines with its Department head was incorporated to the Philippine General Hospital.
March 10, 1922 – The Philippine Legislature enacted Act No. 1043 which became
incorporated in the administrative code as Section 2465 and provides that the Department of
Legal Medicine and Ethics of the University of the Philippines became a branch of the Department
of Justice.
December 10, 1937 – The creation of the Division of Investigation under the Department
of Justice was done by the Commonwealth Act 181 in which a medico-legal section was under
the division with Dr. Gregorio T. Lantin as the head.
March 3, 1939 – The Department of Legal Medicine and Ethics of he Univrsity of the
Philippines was abolished and its functions were transferred to the medico-legal section of the
Division of Investigation.
July 4, 1942 – A medico-legal section of the Manila Police Department was created under
Dr. Pablo Anzures.
1945 – The Provost Marshall of the United States Army created the criminal investigation
laboratory with the Medical Examiner as an integral part under Dr. Mariano Lara as the Chief
Medical Examiner.
June 28, 1945 – the Division of Investigation was reactivated under the Department of
Justice.
June 19, 1947 – The Bureau of Investigation was created by the Republic Act 157. then,
the Bureau of investigation was made the National Bureau of Investigation by the Executive
Order from the President of the Philippines. The medico-legal section was created under the
National Bureau of Invetigation with its head Dr. Enrique V. de Los Santos.
 The existence of the medico-legal division in the criminal laboratory of the G-2 of the
Philippine Constabulary also occurred.
At that time, all provincial, municipal and city health officers, physicians of hospitals,
health centers, asylums, penitentiaries and colonies became he ex-officio medico-legal officers.
In remote places, the service of a “Cirujano Ministrante” or the Sanitary Inspector may
perform the medico-legal work if a registered physician is not available.

The Medico-Legal System

The medico-legal system adopted in a particular country depends upon the laws of such
country. The ones commonly used are the Medico-legal Office System, Medical Examiner System
and the Coroner System. Some countries employed the three system at the same time but other
countries preferred two or a certain system.

A. Medico-legal Office System

This is the medico-legal system used in the Philippines at present which is handled by a
Medical Jurist or Medico-legal Officer who is a registered physician duly qualified to practice
medicine in the Philippines. The National bureau of Investigation, Manila Police Department and
the Philippine Constabulary had their own medico-legal offices with their own respective Medico-
legal Offecers. The Medico-Legal Officer is the one who investigates medico-legal cases of death,
physical injuries, rape and other sexual crimes. His duty is to examine the victim of assistant, to
make a report and to appear in court as expert witness when summoned by the proper
authorities.
Inspite of severl medico-legal cases in the Philippines, the medico-legal investigation is
still insufficient because of the following reasons:
1. Look of proficiency by the physician in medico-legal work
2. Inadequate facilities
3. inadequate means of transportation and communication
4. Lack of sufficient training in medico-legal work by the police investigator and other law
enforcement agent
5. Insufficient physician and personnel to handle medico-legal cases

B. Medical Examiner System

In some parts of the United States, the Medical Examiner System is the preferred,
although the Coroner System is still used in some states. The Medical Examiner System is
handled by the Chief Medical Examiner who is a Doctor of Medicine and appointed by the Mayor
from the classified lists compiled by the Civil Medical Examiner is on a 24-hour work with clerical
staff always present.
The duty of the Medical Examiner is to investigate the cause of death especially violent
death or other circumstances leading to the death of the victim. The Medical Examiner on duty
after being informed by the police officer of a certain crime that needs to be investigated will go
to the place of the crime, interview witnesses, examine the victim and then take specimens if
any, for examination.
During trial, the Medical Examiner will then present his medical report to the court.

C. Coroner System
The Coroner System probably originated in England, although there are no recdords of
its actual origin. In common law, the office of the Coroner is a very ancient one. The name
“Coroner” is probably derived from the title “Custodes Placitorum Coronne” or “Keeper of he
King’s Pleas” as mentioned in Articles of Eyre of 1194. Magna Charta (1215) refers to the
coroner as “Coronator”. A report although there is evidence that coroners existed in Australia.
United States and other colonies of England.
II. GENERAL CONSIDERATION:
a. Evidence – is the means, sanctioned by law, of ascertaining in a judicial proceeding
the truth respecting a matter of fact.
b. Forensic Medicine – is a branch of medical science which deals with application of
medical knowledge to elucidate legal problems.
c. Law –
1. Criminal Law –
2. Civil Law –
3. Remedial Law -
d. Legal -
e. Legal Medicine – is a branch of medicine which deals with application of medical
knowledge to the purposes of law and justice.
f. Medical -
g. Medical Jurisprudence – is a branch of law which deals with the organization and
regulation of the medical profession.
h. Medicine -
1. Internal Medicine –
2. Surgery –
3. Pathology –
4. Gynecology –
5. Obstetrics –

1. Forms of medical Evidence:

a. Real or autopic
b. Testimonial
c. Experimental
d. Documentary
2. Methods of Processing Evidence:
a. Photography and sound recording
b. Sketching
c. Description
d. Testimony of witnesses
3. Kinds of Evidence Necessary for Conviction
a. Direct Evidence
b. Circumstantial evidence

e. Kind of Witnesses:

1. Expert witnesses - opinion of a witness regarding a question of science,

art or trade, when he is skilled therein, may be received in evidence.
2. Ordinary Witnesses - all persons who, having organs of sense, can
perceives, and perceiving, can make their their perception to others., may be witnesses.

III Medico-legal Aspect of Identification

A. When an unjnown body is found, the following should be noted by the unvestigator to
facilitate idebtifcation.
1.. Place where body is found
2. Time when found
3. Cause of Death
4. Time when death occurred
5. Approximate age
6. Supposed profession
 7. Description of the body

B. Poinrs of Idenditfication applicable to both living and dead before onset of decomposition.
1. Accupatyional marks 7. Deformities
2. Race 8. Birth marks
a. Color of skin 9. Injuries leaving permanent result
b. Shape of skull 10. Moles
c. Shape of skull 11. Scars
3. Stature 12. Tribal marks
4. Teeth 13. Sexual organ
5. Tattoo marks 14. Blood group
6. Weight 15. Fingerprints

IV. MEDICO LEGAL ASPECTS OF DEATH (CRIM)

A. DEATH – is the termination of life. It is the complete cessation of all the vital functions
without possibility of resuscitation.

B. TYPES OF DEATH:

1. Brain death – death occurs when there is irreversible coma absence of

electrical brain activity and complete cessation of all the vital functions without
possibility of resuscitation.

2. Cardio-Respiratory Death – death occurs when there is continuos and

persistent cessation of hearth action and respiration.

C. KINDS OF DEATH:

1. Somatic or Clinical Death – state of the body in which there is complete,

persistent and continuos cessation of the vital functions of there brain, hearth and
lungs which maintain life and health.
2. Molecular or Cellular Death – 3-5 hours later death of individual cells.
3. Apparent Death or State of Suspended Animation – not really death but
merely a transient loss of consciousness or temporary cessation of the vital functions
of the body on account of disease, external stimulus, it may arise especially in
hysteria, uremia, catalepsy and electric shock.

D. SIGNS OF DEATH:

1. Cessation of heart action and circulation.

2. Cessation of respiration.
3. Cooling of the body (Algor Mortis)

 Post-mortem caloricity – is the rise of temperature of the body due to

rapid and early putrefactive changes or some internal changes. (Observed in
the first two or some internal changes. (Observed in the first two (2) hours
after death)

4. Insensibility of the body and loss of power to move.

 5. Changes in the skin:

a.) Livid discoloration due to the gravitation of blood.

b.) Loss of elasticity of the skin:
 Post –mortem Contact Flattening – body becomes flattened on areas
which are in contact with the surface it rests.
c.) Opacity of the skin.
d.) Effect of application of heat.

6. Changes in and about the eye:

a.) Loss of corneal reflex.

b.) Clouding of the cornea.
c.) Flaccidity of the eyeball.
d.) Pupil is in the position of rest, (non-reactive)
e.) Ophthalmoscopic Findings.

a. “Tache Noir de la Sclerotique - a spot which maybe oval or round triangular with
the base towards the cornea and may appear in the selera a few hours after death.
(yellowish-black ) due to thin.

E. Changes in the Body Following \death

1. Stage of Primary flaccidity

2. Stage of Rigor Mortis (post-mortem rigidity cadaveric or death struggle of
muscles
3. satge of secondary flaccidity
4. Putrefation or decay
5. Cadaveric

F. Changes in the Blood

1. Coagulation of blood
2. Posr mortem lividity
a. Hypostatic lividity- inside blodd vessels
b. Diffusion lividity - outside the blood vessels in the tissue of the
body
G. Causes of Death

1. Natural Death
2. Violent Death
a. Accident
b. Negligent
c. Infanticidal
d. Parricidal
e. Murder
f. Homicidal
3. Judicail Death
V. Medico-Legal Aspect of Physical Injuries

A. Physical Injuries - effects of the application of stimulus to the body

B. Causes of Physical Injuries

1. Physical Violence
2. Heat or cold
3. Electrical energy
4. Chemical energy
5. Radiation
6. Change in the atmospheric pressure

C. Injuries brought about by physical violence - lead to production of wound

1. Wound - the solution of the natural continuity of tissue of the living body
2. Vital reaction - sum total of all reactions of tissue tissue and organs for
which activities of living cells are necessary.
3. Defense wounds - result of instinctive reaction of self-protection

D. Classification of Wounds:

1. As to severity
a. Mortal wounds
b. Non-mortal wounds

2. As to Kinds of Instruments Used

a. Brought about by blunt instrumenyt
b. Brought abouyt by sharp instruments
1. Sharp-edge instrument
2. Sharp-pointed
3. Sharp-edge and pointed
c. Brought about by tearing force
d. Brought about by change of atmospheric pressure
e. brought about by heat and cold
f. brought babout by infection

3. As to mannets of Inflection
a. Hit by means o9f blolo, blunt insdtrument, etc.
b. thrusr stab
c. Tearing or stretching
d. Gunpowder explosion
e. Slidong or rubbing

4. As regards the Depth

a. Superficial
b. Deep
1. penetrating]
2. Perforating

5. As regards the relation of the site of the application of force and location of
injury
a. Coup injury - injurymfound at site of the application of force
b. Contre Coup - injury found opposite the site of the application of
force.
 c. Coup Contre Coup - injury found at the site and also opposite the
application of force
d. Locus minoris resistancia - injury found both at the site or opposite
the site of the application of the force but in some areas offering least
resistance to the force applied.
e. Extensive Injury - injury involving a greater area beyond the site of
the application of force.

6. As to Regions of Organs

7. Legal Classification
a. Mutilation - intentional act of lpping or cutting of any part of the
living body
b. Serious Physical Injury - injury that will incapacitate the subject
for more than 90 days
c. Less Serious Physical Injury - Injury that will require medical
attendance for 10 days or more but not more than 30 days
d. Slight Physical Injury & Maltreatment - Injury that will
incapacitate subject and require medical attendance from 1 to 9 days

8. As to the Types of Wounds:

a. Closed Wounds - when there is no breach of continuity of skin or
mucous membrane.
1. Superficial Closed Wounds
a. Epithelia - extraversion of blood in the subcutaneous tissue
or mucous membrane
b. Contusion or bruise - wound not on the surface of the skin
but in the substance of the true skin and the substance of
cellular tissue-color is red and sometimes purple soon after
the injury.

2. Change oin the Color of Contusion:

a. 4-5 days color changed to green
b. 7-10 days it becomes yellow & gradually disappear on the
14th or 15th day

Note: The ultimate disappearance of color varies from 1 to 4 weeks

depending upon the severity and constitution of the body.
c. Hecatomb(blood tumor) - extravasation of blood in a newly
formed cavity
d. Ecchymosis - a form of hematoma only that the extent of
extravasation of blood is wider but thinner.

3. Deep Closed Wounds:

a. Simple fracture
b. Sprain - subcutaneous separation or tearing of the articular
tendons, ligaments or muscles.
c. Strained – tearing or rupture of muscle fibers
d. Dislocation – displacement from each other of the articular
surfaces of bones entering into the formation of a joint.
e. Cerebral or brain concussion – the jarring or of the brain
leading to some commotion of the cerebral substance.
f. Internal Hemorrhage
 1. Intracranial
2. Rupture of organs
3. Laceration of organs

4. Open Wounds – when there is communication with the

outside or break in the skin or mucous membrane.

a. Abrasion – characterize by the removal of the superficial

layer of the skin brought about by friction against a hard
rough surface.

1. Forms of Abrasion
a. Linear
b. Multi-linear
c. Confluent – almost indistinguishable due to severity of
friction and roughness of the object.
d. Multiple - several abrasion noted on the body surface
of a person.
2. Types of Abrasion:
a. Scratches c. Impact or imprint abrasion
b. Grazes d. Pressure or friction abrasion

b. Incised wound - produced by forcible contact

c. Lacerated Wound - produced by forcible contact of the body
with a blunt instrument.
d. Stab Wound - produced by a sharp-pointed and sharp edge
instrument.
e. Punctured Wound - produced by a sharp-pointed instruments
f. Wound produced by powder explosion
1. Firearm
2. Granade, dynamite, etc.
g. Mutilation
h. Avulsion

E. Medico-Legal Aspect of Wounds:

1. The ff. rules must be always observed.
a. All injuries must always be described however small for it may be important
later.
b. The decription of wounds must be comprehensive.

2. General Investigation of Surroundings

a. Place where crime was committed
b. Examination of clothing, stains, cuts, hairs and other foreign bodies that may be
found in the scene of the crime.
c. Investigation of those persons who may be witnesses to the incident or which
could give light to the case.
d. Examination of the wounding instrument.
e. Photography, sketching, or accurate description of the scene of the crime for
purposes of preservation.

3. Examination of the Wounded Body:

Examination applicable to the living and dead victim:
a. Age of the wound from the degree of healing
 b. Determination of the weapon used in the commission of the offense.
c. Determination whether the injury is accidental, suicidal or homicidal.
d. Reason for the multiplicity of wounds in cases where there are more than one
wound.

4. Examination of the Wound:

a. Characteristic of the wound
b. Location of the wound
c. Direction of the wound
d. Number of the Wound
e. Extent of the Wound
f. Condition of the surrounding of the wounds
g. Condition of the locality
1. Degree of hemorrhage
2. Evidence of struggle
3. Information as to the position of the body
4. Presence of letter or suicide note
5. Condition of the weapon

5. Determination whether the wounds were inflicted during life or after

death:
a. Hemorrhage - more profuse when wound was inflicted during lifetime of the
victim
b. Signs of inflammation - there may be swelling of the area surrounding the
wound. Other vital reaction maybe present whenever the wound was inflicted
during life.
c. Signs of repair - fibrin formation, scab or scar formation conclusively show that
wound was inflicted during life.
d. Retraction of the edge of the wound - Owing to the vital reaction of the skin
and contractility of the muscular fibers, the edges of the wound inflicted during
life retract and cause gaping.

6. Points to consider in the determination whether the wound is homicidal,

suicidal or accidental:

a. External signs and circumstances related to the position and attitude of the body
when found.
b. Location of the weapon or the manner in which it is held.
c. The motive underlying the commission of the crime or the like.
d. The personal character of the deceased.
e. The possibility of the offender to have purposely changed the truth of the
condition.
h. Other information:
1. Signs of struggle
2. Number and directions of wounds
3. Nature and extent of the wound
4. State of the clothing

7. Length of time of survival of the victim after infliction of wound:

a. Degree of healing
b. Changes in the body in relation to the time of death
c. Age of the blood stain
 d. testimony of witnesses when the wound was inflicted.

8. Possible instrument used by the assailant in inflicting the injuries:

a. Contusion - by blunt instrument

b. Incised wound - by sharp-edged instrument
c. Lacerated wound - produced by blunt instrument
d. Punctuated wound - by sharp pointed instrument
e. Stab - by sharp-edged and pointed instrument
f. Gunshot wound - the diameter of the wound entrance may approximate the
caliber of the wounding firearm.

9. Which of the injuries sustained by the victim caused death?

This can be ascertained by examining by examining individually the wounds and
noting which of them involved injury to some vital organs or large vessels or led to
secondary result causing death.

10. Which of the wounds was inflicted first?

The ff. must be taken into consideration :

a. Relative position of the assailant and the victim when the first injury was inflicted
on the latter
b. Trajectory or course of the wound inside the body of the victim.
c. Organs involved, degree of injury sustained by victim.
d. Testimony of witness.
e. Presence of defense wounds on the body of the victim if the victim tried to make
defense act during the initial attack, then the defense wounds must have been
inflicted first.

11. Relative Position of Victim and Assailant when Injury was inflicted:

The ff. has to be considered:

a. Location of the wound in the body of the victim
b. Direction of the wound
c. Nature of the instrument used in inflicting the injury
d. Testimony of witnesses

F. Death or Physical Injuries Brought About by Powder Propelled Substances:

1. Production of Combustions:
a. Bullet - Gunshot wound
b. Flame - Singeing
c. Smoke -smudging
d. Gun powder residue - tattoing
e. Grime - tattoing

2. Firearm Wounds:
a. Gunshot Wound
 Difference Between Entrance and Exit

ENTRANCE EXIT
1. Appears to be smaller than missile owing to 1. Always bigger than missile
elasticity of tissue except contact fire.
2. Edges inverted 2. Edges everted
3. Usually ovaloid or rounded 3. Variable shape
4. Contusion collar present 4. Contusion collar absent
5. Other product of combustions when firing is 5. Always absent
near
6. Paraffin test may be positive 6. Always negative
3. Determination of Relative Position of Victim & Assailant:

a. Contusion Collar - the wider side points to the source of the missile.
b. Smudging & Tattoing - the side with more or intense deposit points to the
source of the missile.

4. Determination of the probable caliber of the firearm used in the infliction -

measure in centimeter of the cross diameter of the gunshot wound fro collar to collar - the
shortest is the probable caliber.

5. Determination of the distance of fire:

a. Contact fire - intense laceration & undermining of the point entrance. Normal
bigger than exit.
b. Distance of six(6) inches presence of smudging, singeing and tattoing.
c. Beyond six(6( inches but within thirty six(36) inches - presence of the tattoing.
d. Beyond thirty six(36) inches only the gunshot wound will be present

G. Shotgun Wound

1. Kinds of bore of shotgun

a. Unchoked bore or straight bore
b. Choked bore
1. Improved cylinder - narrowing of the bore from rear to the muzzle is 3-5
thousandth of an inch.
2. Half Chock - narrowing of the barrel is 15-20 thousandth of an inch.
3. Full Chock - narrowing of the barrel is 35-50 thousandth of an inch.

2. Characteristics of shotgun wounds

a. Contact fire - entrance of wound is irregular with severe destruction of the
underlying tissue. There is singeing and smudging.

b. Near shot up to six(6) inches.

1. Mark laceration of skin.
2. Gunpowder maybe driven into the deeper area of the wound.
3. mark smudging of the skin & deeper portion of the wound of entrance.
4. Mark tattoing.
5. Hair is singe.
6. Wad may be found inside the wound of entrance.

c. Distance of about one(1) yard

1. Pellers enter as one mass thus making entranc wound with irregular edges.
2. Surounding skin may be blacken with light buning & tattooing.
 d. Distance of 2 to 3 yards –
1. The wound of entrance has big central hole with rugged edges with few stray
wound of entrance wound.
2. Smudging & tattooing – no longer evident

e. Distance of 4 yards – pellets may enter skin area of about 6 to 8 inches

diameter although there may be a central care where a group might have
entered.

H. Death by Asphyxia – all forms of violent death which results primarily from the
interference with the process of respiration or to condition in which the
supply of oxygen to the blood or tissue or both has been reuced below
normal level.
1. Hanging
2. Stangulation
a. by ligature
b. manual or throtting
c. special forms of strangulation
c.1. palmer
c.2. garroting
c.3. mugging or yoking
c.4. compression of neck with stick

3. Suffocation –
a. smothering – closing mouth and nostrils by solid objects
b. choking

4. Asphyxia by submersion in water (drowning)

5. Asphyxia by pressure on the chest
6. Asphyxia by irrespirable gases

I. Death or Physical Injuries Due to Vehicular Accidents

1. Kinds of injuries in vehicular accident cases

a. sustained by the pedestrian
a.1. impact injuries
1. primary impact injuries
2. subsequent impact injuries
a.2. Secondary injuries
a.3. Run over injuries

b. Sustained by driver & passengers

1. impact injuries
2. turn-turtle injuries

2. Medical Evidence in Vehicular Accident Cases

a. Evidence from the victim
o Crash injury
o Tire thread marks
o Abrasion prints
o Blood, hair or clothing of victim may be found sticking on the part of
the vehicle which hit the victim.
 o Physical defects of the victim like poor eyesight
o Inebriation of the victim – like under the influence of alcohol
b. Evidence from the driver
* Physical defect like poor eyesight
* Under the influence of alcohol or drugs by drive
* History of grudge between the driver and the victim.

VI – MEDICO-LEGAL ASPECTSEXUAL CRIMES:

A. VIRGINITY – is a condition of a female who not experienced sexual intercourse.

KINDS OF VIRGINITY:
a. Moral virginity
b. Demi-virginity
c. Virgo-Inacta
d. Physical virginity
1. True physical virginity
2. False physical virginity

POINTS TO BE CONSIDERED IN THE DETERMINATION OF THE CONDITION OF

VIRGINITY.
a. Breast
b. Vaginal canal
c. Labia majora minora
d. Fourshette & perineum
e. Hymen
f. Rougosites

B. DEFLORATION – laceration or rupture of the hymen as a result of sexual intercourse

CALSSIFICATION PF HYMENAL LACERATION

a. Incomplete Laceration
* Superficial
* Deep
b. Complete
c. Complicated

HEALING TIME HYMENAL LACERATION

a. superficial – 2 to 3 days
b. extensive tear – 7 to 10 days
c. complicated – if with intervening infection will require longer to heal

DURATION OF LACERATION OF THE HYMEN

a. fresh bleeding laceration – rupture quite recent

b. healing – after 24 to 7 days
c. recently healed – 7 days to 3 months
d. old healed – 3 mos to years

MEDICAL EVIDENCE TO CONSIDER IN SEXUAL CRIMES:

a. Evidence from the victim
1. Alleged time and place of the commission of the crime.
 2. Date, time and place of the examination.
3. Condition of clothing.
4. Physical and mental development of victim.
5. Gait, facial expression etc.
6. Examination of body for sign of violence
7. Examination of genetalia.
a. hymen
b. hymental orifice
c. vaginal canal
d. rougosites
e. fourshette
f. pubic hair
g. labias
h. presence of spermatozoa

b. SEXUAL CRIMES

1. rape
2. seduction
a. qualified
b. simple

3. Acts of lasciviousness
4. Abduction
a. forcible
b. consented

5. Corruption of minors
6. White slave trade
7. Adultery
8. concubinage
9. Unnatural sexual offenses

VII. MEDICO LEGAL ASPECT OF PREGNANCY

PREGNANCY – is a state of a woman who has within her body the going product of conception.

a. Legal importance of the study of pregnancy

* Pregnancy ground for the suspension of the execution of the death sentence
in a women.
* A conceived child is capable of receiving donation.
a. Archeim – Zondel Test
b.Friedman test
c. Xenopus of Hogben Test
d. Qualitative color test for pregnandial
e. Estrone Administration

b. Duration of pregnancy – 270-280 days from onset of last menstruation.

c. Abnormally prolonged gestation – beyond 300 days.
d. Minimum period of gestation – compatible with viability of the child born at 180 days
may live.
e. Super fecundation – fertilization made by separate intercourse of two ova which have
escaped at the same act of ovulation.
 g. Pseudocysis or spurious pregnancy – imaginary pregnancy

VIII. MEDICO LEGAL ASPECTS OF DELIVERY

1. Delivery is the process by which in a woman gives birth to her offspring.

2. Puerperium – is the interval between the termination of labor (delivery) to the
complete return of the reproductive organ its normal pregnant state-last from 6 to 8
weeks.
3. The study of delivery is important because proof delivery is necessary in judicial action
on the following:

a. Legitimacy
b. Abortion
c. Infanticide
d. Concealment of birth
e. In slander or libel

4. Methods of delivery

a. Natural Route – the normal passages

* Spontaneous
* Surgical intervention
* Instrumentation

b. Surgical Route –
* Abdominal caesarian section
* Vaginal caesarian section
* Post-mortem caesarian section

IX. MEDICO LEGAL ASPECT OF ABORTION

Willful killing of the fetus in the uterus, or violent expulsion of the fetus from the natural
womb and which results to the death of the fetus.

A. Principal elements of crime:

1. That the expulsion of the product of conception is induced.

2. That the fetus dies either as an effect of the violence used, drug administered or
fetus was excelled before the term of its viability.

B. Provision of the Revised Penal Code on Abortion

1. Intentional Abortion Elements:

a. That the woman is pregnant
b. Violence was applied on such pregnant woman without the intention of
abortioning her.
c. The woman aborted as result of the violence.

2. Unintentional Abortion Elements:

a. The woman must be pregnant
b. Violence was applied on such pregnant woman without the intention of
abortioning:
c. The woman aborted as aborted as result of the violence.
 3. Abortion Practiced by the woman herself or by her parents

Elements:
a. The woman is pregnant
b. Abortion is intended to be committed
c. Abortion is induced by
1. The pregnant woman
2. Other person with consent of the pregnant woman
3. The presents of the woman, or either of them for the purpose of
concealing her dishonor and with the consent of the woman
herself
4. Abortion practiced by a physician or midwife and dispensing of
abortions, Elements:
a. The woman is pregnant
b. The physician induced or assisted in causing the abortion
c. The acts done by the physician or midwife intended to cause
an abortion.

There must be intention of the physician to produce abortion and the absence of
intention will not make the physician criminally liable.

C. Kinds of Abortion
1. Spontaneous or natural
2. Induced
a. therapentic
b. criminal

IX. MEDICO LEGAL ASPECT OF BIRTH

a. Legal importance of the study of birth

1. Birth determines personality.

2. Appearance of a child is ground for the revocation of donation.
3. Proof of live birth must first be shown before of the child by the prosecution in
the case of infanticide

XI. MEDICO LEGAL ASPECT OF INFANTICIDE:

INFANTICIDE – is the killing of a child less than three (3) days old.

How the crime committed:

a. By omission or neglect
* Failure to litigate the umbilical cord
* Failure to protect the child from heat and cold
* Omission to take the necessary help of a midwife or skilled physician.
* Omission to supply the child with proper proof food.
* Omission to remove the child from the mother’s discharge with
resulted to suffocation .

b. By commission
* By inflicting physical injuries
* By suffocation
 * By strangulation
* By drawing
* By poisoning
* By burning
* By deliberate exposure to heat and cold

c. Other allied causes

* Abandoning a minor
*Abandoning a minor by person entrusted with custody indifference of
parents.

XII. MEDICO-LEGAL ASPECT OF PATERNITY AND FILIATION

PATERNITY – is the civil of the father with respect to the child begotten him.

FILIATION – is the civil status of the child in relation to its mother or father.

a. Legal importance of determining Paternity & Filiation

1. For succession
2. For enforcement of the naturalization and immigration laws.

b. Kinds of children
1. Legitimate children (proper) – born in lawful wedlock or within 300 days after the
dissolution of marriage.

Presumption of Legitimacy – children born after 180 days following the celebration of
marriage, and before 300 days following its dissolutions or the separation of the spouses shall be
presumed to be legitimate.

Against their presumption no evidence shall be admitted other than that of the physical
impossibility of the husband’s having access to his wife within the 180 days of the 300 which
preceded the birth of the child.

This physical impossibility may be caused by:

a. The impotence of the husband;
b. the fact that the husband and wife were living separately in such a ay that access was
not possible.
c. By the serious illness of the husband.

Requisites of the presumption:

a. There is a valid marriage
b. the birth of the child took place after 180 days following the celebration of marriage or
within 300 days following its dissolution or separation of spouse;
c. There is no physical impossibility of the husband having access to the wife during the
first 120 days of the 300 proceeding the birth of the child.

2. Legitimate Children

Legitimation – is defined as a remedy or process by which a child born out of lawful

wedlock and are therefore considered illegitimate are by fiction of law considered by subsequent
valid marriage of the parents.
Children that can be legitimated:

1. Natural children (proper)

Natural children are those born outside lawful of parents who, at the time of the conception of
the former were not disqualified by any impediment to marry each other.

C. Adopted Children

ADOPTION – is defined the act or proceeding by which of paternity and filiation are recognized
as legally existing between persons not so related by nature.

Persons who may be adopted:

a. The natural child by the natural father or mother;
b. Other illegitimate children, by the father or mother;
c. A step-child, by the step-father or step-mother;
d. Any person, even if age provided adopter is sixteen years older

2. Illegitimate Children

A. Natural Children

a. Natural Children (proper)

b. Natural children by legal fiction – natural children by legal fiction are those born of void degree
of annulment.

3. Natural children by presumption - are those natural children acknowledge the father or
the mother separately if the acknowledging parent was legally competent to contact marriage at
the time of conception.

b. Spurious Children

Illegitimate who are not natural are considered spurious children may be:

1. Adulterous Children – conceived in an act of adultery or concubinage.

2. Sacrilegious Children – children born of parents who have been ordained in sacris.
3. Incestuous Children – children born by parents who are legally incapable of
contracting valid marriage because of their blood relations as marriage between brothers
and sisters, father and daughter, etc.
4. Manceres – children conceived by prostitute. It is very difficult to determine the father
because of the nature of the work.

ARTIFICIAL INSEMINATION – is the introduction of seminal fluid with spermatozoa in the

generative of a woman by any means of springe, pipette, irrigator, etc.

Status of Children born by artificial Insemination:

a. If the donor is the husband, the child must be unquestionable legitimate.
b. If the semen came from a donor than the husband, with the consent of the later, the
child may also considered legitimate in as much as it born lawful wedlock and there is
consent of the husband.
c. If the semen came from a third party and introduced to the wife without consent or
against the will of the husband, the child is illegitimate (adulterous).
EVIDENCES OF PATERNITY AND FILLETING

1. Medical Evidences

a. Parental likeness
b. Blood grouping

c. Evidence from the mother

* Proof of previous delivery

* Proof of physical potency & fertility
* Proof of capacity to have access with the husband
*Evidence from the father
a. Proof of physical [potency and fertility
b. Proof of access

2. Non-Medical Evidences:

a. Record of birth in the civil registrar, or by an authentic document or a final judgment.

b. Continuous possession of the status of a legitimate child.
c. Any other allowed by the Rules of Court and Special Laws.

XIII. MEDICO-LEGAL ASPECT OF IMPOTENCY AND STERILITY

IMPOTENCY – is the physical incapacity of either sex to allow or grant to the other legitimate
sexual gratification.

a. Legal importance of impotency

1. Impotency, if proven, will overthrow the presumption of legitimacy.
2. Impotency maybe ground for the annulment of marriage

b. Cause of impotency
1. General or functional, unconnected directly with the sexual organs:
* age
* Illness
* Emotion
* Hormonal dysfunction
2. Local or organic, in direct connection with the sexual organs:
* Congenital defects
a. In males
* Non-development of the penis
* Mal development of the penis
* Penis adherent to the scrotum
* Duplex organ

b. In females
* Absence of vagina
* Vagina ill-developed
*Vagina accluded by intra-uterine disease

* Disease of Accident
a. In males
*Penis
 - acute disease of the penis as gonorrhea
- chronic disease of the penis as epithelioma
- complete amputation of the penis

*Testes
- removal of the testes
- sexual abuse

b. In the females
- Vaginal laceration
- Disease of the vulvae
- Obstruction of the vaginal canal due to tumor cyst or fibroid

STERILITY – is the loss of power procreation and is absolutely independent of whether or not
impotency is present. A man or a woman maybe sterile and yet impotent impotent yet not sterile.

A. General functional, unconnected directly with the sexual organs.

B. Local cause of sterlity
a. congenital
1. in the male
o Absence of testicle
o Absence of penis
o Mal-development of the testicle
o Mal-development of the testes in uterus
o Misplacement of the testes
o Mal-formation of the penis, as epipadias or hypospadias
o
2. in the female
o Absence or mal-development of the ovary
o Absence or mal-development of the uterus
o Absence of the vagina

b. Acquired conditions:
1. in the male
o Complete amputation of the penis
o Excision of the testicle
o Diseases of the testicle
o Atrophy of the testicle

2. in the female
o Excision of the ovary
o Diseases of the ovary
o Occlusion of the vagina from the diseases
o Diseases of the vagina
o Occlusion of the fallopian tubes