(As of 05/26/2020, 10:00PM) This is exactly what | have indicated it to be: an outline of some sorts, which | based from the required readings * original texts, cases, and annotations as well as the discussions of Atty. Patdu and the Block C 2017 Reviewer, and formatted for easier memorization and recall All for love. “BB LEGAL MEDICINE Pee ee Ue Curry emer ter, Makati Cit |. GENERAL CONCEPTS ‘A. DEFINITIONS 1. Legal Medicine* ‘* Branch of medicine which deals with the application of medical knowledge to the purpose of law and in the administration of justice? '* Application of Medicine to Law al Jurisprudence ‘© Legal aspect of medical practice® ‘* Application of Law to Medicine B, SCOPE AND SIGNIFICANCE © LAWAND MEDICINE © Legal medicine has emerged from being a field that was almost exclusively concemed with forensic pathology and — psychiatry in country-specific settings to now encompass the _ bioethics, organization, liability, _and management of health care delivery 1Used synonymously with Forensic Medicine *Solis, Legal medicine p. 1 'Solis, Medical Jurisprudence p.1 and the growing global movement toward human rights in health* © It is inevitable that the two disciplines intersect, 1. Application of Medical Science to Law. - Medicine and forensic science can help, elucidate legal problems, Examples: cwIL LAW © determination of civil personality (NCC, art. 40, 41, 42) © Urmitation of person's capacity to act (NCC, art. 38, 39) © marriage and legal separation - psychological incapacity paternity and filation testamentary capacity of a person making a will CRIMINAL LAW © Circumstances affecting criminal UUability (insanity) © Crimes against persons © Crimes against chastity © Dangerous Drugs Act © vAWe REMEDIAL LAW © Physical and mental examination of ‘the person (rule 28) © Proceeding for hospitalization of an insane person (rule 104) © DNAevidence LABOR LAW ~ Employee's Compensation INSURANCE LAW. SPECIAL LAWS ~ Juvenile Justice Act, Code of Sanitation Capacity to Enter Contracts 2. Application of Legal Principles to Medicine. - Law regulates various aspects_of the health care sector playing an important role in the protection of health and safety. *S Sandy Sanbar, Introduction: Legal Medicine, in AMERICAN COLLEGE OF LEGAL MEDICINE, LEGAL. MEDICINE (7th ed. 2007} Billie Blanco (2) | Ateneo Law 2022] 1Examples: © Regulation of | Professions - Medicine and Allied Medical Sciences Licensing of Hospitals Duties imposed by law on Health Care providers Heatth Insurance Health related Laws Medical Negligence Hospital Liability Health Maintenance Organizations Medical Privacy Rights of Patients Medical Records Pete eM Aenea Branch of medicine | Application of a that deals with use of | broad range _of medical knowledge | scientific disciplines to elucidate legal |to public or legal problems. concerns, eg, Forensic Forensic entomology, Forensic odontology, Forensic anthropology, Forensic toxicology, Forensic chemistry, Forensic computer science. Pathology, Forensic |e.g., Psychiatry, Clinical Forensic Medicine. . FORENSIC SCIENCE® [Note: The first eight here are those in the syllabus. | Included the rest of the disciplines from Prahlow in ‘the ‘Other Disciplines’ section. -BB] 1. Forensic Pathology Forensic Pathology represents a subspecialty within the medical specialty of pathology’, dealing specifically with the investigation of 4. Prahlow, Forensic Pathology for Police, Death Investigations, Attorneys, and Forensic Scientists, Chapter 2, DO! 10.1007/978-1-59745-404-9 2 "Pathology literally means"the study of disease, sudden, unexpected, and/or violent deaths. Rules of Court, Rule 138 §5 Sec. 5. Additional requirements for other applicants. - xxx No applicant shall be admitted to the bar examinations unless he has satisfactorily completed the following courses in a law school. or university duly recognized by the government: civil law, commercial law, remedial law, criminal. law, public and private international law, political law, labor and social legislation, medical jurisprudence, taxation and legal ethics. © The autopsy is central to the practice of forensic pathology. Code on Sanitation, PD. 856 $95 (1975) Person authorized to perform Autopsies: 1. Health officers 2. Medical officers of law enforcement agencies, and 3. Members of the medical staff of accredited hospitals ‘Autopsies shall be performed in the following 1. Whenever required by special Laws; 2. By Order of Court or Fiscal, 3. Upon written request of police authorities, 4, Whenever the Solicitor General, provincial or city fiscal as authorized by existing laws, shall deem it necessary to disinter and take possession of remains for examination to determine the cause of death; and 5. Whenever the nearest kin shall request in writing the authorities concerned to ascertain the cause of death ‘Autopsies may be performed on patients who die in accredited hospitals subject to the following requirements: 41. The Director of the hospital shall notify the next of kin of the death of the deceased and request permission to perform an autopsy 2. Autopsy can be performed when the permission Is granted or no objection is raised to such autopsy within 48 hours after death. 3. In cases where the deceased has no next of kin, the permission shall be secured from the local health authority Billie Blanco (2) | Ateneo Law 2022 | 22. Forensic Psychiatry Forensic Psychiatry represents a discipline dealing with the evaluation of the mental state of criminals © Occasionally, forensic pathologists will interact with forensic psychiatrists and police investigators to form a psychiatric profile” of a suspect in a particular murder or series of murders. © A ‘psychological autopsy” is sometimes necessary when attempting to determine the state of mind of a suicide victim. 3. Clinical Forensic Medicine Clinical Forensic Medicine is that branch of medicine that deals with both the provision of clinical services (1e., diagnosis, treatment, and management) to patients and the medicolegal aspects of patient care Examples: Request for _physical examination of person in custody; Aging of wounds to determine if consistent with Alleged date of infliction 4, Forensic Entomology Forensic entomology is a subspecialty within the biological science discipline of entomology’ that primarily deals with insect succession patterns. in decomposing human bodies. © Evaluation of insects (including larval stages, or maggots) found ‘on decomposing bodies can permit scientific estimation of the time of death. In certain circumstances, information regarding the location of death may also ascertained. 5. Forensic Odontology Forensic Odontology is a subspecialty within dentistry in which a dentist has 2 specialized expertise in using dental examination to assist. inthe identification of human remains, and in the evaluation of bite-marks, wherein 2 bite-mark on a victim may be “matched” to a suspect. © The majority of a forensic odontologist’s involvement in forensic casework involves assisting forensic pathologies in the identification of bodies. © Assistance is usually provided in cases where the body is not visibly identifiable, and identification by fingerprint comparison or other means is not possible. © The common types of cases are persons who are badly bumed and those who are badly decomposed, Note: Presidential Decree No, 1575 requires practitioners of dentistry to keep and _maintain_an_accurate_and complete record of the dentition of all their patients. Upon the lapse of 10 years from the Last entry, dental practitioners shall. turn over the dental records of their patients to the National Bureau of Investigation for record purposes. Forensic Anthropology Forensic Anthropology is 2 subspecialty within the scientific field of physical anthropology’, in which forensic anthropologists examine _ skeletal remains (bones). © Forensic anthropologists attempt to answer questions about bones, including questions regarding species of origin (i.e, human versus nonhuman), gender, age, race, stature, nutritional status, existence of disease processes, "Physical anthropology refers to the study of the physical character of human beings Billie Blanco (2) | Ateneo Law 2022 | 3 “Entomology refers to the study of insects.7 8 and the presence and character of skeletal trauma through the study of bones, Forensic Toxicology Forensic Toxicology is a discipline that involves the identification and quantification of drugs and other poisons or toxins in body tissues, including blood, © Screening tests are said to be ‘qualitative, where a test is either positive (indicating that the drugftoxin is present) or negative (indicating that the drug/toxin is not present). When specific levels of drugs or toxins are determined, the tests are said to be Qualitative’ For a result to have forensic significance, two separate methodologies are required: an initial (screening) test, and 2 confirmatory (quantitative) test © Another function of /— some toxicology laboratories is drug identification Forensic Chemistry Forensic Chemistry is the application of chemical science or chemistry in solving or proving the crime in the court of law. It is the scientific examination and identification of physical evidence such as blood and seminal fluids, gunpowder residues, explosives, hairs and fibers, tool marks, glass fragments/fractures, paints and soil Note: Dactyloscopy (or Fingerprint Evidence) is a valuable means for identifying people through fingerprints which represent unique patterns of the ridges on the pads of the fingers (including the thumbs). A fingerprint represents 2 specific, individual characteristic of a particular person, Fingerprint examiners rely on various class characteristics (L., loops, whorls, and arches) as well as individual characteristics (‘ridge characteristics’ or iminutiae’) of fingerprints in their examinations. © An evidence fingerprint (such as a latent” or invisible fingerprint) at a crime scene can be matched to a known print in a database OTHER DISCIPLINES: 1. Trace Evidence Trace Evidence is @ general term used to describe various relatively small pieces of evidence that can be evaluated scientifically. Such evidence can include such items as hait, fibers, paint chips, glass fragments, soil, gunshot residue (primer components, gunpowder, etc), accelerants, and explosives © With certain types of evidence, the mere identification of the trace evidence may have a significance in a particular case, for example, the identification of gunpowder on the clothing of a shooting victim, © With other types of trace evidence, crime laboratory scientists may be able to ‘match’ or “associate” a particular piece of evidence collected from a crime scene to a source, including the_-—alleged perpetrator of a crime 2. Firearms and Toolmarks Examiners Firearms and Toolmarks Examiners are forensic scientists with a specific expertise in the evaluation of firearms and ammunition © As part of their job, these scientists are able to match an evidence bullet (such as that collected from a body at autopsy) to a particular suspect weapon, © Other toolmark patterns can allow examiners to “match” bullet casings to specific weapons (firing pin impressions, ejector marks, extractor masks, etc) Billie Blanco (2E) | Ateneo Law 2022 | 4© Marks left by other items such as knife blades or blunt instruments, may also. be specific enough to allow toolmarks examiners to match a suspect weapon to a crime scene or even occasionally to a body (via marks produced in cartilage or bone), © Firearms and toolmarks examiners are also able to evaluate firearms regarding functionality, answering questions related to whether or not a firearm — functions appropriately, etc 3. Document Examination Document Examiners evaluate handwriting or machine-produced printing (e.g. typewriters, computer printer, copiers, etc) and other documents. © Forensic scientists play a very important role in a variety of crimes, including forgeries, fraud cases, and counterfeit operations. © Document examiners occasionally perform — other forensic tests, such as fingerprint analysis, impression analysis, or voice analysis Serology/DNA Forensic serologists can perform tests to determine if a suspicious fluid or stain is saliva, semen, or blood. © Tests are available to determine if the evidence, such as blood, is of human origin. Once it is identified as human, then DNA (deoxyribonucleic acid) testing can be attempted, With the exception of identical twins, no two individuals’ DNA is exactly alike. Blood Spatter Analysis Blood Spatter Analysis encompasses the evaluation of blood drops at a crime scene (or sometimes on a body or elsewhere) * Based on the size, shape, character, density, and location of blood spatter, forensic scientists are able to determine possible causes of, or scenarios responsible for creating the particular pattern. © Specific features that are able to be determined include the direction of travel, the relative velocity, and the angle of impact of the blood droplets Impression Analysis Impression evidence includes items such as tire tracks, footprints, and shoeprints, although many different objects may cause impression evidence. © Toolmark evidence is 2 form of impression evidence © As. with firearms examiners being able to include or eliminate a particular weapon as being the source of a particular bullet based on class characteristics, investigators evaluating other types of impression evidence can frequently include or exclude a suspect item (like a shoe) based on class characteristics. Computer Forensics Computer forensics is a rapidly evolving discipline concerned with computer and electronic crimes. © Examples of the types of crimes investigated include identity theft, credit card, and other financially motivated fraud, child pornography, ete. Forensic Artistry Forensic Artistry relies on an artists’ ability to draw or sculpt an image of how a suspect or victim might appear. © The appearance may be created on the basis of witness recollections of a suspect or on other criteria, some of which may have more scientific basis, such as occurs with computer assistance when an attempt is Billie Blanco (2) | Ateneo Law 2022 | 5made to show how a missing 8. Polygraph Laboratory; and person or suspect might appear 9. Questioned Documents several years later. Laboratory. 9. Forensic Engineering © The frontline services of the Philippine Forensic Engineering is 2 discipline that National Police NBI Crime Laboratory can encompass virtually any type of and corresponding fees for their services engineering are’ © Examination of collapsed buildings, bles and fer srcresis one se of forensic engineering Accreditation of Morgues and | P3,000.00 © Other topics include vehicular collisions Funeral Parlors and accident reconstruction, evaluation of engines, or other devices for defects ‘Autopsy (Non-Criminal Cases) | P1,200.00 responsible for injuries/death, and evaluation of electrical appliances or DNA Examination 20,000 sources of electricity in cases of per suspected electrocutions. specimen Drug Test 400.00 D. FORENSIC SCIENCE IN THE PHILIPPINES * Major agencies of government concerned with forensic investigations: i) National Bureau of Investigation = Taft Avenue, Manila Examination of Altered or | P2,000.00 Erased Documents Examination of Counterfeit Bills | 2,000.00 2) Philippine National Police — Fingerprinting Services (Travel | P200.00 Camp Crame, Quezon City - Abroad) Scene of the Crime Operation (S0CO Units) Handwriting Identification 3,500.00 3) Local Crime Laboratories Histopathological_ Examination | P1,000.00 Resources usually go to analysis of (Non-Criminal Cases) drugs and DNA © The different divisions under the Macro-Etching Examination for | None National Bureau of Investigation (NBI) Motor Vehicle Applied for PNP Office of Forensic Investigation Services Clearance at Highway Patrol are as follows" Group 1. Behavioral 5. D ey Macro-Etching for Lifting of | 200.00 2. Dattyloscopy Division; ‘Alarm, Verification, and 3. Firearms Investigation Division Re-stamping 1D); 4, Forensic Chemistry Division Polygraph Examination P600.00 (FCD); Semen Determination | P500.00 5. Identification and Records (Non-Criminal Cases) Division (RD); 6. Medico-Legal Division (MLD); Serology Examination | P500.00 7. Photography and Publication (Non-Criminal Cases) Laboratory; *het://nbi gov ph/services/forensic-investigaion-service *°netp://www pnp govph/images/Downloads/CLGService y. sdf. Billie Blanco (2E) | Ateneo Law 2022 | 6Signature Identification 2,000.00 Stencil Tracing and Test P350.00 of Firearm for Licensing Virginity Determination | P:100.00 (Non-Criminal Cases) Examination of Expert Witness, Rule 130, Sec. 48-49 Section 48. General rule. — The opinion of witness is not admissible, except as indicated in the following sections. Section 49. Opinion of expert witness. — The opinion of @ witness on a matter requiring special. knowtedge, skill, experience or training which he shown to posses, may be received in evidence. CASE DOCTRINE Dela Torre v. Imbuido Medical malpractice or, more appropriately, ‘medical negligence, is that type of claim which a victim has available to him or her to redress @ wrong committed by a medical professional which has caused bodily harm In order to successfully pursue such a claim, a patient, or his or her family as in this case, “Trust prove that a health care provider, in most cases a physician, either failed to do something which a reasonably prudent health care provider would have done, or that he or she did something that a reasonably prudent provider would not have done; and that failure or action caused injury to the patient. [lp medical negligence cases, there is 2 physician-patient relationship between the doctor and the victim but just ke in any other proceeding for damages, four essential elements must be established by the plaintiff, namely: (1) duty; (2) breach; (3) injury; and (4) proximate causation. All four elements must be present in order to find the physician negligent and, thus, able for damages. It Is settled that a physician's duty to his patient relates to his exercise of the degree of care, skill and diligence which physicians in the same general neighborhood, and in the same general Line of practice, ordinarily possess and exercise in ike cases. There is breach of this duty when the patient Is injured in body or in health. Proof of this breach rests upon the testimony of an expert ‘witness that the treatment accorded to the patient failed to meet the standard level of care, skill and diligence. To justify an award of damages, the negligence of the doctor must be established to be the proximate cause of the injury. Upon review, however, the Court agrees with the CA that His study and assessment were restricted by limitations that denied his full evaluation of Carmen's case. He could have only deduced from the injuries apparent in Carmen's body, and in the condition when the body was examined. There was also no reference to the respondents’ defense that the emergency caesarian section operation had to be performed in order to protect the lives and safet) of Carmen and her then unborn child. On the other hand, the CA respondents also emphasized in their pleadings before the RTC that Dr. Nestor had his training and azar i use and obstetrics since 1970. Billie Blanco (2E) | Ateneo Law 202217Moreover, while Dr. Patilano opined that Carmen died of peritonitis which could be due to the poor state of the hospital equipment and medical Itis also significant that Dr. Patilano did not appear to have thoroughly examined Carmen's vital organs such as her heart, lungs, uterus and Il MEDICAL SCIENCE AND THE LAW ‘A. BIRTH WHEN IS A PERSON CONSIDERED BORN? Givil Code, Art. 40-41 ‘Art. 40. Birth determines personality, but the conceived child shall be considered born for all purposes that are favorable to it, provided it be born later with the conditions specified in the following article, ‘Art. 44. For civil purposes, the fetus is considered born if it is alive at the time it is completely delivered from the mother's womb. However, if the fetus had an intra-uterine life of less than seven months, it is not deemed born if it dies within ‘twenty-four hours after its complete delivery from the maternal womb, © WHAT IS THE INTRAUTERINE LIFE? © A conceived child shall be considered born for all purposes favorable to it provided that: = Delivered alive - INTRAUTERINE LIFE of 7 months or older (7m, >7m); or = Delivered alive at less than 7 months, does NOT die within 24 hours (<7m), © GESTATIONAL AGE © Counted from first day of last menstruation of mother © May also be based on early ultrasound © From first day of last. menstruation - expected date of delivery will be from 38 to 42 weeks © The law assumes that a baby born at 7 months would survive. Billie Blanco (2E) | Ateneo Law 2022 | 81. Abortion ‘© Medical Definition © Abortion - — products of conception expelled at 20 weeks or less (24 weeks) © Fetal death in utero - More than 20 weeks or weighs 500g or more © Usual Causes of Abortion. infection, nutrition, anatomic abnormalities, alcohol and tobacco, chromosomal abnormalities of fetus, Legal Definition dL) Revised Penal Code - arts 256, 257, 258, 259 Intentional Abortion; © Unintentional abortion; Abortion practiced by the — woman herself of by her parents; and © Abortion practiced by a. physician or midwife and dispensing of abortives. INTENTIONAL ABORTION 1) use of any violence upon the person of the pregnant woman; or © Abortion caused by trauma - as a rule, caused by eventtrauma that occurred weeks before (more fatal in later stages of pregnancy) © In later stages, a fetus might die because of Uterine rupture, Placental Abruption 2. without using violence. © could be drugs eg, moming after pills - not legal, alter hormone levels to prevent implantation UNINTENTIONAL ABORTION xxx [A]ny person who shall cause an abortion by violence, but unintentionally © ABORTION IN THE PHILIPPINES © More than 65% of women dont use modern contraceptives, and maternal mortality rates are still high in the Philippines, standing at 114 deaths per 100,000 live births in 2015." © Studies have shown that unsafe abortion is a significant contributor to the high maternal mortality ratio inthe Philippines. In one 2012 estimate, roughly 610,000 abortions are thought to have taken place that year in the country. Due to restrictive laws, many of these abortions are unsafe. About 1,000 Filipina women die each year from unsafe abortion complications while tens of thousands are hospitalized.*? © Spontaneous Abortion (Miscarriage) © Chromosomal abnormalities of Fetus “How bitter herbs and botched abortions kill three women 2 day in the Philippines, THE GUARDIAN, https /wwwtheguardian,comyglobal- development/2017/ul/L0 /now-bitter-herbs-and-bote hed-abortions-kill-three-women-a-day-in-the-philip pines (last accessed Feb. 13, 2020) 2Clzire, Abortion In The Philippines: Behind The Country High Rates of Maternal Mortality, HOW TO USE ABORTION BILL (Aug, 2, 2018), https /ww howtouseabortionpill org/blog/abortion -in-the-philippines-rates/ (last accessed Feb. 13, 2020) Billie Blanco (2E) | Ateneo Law 2022 | 9© Anatomic abnormalities (cervix, uterus) ©. Infection © Poor nutrition © Certain diseases if untreated or uncontrolled (Thyroid disease, diabetes, high blood pressure) © Advanced age of mother © Alcohol or Drug use The killing of any child Less than three days of _age (Revised Penal Code, Art 255) ‘CASE DOCTRINE People v. Paycana The RTC, as affirmed bi Bearing the penalty of reclusion perpetua to death, the crime of parricide is committed when: (1) a person is killed; (2) the deceased is killed by the ‘accused; and (3) the deceased is the father, mother, or child, whether legitimate or illegitimate, or a legitimate other ascendant or other descendant, or the legitimate spouse of the accused. The key element in_parricide is the relationship of the offender with the victim. In the case of parricide of @ spouse, the best proof of the relationship between the accused and the deceased would be the marriage certificate. The testimony of the accused of being married to the victim, in itself, may also be taken as an admission against penal. interest {As distinguished from infanticide, The case before us is governed by the first clause of Article 48 because by a single act, that of stabbing his wife, appellant committed the grave felony of parricide as well as the less grave felony of unintentional abortion. A complex crime is committed when @ single act constitutes two or mare grave or less grave felonies. Under the aforecited article, when @ single act constitutes two or more grave or less grave felonies the penalty for the most serious crime shall be imposed, the same to be applied in its maximum period irrespective of the presence of modifying circumstances. Applying the aforesaid provision of law, the maximum penalty for the mast serious crime (parricide) is death. However, the Court of Appeals properly commuted the penalty of death imposed on the appellant to reclusion perpetua, pursuant to Republic Act No. 9346. B. CAPACITY TO ACT/LIMITATIONS ON CAPACITY TOACT Givil Code, Art. 37-39 ‘Art. 37, Juridical capacity, which is the fitness to be the subject of legal relations, is inherent in every natural person and is lost only through death. Capacity to act, which is the power to do acts with Legal effect, is acquired and may be Lost. Art. 38, Minority, insanity or imbecility, the state of being a deaf-mute, prodigality and civil interdiction are mere restrictions on capacity to act, and do not exempt the incapacitated person from certain obligations, as when the latter arise from his acts or from property relations, such as easements. Art. 39. The following circumstances, among others, modify or Umit capacity to act. age, Insanity, imbecility, the state of being a deaf-mute, penalty, prodigality, family relations, alenage, absence, insolvency and trusteeship. The consequences of these circumstances are governed in this Code, other codes, the Rules of Court, and in special laws. Capacity to act is not Limited on account of religious belief or political opinion, Billie Blanco (2€) | Ateneo Law 2022 | 10Genetic Appearance | Individual’s (genotype) | (phenotype) | concept of self, roles in XX, XY social and cultural Variations: | eg, context xO (Turners | congenitat syndrome) | Adrenat xxY Hyperplasia, (KUnefetters | androgen syndrome) | insensitivity CIDE ‘Syndrome CASE DOCTRINE People v. Cagandahan The determination of a person's sex appearing in his birth certificate is 2 legal issue and the court must look to the statutes Article 412 of the Civil Code provides that, "[n]o entry in a civil register shall be changed or corrected without @ judicial order.” Together with Article 376 of the Civil Code, this provision was amended by Republic Act No. 9048 in so far as Clerical or typographical errors are involved. entries envisaged in Article 412 of the Civil Code and correctable under Rule 108 of the Rules of Court are those provided in Articles 407 and 408 of the Civil Code. newborn who has XX chromosomes coupled with CAH usually has a (2) ‘swollen clitoris with the urethral opening at the base, an ambiguous genitalia often appearing more male than female; (2) normal. internal structures of the female reproductive tract such as the ovaries, uterus and fallopian tubes, as the child grows older, some features start to appear male, such as deepening of the voice, facial hair, and failure to menstruate at puberty About 1 in 110,000 to 18,000 children are born with CAH Intersex individuals are treated in different ways by different cultures. In most societies, intersex Individuals have been expected to conform to either 2 male or female gender role. Since the rise of modern medical science in Western societies, some intersex people with ambiguous external, genitalia have had their genitalia surgically modified to resemble either male or female genitals. More commonly, an intersex individual is considered as suffering from a "disorder" which is almost always recommended to be treated, whether by surgery and/or by taking lifetime medication in order to mold the individual as neatly as possible into the category of either male or female, this case, we consider In decidin It has been suggested that there is some middle ground between the sexes, 2 ‘no-man's land’ for those Individuals who are neither truly ‘mate’ nor trul 1m the instant case, if we determine respondent to be a female, then there is no basis for @ change in the birth certificate entry for gender But if we determine, based on medical testimony and scientific development showing the respondent to be ‘other than female, then a change in the subject's birth certificate entry isin order. Biologically. nature endowed respondent with a mixed (neither consistently and categorically female _nor consistently and categorically male) composition. Billie Blanco (2E) | Ateneo Law 2022 | 11Respondent has female (XX) chromosomes. However, respondent's body system naturally produces high levels of _male hormones {androgen)_As a result, respondent has ambiguous genitalia and the phenotypic features of a male. Uttimately, we are of the view that Where the person is biologically or naturally intersex the determining factor in his gender classification would be what the lual, like respondent, having reached the age of majority, with good reason thinks of his/her sex. Respondent here thinks of himself as a male and considering that, his body produces high Levels of male hormones androgen) there is preponderant biological support for considering him as being male. Sexual development in cases of intersex persons makes the gender classification at birth inconclusive. It is at maturity that the gender of such persons, Uke respondent, is fixed Respondent here has simply let nature take its course and has not taken unnatural steps to arrest or interfere with what he was born with. And accordingly, he has already ordered his ife to that of @ male. Respondent could have undergone treatment and taken steps, Uke taking Ufelong medication, to force his body into the categorical, mald of a female but he did not. He chose not to do so. Nature has instead taken its due course in respondent's development to reveal more fully his male characteristics. In the absence of a law on the matter, the Court will not dictate on respondent concerning a matter so innately private as one's sexuality and Lifestyle preferences, much less on whether or not to undergo medical treatment to reverse the male tendency due to CAH, The Court will not consider respondent as having erred in not choosing to Undergo treatment in order to become or remain as a female. Neither will the Court force respondent to undergo treatment and to take medication in order to fit the mold of a female, as society commonly currently knows this gender of the human species Respondent is the one who has to live with his intersex anatomy. To him belongs the human right to the pursuit of happiness and of health. Thus, to him should belong the primordial choice of what courses of action to take along the path of his sexual development and maturation. In the absence of evidence that respondent is an incompetent and in the absence of evidence to show that classifying respondent as a male will harm other members of society who are equally entitled to protection under the law, the CBUft affirms as valid and justified the respondent's position and his personal judgment of being 2 ale In so ruling we do no more than give respect to (1) the diversity of nature, and (2) how an individual deals with what nature has handed fut. In other words, we faspect respondent’ Congenital condition and his mature decision to be a male. Life is already difficult for the ordinary person. We cannot but respect how respondent deals with his unordinary state and thus help make his fe easier, considering the unique circumstances in this case ‘As for respondent's change of name under Rule 1103, this Court has held that alehahge of ame ls hot a matter of right but of judicial discretion, to be exercised in the light of the reasons adduced and the consequences that will follow. The trial, Court's grant of respondent's change of name from. Jennifer to Jeff implies a change of a feminine ame to a masculine name Considering the consequence that respondent's change of name merely recognizes his preferred gender we find merit_in respondent's change of name. Such @ change will conform with the change of the entry In his birth certificate from female to male 2. Age © Minority Republic Act No. 9344, Secs. 6 and 7 SEC. 6. Minimum Age of Criminal Responsibility. - ‘A child 15 years of age or under at the time of the commission of the offense shall be exempt from criminal ability SEC. 7. xxx The age of a child may be determined from the child's birth certificate, baptismal certificate or any other pertinent documents. In the absence of these documents, age may be based on information from the child himself/herself, testimonies of other persons, the physical appearance of the child and other relevant evidence. xxx * Old Age: Over 70 years —* Mitigating circumstance Billie Blanco (2£) | Ateneo Law 2022 | 123. Deaf Mute CASE DOCTRINE People v. Parazo Dr. Rosa Mendoza, Senior Chiet Staff Officer of the Supreme Court CUnic Services, submitted 2 Memorandum Reports, dated July 29, 1998 and March 5, 1999, respectively, on the mental, neurologic and otolaryngolagic examination and evaluation of appellant. On July 20, 1998, the appellant was examined, on the basis of which examination SC Medical Services Psychologist Ill Beatriz 0. Cruz came out with findings and general observation. In connection therewith, there was presented the Memorandum Report of July 29, 1998, stating thus: ‘Based on the foregoing, it//appears| thatthe problem of appellant Marlon Parazo is the severe hearing defect or deafness. The presence of an organic disorder cannot be determined because of the latter's inability to communicate. However, some degree of mental retardation was gathered with the use of ‘Paper and Pencil Test” His metal lige (517 \yeais|/and| ST months, His Intetigence Quotient (IQ) is 60. This mental retardation could be secondary to an inherent defect in the brain or secondary to the sensory deprivation [deafness] which connotes a substantial_Umitation in intelectual and adaptive functioning: Appellant was then also examined at the UP-PGH Medical Center. Meredith F. Castro, MA, Psychologist, PGH, Manila, on the other hand, supported the assessment findings of Dra. Ma. Luz ©. Querubin, Charlotte M. Chiong, M.D., Otology, Neurotology, Neurotologic Skull Base Surgery, Diplomate, Philippine Board of Otolaryngology-Head and Neck Surgery, PGH certified that no wave responses weie generated in the left suggestive of profound hearing loss in that ear and that in the fight ear there was a response 80 db click intensities suggestive of a severe hearing loss, For her part, Dr. Grace 0. Orteza, MA, MD, FPNA, Section of Neurology, Department of Medicine, UP-PGH, Manila, in her Assessment stated that ‘xxx there are no significant neurologic findings aside from the manifest deafness and muteness of patient To corroborate the medical findings of the Medical Team from the Philippine General Hospital, we conducted an on-the-spot gathering of vital information's on the physical infirmities of Marlon Parazo to determine whether the same is congenital or acquired Based on the collateral information gathered from Persons who have known the patient since childhood, together with the results of the diagnostic test at UP-PGH and evidenced by the psychological report, it is now established that Marlon Parazo is suffering from (1) Profound Hearing Loss, left ear; (2) Severe Hearing Loss, right ‘ear; (3) Mental Retardation, Mild. Records on hand show that appellant was tried below without the benefit of a sign language ‘expert. The fact that he was “helped and assisted by @ person who has been known to him since 1983", as noted by the trial court of origin and appearing on page 6 of the transcript of stenographic notes for February 8, 1995,(I5 6fIRO moment, absent any clear showing that appellant was aided by a competent sign language expert able to fully understand and interpret the actions and mutterings of appellant, ‘As held in People v. Crisologo: The absence OF afi interpreter in sign language who could have conveyed to the accused, a deaf-mute, the full facts of the offense with which he was charged ‘and who could also have communicated the accused's own version of the circumstances which led to his implication in the crime, deprived the accused of a full and fair trial and a reasonable ‘opportunity to defend himself, Not even the accused's final plea of not guilty can excuse these inherently unjust circumstances. The absence of a qualified interpreter in sign language and of any other means, whether in writing or otherwise, to inform the accused of the charges against him denied the accused his fundamental right to due process of law. The accuracy and faimess of the factual process by which the guitt or innocence of the accused was determined was not safeguarded. The accused could not be said to have enjoyed the right to be heard by himself and counsel, and to be informed of the nature and cause of the accusation against him in the proceedings where his life and Uberty were at stake” All the foregoing studiedly considered, the court is, of the irresistible conclusion that evant richly deserves a re-arraignment and re-trial, to the end Billie Blanco (2E) | Ateneo Law 2022 | 134, Mental State © Imbecility © Wechsler IQ test ratings identify those as imbeciles who suffer moderate mental retardation 1) Idiot - 2 years old, profound Mental Retardation IQ - below 20; 2) Imbecile - 2-7 years old, moderate to severe mental retardation - 10 20-49; and 3) Moron - 7-12 years old, Mild mental retardation -- 1Q 50-69. © Terms used - idiot, imbecile, moron, mild __ retardation, moderate retardation, severe retardation, and _ profound retardation, intellectual disability © Intellectual disability - may be assessed by psychologists and psychiatrists, © Causes: Trauma to head, genetics (Down Syndrome), Infections (Meningitis), Lead poisoning or exposure to toxic substances, ‘* Insanity/Unsound Mind © Insane, - A person with a psychiatric condition is considered insane, usually those who suffer hallucinations, delusions, disordered thinking. = Lucid intervals - usually, those with a_ psychiatric condition, controlled by medication, or therapy would “think clearly.” © Competency to stand Trial © Exempting Circumstance © Death convict who becomes insane after his final conviction cannot be executed while in a state of insanity © Detention by reason of insanity or imbecility is not considered 2 penalty © Violent insanity shall be considered legal grounds for the detention of any person © Raises penalty for rape, serious physical injuries, if victim becomes insane; rape if victim is insane © Ground for annulment © Capacity to give consent to contract [Unsound Mind] Note: Diseases that Could Affect Soundness: Multiple sclerosis Psychiatric Conditions: severe depression, bipolar —disorder, schizophrenia Alzheimer’s disease Stroke, cerebrovascular diseases Metabolic disorders Hepatic encephalopathy Meningitis NoMa Developmental disorders include autism and mental retardation, disorders which are typically first evident in childhood. Personality disorders are clinical syndromes which have a more Long lasting symptoms and encompass the individual's way of interacting with the world. They include Paranoid, Antisocial, and Borderline Personality Disorders. ‘CASE DOCTRINE People v. Aquino In this case, It cannot be said that she was in no Billie Blanco (2E) | Ateneo Law 2022 | 14Position to defend herself, for, in fact, she succeeded in repelling appellant's aggression against her children What is apparent is that the killng was done impulsively or on the spur of the moment, Neither are we persuaded by EDGARDO' plea of "temporary insanity As the OSG aptly stated, ‘temporary insanity” is not recognized in this, Moreover, EDGARDO was Unable to substantiate his claim We disagree with the trial court in appreciating in appellant's favor the mitigating circumstance of intoxication. EDGARDO declared that he drank Liquor on the day of the incident in question, and the trial court held that his intoxication was corroborated by Roselyn’s testimony that EDGARDO's eyes were ‘red: when she saw him. For intoxication to be mitigating, the following conditions must be present: (1) the same is not habitual or is not subsequent to the plan of the commission of a felony; otherwise, it is aggravating if it is habitual and intentional: and 2) the consumption of alcoholic drinks was in such quantity as to blur the accused's reason and deprive him of a certain degree of control In this case, EDGARDO was unable to prove both requisites Nevertheless, we appreciate in EDGARDO's favor the mitigating circumstance of voluntary surrender. Immediately after the incident, when purok leader Benjamin Costimiano followed him in the house of Francisco Franco, EDGARDO voluntarily gave the knife to Franco and went with the latter to the Police Headquarters where he was forthwith detained. The information against himwas filed much later. The trial court correctly considered the existence of the generic aggravating circumstance of dwelling, since the crime was committed inside the house of the victim, who had not given any provocation, We do not find merit in EDGARDO's claim that he was arrested without a warrant, was subjected to custodial interrogation without the assistance of 2 counsel, and was denied his right to remain silent and to have an effective counsel. In the first place, there is no clear evidence that he was arrested. On the contrary, he voluntarily turned over his knife to purok leader Costimiano and went with the latter to the Police Department, for which reason we even appreciate in his favor the mitigating circumstance of voluntary surrender. Second, the records do not disclose that a custodial Interrogation of EDGARDO was made, although 2 preliminary investigation was conducted by Prosecutor Floresta Accordingly, which is punishable by reclusion temporal under Article 249 of the Revised Penal Code, ‘© Psychological Incapacity CASE DOCTRINE “Antonio v. Reyes Article 36 of the Family Code states that ‘[a] marriage contracted by any party who, at the time of the celebration, was psychologically incapacitated to comply with the essential marital obligations of marriage, shall Ukewise be void even if such incapacity becomes manifest only after its solemnization” The concept of Billie Blanco (2E) | Ateneo Law 2022 | 15The Spanish Civil Code of 1889 prohibited from contracting marriage persons ‘who are not in the full enjoyment of their reason at the time of contracting marriage” Marriages with such persons were ordained as void, in the same class as martiages with underage parties and persons already married, among others. A party's mental capacity was not @ ground for divorce under the Divorce Law of 1917, but a marriage where ‘either party was of unsound mind” at the time of its celebration was cited as an “annullable marriage’ under the Marriage Law of 1929. Divorce on the ground of a spouse's incurable insanity was permitted under the divorce law enacted during the Japanese occupation. Upon the enactment of the Civil Code in 1950, a marriage contracted by @ party of ‘unsound mind” was classified under Article 85 of the Civil Code as a voidable marriage. The mental capacity, or tack thereof, of the marrying spouse was not among the grounds for declaring a marriage void ab initio. Similarly, among the marriages classified as Voidable under Article 45 (2) of the Family Code is one contracted by a party of unsound mind, Such cause for the annulment of marriage is recognized as a vice of consent, just Uke insanity impinges on consent freely given which is one of the essential requisites of @ contract. The initial common consensus on psychological incapacity Under Article 36 of the Family Code was that it did hot constitute a specie of vice of consent. Justices Sempio-Diy and Caguioa, both members of the Farrily Code revision committee that drafted the Code, have opined that psychological incapacity is, not a vice of consent, and conceded that the spouse may have given free and voluntary consent to a marriage but was nonetheless incapable of fulfilling such rights and obligations. Dr. Tolentino Ukewise stated in the 1990 edition of his commentaries on the Family Code that this ‘psychological incapacity to comply with the essential marital obligations does not affect the consent to the marriage. There were initial Criticisms of this original understanding of Article 36 as phrased by the Family Code committee. Tolentino opined that ‘psychologically incapacity to comply would not be juridically different from physical incapacity of consummating the marriage, Which makes the marriage only voidable under Article 45 (5) of the Civil Code x x x [and thus] should have been a cause for annulment of the marriage only" At the same time, Tolentino noted [it] would be different if it were psychological Incapacity to understand the essential marital obligations, because then this would amount to lack of consent to the marriage: These concerns though were answered, beginning with Santos v. Court of Appeals, wherein the Court, through Justice _Vitug, acknowledged _ that, was further affirmed in the Molina case. Therein, the Court, through then Justice (now Chief Justice) Panganiban observed that ‘[tJhe evidence [to establish psychological incapacity] must convince the court that the parties, or one of them, was mentally or psychically ill to such extent that the person could not have known the obligations he was assuming, or knowing them, could not have given valid assumption thereto. Jurisprudence since then has recognized that It might seem that this present understanding of psychological incapacity deviates from the literal wording of Article 36, with its central phase reading ‘psychologically incapacitated to comply with the essential marital obligations of marriage. At the same time, it has been consistently recognized by this Court that the intent of the Family Code committee was to design the law as to allow some resiliency in its application, by avoiding specific examples that would limit the applicability of the provision under the principle of ejusdem generis. Rather, the preference of the We likewise observed in Republic v. Dagdag: Whether or not psychological incapacity exists in 2 given case calling for annulment of a marriage, Billie Blanco (2E) | Ateneo Law 2022 | 16