Medico-Legal Investigation of Death

Andrew M Marcella, MD,DPBS,FPCS,FPSGS

Officials of the Government Authorized to Make Death Investigation

• Provincial and City Fiscals

• Judges of CFIs (now RTCs)
• Justice of Peace (now MTCs)
• NBI Director
• Chief of Police
• Solicitor General
Stages of Medico-Legal Investigation

Crime Scene Investigation

Autopsy
Methods of Conducting a Search

• Strip/Line Method
• Double strip/Grid Method
• Spiral
• Wheel
• Zone
AUTOPSY
KINDS OF AUTOPSY

• Hospital or Non-Official Autopsy - elective

• Medico-Legal or Official Autopsy - mandatory
When is Autopsy Performed on a Body:

• Whenever required by a special law

• Upon order of the court, mayor, provincial or city fiscal
• Upon written request of police authorities
• Nearest kin shall request
Persons Who are Authorized to Perform autopsies and Dissections

• Health Officers
• Medical Officers of Law Enforcement Agencies
• Members of the Medical Staff od Accredited Hospitals
Pathologic vs Medico-Legal Autopsies

Medico-Legal
Pathologic Autopsy
Autopsy

Must have consent of

Requirement Law gives consent
the next of kin
Correlation of tissue
Confirmation of
Purpose changes in the
clinical findings
criminal act
Notation of all Effect of wrongful act
Emphasis
abnormal findings on the body

Summation of all Must be specific; if

Conclusion
abnormal findings related to criminal act
Need not be
Minor or Non- Must be included if
mentioned in the
Pathological deemed useful
report
MANDATORY AUTOPSY

• Death by violence
• Accidental deaths
• Suicide
• Sudden death of persons apparently healthy
• DOA
• Death unattended by a physician
• Death occurring in an unnatural manner
GUIDELINES

• The pathologist must be properly guided

• It must be comprehensive
• Severely mutilated, decomposing, or damaged by fire can still be autopsied
• Show respect for the body; unnecessary dissection should be avoided
• Proper identity of the body must be established
• Dead body must not be embalmed before autopsy
• Body must be autopsied in the same manner found in the crime scene
NEGATIVE AUTOPSY

Despite all efforts including gross, microscopic, and toxicological analyses, there is
failure to reveal a cause of death

NEGLIGENT AUTOPSY

No cause of death is found on account of imprudence, negligence, lack of skill, or lack

of foresight of the examiner
CAUSES OF DEATH

Andrew M Marcella, MD,DPBS,FPCS,FPSGS

IMMEDIATE Apply to cases when trauma or disease kill quickly
(Primary)
Cause of deaths Ex: extensive lactation as a result of VA

PROXIMATE
(Secondary) Injury or illness was survived for a sufficiently prolonged interval
Cause of Death
MECHANISM OF DEATH - the physiologic derangement or biochemical disturbance
incompatible with life (ex: cardiorespiratory arrest)

MANNER OF DEATH - explanation as to how the cause of death came into being or
how the cause of death arose

MEDICO-LEGAL MASQUERADE - violent deaths accompanied by minimal or no

external evidence of injury, or natural death where signs of violence may be present
MEDICO-LEGAL
CLASSIFICATION OF THE
CAUSES OF DEATH

Andrew M Marcella, MD,DPBS,FPCS,FPSGS

NATURAL DEATH

• Death caused by natural disease condition of the body

• Disease may develop spontaneously or it might have been the result of physical injury
inflicted prior to its development
• If signs of violence are associated with natural death (postmortem violence?)
• Impossible crime - accused not responsible for the death but merely for the physical
injuries he had inflicted
VIOLENT DEATH

• Due to physical injuries inflicted on the body by some form of outside force
• The physical injury must be the proximate cause of death
• The victim must be previously healthy
• Death may be expected from the physical injury
• Death ensued within reasonable time
VIOLENT DEATH
Penal Classification

• ACCIDENTAL DEATH
• Death due to misadventure or accident
• Something that happens outside the sway of will, lies beyond the bounds of human
foresight
• Pure accidental death is exempt from criminal liability
2. NEGLIGENT DEATH - death due to reckless imprudence, negligence, lack of skill or lack of
foresight
3. SUICIDAL DEATH - the law does nor punish a person who commit suicide, but the person who
assists someone to commit suicide, to the extent that he himself kills that person shall be liable for the
death.
Acts punishable in giving assistance to commit suicide:
• Offender assisted in the commission of suicide which was consummated
• Offender assisted in the commission of suicide to the extent of doing the killing himself which was
consummated
• Offender assisted in the commission of suicide which was not consummated
4. PARRICIDAL DEATH - killing of one’s relative
• A person was killed by the offender
• The person killed was the father, mother, or child whether legitimate or illegitimate,
or any of his ascendants or descendants, or spouse of the offended
• Killing of a common law wife, or an illegitimate grandfather is NOT parricide
• Brothers, sisters, or even aunts and uncles is NOT parricide because they are only
collaterals
5. INFANTICIDE - killing of a child less than 3 days old
• If the killer is the mother or father, or legitimate descendants, the crime is parricide. Otherwise the penalty for murder shall be imposed
6. MURDER - killing of a person with any of the following circumstances:
• With treachery, taking advantage of superior strength, with the aid of armed men, or employing means to weaken the defenses, or means of
persons to insure or afford immunity
• In consideration of a prize or rewards, or promise
• By means of inundations, fire, poison, explosion, or employing any means involving great waste and ruins
• On occasion of any calamities or an earthquake, epidemic, or any public calamity
• With evident premeditation
• With cruelty, inhumanely augmenting the suffering of the victim, or outraging or scoffing at person or corpse
Requisites of Murder:
• The offender killed the victim
• The killing was attended by any of the qualifying circumstances mentioned
• There was intent to kill
• The killing is not parricide or infanticide
7. HOMICIDE - killing a person without intent to kill; not murder, parricide or infanticide

8. DEATH IN A TUMULTUOS AFFRAY - death of a person in a confused or tumultuous

affray, but the actual killer is not known, and the person or persons who inflicted violence or
serious physical injuries are not known

9. DEATH OR PHYSICAL INJURIES UNDER EXCEPTIONAL CIRCUMSTANCES -

any legally married person who caught his/her partner committing sexual intercourse with
another, who shall kill any or both in the act, oe immediately thereafter, or shall inflict upon them
serious physical injuries of any other kind, shall suffer the penalty of destierro.
EUTHANASIA
Mercy Killing

• Deliberate and painless acceleration of death of a person usually suffering from an

incurable and distressing disease.
• No particular law dealing specifically with the matter
• Medical ethics states that the duty of a physician is to save lives and not to end it
• Active vs Passive Euthanasia
WAYS OF PERFORMING EUTHANASIA

1. Administration of lethal dose of poison

2.Overdosage of sedatives, hypnotics, other pain killers

3.Injection of air into the bloodstream

4. Failure to institute necessary management procedure which is essential to preserve life