Legal Medicine

Guadalupe D. Villaret-Matejka, MD
College of Law
University of San Agustin
Objective:
• To provide law students with fundamentals
of forensic science and equip them with
knowledge needed for the law profession.
Definition:
• 16th century Italy and Britain: Medicine
legale
• Latin: forensis – public; of a forum: Forensic
science – science that is applied to legal matters
• Medical jurisprudence: University of Edinburgh
1789 by Dr. Andrew Duncan, "medical police and
juridical medicine".
• Health Law: economics of health care, public
policy and healthcare regulation, bioethics
Definition:
• Scientific method:
1. Observation and collection of data
2. Conjecture of collected data (analysis)
3. Formulation of hypothesis
4. Testing the hypothesis or reconstruction
5. Theory
Objectives of this chapter:
Define legal medicine

Importance of legal medicine

Scope of legal medicine

Medico-legal cases
Forensic Medicine
• The application of medical science to
elucidate legal problems
Dr. Pedro Solis
• Deals with investigation, preparation,
preservation and presentation of evidence
and medical opinion in courts
Dr. William J. Currran
Legal Medicine
• The application of medicine to legal
science.
Dr. Pedro Solis
• Areas of medicine concerned with
relations with substantive law and with
legal institutions
Dr. William Curran
Medicolegal practitioners
• Doctors handling medicolegal cases
• Forensic experts, scientist
• Health officers
• Medical officers of law enforcement agency
• Members of medical staff of accredited hospital
• Private practitioners
• PNP criminal laboratory
• NBI criminal laboratory
Forensic Science in the
Philippines
• Spanish regime
• “Medico Titulares” – in charged of public sanitation and
medico-legal aid
• American regime
• Medico-Titulares under the Board of Health
• Philippine Republic
• Medico-legal Division was established at the PGH and
was later transfer under the authority of Department of
Justice.
• In 1947, the Medico-legal Division was transferred to
the National Bureau of Investigation
Forensic sciences
• Forensic anthropology
• Forensic medicine
• Forensic pathology
• Forensic pschiatry/psychology
• Forensic meteorology
• Forensic DNA analysis
• Forensic odontology
Forensic sciences
• Forensic archeologist
• Forensic entomology
• Forensic chemistry and toxicology
• Fingerprint experts
• Handwriting experts
• Forensic linguistics
• Forensic nursing, etc……
• Bioethics, liability, management of health care
Scope of Forensic Medicine
• Crime Scene Investigation
• Medico-legal aspects of Identification
• Medico-legal aspect of Death
• Causes of Death and Conduct of Autopsy
• Medico-legal aspect of Physical Injuries
• Ballistics
• Sex Crimes
• Pregnancy/Abortion/Paternity and Filiation
• Disturbance of Mentality
• Alcoholism and Poisoning
Medico-legal cases
• Injuries or death involving persons who have no
means of being identified.
• Persons pronounced as “dead on arrival”.
• Deaths under the following circumstances:
1. Death occurring within 24 hours of
admission when cause of death is unknown
2. Unexpected death when the decease is in

apparent good health

3. Death due to natural cause but with
physical evidence of foul play.
4. Death as a result of violence, accident,
suicide or poisoning.
5. Death due to improper or negligent act
of another person.
Medicolegal cases
• Victims of physical injuries cause by any of the
following.
1. GSW, SW, mauling, etc….
2. VA
3. Asphyxia
4. Electrocution, burns
5. Accident, homicide or suicide
6. Poisoning
• Cases of child abuse, domestic violence, rape,
alcoholism and drug addiction.
• Cases involving mental competency of the
patient.
• Iatrogenic causes brought about by negligent
acts or omissions of the hospital staff resulting in
violation of rights of patients or leading to
patient`s physical and mental incapacitation,
physical injury and death.
• Under Philippine Laws, medico-legal
deaths must undergo mandatory autopsy.
June, a defense lawyer for S&E Heaters, was thwarted at every turn by the one
fact that she could not change: The plaintiffs lawyer knew more about his
clients's case than she did. June's clients stood to loose millions unless she could
prove that their product, a hot water heater, was not at fault in the electrocution
death of Mr. Edwards.

When Mr. Edwards was electrocuted 2 years ago, the EMS paramedics thought
it was an accidental death. They'd taken the body to the ME who checked the
ocular fluid and learned that Mr. Edwards had been intoxicated when he stuck a
metal screwdriver into his hot water heater while standing barefoot on wet
carpet. For the defense, that was good news. It meant Mr. Edwards was
negligent and his death wasn't cause b a defective hot water heater.

But the medical examiner (ME) had screwed things up. He hadn't ,followed the
rules about chain of custody of evidence. Because he could not account for the
location of the blood alcohol evidence at all times, it was possible it had been
tampered with. The plaintiffs lawyer successfully argued to exclude the evidence
from the case.
Because of that, June worried that her client would have to
write the Edwards family a settlement check with lots of
zeroes.
"What are you moping around." June's boss asked her.
She explained everything.
You're overlooking something, aren't you? He asked.
"What?"
"I see Mr. Edwards was an organ donor. And you know
what that means."
June thought about it a while. Finally, her face lit up.
What did June realized that made the case defensible?
CRIME SCENE INVESTIGATION
Crime scene:
• Crime scene: It is the place where the essential
ingredients of the criminal act took place.
• Crime scene investigation: collection of the
physical evidences that may lead to the identity
of the perpetrator, the manner the criminal act
was executed and other things that may be
useful in the prosecution of the case.
Members of the team:
• Police investigators
• Medico-legal experts (medical examiners)
• Fingerprint experts
• Photographer
• Chemist
• Sketch artist
• Evidence recorder
Methods of conducting the
search:
• Strip method
• Double strip or grid method
• Spiral method
• Wheel method
• Zone method
Salient points:
• Determine if the victim is alive or not.
• Preserve the scene of the crime until proper
markings/photographs are taken.
• The scene of the crime must be cordoned off.
• The immediate environment inspected for clue
and evidences.
• Evidence collected must be properly identified,
sealed and signed by the investigator and
endorsed to the custodian.
The neighbors gathered on the street outside, watching with mixed horrors and fascination as
the firefighters battled the blaze in the front half of the house.

Bill put his arm around Lisa and held her close. "I wonder if he is ok," she said.

He shrugged. "It depends on where he was in the house. Since the bedroom is in the back,
maybe he is all right."

The house had been the only real asset of the owners possessed, and it was heavily mortgaged.

"I know his wife is out of town,"said Lisa, "but I saw him about an hour ago, taking out the
trash. How can this be happening?"

A firefighter emerged from the front door with the family canary squawking in his cage. He
handed the cage to Bill. "Can you care for the bird until the wife comes home?"

"Of course," Bill responded. He didn't know how his neighbor could sleep through a fire with
that damn bird in his bedroom. The bird was loud enough to keep Bill up at night.
Just then, EMS workers came out of the front door with a body on a stretcher.
Lisa's stomach turned when she saw the lifeless remains of her neighbor.

"Found him in bed," he heard one of the firefighters tell the EMS guy.

Bill stared. The old guy didn't smoke, but his trophy wife often puffed
obscenely on a fat cigar. She was too proud of the home, he thought, to have
set the blaze intentionally.

"What a horrible way to die," Lisa said quietly to bill. "It must have been
smoke inhalation because the body doesn't look burned or anything."

"He didn't die of inhalation," Bill suddenly blurted out. "He was dead before
the fire even started."

What brought bill to this conclusion.

 Evidence:

• Evidence is the means of ascertaining in a judicial

proceeding the truth respecting a matter of fact.

• If it is medical in nature then it is called medical

evidence.

• Admissibility of evidence
Evidence
• All evidences collected must be protected,
identified and preserved.
• Evidence custodian is responsible to preserve
the shape, minimize contamination and chemical
changes and transfer of evidences.
• Types of evidences:
• Autoptic or real evidence
• Limitations
• Indecency and impropriety
• Repulsive objects and those offensive to the sensibilities
Evidence
• Testimonial evidence
• Ordinary witness (privilege of communication, dying
declaration)
• Expert witness
• Experimental evidence
• Documentary evidence
• Medical certification/report
• Medical expert opinion
• deposition
• Photographs, videos
Evidence
• Physical evidence
• Corpus delicti evidence
• Associative evidence

• Tracing evidence

• Criminalistics - identification, collection,

preservation and mode of presentation of
evidence
Physical evidence examination should
prove:

• That a crime has indeed taken place.

• Determine the perpetrators MO.
• Establish contact between a victim and a
suspect.
• Establish contact between a person and a
scene.
• Support or disprove a witness`testimony
• Provide investigative lead.
Preservation of evidence
• Photographs, audio/video tape, micro film
• Sketching
• Rough sketch
• Finished sketch
• Description
• Manikin method
• Preservation in the mind of the witness
• Special methods