Summary of Legal Medicine FROGLETS NOTES Book by Solis

treatment CHAPTER I Purpose in examining a Purpose in examining a GENERAL CONSIDERATION patient is to arrive at a patient is to include those definite diagnosis so that bodily lesions in his report Legal Medicine- branch of which deals with application of appropriate treatment can and testify before the court medical knowledge to the purposes of law and in the be instituted or before an investigative administration of justice. It is the application of basic and body clinical, medical and paramedical sciences to elucidate Minor or trivial injuries are Records all bodily injuries legal matters. usually ignored inasmuch even if they are small or as they do not require usual minor because these  Concept and practice of Legal Medicine in the treatment. injuries may be proofs to Philippines is of Spanish origin. qualify the crime or to justify the act. Legal Medicine Forensic Medicine Application of medicine to Application of medical legal cases science to elucidate legal Example: problems Presence of PHYSICAL INJURIES of a victim of sexual abuse = presumes that force was applied; hence, crime Medical Jurisprudence- knowledge of law in relation to committed must be RAPE. the practice of medicine. It concerns with the study of the rights, duties and obligations of medical practitioner with Presence of PHYSICAL INJURIES on the offender of the particular reference to those arising from doctor-patient crime of physical injuries= proof that the victim acted in relationship. SELF-DEFENSE.

NATURE OF THE STUDY OF LEGAL MEDICINE OTHER DEFINITIONS

 Knowledge of legal medicine means the ability to 1. LAW- rule of conduct, just, obligatory, laid by acquire facts, the power to arrange those facts in legitimate power for common observance and their logical order, and to draw a conclusion from benefit. the facts which may be useful in the administration of justice. Characteristics of Law:  Medical Jurist (medical examiner, medico-legal officer, medico-legal expert) – a physician who - It is a rule of conduct; specializes or is involved primarily with medico- - It is dictated by legitimate power; and legal duties. They are mostly in the service of the - Compulsory and obligatory to all. government. Forms of Law:  It is the duty of every physician, when called upon by the judicial authorities, to assist in the A. Written or Statutory Law (Lex administration of justice on matters which are Scripta) – composed of laws which are medico-legal in character.‖ produced by the country’s legislations  To be involved in medico-legal duties, a and which are defined, codified and physician must possess sufficient knowledge of: incorporated by the law-making body. o Pathology Ex. Philippine Laws. o Surgery B. Unwritten or Common Law (Lex non o Gynecology Scripta) – composed of unwritten laws o Toxicology based on immemorial customs and o Other branches of Medicine germane usages. Sometimes referred to as case to the issues involved. law, common law, jurisprudence or customary law. Ex. Laws of England. Ordinary Physician Medical Jurist Sees an injury or disease Sees injury or disease on 2. FORENSIC- denotes anything belonging to the on the point of view of the point of view of cause court of law or used in court or legal proceedings 1 By 4D2014-2015

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or something fitted for legal or public 2. Proceedings for hospitalization of an insane argumentations. person (Rule 101); and 3. Rules on evidences (Part IV). 3. MEDICINE- a science and art dealing with preventation, cure and alleviation of disease. It is In SPECIAL LAWS: that part of science and art of restoring and preserving health. It is the science and art of 1. Dangerous Drug Act (RA 6425, as amended) diagnosing, treating, curing and preventing 2. Youth and Child Welfare Code (PD 603) disease, relieving pain, and improving the health 3. Insurance Law (Act No. 2427 as amended) of a person. 4. Code of Sanitation (PD 856) 5. Labor Code (PD 442) 4. LEGAL- that pertains to law, arising out of, by 6. Employee’s Compensation Law virtue of or included in law. Refers to anything conformable to the letters or rules of law as it is MEDICAL EVIDENCE administered by the court. Evidence- the means, sanctioned by the Rules of Court, of

ascertaining in a judicial proceeding the truth respecting a 5. JURISPRUDENCE- science of giving a wise matter of fact. interpretation of the law and making just application of them to all cases as they arise. If the means employed to prove a fact is medical in nature then it becomes a medical evidence. PRINCIPLE OF STARE DECISES TYPES OF MEDICAL EVIDENCE A principle that, when the court has once laid down a principle of law or interpretation as applied to a 1. Autoptic or Real Evidence – evidence made certain state of facts, it will adhere to and apply to all future known or addressed to the senses of the court. It cases where the facts are substantially the same. is not limited to that which is known through the sense of vision but is extended to what the sense BRANCHES OF LAW WHERE LEGAL MEDICINE MAY of hearing, taste, smell and touch is perceived. BE APPLIED (Sec.1, Rule 130) In CIVIL LAW, knowledge of legal medicine may be useful Limitations to the Presentation of Autoptic on the following: Evidence: 1. Determination and termination of civil personality a) Indecency and Impropriety – presentation (Art.40-41); of evidence may be necessary to serve the 2. Limitation or restriction of a natural person’s best interest of justice but the notion of capacity to act (Art. 23 and 29); decency and delicacy may cause inhibition 3. Marriage and legal separation of its presentation. 4. Paternity and filiation 5. Testamentary capacity of a person making a will. Ex: Court may not allow exposure of the genitalia of an alleged victim of sexual In CRIMINAL LAW, legal medicine is applicable in the offense to show the presence and degree of following provisions of the Penal Code: the genitalia and extra-genitalia injuries 1. Circumstances affecting criminal liability; suffered. 2. Crimes against person; b) Repulsive Objects and those Offensive to 3. Crimes against chastity. Sensibilities – foul smelling objects, In REMEDIAL LAW, legal medicine is applied in the persons suffering from highly infectious and following provisions of the Rules of Court: communicable disease, or objects which when touch may mean potential danger to 1. Physical and mental examination of a person the life and health of the judge may not be (Rule 28); presented.

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However, if such evidence is necessary in 4. Documentary Evidence- Medical Documentary the adjudication of the case, the question of Evidence may be: indecency and impropriety or the fact that a. Medical Certification or Report on: such evidence is repulsive or offensive to i. Medical examination sensibilities, it may be presented. This will ii. Physical examination depend on the sound discretion of the court. iii. Necropsy/ autopsy iv. Laboratory 2. Testimonial Evidence – a physician may be v. Exhumation commanded to appear before a court to give his vi. Birth testimony. His testimony must be given orally vii. Death and under oath or affirmation. b. Medical Expert Opinion c. Deposition A physician may be presented in court as an ordinary witness and/or as an expert witness: 5. Physical Evidence – these are articles and materials which are found in connection with the ORDINARY WITNESS EXPERT WITNESS investigation and which aid in establishing the A physician who A physician on identity of the perpetrator or the circumstances testifies in court on account of his training under which the crime was committed, or in matters perceived from and experience can general assist in the prosecution of a criminal. his patient in the course give his opinion on a of physician-patient set of medical facts. Criminalistics - is the identification, collection, relationship. He can deduce or preservation and mode of presentation of infer something, physical evidence. It is the application of (Sec. 20, Rule 130, determine the cause sciences such as physics, chemistry, medicine Rules of Court) of death, or render and other biological sciences in crime detection opinion pertinent to and investigation. Exception: Privilege of the issue and medical Communication nature. Type of Physical Evidences: between physician and patient. (Sec. 48-49, Rule a. Corpus Delicti Evidence – objects or 130) substances which may be a part of the (Sec. 24 c, Rule 130) body of the crime. The probative value of b. Associative Evidence- these are the expert medical physical evidence which link a suspect testimony depends to the crime. upon the degree of c. Tracing Evidence- these are physical learning and evidence which may assist the experience on the line investigator in locating the suspect. of what the medical expert is testifying, the PRESERVATION OF EVIDENCE basis and logic of his The physical evidence recovered during medico-legal conclusion, and other investigation must be preserved to maintain their value evidences tending to when presented as exhibits in court. show the veracity or falsity of his Methods of Preserving Evidence testimony. 1. Photographs, audio and/or video tape, micro- film, Photostat, Xerox, voice tracing, etc. 3. Experimental Evidence – A medical witness 2. Sketching- rough drawing of the scene or object may be allowed by the court to confirm his to be preserve is done. It must be simple, allegation or as a corroborated proof to an identifying significant items and with exact opinion he previously stated. measurement.

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Kinds of Sketch:  The preservation is co-terminus with the life of the witness. Rough Sketch- made at the crime scene or  Human mind can easily be subjected to during examination of living or dead body. too many extraneous factors that may cause distortion of the truth. Finished Sketch- sketch prepared from the rough sketch for court presentation. 6. Special Methods- Special way of treating certain type of evidence may be necessary. Preservation Essential Elements to be Included in a may be essential from the time it is recovered to Sketch: make the condition unchanged up to the period it reaches the criminal laboratory for appropriate a. Measurement must be accurate; examination. b. Compass direction must always be indicated to facilitate proper orientation Special Ways of Preservation: in the case of crime scene; c. Essential item which has a bearing in a. Whole human body- embalming. the investigation must be included; b. Soft tissues (skin, muscles, visceral d. Scale and proportion must be stated by organs) – 10% formalin solution. mere estimation; c. Blood- refrigeration, sealed bottle e. There must be a title and legend to tell container, addition of chemical what it is and the meaning of certain preservatives. marks indicated therein. d. Stains (blood, semen) – drying, placing in sealed container. 3. Description- putting into words the person or e. Poison- sealed container. thing to be preserved. It must cause a vivid impression on the mind of the reader, a true CHAPTER II picture of the thing described. DECEPTION DETECTION

Minimum Standard Requirements which must be Methods of deception detection used by law satisfied in the description of the person or thing enforcement agencies: to make it complete: 1. Devices which record the psycho-physiological response a. Polygraph or lie detector machine – records a. Skin Lesion physiological changes that occur in association with b. Penetrating wound lying in a polygraph. c. Hymenal Laceration d. Person Phases of Examination i. Pre-test interview 4. Manikin Method- miniature model of a scene or ii. Actual interrogation and recording through the of a human body indicating marks of a various instrument aspects of the things to be preserved. 5. Preservation in the Mind of the Witness Standard test questions: 1. Irrelevant questions – no bearing to the case Drawbacks of preserving evidence in the mind of under investigation (ex: age, citizenship, the witness: occupation, etc). 2. Relevant questions – pertaining to the issue  The capacity of a person to remember under investigation (ex: Did you shoot to death time, place and event may be Mr. X?). destroyed or modified by the length of 3. Control questions – unrelated to the matter time, age of the witness, confusion with under investigation but are of similar nature other evidence, trauma or disease, although less serious as compared to those thereby making the recollection not relevant questions (ex: Have you ever used a reliable; gun?).

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iii. Post-test interrogation a. Truth serum – In the test, hyoscine hydrobromide is given hypodermically in repeated doses until a state of Supplementary tests: delirium is induced. When the proper point is reached, i. Peak-of-tension test – may be given if subject is the questioning begins and the subject feels a not yet informed of the details of the offense for compulsion to answer the questions truthfully. which he is being interrogated by the investigator. b. Narcoanalysis or narcosynthesis – practically the ii. Guilt complex test – applied when the response same as that of administration of truth serum. The to relevant and control questions are similar in only difference is the drug used. Psychiatric sodium degree and consistency in a way that the amytal or sodium penthotal is administered to the examiner cannot determine whether the subject is subject. telling the truth or not. c. Intoxication – the apparent stimulation effect of iii. Silent answer test – conducted in the same alcohol is really the result of the control mechanism of manner as when relevant, irrelevant and control the brain, so alcohol, like truth serum, and questions are asked, but the subject is instructed narcoanalytic drugs ―inhibit the inhibitor‖. (In vino to answer the questions silently, to himself, without veritas – in wine there is truth) making any verbal response. 3. Hypnotism – the alteration of consciousness and Factors responsible for the 25% errors of the lie concentration in which the subject manifests a detector: heightened of suggestibility while awareness is 1. Nervousness or extreme emotional tension maintained. experienced by a subject who is telling the truth regarding the offense in question 4. By observation 2. Physiological abnormalities Physiological and psychological signs and symptoms of 3. Mental abnormalities guilt: 4. Unresponsiveness in a living or guilty subject a. Sweating – if accompanied with a flushed face 5. Attempt to ―beat the machine‖ by controlled indicate anger, embarrassment or extreme breathing or by muscular flexing nervousness. If with a pallid face, may indicate shock 6. Unobserved application of muscular pressure which or fear. Sweating hands indicate tension. produces ambiguities and misleading indications in b. Color change – flushed face may indicate anger, the blood pressure tracing embarrassment or shame. Pale face is sign of guilt. c. Dryness of the mouth – nervous tension causes b. Word association test – A list of stimulus and non- dryness of the mouth which causes continuous stimulus words are read to the subject who is swallowing and licking of the lips. instructed to answer as quickly as possible. The time d. Excessive activity of the Adam’s apple – on interval between the words uttered by the examiner account of dryness of the throat, subject will swallow and the answer of the subject is recorded. The test is saliva which causes frequent upward and downward not concerned with the answer, be it a ―yes‖ or ―no‖. movement of the Adam’s apple. The important factor is the time of response in relation e. Fidgeting – constantly moving about in the chair, to the stimulus or non-stimulus words. pulling his ears, rubbing his face, picking and tweaking the nose, etc. Indicative of nervous tension. c. Psychological stress evaluator (PSE) – detects, f. ―Peculiar feeling inside‖ – there is a sensation of measures, and graphically displays the voice lightness of the head and the subject is confused. modulations that we cannot hear. When a person Result of troubled conscience. speaks, there are audible voice frequencies, and g. Swearing to the truthfulness of his assertion – ―I superimposed on these are the inaudible frequency swear to God I am telling the truth‖ modulations which are products of minute oscillation h. ―Spotless past record‖ – subject may assert that it is of the muscles of the voice mechanism. Such not possible for him to do ―anything like that‖ oscillations of the muscles or microtremor occur at the inasmuch as he is a religious man and that he has a rate of 8 to 14 cycles per second and controlled by the spotless record. central nervous system. i. Inability to look at the investigator “straight in the eye” – because of fear that his guilt may be seen in 2. Use of drugs that try to ―inhibit the inhibitor‖ his eyes.

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j. “Not that I remember” expression – resort to this e. The subject is given the opportunity to make a expression to avoid committing something prejudicial lengthy, time-consuming narration. to him. 6. Confession – an expressed acknowledgment by the 5. Scientific interrogation – the questioning of a person accused in a criminal case of the truth of his guilt as to suspected of having committed an offense or of persons the crime charged, or of some essentials thereof. who are reluctant to make a full disclosure of information in his possession which is pertinent to the investigation. Requirement for the Admissibility of Evidence Obtained Through Interrogation Suspect – person whose guilt is considered on reasonable ground  Custodial Investigation and Self-Incrimination (1987 Constitution) Witness – person other than the suspect who is  Miranda v. Arizona (Miranda Rights)- safeguards requested to give information were established for the interrogation of suspected persons. Different types of criminal offenders a. Based on behavioral attitude: Some Techniques of Interrogation i. Active aggressive offenders – commit crimes in an impulsive manner  Emotional Appeal- The interrogator creates a ii. Passive inadequate offenders – commit crimes mood that is conducive to confession. He may be because of inducement, promise or reward. sympathetic or friendly to the subject. b. Based on the state of mind  Mutt and Jeff Technique- One interrogator (Mutt) i. Rational offenders – commit crime with motive or is arrogant and relentless; he knows the subject intention to be guilty. The other (Jeff) is friendly, ii. Irrational offenders – commit crime without sympathetic, and kind. When Mutt is not present, knowing the nature and quality of his act. Jeff will advise the subject to make a quick c. Based on proficiency decision and plea for cooperation. i. Ordinary offenders – engaged in crimes which  Bluff on Split-Pair Technique- Applicable where require limited skill there are two or more persons who allegedly ii. Professional offenders – commit crimes which participated on the commission of a crime. All of require special skills rather than violence. them are interrogated separately and the d. Psychological classification interrogator may claim that the subject was i. Emotional offenders – commit crimes in the heat implicated by the author and that there is no use of passion, anger, or revenge. for him to deny participation. ii. Non-emotional offenders – commit crimes for  Stern Approach- Immediate and clear response financial gain and are usually recidivist or from the subject is demanded and the repeaters. interrogator uses harsh language.  The subject is given the opportunity to make a Techniques of Interrogation lengthy, time-consuming narration. a. Emotional appeal – interrogator must create a mood that is conducive to confession Basis of Interrogator’s Inference that the Subject is not b. Mutt and Jeff technique – there must be at least 2 Telling the Truth investigators with opposite character; one (Mutt) who is arrogant and relentless, and the other (Jeff) who is  The statements have many improbabilities and friendly, sympathetic and kind. gaps on its substantial parts. c. Bluff on split-pair technique – applicable where  The statements are inconsistent with the material there are two or more persons who allegedly facts. participated in the commission of a crime. While one  The statements are incoherent. of them is interrogated, the interrogator may claim that the subject was implicated by the author and that Confession there is no use for him to deny participation. d. Stern approach – questions must be answered clearly, and the interrogator utilizes harsh language. 6 By 4D2014-2015

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 Is an expressed acknowledgement by the authorized by the regulation, or (2) by accused of the truth of his guilt as to the crime inflicting such punishment in a cruel charged, or of some essentials thereof. and humiliating manner; or by  Confession is a statement of guilt while maltreating to extort a confession or admission is usually a statement of fact by the obtain information. accused which does not directly involve an  Tokyo Declaration- provides guidelines to be acknowledgment of guilt. observed by physicians concerning torture and other inhuman treatment Kinds of Confession o The doctor shall not countenance, condone, or participate in the practice  Extra-judicial Confession- is a confession made of torture or other forms of inhuman outside of the court prior to the trial of the case. procedures o Under the Rules of Court, extra-judicial o The doctor shall not provide premises, confession is not a sufficient ground for instruments, substances, or knowledge conviction unless corroborated by to facilitate such in practices evidence of corpus delicti. o The doctor shall not be present during o Extra-judicial confession may be: any procedure during which inhuman . Voluntary- the accused treatment is used or threatened speaks on his free will and o A doctor must have complete clinical accord, without inducement independence in deciding upon the of any kind, and with full and care of a person for whom he is complete knowledge of the medically responsible nature and consequence of o Where the prisoner refuses the confession. nourishment and is considered by the . Involuntary- obtained through doctor as capable of forming an force, threat, intimidation, unimpaired and rational judgment duress, or anything concerning the consequences of such influencing the voluntary act voluntary refusal of nourishment (as of the confessor. Such are confirmed by at least one other inadmissible in evidence. independent doctor), he or she shall  Judicial Confession- is the confession of an not be fed artificially. Such accused in court. It is conclusive upon the court consequences of the refusal of and may be considered to be a mitigating nourishment shall be explained by the circumstance. doctor to the prisoner o Under the Rules of Court, admissions o The World Medical Association will made by the parties in the pleadings, or support and encourage the in the course of the trial or other international community, the national proceedings do not require proof and medical associations, and fellow cannot be contradicted unless doctors, to support the doctor as previously shown to have been made his/her family in the face of threats or through palpable mistake. reprisals resulting from refusal to condone the use of torture and Maltreatment of Prisoners inhuman treatment.

 Elements (Art. 235, RPC) CHAPTER III o The offender is a public officer or MEDICO-LEGAL ASPECTS OF IDENTIFICATION employee o The offender has under his charge a Identification is the determination of the individuality of a convicted or detention prisoner person or thing. o The offender maltreats the prisoner by Importance of Identification overdoing in the correction and handling of the prisoner by the (1) imposition of punishment not

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 To establish the identity of the offender and that  Those which are based on scientific knowledge- of the victim in the prosecution of the criminal made by trained men, well-seasoned by offense. experience and observation  To identify a person missing or presumed dead in order to facilitate the settlement of the estate, Ordinary Methods of Identification retirement, insurance, and other social benefits.  Identification resolves the anxiety of the next-of-  Points of Identification Applicable to Living kin, other relatives and friends as to the Persons Only whereabouts of a missing person or victim of o Characteristics which may easily be calamity or criminal act. changed  Identification may be needed in some . Growth of hair, beard or transactions like cashing of check, entering a mustache premise, sale of property, release of dead bodies . Clothing- a person may have to relatives, parties to a contract, etc.. a special preference for certain form, texture or style Rules in Personal Identification . Frequent place of visit- A person’s special desire or  Law of Multiplicity of Evidence in Identification- habit to be in a place if he the greater the number of points of similarities has the opportunity to do so and dissimilarities of two persons compared, the . Grade of profession- e.g. a greater is the probability for the conclusion to be mechanic may be recognized correct. by his tools, a clergy man by  The value of the different points of identification his robe, or a nurse by her varies in the formulation of conclusion (e.g. visual cap recognition by relative or friends may be of lesser . Body ornamentations- value as compared with fingerprints or dental earrings, necklaces, rings, comparison). pins, etc. Usually worn by  The longer the interval between the death and persons the examination of the remains, the greater is the o Characteristics that may not be easily need for experts in establishing identity. changed  It is necessary for the team to act in the shortest . Mental memory- a possible time specially in cases of mass disaster. recollection of time, place,  There is no rigid rule to be observed in the and events. procedure of identification of persons. . Speech- a person may stammer, stutter, or lisp; Methods of Identification manner of talking and quality of the voice.  By comparison-Identification criteria recovered . Gait- a person, on account of during investigation are compared with records disease or some inborn traits, available in the file. may show a characteristic  By exclusion- If two or more persons have to be manner of walking. identified and all but one is not yet identified, then . Mannerism- stereotype the one whose identity has not been established movement or habit peculiar may be known by the process of elimination. to an individual. (E.g. way of sitting, movement of hand, Identification of Persons movement of body, movement of facial muscles, Classification of the Bases of Human Identification manner of leaning, etc.) . Hands and feet- Size, shape,  Those which laymen use to prove identity- no and abnormalities. special training or skill required  Foot or hand impression- develops when a 8 By 4D2014-2015

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foot or hand is  Negro- Thick lips pressed on and prominent mouldable eyes materials like mud, . Shape of the skull clay, cement  Caucasian- mixture, or other Elongated skull semi-solid mass.  Malayan- Round  Footprint or head apparel handprint- a  Mongolian- Round footmark or head handmark on a  Red Indians and hard base Eskimos- Flat head contaminated or . Wearing Apparel- Casual and smeared with customary wearing may foreign matters like indicate race as well as dust, floor, blood, religion, nationality, region, etc. and custom. . Complexion o Stature- change in height; rate of . Changes in the eyes- near- growth sightedness, far-sightedness, o Tattoo marks- introduction of coloring state of being color blind, etc. pigments in the layers of the skin by . Facies- different kinds of multiple puncture. facial expressions brought o Weight- not a good point of about by disease or racial identification for it is easily changed influence. from time to time. . Left- or right-handedness o Deformities- may be congenital or . Degree of nutrition- in acquired relation to height and age. o Birth marks o Injuries leaving permanent results- e.g.  Points of Identification Applicable to Both Living amputation, improper union of fractured and Dead before Onset of Decomposition bones o Occupational marks- certain o Moles occupations may result in some o Scar- a remaining mark after healing of characteristic marks or identifying the wound. guide . Age of scar o Race  Recently formed- . Color of the skin slightly elevated,  Caucasian-Fair reddish or bluish in  Malayan-Brown color, and tender to  Mongolian-Fair touch  Negro- Black  Few weeks to two . Feature of the face months- scar has  Caucasian- inflammatory Prominent sharp redness, and it is nose soft and sensitive  Malayan- Flat nose  Two to six months- with round face brownish or  Mongolian- Almond coppery red, free eyes and from contraction prominent cheek and corrugation, bone and soft

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 Six months or 3. Waering apparel more- scar is white, 4. Foreign bodies glistening, 5. Identification by close friends and relatives contracted, and 6. Identification record tough 7. Photographs

Anthropometry (Bertillon System) - scheme utilizing anthropometrical measurement of the II. SCIENTIFIC METHODS OF IDENTIFICATION human body as the basis of identification A. Fingerprinting B. Dental identication Basis C. Handwriting 1. The human skeleton is unchangeable after D. Identification of skeleton twentieth year. E. Determination of sex 2. It is impossible to find two human beings having F. Determination of Age bones exactly alike. G. Identification of Blood 3. The necessary measurement can easily be H. Identification of Hair and Fibers taken. A. Fingerprinting Information included - considered to be the most valuable method of 1. Descriptive Data - color of hair, eyes Identification 2. Body marks - moles, scars - the finger may be wounded or burned, but the whole 3. Anthropometrical measurements pattern with all its details will reappear when the A. Body measurement wound heals B. Measurement of head 1. There is no two identical fingerprints C. Measurement of the limbs 2. Fingerprints are not changeable

Portrait Parle (spoken picture) Practical uses - verbal, accurate and picturesque description of 1. Help establish identity in cases of dead bodies the person identified. Such information may be 2. Prints recoveres from crime scene associate person given bybthe witness, relatives, or persons who 3. Prints on file are useful for comparative purposes ate acquainted with the physical features of the 4. Among illiterates, right thumbprint is recognized as person to be identified substitute for signature. 1. General impression 2. Age, sex Dactylography is the art and study of recording 3. Race or color fingerprints as a means of identification 4. Height 5. Weight Dactyloscopy is the art of identification by comparison of 6. Built fingerprints 7. Posture 8. Head Poroscopy is the study of the pores found on the 9. Hair pappillary or friction ridges of the skin 10. Face 11. Neck Merhods of Producing Impression 12. Shoulder 1. Plain method - bulbs of the last phalanges of the 13. Wrist fingers and thumb are pressed on 14. Hands the surface of the paper after 15. Fingers pressing them on ink 16. Arms 2. Rolled method - bulbs of the thumb and other fingers 17. Feet are rolled on the surface of the paper after being rolled on an ink Extrinsic Factors in Identification pad 1. Ornamentation 2. Personal belongings Kinds of Impression 10 By 4D2014-2015

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1. Real impression - impression of the finger bulbs with 2. The enamel of the teeth is the hardest substance the use of printing ink on the in the body. It may outlast all other tissues. surface of the paper 3. After death, the greater the degree of tissue 2. Chance impression - impresses by mere chance deatruction, the greater is importance of the without any intention to produce it dental characteristic. 4. The more recent the ante-mortem records of the How to Get Fingerprint Impressions on Dead Bodies person to be identified, the more reliable is the - In case of fresh bodies, the fingers are comparative or exclusionary mode of uncleanched and each one is inked individually identification that can be done. with the aid of small rubber roller. - If the "floater" has been in the body if water for a Causes of Unreliability of the Dental Records longer time and the friction ridges have 1. The dentist may only concern himself with the disappeared, the skin of the fingertips is cut affected teeth and may not care to have a away. This area of the skin is placed in a small detailed examination of the other teeth. labelled test tube containing formaldehyde 2. No uniformity in nomenclature in the charting of solution. teeth 3. Although there may be a law obligating dentists Types of Fingerprint Patterns to have a record of their patient, the law does not 1. Arches - the ridgea go from one side of the mention the agency which will enforce it pattern to another, never turning back to make a 4. Changes in the teeth which are not seen by the loop dentist A. Plain arches B. Tented arches C. HANDWRITING - The handwriting of a person may be proved by a 2. Loops - one or more ridges enter on either side, witness who believes it to be the handwiting of recurves and terminate on the same side from such person, and has seen the person write, or which it entered has seen writing purporting to be his upon which A. Ulnar loop the witness has acted or been charged, and has B. Radial loop thus acquired knowledge of the handwriting of such person. 3. Whorls - patterns with two deltas and patterns too irregular in form to classify The genuineness of any disputed writing may be A. Simple whorl proven by any of the following ways B. Central pocket loop 1. Acknowledgement of the alleged writer C. Lateral pocket loop 2. Statement of the witness who saw the writing D. Twin loop 3. Opinion of persons who are familiar with the E. Accidentals handwriting of the alleged writer 4. Opinion of an expert Q: Can fingerprints be effaced? A: No, as long as the dermis of the bulbs of the finger is not Practical Uses of Handwriting Examination completely destroyed, the fingerprints will always 1. Financial crime remain unchanged and indestructible. 2. Death inveatigation 3. Robberies Q: Can fingerprints be forged? 4. Kidnapping with ransom A: There is considerable controversy as various 5. Anonymous threatening letters experiments could almost make an accurate 6. Falsification of documents reproduction, still there is no case in record known or have been written. Bibliotics - science of handwriting analysis

B. DENTAL IDENTIFICATION Graphology - study of handwriting for the purpose of 1. The possibility of two persons to have the same determining the writer's personality, dentition is quite remote. character and aptitude.

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Handwriting - complex interaction of nerves c. Logwood ink d. Carbon ink Writing - conscious act, but on the account of repeated act e. Ballpoint ink it becomes habitual and unconscious CHAPTER III Movements in Writing MEDICO-LEGAL ASPECTS OF IDENTIFICATION 1. Finger movement- letters are made entirely by the action of the thumb, the pointing and middle Instruments Necessary in Questioned Document fingers Examination: 2. Hand movement – letters are produced by the action of the hand as a whole with the wrist as 1. Photographic instruments- to view the writing in the center of action sufficient magnification for detail examination and 3. Arm movement – movement in writing is made preparation of evidence for presentation by the hand and arm supported with the elbow at 2. Magnifying lend and stereoscopic binocular the center of later swing microscope- to determine unusual appearances of 4. Whole arm movement – action is produced by writing. Obliterations, erasures and alterations may be the entire arm without any rest more visible 3. UV lamp and infra red radiation- to mae visible the chemical erasures 4. Measuring caliper The Form, Style and Characteristics of the Handwriting 5. Good lighting facilities of a Person are Basically Determined By: Purpose of Handwriting Examination Primary Factors 1. Survival of the letters are formed when a person 1. Whether the document was written by the suspect begins to write 2. Whether the document was written by the person 2. Inclusion of some characteristics due to whose signature it bears admiration of a peculiar design in writing 3. Whether the writing contains additions or deletions 3. Identifying characteristics may be the result of 4. Whether the document such as bills, receipts, suicide the great volume of writing done notes or checks are genuine or a forgery 4. The presence or absence of physical abnormalities or defects originating from illness, Points to Consider in Questioned Document Examination injury, psychological variations and other similar conditions  Slant, spacing, size, proportion of the letters, speed and rhythm in writing, shading, pen strokes Secondary Factors  The greater the variation in the way of writing, the 1. Position of writer greater the amount of standard of writing needed to 2. Temporary physical or psychological disturbance form a reliable impression 3. Other external temporary variables 4. Physical and chemical factors  To determine whether a certain instrument or A. Writing instrument document has been written by a certain person, a. Ballpen compare the writings with some standard of writings of b. Fountain pen the same person c. Steel pen o Two Types of Standard Writings: d. Pencil . Collected Standards: handwriting B. Paper by the person who is suspected to a. Color have written the questioned b. Surface appearance document; may be found in the c. Watermarks private or public records of the d. Weight and thickness persons C. Ink . Requested Standard: standards a. Iron gallotannate ink made by the alleged writer upon b. Washable ink request of the examiner; usually 12 By 4D2014-2015

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applicable only to recently written 7. Length of interment or length from the time of death documents May be determined by the nature and presence of soft tissues and the degree of erosion of the bones. Disguised writing Ordinarily, all the soft tissues in a grave disappear within a year. The deliberate attempt on the part of the writer to alter his 8. Presence or absence of ante or post mortem injuries writing habit to invent a new writing style of by imitating the 9. Congenital deformities and acquired injuries on the writing of another person. hard tissues causing permanent deformities  Done by changing the direction of the slant, changing the speed in writing, deliberate (pp. 86-102) carelessness Procedure of the Test Signature forgery Two Methods may be utilized and both should be Signature forgery examination is the most common activity employed in the examination: of a questioned document examiner 1. Detection of Agglutinins Classifications of Signature Forgery 2. Detection of Agglutinogens 1. Traced forgery: the outlining of a genuine signature Value of the Test from one document onto another 2. Simulated forgery: an attempt to copy in freehand  It may solve disputed parentage (maternity or paternity). manner the characteristics of a genuine signature  Positive result - not conclusive that the one in question is either from the memory of the signature or from as the offspring model. 3. Spurious forgery: one prepared primarily in the  Negative result - conclusive that he is not the child of the forger’s own handwriting wherein little or no attempt alleged parents. Grouping is true not only with blood but has been made to copy the characteristics of the also with other body fluids like saliva, vaginal secretion, genuine writing seminal fluid, milk, urine and others

INHERITANCE PATTERNS OF ABO BLOOD GROUPS Typewriter Identification Group of Group of Exclusion The identification of the typing machine used in a Parents Children Cases questioned document O x O O A, B, AB

O x A O, A B, AB IDENTIFICATION OF THE SKELETON O x B O, B A, AB

A x A O, A B, AB In the examination of bones, the following points can be determined: A x B O, A, B, AB 1. Whether the remains are of human origin or not: B x B O, B A, AB Study the shape, size, and general nature of the O x AB A, B O, AB remains, especially that of the skull A x AB A, B, AB O 2. Whether the remains belong to a single person or not: B x AB A, B, AB O Any plurality or excess of the bones after a complete AB x AB A, B, AB O lay out denotes that the remains belong to more than one person 3. Height Different Characteristics of Blood from Different Sources: 4. Sex: Study the pelvis, skull, sternum, femur and humerus 1. Arterial Blood – bright scarlet in color, leaves the blood 5. Race vessel with pressure, high oxygen contents 6. Age: 2. Venous Blood – dark red in color, does not spill far Determined by the appearance of ossification centers from the wound, low oxygen content and union of bones and epiphyses, dental 3. Menstrual Blood – does not clot, acidic in reaction identification, and obliteration of cranial structures owing to mixture with vaginal mucous, on 13 By 4D2014-2015

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microscopic examination, there are vaginal epithelial same degree as cells, contains large number of Deoderlein’s bacillus. human’s 4. Man’s or Woman’s Blood- no method of Note: Medullary index (I) is the relation between the differentiating man and woman’s blood diameter of the medulla and the diameter of the whole hair. 5. Child’s Blood- at birth, it is thin and soft compared The hair and fiber may be examined microscopically in its with that of adult, red blood cells are nucleated and cross-section and longitudinal aspect.Comparative study exhibit greater fragility, red blood cells count more must be made to show similarity of the hair and fiber. than in adult. Other Points in the Identification of Hair: Identification of Hairs and Fibers 1. Characteristics of the hair: Hair on body surfaces is fine while those from the beard, 1. Addition of a substance that will coat the outer mustache and scalp are very thick. surface of the hair so as to impart a different Hair from the eyebrows and lashes is tapering gradually to color. finepoints. Ex.: Salts of bismuth, lead, silver and pyrogallic acid 2. Length of the Hair: Hair from the scalp grows 2.5 cms. a month. 2. Addition of substances which bleach or Beard hair grows at the rate of 0.4 millimeter a day. change the natural color of the fiber or 3. Color of the hair: hair.  May be black, blonde or brunette. Ex.: Hydrogen peroxide, chlorine and  Hair from older persons may be white or gray. diluted nitric acid  The hair may be artificially colored by bismuth, lead or

silver salts. Distinctions between Human and Animal Hair:  It may be bleached by addition of hydrogen peroxide, Human Animal chlorine or diluted hydrochloric or nitric acid. Medulla Air network in fine Air network in grains forms of large Male or a Female Hair and small In many instances it is quite impossible to state the sex sacks. from the hair, but certain points may be worthy of mention: Cells invisible without  Hair on the scalp of male is shorter, thicker and more treatment in water Cells easily wiry than that of female's. visible  Eyebrow hair of a male is generally long and more wiry Value of I lower than than that of a female's. 0.3 Value of I higher Estimation of Age Based on the Hair: Fuzz without medulla than 0.5  Hair of children is fine, short, and deficient of pigments and, as a rule, devoid of medulla. Fuzz with  At the adolescent age, hair may appear at the pubis. medulla Hair on the scalp becomes long, wiry, and thick. Cortex Looks like a thick muff Looks like a  In the case of older persons, the color is usually white fairly thin hollow or gray, with marked absorption of pigments and Pigments in the form cylinder degenerative changes of fine grains Pigments in the form of irregular CHAPTER IV grains larger MEDICO-LEGAL ASPECTS OF DEATH than that of human’s Importance of Death Determination 1. The civil personality of a natural person is extinguished Cuticle Thin scales not Thick scales by death; protruding, covering protruding, do 2. The property of a person is transmitted to his heirs at one another to about not cover one the time of death; 4/5 another the

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3. The death of the partner is one of the causes of Death will have occurred when these conditions first dissolution of partnership agreement; coincide. (Section 1, Chapter 378 of Kansas Statute) 4. The death of either the principal or the agent is a mode of extinguishment of agency; Brain Death 5. The criminal liability of a person is extinguished by 1. According to Harvard Report of 1968, the following are death; the characteristics of ―irreversible coma‖: 6. The civil case for claims which does not survive is dismissed upon the death of the defendant. a. Unreceptivity and Unresponsibility  There is a total unawareness to externally applied Death stimuli and inner need and complete unresponsiveness  is the termination of life.  it is the complete cessation of all the vital functions b. No movements or breathing without possibility of resuscitation.  Observation covering a period of at least l hour by  it is an irreversible loss of the properties of living matter. physicians is adequate to satisfy the criteria  an event that takes place at a precise time.  the ascertainment of death is a clinical and not a legal c. No reflexes problem. Irreversible coma with abolition of central-nervous system activity is evidenced in part by the absence of Based on the Criterion Used in its Determination, death elicitable reflexes. may be:  The pupil will be fixed and dilated and will not respond to 1. Brain Death a direct source of bright light.  Death occurs when there is deep irreversible coma,  Ocular movement (to head turning and to irrigation of the absence of electrical brain activity and complete ears with ice water) and blinking are absent. cessation of all the vital functions without possibility of  There is no evidence of postural activity (decerebrate or resuscitation. other).  Swallowing, yawning, vocalization are in abeyance. 2. Cardio-Respiratory Death  Corneal and pharyngeal reflexes are absent.  Death occurs when there is a continuous and persistent  As a rule, the stretch or tendon reflexes cannot be cessation of heart action and respiration. elicited, i.e. tapping the tendons of the biceps, triceps  It is a condition in which the physician and the and pronator muscles, quadriceps and gastrocnemius members of the family pronounced a person to be dead muscles with the reflex hammer elicits no contraction of based on the common sense or intuition the respective muscles.  Plantar or noxious stimulation gives no response. 3. Brain and Cardio-Respiratory Death A person will be considered medically and legally dead if in d. Flat electro-encephalogram the opinion of a physician based on ordinary standards of  Of great confirmatory value is the flat or iso-electric medical practice, there is: E.E.G. assuming that the electrodes have been properly  absence of spontaneous respiratory and cardiac applied, that the apparatus is functioning normally, and function, and because of the disease or condition which that the personnel in charge are competent. caused, directly or indirectly, these functions to cease, or because of the passage of time since these functions Note: All of these tests shall be repeated at least 24 ceased, attempts at resuscitation are considered hours later with no change. It is emphasized that the hopeless; patient be declared dead before any effort is made to  absence of spontaneous brain function and if based on take him off the respirator, if he is then on respirator. ordinary standards of medical practice during reasonable attempts to either maintain or restore 2. In 1969, the Ad Hoc Committee of Human Transplantation spontaneous circulatory or respiratory function in the convened under the auspices of the Institute of Forensic absence of aforesaid brain function, it appears that Sciences, Duquesne University School of Law adopted the further attempts at resuscitation or supportive proposed criteriafor the determinationof death otherwise maintenance will not succeed. known as Philadelphia Protocol, and the following were considered:

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a. Lack of responsiveness to internal and external A. KINDS OF DEATH environment; 1. SOMATIC DEATH OR CLINICAL DEATH b. Absence of spontaneous breathing movements for 3  state of the body in which there is complete, persistent and minutes, in the absence of hypocarbia and while breathing continuous cessation of the vital functions of the brain, room air. heart and lungs which maintain life and death; c. No muscular movements with generalized  hardly impossible to determine the exact time of death; flaccidity and no evidence of postural activity or shivering;  immediately after death, - the face and lips become pale d. Reflexes and response: - the muscles become flaccid d.1. Pupils fixed and dilated, non-reactive to strong - the sphincters are relax stimuli; - the lower jaw tends to drop d.2. Corneal reflexes absent; - the eyelids remain open d.3. Supra-orbital or other pressure - pupils dilate response absent (both pain response - skin loses its elasticity and decerebrate posturing); - body fluids tend to gravitate to the most d.4. Absence of snucking or snouting dependent portions of the body response; - body heat gradually assumes the d.5. No reflex response to upper airway temperature of the surroundings stimulation; d.6. No reflex response to lower airway 2. MOLECULAR OR CELLULAR DEATH stimulation;  After cessation of the vital functions, there is still animal life d.7. No ocular response to ice water among individual cells. stimulation of the inner ear;  About 3-6 hours later, there is death of individual cells d.8. No deep tendon reflexes; known as molecular or cellular death d.9. No superficial reflexes;  Exact occurrence cannot be definitely determined due to d.10. No plantar responses. several factors

e. Falling arterial pressure without support by drugs or 3. APPARENT DEATH OR STATE OF SUSPENDED other means. ANIMATION f. Iso-electric electro-encephalogram (in the absence of  This condition is not really death but merely a transient loss hypothermia, anesthetic agents and drugs intoxication) of the vital functions of the body on account of disease, recorded spontaneously and during auditory and tactile external stimulus or other forms of influence. stimulation.  It may arise especially hysteria, uremia, catalepsy and

electric shock It is further laid down that these criteria shall have been

present for at least 2 hours and that death should be B. SIGNS OF DEATH certified by two physicians other than the physician of a

potential organ recipient. 1. CESSATION OF HEART ACTION AND CIRCULATION

 There must be continuous cessation of the heart action and Other Set of criteria to Establish Brain Death: the flow of blood in the whole vascular system 1. Mohandas and Chou (1971) – standards of Brain Death

accepted at the University of Minnesota Science Methods of Detecting the Cessation of Heart Action and Center. Circulation

a. Examination of the Heart 2. The Ottawa General Hospital (1970) - a.1. Palpation of the Pulse- may be made at the guidelines for the criteria of cerebral death. region of the wrist or at the neck

a.2. Auscultation for the heart sound at the 3. In France (1968) - the Council of Ministers published a precordial Area - the rhythmic contraction and decree which adopted the official definition of death on relaxation of the heart is audible through the recommendation of the French Academy of Medicine. stethoscope. Heart sound can be audible

during life even without the aid of a stethoscope by Note: The use of the criteria of brain death may only be placing the ear at the precordial area applied to those persons who are potential organ donors. 16 By 4D2014-2015

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Difficulties in Auscultation may be encountered in:  The fingers are spread wide and the finger webs are (a) Stout person viewed through a strong light. (b) Fatty degeneration of the heart.  Living: the finger webs appear red (c) Pericardial effusion. Dead: yellow

a.3. Flouroscopic Examination- will reveal b.6. Application of Heat on the Shin the shadow of the heart in its rhythmic contraction and  If heated material is applied on the skin relaxation. The shadow may be enlarged and the Living: blister formation, congestion, and other vital excursion made less visible due to reactions of the injured area will be observed. pericardial effusion. Dead: will not produce true blister, no sign of congestion, or other vital reactions. a.4. By the Use of Electrocardiograph This is the best method of determining heart b.7. Palpation of the Radial Pulse With Fingers action but quite impractical  Living: will feel the rhythmic pulsation of the vessel due to the flow of blood. b. Examination of the Peripheral Circulation: Dead: No such pulsation will be observed b.1. Magnus’ Test:  A ligature is applied around the base of a finger with b.8. Dropping of Melted Wax moderate tightness. Melted sealing wax is dropped on the breast of a person.  In a living person there appears a bloodless zone at Dead: there will be no inflammatory edema the site of the application of the ligature and a livid at the neighborhood of the dropped melted area distal to the ligature. wax.  If the ligature is applied to the finger of a dead man, there is no such change in color. 2. CESSATION OF RESPIRATION  must be continuous and persistent. b.2. Opening of Small Artery:  Living: the blood escapes in jerk and at a distance. In the following conditions there may be suspension of  Dead: the blood vessel is white and there is no respiration without death ensuing: jerking escape of blood but may only ooze towards a. In a purely voluntary act, as in divers, swimmers, etc. but the nearby skin. it cannot be longer than two minutes;  When bigger arteries are cut, blood may flow b. In some peculiar condition of respiration, like Cheyne- without pressure continuously. Stokes respiration, but the apneic interval cannot be longer than fifteen to twenty seconds; b.3. Icard's Test c. In cases of apparent drowning;  This consists of the injection of a d. Newly-born infants may not breathe for a time after birth solution of fluorescein subcutaneously. and may commence only after stimulation or  If circulation is still present, the dye will spread all spontaneously later. over the body and the whole skin will have a gleenish-yellow discoloration due to flourescein. INTERNAL HYPOSTASIS IN VISCERAL ORGANS  This test should be applied only with the use of the daylight as the color is difficult to be appreciated Post-mortem lividity occurs in internal organs. with the use of artificial light. Post Mortem Lividity Simple Congestion

b.4. Pressure on the Fingernails: Staining in organs is Generally uniform and irregular and occurs in most found all over the body.  lf pressure is applied on the fingernails dependent parts. intermittently, there will be a zone of paleness at the site of the application of pressure which become Dull and lustreless mucous Not so. membrane livid on release. Imflammatory exudates is Not seen in simple  There will be no such change of color if the test is not seen, areas of redness congestion. applied to a dead man. alternating with pale areas

found in a hollow viscus. b.5. Diaphanous Test

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3. Liquefaction of the Soft Tissues

Post Mortem Haemorrhage of Phosphorus Lividity scurvy poisoning Factors Modifying the Rate of Putrefaction Presence can be Presence can be revealed in history. revealed in Internal Factors history. Age Skin lesion Skin lesion present Skin lesion Condition of the Body appears after before death present before Cause of Death death. death Present in the May be found all May be found all External Factors most dependent over the skin and over the skin and Free Air Earth portions of the organs. organs. Water body. Clothings

FACTORS INFLUENCING THE CHANGES IN THE BODY CHANGES IN THE BLOOD: AFTER BURIAL Hydrogen Ion Concentration State of the Body before Death: An emaciated person at Rise of non-protein nitrogen and free amino-acid the time of death will decompose slower than a well- Chemical: Chloride in the plasma, Magnesium as nourished individual. Skinny persons have more tendency a result of diffusion, Potassium increases owing to to decompose. diffusion. Time elapsed between death and burial and AUTOLYTIC OR AUTODIGESTIVE CHANGES AFTER environment of the body. DEATH Effect of Coffin: the use of a coffin will delay After Death, proteolytic, glycolytic and lipolytic ferments of decomposition if it is airtight and hard. glandular tissues continue to act which lead to the autodigestion of organs. This action is facilitated by weak Clothing and Any other Coverings on the Body when acid and higher temperature and delayed by the alkaline buried: Clothings retard decomposition because it affords reaction of the tissues of the body and low temperature. protection from insects and aids adipocere formation. Their early appearance is observed in the parenchyatous and glandular tissues. Depth at which Body is buried: the greater the depth the body is buried the better the preservation.

Condition and type of soil: Dry, arid and sandy soil PUTREFACTION OF THE BODY promotes mummification.

Putrefaction is the breaking down of the complex proteins Inclusion of something in the Grave which will hasten into simpler components associated with the evolution of Decomposition foul smelling gasses and accompanied by the change of color of the body. Access of Air to the Body after Burial: Air may hasten evaporation of the body fluid and promotes mummification. Tissue changes in Putrefaction: Mass Grave: There is relatively rapid decomposition of the 1. Changes in the color of the tissue bodies 2. Evolution of Gasses in the tissues Trauma on the Body: Effects of the Pressure of Gasses of Putrefaction CHRONOLOGICAL SEQUENCE OF THE Displacement of Blood, Bloating of the Body, Fluid Coming PUTREFACTIVE CHANGES OCCURING IN out of both nostrils and mouth, Extrusion of the Fetus in a TEMPERATE REGIONS gravid uters, floating of the body.

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Greenish Discoloration over the iliac fosae. 1-3 days Face swollen and red. Greenish discoloration 1 – 2 wks Eyeballs are soft and yielding. on the eyelids, lips, neck and sternum. Skin Greenish discoloration spreading over the 3-5 days of the hands and feet wrinkled. Upper surface while abdomen, external genitals and other of brain greenish in color. parts of the body. Frothy blood from the moth Skin wrinkled. Srotum and penis distended 4 wks and nostrils. with gas. Nails and hair still intact. Lungs Abdomen distended with gas. Cornea fallen 8-10 days emphysematous and covered the heart. in and concave. Purplish red streaks of veins Abdomen distended, skin of hands and feet 6 – 8 wks prominent on the extremities. Sphincters come off with nails like a glove. relaxed. Nails firm. Body greenish-brown. Blisters forming all 14 – 20 over the body. Skin peels off. Features days Factors Influencing the Floating of the Body in Water unrecognizable. Scrotum distended. Body swollen up owing to distention. Maggots Age: Bodies of fully-developed and well-nourished newly- found on the body. Nails and hair loose and born infants float rapidly. easily detached. Soft parts changes into a thick, semi-fluid 2-5 mos Sex: Women float sooner than men. black mass after death Conditions of the body: Stout persons float quicker.

Season of the Year: The moist hot air of summer is very CHRONOLOGICAL SEQUENCE OF THE favourable for putrefaction. PUTREFACTIVE CHANGES OCCURING IN TROPICAL REGIONS Water: Dead body floats in a shallow and stagnant water of creeks or pond sooner than in deep water in running Rigor mortis present all over. Hypostasis well 12 hrs streams. developed and fixed. Greenish discoloration showing over the castum. External Influence: the presence of heavy-wearing Rigor mortis absent all over. Green 24 hrs apparel or addition weight in the pockets or attached to the discoloration over whole abdomen and body delays floating. spreading to chest. Abdomen distended with gasses. Order of putrefaction when body is in water: Face, neck Ova of flies seen. Trunk bloated. Face 48 hrs. and sternum; shoulders; arms; abdomen; legs. discoloured. Blisters present. Moving maggots seen. INFLUENCE OF BACTERIA IN DECOMPOSITION Whole body grossly swollen and disfigured. 72 hrs Hair and nails loose. Tissues soft and Decomposition is due to action of bacteria in various discoloured. tissues of the body. Aerobic activities are present in the Soft viscera putrefied. 1 wk early stages of decomposition, later on activities of the Only more resistant viscera distinguishable. 2 wks anaerobes are the most prominent with the production of Soft tissues largely gone. gasses. Softening of tissues is the result of bacterial action, Body skeletonised. 1 mo. proteolytic and autolytic ferments. The microorganism that plays an important role in decomposition is Clostridium Welchii. It grows in the CHRONOLOGICAL SEQUENCE OF THE parenchyatous organs and is responsible for the PUTREFACTIVE CHANGES WHEN THE BODY HAS disintegration of cytoplasm, destruction of nuclei and BEEN SUBMERGED IN WATER generation of gasses in the cells. Very little change if water is cold. Rigor mortis 4-5 days Other destructive agents during decomposition include flies may persist. and maggots, reptiles, rodents, other mammals, fishes and The skin on the hands and feet became 5-7 days crabs, and molds. sodden and bleached. The face appears softened and has a faded white color. Special Modification of Putrefaction

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I. Mummification: the dehydration of the whole body approximate time of death may be deduced from the which results in the shivering and preservation of the amount of food in the stomach in relation to his last meal. body. Mummification usually happens in warm countries where evaporation of body fluids takes place Presence of live fleas in the clothing (drowning cases): a earlier and faster than decomposition. flea can survive for approximately 24hrs submerged in water. Fleas recovered, usually from the clothing of the Kinds of mummification: victim, is observed if it still living to approximate the time when said was submerged in water. Natural: the body will become dehydrated and mummified due to the forces of nature. Amount of urine in the bladder: the amount of urine in the urinary bladder may indicate the time of death when taken Artificial: (1) acceleration of the evaporation of the tissue into consideration, he was last seen voiding his urine. fluids of the body before actual onset of decomposition; (2) addition of preservatives to inhibit decomposition. State of the clothings: a circumstantial proof of the time of death is the apparel of the deceased II. Saponification or Adipocere Formation: a condition wherein the fatty tissues of the body are transformed Chemical changes in the Cerebro-Spinal Fluid to soft brownish-white substance known as adipocere. Post-mortem clotting and decoagulation of blood: blood Factors Influencing Adipocere Formation clots inside the blood vessels in 6-8hrs after death.

State of Health before Death, Time interval between death Presence or absence of soft tissues in skeletal remains: and burial, effect of a coffin, presence of clothing, type of under ordinary conditions, the soft tissues of the body may soil, access of air to the body after burial, mass grave. disappear 1-2yrs after burial.

III. Maceration: the softening of the tissues when in a fluid Condition of the Bones: if all the soft tissues have already medium in the ansence of putrefactive microorganism disappeared from the skeletal remains, the degree of which is frequently observed in the death of the fetus erosion of the epiphyseal ends of long bones, pulverization en utero. of flat bones and diminution of weight due to the loss of animal matter may be the basis of the approximation. Duration of Death

Presence of Rigor Mortis: in warm countries, rigor mortis sets in from 2-3 hrs after death. It si fully developed in the PRESUMPTION OF DEATH body after 12 hrs. It may last from 18 – 36 hrs and its disappearance is concomitant with the onset of Rule 131 Section 5 Rules of Court putrefaction. Article 390 Civil Code Presence of Post-mortem lividity: usually develops 3-6 hrs after death. Appears as small petechia-like red spots which  Disputable Presumption: not heard from for 7 later coalesce with each other to involve bigger areas in the years = DEAD most dependent portions of the body. o Dead for all purposes. EXCEPT: SUCCESSION Onset of Decomposition: In tropical areas, decomposition  Absentee shall not be presumed dead for the is early and the average time is 24-48hrs after death. purpose of opening his succession till after absence of 10 years. Stage of Decomposition: the approximate time of death o If he disappeared after 75 years old: may be inferred from the degree of decomposition. Absence of 5 years SUFFICIENT to open succession. Entomology of the Cadaver: to approximate the time of death, the presence of flies in the cadaver is sometimes Article 391 Civil Code used.  Presumed DEAD FOR ALL PURPOSES: Stage of digestion in the stomach: it normally takes 3-4 hrs for the stomach to evacuate its contents after a meal. The 20 By 4D2014-2015

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o Lost on board a vessel lost during sea other, shall prove the same; in the absence of proof, it is voyage, missing airplane, not been presumed that they died at the same time and there shall heard of for 4 years since loss of be no transmission of rights from one to the other. vessel or airplane. o Person in armed forces who has taken CHAPTER VII part in war, missing for 4 years SPECIAL DEATHS o Person In danger of death other circumstances and his existence not I. JUDICIAL DEATH known 4 years. METHODS Article 392 Civil Code 1. Death by Electrocution If absentee appears or without appearing his 2. Death by Hanging existence is proved, he shall recover his property in the 3. Death by Musketry condition in which it may be found, and the price of any 4. Death by Gas Chamber property that may have been alienated or the property acquired therewith; but he cannot claim either fruits or OTHER METHODS OF CAPITAL PUNISHMENT rents. 1. Beheading PRESUMPTION OF SURVIVORSHIP 2. Crucifixion 3. Beating Rule 131 Section 5(jj) Rules of Court 4. Cutting Asunder 5. Precipitation from a height When 2 persons die in same calamity, such as: 6. Destruction by a wild beast 7. Flaying  Wreck 8. Impaling  Battle 9. Stoning  Conflagration 10. Strangling 11. Smothering Not shown who died first; there are no particular 12. Drowning circumstances from which it can be inferred, the survivorship is presumed from the probabilities resulting II. EUTHANASIA from the strength and age of the sexes, according to the ―Mercy Killing‖ – deliberate and following: painless acceleration of death of a person usually suffering from an 1. Both UNDER 15: Older presumed survived incurable and distressing disease. 2. Both ABOVE 60: Younger presumed survived TYPES: 3. One UNDER 15, Other ABOVE 60: UNDER 15 presumed survived 1. Active Euthanasia 4. One OVER 15, Other UNDER 60, 2. Passive Euthanasia a. Different Sex: Male presumed a. Orthothanasia survived b. Dysthanasia b. Same Sex: Older

5. One UNDER 15, or ABOVE 60, the other BETWEEN those ages: latter presumed Ways of Performing Euthanasia survived 1. Administration of a lethal dose of poison Article 43, Civil Code: 2. Overdosage of sedatives, hypnotics, other pain relieving drugs If there is a doubt, as between 2 or more persons 3. Injection of air into bloodstream who are called to succeed each other, as to which of them 4. Application of strong electric currents died first, whoever alleges the death of one prior to the 21 By 4D2014-2015

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5. Failure to institute the necessary 7. Evidence which will rule out management procedure which is essential homicide, murder, parricide, and to preserve the life of the patient. other manner of violent death.

Ways of Performing Euthanasia CHAPTER VIII DISPOSAL OF THE DEAD BODY 1. Patient himself 2. The physician, with or without the Persons Charged with Duty of Burial: knowledge and and consent of the patient 1. If married: surviving spouse if possesses means to pay 3. Poison was administered by the physician to the necessary expenses. the patient without the knowledge and consent of the patient, then it is murder. 2. Unmarried or child: nearest kin if they be adults and Treachery is inherent to the act of poisoning within the Philippines and in possession of means to pay and treachery qualifies it to murder. the necessary expenses.

III. SUICIDE 3. Unmarried or no kin left with means: municipal Psychological Classification of Suicide authorities 1. First degree – deliberate, planned, premeditated, self-murder *Shall perform such duty within 48 hours after death, if able 2. Second degree – impulsive, to do so. unplanned, under great provocation or mitigating circumstances Right of Custody to body: 3. Third degree – sometimes called To the person charged with the duty of burying the body accidental suicide. This occurs when a except when inquest is required by law to determine cause person puts his or her life into jeopardy of death or cause of death is accompanied by by voluntary self – injury communicable disease, custody of which will remain to 4. Suicide under circumstances which local board of health or municipal council until buried. suggest a lack of capacity for intention as when the person was psychotic or Right of custody means possession, the holding of a thing under influence and effects of drugs or the enjoyment of a right. Enjoyment of a thing could and alcohol. either be in the concept of ownership or holder of a thing 5. Self-destruction due to negligence while ownership belongs to another. The right of 6. Justifiable suicide – self- destruction possession of a corpse is equivalent to ownership and action of a person with terminal illness. unlawful interference is an actionable wrong.

Evidence that will infer death is suicidal: Surviving spouse has the preferential right and duty to make the arrangements but if deceased spouse left a will 1. History of depression, unresolved stating among other things the manner his body will be personal problem, mental disease disposed, such provision will prevail over the provisions of 2. Previous attempt of self- the Administrative Code. destruction 3. If committed by infliction of Methods of Disposal of the Dead Body physical injuries, the wounds are located in areas accessible to the 1. Embalming hand, vital parts of the body and usually solitary. - Artificial way of preserving body be injecting 4. Effects of act of self-destruction formalin and perchloride of mercury or arsenic in the found in the body of the victim common arteries and the femoral arteries. 5. Presence of suicide note 6. Suicide scene in place not 2. Burial or Inhumation susceptible to public view - Body must be buried within 48 hours after death except when required for legal investigation or authorized

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by local health authorities or when embalmed (impliedly (b) A burial ground shall at least be 25 meters distant from allowed). After 48 hours, new permit is needed. If with any dwelling house and no house shall be constructed communicable disease, within 12 hours after death unless within the same distance from any burial ground. directed otherwise by local board of health. (c) No burial ground shall be located within 50 meters from In Philippines, body needs to be buried within 24 either side of a river or within 50 meters from any source of hours because of the climatic condition. water supply.

 Death Certificate necessary before burial except The burial remain is subject to the following requirements: in cases of emergency. Primary duty of physician to furnish if available. If not, local health officer, (a) Shipment of remains abroad shall be governed by the mayor, the secretary or of a councilor. Order is rules and regulations of the Bureau of Quarantine. successive and exclusive. (b) The burial of remains in city or municipal burial grounds - It must be forwarded within 48 hours after death. shall not be prohibited on account of race, nationality, religion or political persuasion. * The person who issued the death certificate shall notify the justice of the peace or the auxiliary justice or the mayor (c) Except when required by legal investigation or when if neither of the two is available if he observed any permitted by the local health authority, no unembalmed indication of violence or crime. Permission from the remains shall remain unburied longer than 48 hours after provincial fiscal or mayor is necessary if death due to death. violence or crime. Study Articles 305, 306, 307, 309 and 2219 of the NCC Burial and transfer Permits as well as Articles 132 and 133 of the RPC.

Municipal secretaries, in the capacity of Limitations to the Funeral Rites secretaries of municipal boards of health or as clerks to municipal councils as the case may be, shall issue burial or a. Will of the deceased transfer permits upon the presentation of the death b. Burial of the person sentenced to death must not be held certificate. Copy of death certificate shall accompany with pomp (Art. 85, RPC) transfer permit if body will be transferred from one municipality to another. Those bodies with dangerous c. Restrictions as to funeral in cases of deaths due to communicable disease shall not be carried from place to communicable disease place except for burial or cremation. It is the duty of the local health authorities to cause such body to be thoroughly When the cause of death is a dangerous disinfected before being prepared for burial. Only adult communicable disease, the remains shall be buried within members of the family may be permitted to attend the 12 hours after death. They shall not be taken to any place burial. of public assembly. Only the adult members of the family of the deceased may be permitted to attend the funeral. Burial permit (death certificate) must be presented before burial. 3. Disposal of Dead Body to the Sea

The Law Penalizes Desecration of Burial Premises Allowed when death is not due to dangerous (Sec. 2695, Revised Administrative Code) communicable disease. A special permit needs to be secured from officers authorized to issue permits. Burial Grounds Requirements (PD 856, Code of Sanitation) 4. Cremation Burial Grounds Requirements the following requirements shall be applied and enforced: Pulverization of the body into ashes by the application of heat. Body must first be identified and there (a) It shall be unlawful for any person to bury remains in must be a permit for cremation. places other than those legally authorized in conformity with the provisions of this Chapter. When not granted:

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1. If deceased left a written direction that he will not be Persons who can grants permission to used body parts of cremated deceased:

2. Identity has not yet been definitely ascertained a. Before death:

3. Further inquiry needed to cause of death 1. Deceased during his lifetime

5. Use of Body for Scientific Purposes 2. If minor, guardian with the approval of the court or by the legitimate father or mother. Married woman Unclaimed remains may be used by medical can give consent without husbands consent. schools and scientific institutions for studies and research subject to the rules and regulations prescribed by the b. After death: department. 1. Nearest relative Study RA 349 as amended by RA 1056 (Donations of Human Body Parts) 2. Head of hospital or institution having custody in the absence of relatives Donation of Human Organs for Medical, Surgical and Scientific purposes Any person may donate an organ or Persons permitted to detach body parts: any part of his body to a person, a physician, a scientist, a hospital or a scientific institution upon his death for 1. License physician or surgeon transplant, medical, or research purposes subject to the following requirements: 2. Known scientist

(a) The donation shall be authorized in writing by the donor 3. Medical or scientific institutions including eye specifying the recipient, the organ or part of his body to be banks. donated and the specific purpose for which it will be Requirements: utilized. 1. Must be in writing (b) A married person may make such donation without the consent of his spouse. 2. Specify the person/institution granted the authorization (c) After the death of a person the next of kin may authorize the donation of an organ or any part of the body 3. Specify the organ/part to be detached of the deceased for similar purposes in accordance with the prescribed procedure. 4. Signed by the grantor and 2 disinterested persons (d) If the deceased has no next of kin and his remains are in the custody of an accredited hospital, the Director of the 5. Copy furnished to the Secretary of Health hospital may donate an organ or any part of the body of the deceased in accordance with the requirement prescribed in Limitation to the Authorization this Section. Not allowed when died with dangerous (e) A simple written authorization signed by the donor in communicable disease the presence of two witnesses shall be deemed sufficient for the donation of organs or parts of the human body Penal Provision required in this Section, notwithstanding the provisions of the Civil Code of the Philippines on matters of donation. A Imprisonment of not less than six months nor copy of the written authorization shall be forwarded to the more than one year. Secretary. Exhumation (f) Any authorization granted in accordance with the requirements of this Section is binding to the executors, The deceased buried may be raised or administrators, and members of the family of the deceased. disinterred upon lawful order from fiscals, court and any entity vested with authority to investigate. It must be 24 By 4D2014-2015

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identified by relatives, friends or by marks on the body. - smears from vaginal canal and blood for alcohol Physician must describe the coffin, clothing and degree of determination decomposition before stating the actual disease or violence in his report. Even members of NBI are required to get d. Recover foreign bodies permit from the Director of Health for exhumation. - Metalic fragment or whole slug for ballistic Person died with for a cause other than examinations dangerous communicable disease may be disinterred after 3 years of being buried or in special cases, shorter time - Operative sponge, medical instrument to prove when in the opinion of Director of Health, the public health medical negligence will not be endangered. It will be immediately disinfected and inclosed in a coffin, case or box. 2. If the next of kin refuses to give consent for exhumation autopsy, a petition in court must be done. Disinterment of remains is subject to the following requirements: How long can exhumation be done after interment:

(a) Permission to disinter remains of persons who died of Sec 92 Code of Sanitation, Disinterment Requirements: non-dangerous communicable diseases may be granted 1. Permission to disinter remains of persons who after a burial period of three years. died of non - dangerous communicable disease (b) Permission to disinter remains of person who died of may be granted after burial period of 3 years dangerous communicable diseases may be granted after a 2. If death is due to a communicable dangerous burial period of five years. disease, permission may be granted after a burial period of 5 years (c) Disinterment of remains covered in paragraphs "a" and 3. Shorter period may be granted in special cases, "b" of this Section may be permitted within a shorter time subject to the approval of Regional Director than that prescribed in special cases, subject to the (Director of Health) concerned or his duly approval of the Regional Director concerned or his duly authorized representative. authorized representative. 4. In all cases of disinterment, the remains shall be disinfected and placed in a sealed container prior (d) In all cases of disinterment, the remains shall be to disposal. disinfected and places in a durable and sealed container prior to their final disposal.  According to Art 305 of the Civil Code, no human Read article 308 of the NCC remains shall be retained, interred, disposed of or exhumed without the consent of: spouse,  If the dead body is a subject matter of criminal descendants of the nearest degree, ascendants investigation, it may be exhumed anytime of the nearest degree, brothers and sisters

1. There must be a formal request from any of the law enforcement agencies authorized to make investigation  Sec 1098 Revised Administrative Code Shipment addressed to any establishment authorized to perform of remains at sea - no body or remains shall be medico-legal investigation. Reasons could be: shipped to the US except under such conditions as may be prescribed by the United States Public a. Determine cause of death Health Service. The outside box containing the remains shall be plainly marked so as to show b. Determine identity the name, age, nationality, of the deceased person, the cause of death, the destination and c. Recover organs or tissues for further remains. examination for:

- toxicology analysis  If dead body is a subject matter of criminal - histopathological examination investigation, it may be exhumed anytime.

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Requirements to be satisfied in exhumation: g. Actual autopsy and adoption of procedure is needed to accomplish the purpose of exhumation a. Duration of interment as required h. Disinfection of the body and all areas involved b. Exhumation permit to be provided by the Director must be carried out with the assistance of the of Health local health officer and return of the body to the c. Compliance of sanitary requirements, such that burial place the body or remains, after exhumation shall immediately be disinfected and enclosed in a coffin or box and this box shall be placed in an Included in the Exhumation Report: outside box which shall also be securely fastened. a. The name of the deceased person and circumstances b. Purpose of exhumation Procedure in medico - legal exhumations c. Name address and designation of the requesting party a. There must be formal request from any law d. Date, time place of exhumation enforcement agency to make an investigation e. Description of the burial place addressed to any person authorized to perform f. Name and address of the persons who identified medico - legal investigation. The request must the burial place mention the name of the deceased, place and g. Condition of the body and coffin if there is date of interment suspicion as to the cause of interment death etc. Reasons for the request are: h. Name and address of the persons who identified  To determine the cause of death the body of the deceased  Determine the identity of the deceased i. The post-mortem examination and  Recover organs for further examination accomplishment of the purpose of exhumation  Recover foreign bodies j. Conclusions based on the findings and result of b. If the physician found that there is justification to examination the exhumation and a strong probability for the k. Remarks if any purpose to be realized, he may set the date and l. Signature and designation of physician’ time for exhumation c. A written request for exhumation must be sent to the regional director or ministry of health stating: Problems in Exhumation:  Name of deceased a. identity of the deceased - often in disaster victims  Place of exhumation b. refusal of the next-of-kin to give consent or to  Date and time of exhumation cooperate in the exhumation-autopsy - often  Duration of interment when the next-of-kin is involved in the  Purpose of exhumation investigation Remedy: petition in court for an order to exhume body

The Ministry of Health, aside from issuing the CHAPTER IX necessary permit, shall also infor the local health MEDICO-LEGAL ASPECTS OF PHYSICAL INJURIES officer to assist the physician in the exhumation to ensure that public health will not be prejudiced.  Physical injury is the effect of some stimulus on the body d. During exhumation, the grave must be properly identified by the person who was present when  Effect is apparent: stimulus applied is insufficient the body was interred to cause injury and body resistance is great e. During disinterment, care and diligence must be  Effect is real: effect is visible observed to avoid destruction, deformity, contamination or such other effects f. After opening the coffin, the body must be viewed  Effect of application of stimulus: Immediate by any or more persons who can identify the (sharp object causing stab wound); Delayed deceased (blunt object causing contusion) 26 By 4D2014-2015

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c. dolor - pain on account of involvement of sensory nerve Causes of Physical injuries: d. loss of function - on account of trauma, tissue may not be able to function normally a. Physical violence Vital reaction differentiates an ante-mortem from post- b. Heat or cold mortem injury c. Electrical energy d. Chemical energy In the ff instances, vital reactions or changes may not be e. Radiation by radio-active substances observes even if injury was inflicted during life: f. Change of atmospheric pressure (barotrauma) g. Infection a. If PI were inflicted during agonal state of a living person - body cells during that period may not have the potential capacity to react to trauma A. PI by Physical Violence b. If death is so sudden as not to give the tissues in the body the chance to react properly e.g. deaths Effect is the production of wound. due to sudden coronary occlusion

Wound is the solution of the natural continuity of any tissue of the living body. It is the disruption of the anatomic Classification of wounds: integrity of tissue in the body. 1. As to severity: Effect of physical violence may not always result to a. Mortal wound - capable of causing death production of wound but wound is always an effect of immediately after infliction or shortly physical violence. thereafter Parts of body where wound is inflicted Physics of wound production: considered mortal: Wound is kinetic energy times time times area times ―other  Heart and big blood vessel factors‖  Brain and upper portion of  Kinetic energy: mass X velocity (squared) divided spinal cord by 2. Velocity component is the important factor.  Lungs  Time: shorter period used for transfer of energy,  Stomach, liver, spleen and greater likelihood of producing damage. intestine b. Non - mortal wound - not capable of causing  Area of transfer: The larger the area of contract death immediately between the force applied on the body the lesser is the damage to the body.  Other factors: the less elastic and plastic the 2. Kind of instrument used: tissue, the greater the likelihood that a laceration a. blunt instrument (contusion, hematoma, will result. Elasticity and plasticity refer to the lacerated wound) ability of a tissue to return to its normal size and b. sharp instrument: sharp-edged instrument shape after being deformed by pressure. (incised wound) sharp-pointed (puncture wound) sharp - edged and sharp - pointed (stab wound) Vital Reaction: sum total of all reactions of tissue or organ c. tearing force (lacerated wound) to trauma. d. change of atmospheric pressure Ff are common reactions of a living tissue to trauma: (barotrauma) e. heat or cold (frostbite, burns or scald) a. rubor - redness or congestion of the area due to f. chemical explosion (gunshot or shrapnel an increase of blood supply as a part of wound) reparative machine b. calor - sensation of heat or increase in temperature 3. As to manner of infliction:

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a. hit - means of bolo, blunt, instrument, axe 6. Special types of wounds: b. thrust or stab - bayonet, dagger c. gunpowder explosion - projectile or shrapnel a. Defense wound - result of person’s instinctive wound reaction of self - protection; injuries suffered by a person to d. sliding or rubbing or abrasion avoid or repel potential injury from aggressor (injury on flexed forearms when about to be hit by blunt object; incised or stab wound on palm when about to be stabbed 4. Depth of wound: by another) a. superficial - only layers of skin b. deep - inner structure beyond layers of skin b. Patterned wound - Wound in the nature and  penetrating - wounding agent enters shape of an object or instrument and which infers the the body but did not come out or mere object or instrument causing it. piercing of solid organ or tissue or body Penetrating wound - wound where dimension of depth and Ex. Impact of the face on the radiator grill of a car direction is an important factor in its description. It involves may cause imprint of the radiator grill on the face. the skin or mucous surface and the deeper underlying c. Self-Inflicted Wound - Self inflicted wound is a tissues or organs caused directly by the wounding wound produced on oneself. As distinguished from suicide, instrument. Example: punctured, stab, gunshot wounds. the person has no intention to end his life.  Perforating - wounding agent produces Motive of Producing Self-Inflicted Wounds: communication between the inner and outer portion of the hollow organs. (1) To create or deliberately magnify an Traversing pr piercing completely a existing injury of disease for pension or particular part of body workman’s compensation; (2) To escape certain obligations or punishment. During war time soldiers may 5. Relation of site of application of force and cut their fingers to avoid frontline location of injury: assignments and prisoners may inflict a. coup injury - physical injury which is located physical injuries on their body to avoid hard at the site of application of force labor and just be confined in a hospital to b. contre - coup injury - physical injury found receive food and rest. opposite the site of application of force (3) To create a new identity or destroy the c. coup contre - coup injury - physical injury existing one. Fingerprints may be located at site and also opposite the site of destroyed by acid, by cutting or burning. application of force (fixed head is hit with (4) To gain attention or sympathy. moving object then falls on another hard (5) Psychotic behavior object)

d. locus minoris Resistencia - PI located not at the side or opposite the site of application of Some Ways of Self-Mutilation: force but in some areas offering the least resistance to the force applied. Blow on (1) Head banging or bumping - this is forehead may cause contusion at region of commonly observed in overactive children eyeball because of fracture on the and causes hematoma. papyraceous bone forming roof of orbit. (2) Exposure of parts of the body to heat e. Extensive injury - PI involving greater area radiation from open fires, radiators, or of body beyond site of application of force - protective grills over radiator thermophilia. not only wide are of injury but various types (3) Penetrating nail or spike to the chest wall or of injury. (fall from height or run-over of insertion into the urinary bladder in a victim in vehicular accident) female. *stationary head is hit by moving (4) Castration by amputation of the penis. object, contusion is with the site of impact.; when moving (5) Trauma inflicted on the female genitalia to head hits a firm fixed and hard object, Brain contusion may induce abortion or promotes hemorrhage develop at opposite side of impact. and creates an anemia. 28 By 4D2014-2015

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(6) Subcutaneous injection of fecal matters to However, if it is not deliberate then it promote abscess formation. may fall on paragraph 2, Art. 263, (7) Pricking of acne eruption to lead to a Revised Penal Code (Serious Physical severe facial disfigurement. Injuries). (8) Subcutaneous injection of air to create a condition of emphysema. (9) Nail-biting (onychophagia) which may lead  Is vasectomy and tubal ligation within to maceration of the skin and an infection. the purview of mutilation as defined (10) Grinding of the teeth (bruxism) is frequently and penalized by Art. 262 of the seen in the mentally retarded and can lead Revised Penal Code? to abnormal tooth wear, a bilateral The Secretary of Justice rendered an opinion that hypertrophy of the masseter and a pain on vasectomy and tubal litigation are not mutilation and a chewing. legitimate method of contraception despite the fact that it is (11) Pressure on the subcutaneous tissue by a done intentionally and deprives a person of his power of tightly applied cord or belt around the body: reproduction. Because: …these two methods of surgical (a) Tribal customs of metal band sterilization are affected by the closing of a pair of tubes in around the neck or a leg by some either man or the woman so that the sperm and ovum African tribes may cause a cannot meet; it does not involve the removal of permanent disfigurement. reproductive glands or organs as in the case of castration, (b) Use of shoes made of metal by with which it is sometimes confused. chinese women. (12) Pulling of the body hair (Trichotillomania) Serious Physical Injuries:

(Forensic Medicine a Study in Trauma & Art. 263, Revised Penal Code: Environment Hazards by Tedeschi, Eckert &Tedeschi, Vol, 1, p.496) The Crime of serious physical injuries my be due to: Legal Classification of Physical Injuries: 1. Wounding;  Mutilation: 2. Beating; Art. 262, Revised Penal Code 3. Assaulting (Art. 263); or 4. Administering injurious substances (Art. Kinds of Mutilation Punishable Under the Code: 264) without the intent to kill. It may be committed through a simple negligence 1. Intentionally depriving a person, totally or or imprudence partially of some of the essential organs for reproduction, and The main purpose of dividing the provision into four 2. Intentionally depriving a person of any part paragraphs is to graduate the penalties depending upon or parts of the human body other than the the nature and character of the wound inflicted and their organs for reproduction. consequences on the person of the victim. Mutilation is the act of looping or cutting off any part or parts of the living body. In order to be punishable under the In paragraph one, the injured person became insane, Code, it must be intentional, otherwise it will be considered imbecile, impotent, or blind. as a physical injury. Insanity has not been defined or qualified by the  ―Mayhem‖ is the unlawful and violent Article. and deprival of another of the use of a Imbecility infers that the injured person must be part of the body so as to render him of the preadolescent age and that on account of the less able in fighting, either to defend physical injuries inflicted there is an arrest of mental himself or to annoy his adversary. development. Mutilation of other parts of the body other than the organ of reproduction Impotency is the inability to grant to the partner may be classified as mayhem. sexual gratification.

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Blindness must be total or involvement of both In paragraph four, the injured person becomes ill eyes. If only one eye became blind, then the physical injury or incapacitated for labor for more than thirty days and will fall in paragraph 2 of Article 263. impliedly less than 90 days.

In paragraph two, the following nature and character of the It is noteworthy to mention that in paragraph 3 wound or consequences of the injuries inflicted must be and 4 of article 263 there is no mention of periods of present: medical attendance but merely incapacity.

a. Loss of the use of speech or the power to Administering Injurious Substances or Beverages: hear or to smell, or loss of an eye, a hand, a foot, an arm, or a leg; Art. 264, Revised Penal Code: b. Loss of the use of any such member; or c. Becomes incapacitated for the work in which Elements of the Crime: he was therefore habitually engaged. There must be total loss of hearing capacity. If a. The offender inflicted upon another person the loss of power to hear is only in one ear, it is a serious or any serious physical injury. physical injury under paragraph 3, article 263 (People v. b. The infliction of physical injury was done Hernandez, 94 Phil. 49) knowing that the substance or the beverage administered is injurious or took advantage Insofar as loss of a hand is concerned, the of the victim’s weakness or credulity; and prosecution must prove by clear and conclusive evidence c. There was no intent to kill on the part of the that the offended party cannot actually make use of his offender. hand and that such impairment is permanent (People V. If the offender does not know that the substance Reli. C.A. 53 O.G. 5695). administered is injurious, he cannot be held liable under the above provision. In paragraph 3, the following injuries of their consequences are included: The throwing of acid on the face of someone does not fall within the provision because what the a. Deformity; provision contemplates is administering or taking in the b. Loss of any other member of his body; injurious substance or beverages (U.S. Chiong Songco, 18 c. Loss the use thereof; or Phil 459). d. Becomes ill or incapacitated for the performance of the work in which he was The provision does not contemplate of sight or habitually engaged for more than 90 days, less serious physical injuries are the consequence of as a consequence of the physical injuries injurious substances of beverages, but results only in inflicted. serious physical injuries.

If the administration of injuries substances or Deformity is a condition of physical ugliness. It beverages is intentional, the crime committed is frustrated must be a permanent and conspicuous. The loss of the murder. Treachery is inherent when injurious substances or front teeth, the development of a pigmented scar on the beverages are introduced into the body. face, or the loss of the pinna of the ear is considered deformities. However, the development of a scar in Less Serious Physical Injuries: covered parts of the body may not be considered deformity Art. 265, Revised Penal Code: because it is not a conspicuous and visible. The basis to determine whether the physical ―The loss of any other part of his body‖ means injury is less serious or not is by either the period of loss of the parts of the body not mentioned in paragraph 2, medical attendance or period of incapacity; both of which is Art. 263. ten days or more but not more than thirty days. Incapacity means the inability of the injured The fact that the injury only requires medical person to perform, or engage on a work or vocation before attendance for two days but incapacitated the victim from he sustained injury. attending to his ordinary work for a period of 29 days

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makes the crime less serious physical injuries (U.S. v.  The stab wound is Trinidad, 4 Phil. 152). accessible to the hand of the victim There must be proof as to the period of medical  The hand of the victim is attendance. In the absence of such proof of medical smeared with blood attendance or incapacity, although the wound actually  The wounding weapon healed in more than 30 days, the crime committed is only is firmly grasped by the slight physical injuries (People v. Penesa, 81 Phil. 398) hand of the victim (cadaveric spasm) The Crime of less serious physical injuries may  If stabbing is be qualified and a fine or a higher penalty imposed when: accompanied with a. There is a manifest intent to insult or offend slashing movement, the the injured person; wound tailing abrasion is b. There are circumstances adding ignominy to seen towards the hand the offense; inflicting the injury c. The victim is the offender’s parents,  A suicide note may be ascendants, guardian, curators or teachers; present or  There is the presence of d. The victim is a person of rank or person in a motive for self- authority, provided that the crime is not destruction direct assault.  No disturbance in the death scene, wounding instrument is found near (pp.252-268) the victim

In the Description of a Stab Wound, the following must be included: b. Homicidal – stabbing with homicidal intent is the most common a. Length of the skin defect b. Condition of the extremities Characteristics: c. Condition of the edges d. Linear direction of the surface wound 1. Injuries other than stab wound may be present e. Location of the stab wound 2. Stab wound located in any part of the body f. Direction of penetration 3. Usually more than one stab wound g. Depth of the penetration 4. There is a motive h. Tissue and organs involved - If without motive offender is insane or under the influence of drugs Stab Wound(s) may be Suicidal, Homicidal or Accidental: 5. There is a disturbance in the crime scene

a. Suicidal – Evidences showing that the stab wound is suicidal: Medical evidences showing intent of the offender to kill the  Located over vital parts victim: of the body  It is usually solitary. If a. More than one stab wounds multiple, located on one b. Located on different parts of the body part of the body or on parts where vital organs are  If located on covered located parts of the body, the c. Deep clothing is not involved d. Stab wound with serrated or zigzag borders e. Irregular or stellate shape skin defects

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 Different measurement of the stab wounds may a. Located where vital organs are located be produced by one weapon if it is tapering b. Usually singular but may be multiple but located towards the sharp point in one area  Withdrawal of the instrument not on the same c. Parts of the body involved is accessible to the direction as when it was introduced may hand of the victim increases length of the skin defect d. Clothing is usually not involved  Three-cornered file when used as a stabbing e. Wounding is made while the victim is sitting or weapon- three-cornered skin defect standing. There is bleeding towards the lower  The most common immediate cause of death- part of the body hemorrhage f. No disturbance of the crime scene  Accidental stab wounds are rare g. Presence of suicide note h. Wounding instrument found near the body

4. Punctured Wound Punctured would with puncturing instrument loaded with  A result of a thrust of a sharp pointed instrument poison:  External injury small but depth is to a certain degree a. Poison dart- cyanide or nicotine b. Fish spines  Produced by: icepick, needle, nail, spear, pointed c. Dog bites with hydrophobia virus stick, thorn, fang of animal, hook d. Injection of air and poison as a way of  External hemorrhage is limited but internal euthanasia injuries may be severe

 Direct involvement of blood vessels and bloody organs may cause fatal consequences 5. Lacerated Wound (Tear, Rupture, Stretch, ―Putok‖)  Site of external wound can be easily sealed  Punctured would is usually accidental but in rare  A tear of the skin and the underlying tissues due instances it may be homicidal or suicidal to forcible contact with a blunt instrument  Produced by: wood, iron bar, fist blow, stone, butt of firearm, others without sharp objects Characteristics:  Force applied to tissue is greater than its cohesive force and elasticity 1. The opening on the skin is very small and may  The tissue tears and laceration is produced become unnoticeable because of clotted blood

and elasticity of the skin. The wound is much deeper than it is wide. Characteristics: 2. External hemorrhage is limited although internally severe a. Shape and size of the injury do not correspond to 3. Sealing of the external opening will be favorable the wounding instrument for the growth of anaerobic microorganism b. Tear on the skin is rugged with extremities irregular and ill-defined c. Injury developed is at the site where the blunt Medical Evidences that tend to show it is homicidal: force is applied d. Borders of the wound are contused and swollen a. It is multiple and usually located on e. Usually on areas where the bone is superficially different parts of the body located, like scalp, malar region on the face, front b. Deep part of the leg, dorsum of the foot c. Defense wounds on the victim f. Examination shows bridging tissue joining the d. Disturbance of the crime scene- sign of edges and hair bulbs intact struggle g. Bleeding is not extensive because blood vessels

are not severed evenly Proof to show it is suicidal: h. Healing process is delayed

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Classification of lacerated wounds: -Healing is faster - Healing is delayed a. Splitting caused by crushing of the skin between two hard objects -Scar is linear or spindle- - Scar is irregular - Best seen in laceration of the shaped scalp, cut eyebrow of boxer, laceration of the chin of -Caused by a sharp-edged - caused by a blunt motorcyclist instrument instrument b. Overstretching of the skin - When pressure is applied on one side of the bone, the skin over the area will be stretched up to a Gaping of Wound: breaking point to cause laceration

and exposure of the fractured bone The separation of the edges especially in deep wound may - In avulsion, the edges of the be due to the following: remaining tissue is that of laceration 1. Mechanical stretching or dilatation c. Grinding Compression - Presence of a mechanical device - Weight and grinding movement on the edges to prevent may cause separation of the skin coaptation will cause separation d. Tearing - Produced by semi-sharp-edged instrument which causes irregular 2. Loss of Tissue edges on the would - Separation of edges of a wound - Hatchet and choppers may be on account of loss of tissue bridging them. The loss of tissue may be due to:  Lacerated wounds may involve deeper tissues i. Destruction by pressure, like laceration of the muscles and fracture bones infection, cell lysis, burning or  It may be homicidal or accidental but rarely chemical reaction suicidal ii. Avulsion or physical or mechanical stretching resulting to separation of a Distinction between and incised wound and a lacerated portion of the tissue wound: iii. Trimming of the edges

Incised Wound Lacerated Wound 3. Retraction of the Edges -Edges are clean cut; - Edges are roughly cut; - Underneath the skin are dense regular; well-defined irregular; ill-defined networks of fibrous and elastic connective tissue fibers running -No swelling or contusions - There is swelling and on the same direction and forming around the incised wound contusion around the a pattern more or less present in lacerated wound all persons. This is called cleavage direction or lines of -Extremities of the wound - Extremities of the wound cleavage of the skin. are sharp or may be round are ill-defined and irregular - If an incised wound or stab wound or contused was inflicted wherein the long axis of the wound is parallel or on the -Examination by means of a - Examination with a same direction as the cleavage magnifying lens shows that magnifying lens shows that line of the part of the body the hair bulbs are cut the hair bulbs are preserved involved, the wound will appear narrow or slit-like because the 33 By 4D2014-2015

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edges of the wound will not be Pudental areas 1% 1% subjected to the lateral pull of the severed connective tissue fibers Total 100% - If the long axis of the wound is perpendicular to or with an angle with the lines of cleavage, the tendency of the borders of the Factors responsible for the severity of wounds: wound is to separate on account of the retraction of the severed 1. Hemorrhage fibers a. Hemorrhage may influence the severity of wound by:

Practical ways of determining how much of the skin surface a.1. Loss of blood incompatible with is involved in an injury or disease: blood:

 Skin serves as the mechanical protection of the  Blood constitutes about 1/20 body of the body weight of an adult  It is punctuated with sensory nerve endings for  By volume, an average size pain, temperature and touch adult has 5 to 6 quarts of blood  It acts as thermo-regulator, storage of water, excretor of sweat and organ for absorption  A loss of 1/3 to 2/5 of the circulating blood may result  Determination of how much skin is involved is to irreversible hypovolemic important to determine the mode of treatment shock and may be fatal and prognosis  The volume of blood lost may  Significant in cases of: burns, contusion, dermal be related to the rate or manifestation of certain diseases space of time a certain  Burns in children and old age persons, volume of blood has been involvement of more than 70% of the body shed surface- fatal  Males can stand more lost of  Estimation as to how much of the body surface blood than females involved, the rule of the nine is used a.2. Hemorrhage may result in an

increase in pressure in or on the vital Body surface expressed as percentage using the rule of organs to affect the normal function: nine:  Intracranial hemorrhage may Whole of head and neck 9% 9% cause compression of the vital centers of the Whole of one upper 9% 18% brain. extremity  Hemopericardium may cause embarrassment of the Whole of front chest and 18% 18% contraction of the heart. abdomen  Hemorrhage into the chest cavity may cause diminution Whole of posterior chest 18% 18% of the respiratory output with and abdomen subsequent anoxia a.3. Hemorrhage may cause Whole of one lower 9% 18% mechanical barriers to the function of extremity (front) organs:

Whole of one lower 9% 18%  Hemorrhage into the tracheo- extremity (back) bronchial lumina can cause asphyxia

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b. Cause of Hemorrhage: 3. Organs Involved b.1. Trauma:  Trauma on the vital organs of the body are  Destruction of the blood always serious vessel wall or increase  Crushing wounds of the heart, brain or longs are permeability of its wall due to almost fatal external force b.2. Natural Causes: 4. Shock  Common causes of hemorrhage due to natural  May occur with or without violence causes:  Slight blow on genitalia, slight burns in children or o Intra-cerebral old persons, or slight violence on the head or hemorrhage neck may cause severe shock (apoplexy)  But violent traumas to healthy, strong persons o Spontaneous may not produce shock subarachnoid hemorrhage o Rupture of the 5. Foreign body or substance introduced into the body: arteriosclerotic aneurysm of the  Incision with an unsterilized scalpel may not be aorta serious as the bite of a venomous snake o Rupture of the  A foreign substance or body may be toxic by esophageal varices itself or may act as a physical irritant in cases of cirrhosis of the liver and bleeding of The foreign body or substance may be: peptic ulcer of the stomach and a. Bacterial: duodenum - Tetanus o Pulmonary hemorrhage - Pathogenic microorganism o Ruptured ectopic pregnancy b. Viral: o Spontaneous rupture of - Hydrophobia cavernous hemangioma or - Hepatitis hepatoma o Rupture of the c. Foreign body: enlarged spleen - Bullet

2. Size of Injury: - Glass fragments

 Burns affecting 1/3 of the body surface of the - Shrapnel third degree type is usually - Gauze or rubber drain fatal  Bigger wounds are more exposed to infection d. Chemical: and other physical conditions of the surroundings - Cyanide 35 By 4D2014-2015

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- Nicotine b. Tourniquette above the site of the wound e. Toxin c. Placing ice on the bite site

 Snake Venom d. Sucking the wound to drain venom o Characterized as two punctured wounds at the e. Administration of anti-snake venom serum center of the reddened affected area

 Scorpion Venom Snake venom toxicity will depend on: o Has neurotoxic, hemolytic and hemorrhagic effect a. Potency of venom injected o Produces only one punctured wound on the center of a b. The amount of venom depends on the season reddened area of the year and the length of time the o Main symptoms are pain edema and reddening snake has eaten. If a snake has just killed his prey, the toxic content is smaller  Coelenterate Sting (jellyfish) c. Size of Patient o The tentacles penetrate into the skin and cause explosion d. The immediate treatment instituted of the nematocyst and liberation of the venom

o Symptoms are extreme pain, Snake venoms are of two principal classes: urticarial rash, abdominal pain, dilated pupils, paleness a. Neurotoxic - primarily paralyzes the respiratory and labored breathing and cardiac center of the brain. May cause nausea, vomiting, ascending 6. Absence of medical or surgical intervention: paralysis, coma,  A wound may not be fatal, but because of convulsion, and cardiac neglect in its management it may become and respiratory arrest. serious or fatal b. Hematoxic - affects particularly the blood. The manifestations are pain and Fatal Effect of Wounds: swelling of the affected area, intravascular 1. Wound may be directly fatal by reason of: hemolysis, abdominal pain, nausea, vomiting, petechial a. Hemorrhage hemorrhage on the gum, pulmonary and cardiac  Incised wound on carotid artery without edema. surgical intervention is fatal

b. Mechanical injuries on the vital organs Emergency treatment may be:  Blow on the head may not necessarily a. Incision of the wound to promote more produce external lesions but may external hemorrhage to produce severe meningeal hemorrhage drain the venom producing compression of the brain

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c. Shock 2. Changes producing separate  Disturbance of the balance of fluid in pathological lesions the body capable of producing delayed which in turn or immediate death proves to be fatal Ex: Operation performed on a 2. Wound may be indirectly fatal by reason of: patient to ligate bleeding vessel a. Secondary hemorrhage following sepsis inside the abdominal cavity  On account of infection that sets in, with reasonable deeper tissues are involved skill and due diligence but as a result of which b. Specific Infection peritonitis  Pathogenic microorganisms may developed and develop and multiply in the wound caused death of causing septicemia, bacteremia, or patient toxemia

3. Changes where a c. Scarring Effect definite pathological  Chronic gonorrheal infection may condition was cause stricture or urethra present before the

injury d. Secondary Shock Ex: A person suffering from Nature or death due to secondary shock tumor or cyst and was stabbed by - A person may have recovered someone. The stab from the immediate effects of the is not capable of trauma or violence, but may later producing death die of its secondary effects or ordinarily. The changes person may die of the pathological condition and the These changes may be classified accused is liable as follows: for his death

1. Changes whose natural sequence are direct and 4. Changes where a obvious definite Ex: Septicimia, pathological tetanus or condition of totally complications different nature arising from arises after the wounds wounding and the

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consequential  The extravasation or loss of blood from sequence is the circulation brought about by wounds doubtful in the cardio-vascular system. Ex: Tuberculosis  The degree and nature of hemorrhage meningitis that depends upon the size, kind and location develops following of the blood vessel cut. a blow on the head

Kinds of Hemorrhage:

Complication of trauma or injury: a. Primary Hemorrhage  It is the bleeding which 1. Shock occurs immediately after  The disturbance of fluid balance the traumatic injury of resulting to peripheral deficiency which the blood vessel is manifested by the decreased volume of blood, reduced volume of flow, hemoconcentration and rental b. Secondary Hemorrhage deficiency  This occurs not  Clinically characterized by severe immediately after the depression of the nervous system infliction of the injury but  Three major factors operate in the sometime thereafter on production of shock and all are likely to or near the injured area be associated together as the condition develops a. Injury to the receptive 3. Infection: nervous system  Infection is the appearance, growth and b. Anoxemia – reduction of development of microorganisms at the site effective volume of of the injury oxygen carrying capacity of the blood c. Endothelial damage, How injury or trauma acquires infections: thus increasing capillary permeability a. From the instrument or substance which produces the injury b. From the organs involved in the trauma Kinds of Shock: applied c. As an indirect effect of the injury which a. Primary Shock creates a local area of diminished  Caused by immediate nerve resistance causing the invasion and impulse set up at the injured multiplication of microorganisms area which are conveyed to d. Injury may depress the general vitality, the central nervous system especially among the aged and the young children and makes the patient succumb to terminal disease b. Delayed or Secondary Shock e. Deliberate introduction of  Patient shows sign of general microorganisms at the site of the injury collapse which develop some time after the infliction of injury 4. Embolism:  A condition in which foreign matters are introduced in the blood stream causing 2. Hemorrhage

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sudden block to the blood flow in the finer  Capacity for regeneration decreases as age arterioles and capillaries increases  State of nutrition of the individual affects capacity or regeneration The most common emboli in the blood stream are: The following regenerates rapidly: a. Fat Embolus  Causes of Fat Embolus: a. Connective tissues o By injection of oily b. Blood forming tissues substance into the c. Surface epithelium of the skin circulation o By injury of the adipose tissue Those having no power or limited capacity to which forces fat regenerate: into the circulation a. Highly specialized glandular epithelium b. Smooth muscle b. Air Embolism c. Neurons of the central nervous system  Causes of Air Embolism: o Gaping incised wound of the jugular  Small clean-cut wound is covered with vein lymph in 36 hours o Injection of  The edges adhere in two days and wound soapsuds or air into heals on the 7th day leaving a linear scar pregnant uterus for  Larger incised wound shows swelling of the the purpose of edges 8 to 12 hours tubal insuflation or  Blood-stained serum is present in 2 days criminal abortion which afterwards become seropurulent on o Injection of air into the 3rd day, lasting in state from 4 to 5 days the urinary bladder for  Small red granulation forms in 12 to 15 days radiological study and the epithelium grows from the edges o Insuflation of the  Scar develops later other non-potent tubes or hollow organs o Injection of air Healing of Wounds under pressure into the nasal sinus The time of healing wounds is dependent on the after a therapeutic following: vascularity, age of person, degree of rest or lavage immobilization and nature of the injury.

2. Kinds of Healing Wounds Healing of Wounds a. Healing by Primary (First) Intention

It takes place when there is minimal tissue loss, more 1. Power of the human tissue to regenerate approximation of the edges and without significant  Regeneration is the replacement of bacterial contamination. Within 24 hours after the injury, destroyed tissue by newly formed similar there is an acute neutrophilic response and scab will be tissue formed due to dehydration of the surface clot. After  The more highly specialized the tissue, the three days, microphages and fribroblasts will appear. less capacity for regeneration Collagen fibers will bridge the raw area and differentiated surface cells begin to proliferate to cover the exposed area. The normal state of the area may 39 By 4D2014-2015

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return after a lapse of one month with or without the cuts, hair and other foreign bodies in the scene; (c) formation of a scar. witnesses to the incident; (d) wounding instrument; (e) photography, sketching or accurate description of b. Healing by Secondary Intention the scene of the crime for preservation

It take place when the injury causes more extensive loss of cells and tissues. Inflammatory reaction is more 2. Examination of the Wounded Body intense and granulation tissue growth bears all the responsibility for its closure. Production of a large scar and greater loss of skin appendages (hair, sweat and Living Victim Dead Victim sebaceous glands) and slower reparative process may Age of the wound from degree occur. of healing Weapon used c. Aberrated Healing Process Reasons for multiplicity of wounds In some instances, healing process may deviate from Whether injury is accidental, suicidal the normal way on a normal individual and may result or homicidal to: Ante-mortem or post- Dangerous to life of injury mortem wound (1) Formation of Excessive Granulation Tissue or Permanent deformity "Proud Flesh" - It may prevent the closing of wound and Mortal or non-mortal wound caused by injury can be remedied by excision or cautery. Presence of disease or abnormal development at (2) Keloid Formation - It is the a large bulging tumorous Shock produced by wounds scar produced by an abnormal amount of collagen in the time of wounding which connective tissue. may accelerate death Complications produced by Cause of wound (accident, (3) Stricture - It is the contraction of the fibrous tissue of injury suicide, homicide) the scar formed.

(4) Fistula or Sinus Formation - Fistula is a 3. Examination of the Wound communication between an inner cavity and the outside  Character - State the type of wound, characteristic while sinus is a tract of infection traversing the inner part marks, presence of contusion collar, scab of the body. It may remain for a lone time unless the formation, infection, surgical intervention, etc. causal factor (infection or foreign body) is removed.  Location - Region of the body where it is situated, distance of the wound from some fixed point in the CHAPTER X body prominence. Location is important in MEDICO-LEGAL INVESTIGATION OF WOUNDS determining trajectory or course of the wounding weapon  Depth - It is measurable if the outer wound and inner Rules to observe by the physician in examining wounds: end is fixed. It must not be attempted in a living subject if it will prejudice the health or life or in a  ALL injuries must be described. stabbed wound in the abdomen due to movability  Description must be comprehensive with sketches or of the abdominal wall photographs if possible.  Condition of Area Surrounding the Wound - Presence  Examination must not be influenced by other of burning or tattooing in gunshot wounds by near information obtained from others in making a report or contact fire, hesitation cuts in suicidal incised or conclusion. wound or contusion in lacerated wound  Extent - Extensive injury may show marked degree of force applied Outline of Medico-Legal Investigation of Physical Injuries  Direction - It is material in determining the relative 1. General Investigation of the Surroundings: (a) place position of the victim and offender. of the commission of the crime; (b) clothing, stains,  Number - Multiple wounds in different parts of the body are generally indicative homicide or murder. 40 By 4D2014-2015

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 Conditions of the Locality - (a) degree of hemorrhage; and cellular tissues not clot (b) evidence of struggle; (c) position of the body; removed by washing (d) presence of suicide note; (e) condition of Edges and cellular tissues weapon. Edges gape owing to the are not deeply stained and reaction of the skin and can be removed by muscle fibers washing. Factors in Determining Whether Wounds were Inflicted During Life or After Death Edges do not gape but are closely approximated to Inflammation and reparative 1. Hemorrhage is more profuse when the wound was each other unless wound is processes inflicted during lifetime. If wounds are inflicted after caused within one or two death, the amount of bleeding is comparatively less hours after death. due to loss of tone of blood vessels, absence of heart No inflammation or action and post-mortem clotting of blood. Violence reparative processes upon a living body may not show bruise until after

death. Factors in Determining Whether Wound is Homicidal, Suicidal or Accidental 2. Signs of Inflammation such as pus, adhesion of the edges and other vital reactions may be present 1. Nature of the wound inflicted whenever the wound was inflicted during lifetime  Abrasions - extensive in accidental death, rare in although they may be less pronounced when suicidal, not common in murder unless the resistance of the victim is markedly weakened. Post- body is dragged on the ground, common in mortem wounds do not show any manifesting signs homicide especially when victim offered some of vital reaction. degree of resistance.  Contusion - rare in suicide unless done by jumping from a height, may be found in 3. Signs of Repair such as fibrin formation, growth of accidental death often due to a fall or forcible epithelium, scab or scar formation conclusively show contact with some hard object. that wound was inflicted during lifetime. But absence  Incised wound - common in suicide and of such does not show wound was inflicted after homicide. Accidental cuts are frequent death since the tissue may not have been given everyday occurrences but rarely cause of ample time to repair before death took place. death.

2. External signs and position and attitude of the body 4. Retraction of the Edges of the Wound inflicted during when found life cause gaping of the wound while in case of 3. Location of the weapon or manner it is held wound inflicted after, edges do not gape and are 4. Motive closely approximated to each other. 5. Personal character of the deceased 6. Other information such as:  Signs of struggle - Its absence is more in suicide, Distinction between Ante-Mortem and Post-Mortem accident or murder. Presence of hair or portion Wounds of skin on nails of assailant or deceased  Number and direction of wound - Multiple Ante- Post- wounds in concealed parts of the body are Mortem Mortem indicative of homicide. Single wound in a Wound Wound position the deceased could have been Hemorrhage more or less conveniently inflicted is suicidal. In cut-throat, Hemorrhage slight or none copious and generally generally transverse in homicide while oblique at all and always venous arterial in suicide. Marks of spouting of blood  Nature and extent of wound - Homicidal wounds No spouting of blood from arteries may be caused by any wounding instrument Deep staining of the edges Blood is not clotted or a soft while suicidal wounds are due to sharp instruments. 41 By 4D2014-2015

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 State of clothings - Usually no change in its  Determining which of the wounds were inflicted first condition in suicide while it may be in disorderly depends on relative position of the parties, trajectory position due to struggle in homicide. of the wound inside the body, organs involved and degree of injury, testimony of witnesses and presence of defense wounds. Factors in Determining Length of Time of Survival of the Victim After Infliction of the Wound Effect of Medical and Surgical Intervention on the Death 1. Degree of Healing Signs of repair appear in less than a day after 1. If death occurred after medical intervention, offender is infliction of injury. By the degree of the granulation of still liable provided (1) death is shown to be inevitable and tissue formation and other reparative changes, the even without intervention, death is a normal and direct age of the wound may be estimated. consequence; (2) physician must be competent and exercised care and diligence. 2. Changes in the Body Systemic changes such as degree of wasting, 2. Minor wounds were received by victim but death resulted anemia, condition of the face and bed sore formation on account of gross incompetence or negligence of may provide for a basis. physician, offender is liable only for the physical injuries inflicted. 3. Age of the Blood Stain It may be determined from the physical color Effect of Negligence of the Injured on the Death changes of the skin although it is not reliable. Negligence of the victim in the proper care and 4. Testimony of the Witnesses treatment of the injury will not exonerate the offender since In cases where witnesses testify as to the exact he is not bound to submit himself to medical treatment. But time, medical evidence as to duration of survival is if negligence is deliberate and is really the cause of death, merely corroborative. offender can only be held liable for physical injuries.

Possible Instruments Used by Assailant Inferred from Power of Volitional Acts of the Victim After Receiving a Nature of Wound Fatal Blow

 Contusion - blunt instrument The determination of the victim's capacity to perform  Incised wound - sharp-edged instrument inflicted by volitional acts rests upon the medical witness. hitting  Lacerated wound - blunt instrument  Severe injury of the brain and cranial box -  Punctured wound - sharp-pointed instrument usually produces unconsciousness but power  Abrasion - body surface rubbed on rough hard to perform volitional acts depends upon areas surface of the brain involved.  Gunshot wound - diameter of the wound of entrance  Wounds of big blood vessels (carotid, jugular, may approximate caliber of firearm even aorta) - not prevent performance of voluntary acts  Penetrating wound of heart - instantaneously  A physician can only state that it is possible that a fatal but experience shows victim may still be certain injury is possibly caused by a certain capable of locomotion instrument presented. He must be cautious in making  Rupture of organs - victim may still move and categorical statements. speak  In case of multiple offenders and there is conspiracy, it is not necessary to determine who inflicted the fatal blow. Where victim received multiple injuries, Extrinsic Evidences in Wounds determining which injury caused the death depends on the testimony of the physician by examining which 1. From Wounding Weapon of the wounds caused injury to some vital organs or (a) Position - Near the body of the victim in suicidal large vessels or led to secondary results causing and accidental death or firmly grasped by the victim death. in case of suicide 42 By 4D2014-2015

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(b) Presence of blood - In some cases, absence of as being of small caliber and limited range are blood stains is due to the rapidity of the blow and used a toys. The barrel of any firearm shall be compression of the blood vessels or blood may be considered as complete firearm for all purposes wiped out by the clothings in the process of thereof (Section 877, Revised Administrative withdrawal. Code)

(c) Presence of hair and other substance Penal Provisions of Law Relative to Firearm 2. In the Clothings of the Victim In gunshot wounds, holes in the clothing may Alarms and Scandals (Art. 155, Revised Penal Code) determine the wound of entrance whole presence of gunpowder at the hole indicates distance. Clean-cut The penalty of arresto menor or fine not exceeding tears indicates use of sharp-edged instrument. 200 pesos shall be imposed upon: Severe tearing may show struggle. The degree of soaking of the clothing with blood may depict 1. Any person who within any town or public place shall hemorrhage. discharge any firearm, rocket, firecracker, or other explosive calculated to cause alarm or danger; 3. From Examination of the Assailant Determination of the degree of intoxication, mental xxxxxxxxxx condition, physical power, etc of the offender may be necessary. Discharge of Firearms (Art. 254, Revised Penal Code)

4. From the Scene of the Crime Any person who shall shoot at another with any firearm shall suffer the penalty of prision correccional in its minimum and medium periods, unless the facts of the case CHAPTER XIII are such that the act can be held to constitute frustrated or GUNSHOT WOUNDS attempted parricide, murder, homicide or any other crime for which higher penalty is prescribed by any of the articles of the Code. Death or physical injuries brought about by the powder propelled substances may be due to the following: Classification of Small Firearms

 Firearm shot - The injury is caused by the missile Small firearms are those which will propel projectile of propelled by the explosion of the gunpowder in the less than one inch in diameter. cartridge shell and at the rear of the missile. The missile may be single as in the case of a pistol or 1. As to Wounding Power revolver or multiple shots or pellets in case of a a. Low Velocity Firearm - With muzzle velocity of not shotgun. more than 1,400 feet/second (i.e. revolver)  Detonation of high explosives as in grenades, bombs b. High Power Firearm - 2,200 - 2500 feet/second and mine explosion. (i.e. military riffle)

2. As to Nature of the Bore Firearm Wound a. Smooth Bore Weapon - Inside portion of the barrel Definition is perfectly smooth (i.e. shotgun)

 An instrument used for the propulsion of a projectile b. Rifled Bore Firearm - The bore of the barrel has by the expansive force of gases coming from the spiral lands and grooves which run parallel with one burning of gunpowder another but twisted spirally from breech to muzzle  Includes rifles, muskets, shotguns, revolvers, pistols, (i.e. military rifle) and all other deadly weapons from which a bullet, 3. As to the Manner of Firing ball, shot, shell, or other missile may be a. Pistol - Fired only by a single hand (i.e. revolver) discharges by means of gunpowder or other explosives. it also includes air rifles except such b. Rifle - Fired from shoulder (i.e. shotgun) 43 By 4D2014-2015

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4. As to the Nature of Magazine Gunshot Wound of Entrance (Entrance Defect, a. Cylindrical Revolving Magazine - Cartridge is in a Inshoot): cylindrical magazine which rotates at the rear portion of the barrel (i.e. revolver) The appearance of the gunshot wound of entrance depends upon the following: b. Vertical or Horizontal Magazine - Cartridge is held one after another vertically or horizontally by a spring 1. Caliber of the Wounding Weapon: side to side or end to end (i.e. pistol) Excluding other factors which may influence the size of the wound of entrance, the higher the caliber of the Types of Small Firearms of Medico-Legal Interest wounding bullet the greater will be the size of the wound of entrance.  Revolver - It has a cylindrical magazine at the rear of the barrel capable of revolving motion and can 2. Characteristics Inherent to the Wound of Entrance: accommodate of five or six cartridges housed in The wound of entrance, as a general rule, is oval or separate chamber. It has muzzle velocity of 600 circular with inverted edges, except in near shot or in feet/second. gazing or slap wound. The wound of exit is usually  Automatic Pistol - More appropriately called "self- larger than the wound of entrance. loading firearm". Empty shell is ejected when the cartridge is fired and a new one is slipped into the 3. Direction of the Fire: breech automatically. It has muzzle velocity of A right angle approach of the bullet will make the 1,200 feet/second. wound of entrance circular in shape, except when the  Rifle - It has a long barrel and butt and is fired from a missile is deformed or the fire is in contact or near. In shoulder. A military riffle has a magazine and volt cases of an acute angle of approach of the bullet, the action. It has a muzzle velocity of 2,500 wound of entrance is oval in shape with the contusion feet/second and a range of 3,000 feet. A miniature or abrasion collar widest on the side of the acute riffle is a single self-loading weapon. angle of approach.

4. Shape and Composition of the Missile: (pp.336-352) Deformity of the bullet modifies the shape of the wound of entrance. 6. Fragmentation of Hard Brittle Object in the Trajectory: 5. Range: Bone involvement along the trajectory may cause In close range fire, the injury is not only due to the comminuted fracture and each bone fragment may cause missile but also due to the pressure of the expanded additional damage on the surrounding tissues and even in gases, flame and other solid products of combustion. the wound of exit. Distant fire usually produces the characteristic effect

of the bullet alone. 7. Muzzle Blast in Contact Fire:

When gun muzzle is pressed on the skin when fired, all of 6. Kind of Weapon: the products of combustion primarily the muzzle blast will High power weapon has more destructive effect as penetrate the tissues causing severe mechanical compared with low power one. The shape of the bullet destruction on account of pressure. The explosive effect also plays an important role. Conical shape free end will cause extensive laceration of soft tissues and fracture bullets have more piercing power without marked of bones. tissue destruction while missiles with hemispherical free ends are more destructive. 8. Other Consequential Effects on the Body of the Victim: Contact Fire: Aside from direct involvement of vital structures of the The nature and extent of the injury is caused not only body, pressure to other organs and tissues, the gunshot by the force of the bullet but also by the gas of the wound may be the source of hemorrhage, infection, muzzle blast and part of the body involved. The paralysis, shock, loss of functioning etc. which may cause following factors must be taken into consideration: disability or death on the victim.

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1. The Effectiveness of the Sealing Between the Gun a. Wound of entrance is usually large, circular and without Muzzle and the Shin: radiating laceration. If all the gaseous product of combustion is prevented b. Edges are everted due to outward slapping of the skin. from being spilled out, there will be more destructive c. Singeing of the hair, blackening of the wound due to effects on the tissues. fouling, burn, and tattooing. d. Muzzle imprint due to outward slapping of the skin and 2. The Amount of Gas Liberated by the Combustion of heat. the Propellant: e. Pinkish color of the deeper structures due to carbon The greater is the amount of gas in a confined area, monoxide. the greater will be the tissue destruction. Loose Contact or Near Fire: 3. Nature of Bullet: Bigger caliber bullet is obviously more destructive than smaller ones. 1. Entrance wound may be large circular or oval depending upon the angle of approach of the bullet. 4. Part of the Body Involved: The nature, character 2. Abrasion collar or ring is distinct. and extent of injury in contact fire is different 3. Smudging, burning and tattooing are prominent with (1) when the bone is superficially located under the singeing of the hair. skin, and (2) when the bone is deeply located in loose 4. Muzzle imprint may be seen depending upon the degree or soft parts of the body. of slapping of the skin of the gun muzzle. 5. There is blackening of the bullet tract to a certain depth' Pressed and Firm Contact Fire: 6.Carboxyhemoglobinispresentinthewoundandsurrounding areas. 1. On Parts of the Body Where Bone is Superficial: This is commonly observed on the head where Short Range Fire (1 to 15 cm. distance) the skull is just underneath the scalp. The Medium Range Fire (more than 15 cm. but less than 60 following are the characteristics of the injuries: cm) Fired More Than 60 cm. Distance a. The wound of entrance is large, frequently star-shaped b. Edges of the wound may be everted. Instances When the Size of the Wound of Entrance Do c. Areas in the entrance wound is blackened by Not Approximate the Caliber of the Firearm: burns, tattooing and smudging. d. Muzzle imprint, Barrel impression (Profile of In distant fire, the rule is that the diameter of the gunshot the muzzle) on the skin wound of entrance is almost the same as the caliber of the e. The bullet may cause radiating fracture wounding firearm, but in the following instances, the rule is f. Blood and tissue become pink due to carbon not followed: monoxide. g. Fragments of lead and bullet jacket may be 1. Factors which make the wound of entrance bigger than found. the caliber:

Metal Fouling - When the bullet travels the a. In contact or near fire whole length of the tight fitting barrel, it is rotated b. Deformity of the bullet which entered by the lands and grooves. Its surface is scraped c. Bullet might have entered the skin sidewise by the lands and the scraping is ejected from the d. Acute angular approach of the bullet - barrel and strikes the target. It may lodge on the clothings or may cause small abrasions or 2. Factors which make the wound of entrance smaller than superficial lacerations on the skin around the the caliber: main wound. a. Fragmentation of the bullet before penetrating h. Singeing of hair. the skin b. Contraction of the elastic tissues of the 2. Parts of the Body Where the Bone is Deeply Located:

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In shotgun fire, the size of the wound of entrance is when the victim is lying on his back on a hard object dependent upon the distance of the fire. Near fire causes or in small caliber shots the wound of exit tends to be concentration of entry of the pellets, and as distance circular or nearly circular with abrasion at its border. It increases the pellets disperse with individual pellets is also observed that tight-fitting clothings, waist band, causing individual wounds of entry. Only in this instance belt collar, brassiere may also support the skin to may the wound of entrance of the same size as the gauge enhance formation of a circular wound of exit. of the shotgun pellets. Distinction Between Gunshot Wound of Entrance and Other Pieces of Evidence or Findings Used to Wound ot Exit: Determine Entrance of Gunshot: Entrance Wound 1. Examination of the clothing, if involved in the Exit Wound course of the bullet Appears to be smaller than Always bigger than the 2. Examination of the internal injuries caused by the the missile owing to the missile bullet elasticity of the tissue 3. Testimony of witnesses: Edges are inverted. Edges are everted Usually oval or round It does not manifest any Determination of the Traiectory of the Bullet Inside the depending upon the angle definite shape Body of the Victim: of approach finite shape of the bullet. 1. External Examination : "Contusion collar" or ―Contusion‖ is absent "Contact ring is present due a. Shape of the Wound of Entrance to the invagination of the b. Shape and Distribution of the Contusion or skin and spinning of missile Abrasion Collar c. Difference in Level Between the Entrance and Tattooing or smudging may Always absent.. Exit Wounds be present when firing is d. By Probing the Wound of Entrance near Underlying tissues are not Underlying tissues may be 2. Internal Examination : protruding. seen protruding from the wound. a. Actual Dissection and Tracing the Course of the Wound at Autopsy Paraffin test may be positive Paraffin test always b. Fracture of Bones and Course in Visceral Organs negative. c. Location of Bone Fragments and Lead Particles d. X-ray examination The "Odd and Even Rule" in Gunshot Wounds: Exit (Outshoot) Wound: An exit wound does not show characteristic shape unlike the wound of If the number of gunshot wounds of entrance and exit entrance. It may be slit-like, stellate, irregular or even found in the body of the victim is even the presumption is similar to the wound of entrance. This is due to the that no bullet is lodged in the body, but if the number of the absence of external support beyond the skin so the gunshot wounds of entrance and exit is odd, the bullet tends to tear or shatter the skin while sufficient presumption is that one or more bullets might have been amount of kinetic energy is still in the bullet during the lodged in the body. The rule is merely presumptive and process of piercing the skin. actual inspection and autopsy will verify the truth of the Variation on the shape of the wound of exit may be presumption. It may be possible that all of those wounds or attributable to the deformity of the bullet in its passage a majority of them are entrance wounds with some bullets in the body and to the wabbling and stumbling lodged, yet the number may still be even. movement of the bullet during its course and fragmentation of the missiles. How to Determine the Number of Fires Made by the Offender: Shored Gunshot wound of Exit - If the place where the gunshot wound of exit is pressed on a hard object as 46 By 4D2014-2015

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l. Determination of the Number of Spent Shells: hitting the bone the course is deflected to have the wound 2. Determination of Entrance Wounds in the Body of the of entrance as the wound of exit Victim 3. Number of Shots Heard by Witnesses Determining whether the wound is Ante mortem or postmortem: Instances when the Number of Gunshot wounds of Entrance is Less than the Number of Gunshot Wounds If the wounds inflicted after death show no evidence of of Exit in the Body of the Victim: profuse hemorrhage, or there are signs of vital reactions in the tissue, then the gunshot wound is ante-mortem. 1. A bullet might have entered the body but split Wounds inflicted after death show no evidence of profuse into several fragments, each of which made a hemorrhage, no retraction of the edges, and there are no separate exit. vital reactions.

2. One of the bullets might have entered a natural Problems confronting Forensic physician in the orifice of the body, e.g. mouth, nostrils, thereby making it identification of Gunshot Wounds: not visible and then producing a wound of exit. 1. Alteration of the Lesion Due to Natural process 3. There might be two or more bullets which 2. Medical and Surgical Intervention entered the body through a common entrance and later 3. Embalming making individual exit wounds. 4. Problem Inherent to the Injury itself 6. X-ray Examination The use of an X-ray is almost 4. In near shot with a shotgun, the pellets might indispensable in the examination of gunshot injuries. The have entered in a common wound and later use of the apparatus will facilitate recovery of the lodged dispersed while inside the body and making bullet together with the location of its fragments separate wounds of exit. Special Consideration on Bullets:

Instances when the Number of Gunshot wounds of L. Souvenir Bullet: Bullet has been lodged and has Entrance is More than the Number of Gunshot Wounds remained in the body. Its long presence causes the of Exit in the Body of the Victim: development of a dense fibrous tissue capsule around the bullet causing no untoward effect. It may be located just 1. When one or more bullets are not through and through underneath the skin to be easily palpated and may cause and the bullet is lodged in the bodY. 'inconvenience and irritation. Deep seated location may not cause any problem to warrant its immediate removal. 2. When alt of the bullets produce through and through wounds but one or more made an exit in the natural orifices 2. Bullet Migration: Bullet that is not lodged in a place of the body where it was previously located. A bullet which strikes the neck may enter the air passage, and it may be coughed out 3. When different shots produced different wounds of or swallowed and recovered in the stomach or intestine. entrance but two or more shots produced a common exit wound Bullets Embolism - a special form of bullet migration when the bullet loses its momentum u'hile inside the charnber of Instances when there is No Gunshot wound of Exit but the heart or inside the big blood vessels and carried by the the Bullet is Not Found in the Body of the Victim: circulating blood to some parts of the body where it may be lodged. It may cause sudden loss of function of the area 1. When the bullet is lodged in the gastro-intestinal tract supplied or death if vital organs are involved. and expelled through the bowel, or lodged in the pharynx and expelled through the mouth by coughing. 3. Tandem Bullet: Two or more bullets leaving the barrel one after another. In cases of misfire or a defect in the 2. Near fire with a blank cartridge produced a wound of cartridge, the bullet may be lodged in ihe barrel and a entrance but no slug may be recovered. succeeding shot may cause the initial and the succeeding bullet to travel in tandem. There is a strong possibility for 3. The bullet may enter the wound of entrance and upon them to enter the target in a common hole. This might 47 By 4D2014-2015

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create doubt to the statement made by the firer that he 13. no disturbance in the place of death made only a single shot, but ballistic examination can show as to whether the bullet travelled in tandem. Russian Roulette: -agreement among persons to load a revolver with live GUNSHOT WOUNDS MAY BE SUICIDAL, HOMICIDAL cartridge; each member will cock and pull trigger with OR ACCIDENTAL muzzle directed to the temple or other vital parts; the person who will pull trigger with live cartridge in the firing Pieces of evidence that tend to show that the Gunshot(s) chamber will suffer the fatal consequence wound is Suicidal: -may be considered suicidal

1. The shot was fired in a closed or locked room' usually in Evidences to show the gunshot wound is homicidal: the office or bedroom. 1. no point of election in he wound entrance 2. fire is made when victim is at some distance 2. The death weapon is almost always found near the 3. defense wounds (signs of struggle) place where the victim was found. 4. disturbance of the surroundings 3. The strot was fired with the muzzle of the gun in contact 5. wounding firearm cannot be found at crime scene with the part of the body involved or at close range. The 6. witness testimony wound of entrance may show signs of muzzle impression, burning, smudging and tattooing. Evidences to show that the wound is accidental: 1. usually one shot 4. The location of the gunshot wound of entrance is in an 2. no special area of body involved accessible part of the body to the wounding hand. It may 3. determination of relative position of victim and be at the temple, roof of the mouth, precordial or epigastric assailant region. A person committing suicide wilI do the act in his most convenient way, unless he has the intention of 4. witness testimony deceiving the investigator. Points to be considered and included in the report of 5. The shot is usually solitary. If the shot is made on the the physician: head involving the brain, the shocking effect of the injury 1. complete description of wound of entrance and exit will not make him capable of firing another shot. However, 2. location of the wound shots in some parts of the body which may not produce 3. direction and length of bullet tract immediate death cir sudden loss of consciousness, the 4. organs or tissues involved possibility of additional shots is not remote 5. location of missile, if lodges in the body

6. The direction of the fire is compatible with the usual 6. diagram and other illustration showing location of wounds trajectory of the bullet considering the hand used and the part of the body involved. Questions that a physician is expected to answer in

court: 7. Personal history may reveal social, economic, business or marital problem which the victim cannot solve. He may 1. Could the wound be inflicted by the weapon? have history of mental disease, depression, severe 2. At what range was it fired? frustration or previous attempt of self-destruction. 3. Direction of the fire 4. Possibility that gunshot wounds are self-inflicted 8. Examination of the hand of the victim may show 5. Signs of struggle presence of gunpowder. 6. Possibility of the victim to fire or resist the attack after

being injured 9. Entrance wound do not usually involve clothings. 7. Did the victim die instantaneously? 11. victim’s fingerprints on butt 8. Relative position of assailant and victim

12. place where the shot took place may reveal suicide Can the Caliber of the Wounding Firearm be note determined from the size of the gunshot wound of 48 By 4D2014-2015

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entrance? Yes. The caliber may be inferred from the *It is not possible to determine the direction of the shot diameter of the gunshot wound. from the direction of the sound UNLESS that flash or the person firing the shot is seen at that time. Determination of the Length of Survival of the Victim: 1. nature of wound *It is impossible to distinguish and memorise the report 2. organs involved from two firearm of the came caliber.

3. presence or absence of infection *It may be possible for a person who is accustomed to 4. amount of blood loss sound of firearms of different calibers to identify firearm by 5. physical condition of victim the sound produced.

Capacity of the Victim to Perform Volitional Acts: Gunshot wound may not be a near fire: Depends upon the following: 1. when a device is set up to hold the firearm 1. area of body involved 2. clothings are interposed between the victim and the 2. vital organs involved firearm 3. resistance of victim 3. failure of examining physician to distinguish between a *Injuries in the brain and spinal cord which cause near or far shot wound incapacity to do voluntary acts negates the capacity. 4. product of a near shot wound has been washed out of the wound Determination as to length of time a firearm had been fired: X-ray examinations may: 1. Odor of the gas inside the barrel 1. facilitate location of bullet *mixture of gases has peculiar characteristic 2. reveal fragmentation and location order which is noticeable several hours afar discharge. Later, the odor will disappear as 3. show bone involvement gases usually evaporate or chemical transform to doorless 4. reveal trajectory of bullet compounds 5. show effects of bullet wound and other injuries 2. Chemical changes inside the barrel 3. Evidence that may be deduced from the wound SHOTGUN WOUNDS 1. age of wound 2. degree of healing Shotgun- shoulder-fired firearm having a barrel that is 3. degree of infection smooth-bored

Determination Whether the Wounding Weapon is an Classes of shot in a shotgun shell: Automatic Pistol or Revolver: 1. Birdshot- shot are small (0.5 inch to 0.15 diameter); 1. Location of empty shells use for hunting fowls and small animals revolver 2. Buckshot- shot ranges form 0.24 to 0.33 inch in VS automatic pistol diameter; fewer in number of shots (9shots) in clylindrical magazine chamber after fire 3. Single Projectile (rifled slug)- only a single or slug in a driven out of weapon after shot shell 2. Nature of spent bullet revolver Systems employed in the determination of the VS automatic pistol diameter of barrel of a shotgun: no coating 1. Gauge System - determination of number of lead bullet is copper jacketed balls, each fitting of the bore totals to one pound in 3. Nature of base of cartridge or spent shell weight revolver VS automatic pistol 2. Expression of the bore diameter in inches-0.410 bore wider diameter than shotgun is the only shotgun at present designated no such difference 3. Metric system - bore in millimeters that of cylindrical body *Not standard length of barrel.

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e. smudging due to smoke up to 15 inches Grade of choke: f. gunpowder tattooing up to 24 inches 1. Unchoke- diameter of barrel from rear to muzzle is the g. in an unchoked shotgun, to estimate the same distance: measure the distance between the 2. Choke- diameter of barrel at muzzle end is smaller farthest shot in inches and subtract one, the than rest of the barrel number obtained will give the muzzle-target distance in yards *The lethal range is in an area of 30 inches in diameter at 30 to 40 yards according to degree of choking. *A close shot produces more serious injuries because of concentration on specific target and greater kinetic energy Types of shotgun: of pellets.

1. As to number of barrel DETERMINATION OF THE PRESENCE OF a. Single Barrel Shotgun GUNPOWDER AND PRIMER COMPONENTS b. Double Barrel Shotgun

2. As to manner of firing and reloading: The importance of determining the gunpowder on the a. Bolt action skin of the victim: b. Lever Action c. Pump action 1. Determination of the distance of the gun muzzle from d. Autoloading the victim’s body when fired *The presence of gunpowder at or near the wound of entrance shows that the gun muzzle *A shotgun cartridge is usually 2-3/4 or 3 inches long and when fired is not more than 24 inches but its absence will diameter depends on the gauge of the firearm not preclude near fire because other factors might have intervened Shotgun wound of entrance: 2. Determining whether a person has fired a firearm *When a person fires a gun, the powder particles 1. Contact or near contact shot - not more than 6 inches which escape may cling on the Indicators: dorsum of the hand a. shape of wound *Detection of metallic residue on the primer palm b. entrance wound is burned hand may indicate that the individual c. blackening due to smoke was making a defensive movement trying to ward off the d. gunpowder tattooing is densely located weapon e. contusion of tissue *In suicide, residue may be deposited on the f. singeing of hair (less than 6 inches) palm of the hand used to steady the barrel at g. disrupted deeper tissues the time of discharge h. presence of carbon monoxide along the bullet tract Procedures in determining the presence of gunpowder: i. recovery of wad together with shot (pellets) 2. Long range shot - more than 6 inches skin-muzzle 1. Gross examination or examination with the use of distance hand lens Indicators *This examination is not conclusive because a. 2-3 feet muzzle distance-> single wound of other foreign particles may be mistaken for entry gun powder or other primer components. b. 3-4 feet distance-> serrated wound of entry 2. Microscopic examination referred to as ―rat hole‖ 3. Chemical tests c. 5-6 feet-> wad tends to produce independent a. Laboratory test to determine firearm residues injury, usually an abrasion *There is inference of contact or near d. 6 feet-> shots begins to separate from distance of the gun muzzle to the skin when conglomerate shot there is burning, tattooing, smudging visible 10 feet-> produces independent wounds of entry *The same test may be applied to ―Billiard ball ricochetted effect‖- tendency for one dorsum of hand of persons suspected to have shot to stoke another causing changes of the shot fired the gun course

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*The test may involve the bombardment, afterwards their quantity is determination of presence of gunpowder residues of measured. primer components 3. Flameless Atomic Absorption Spectroscopy (FAAS) *Sample of hand washing is subjected to a high Test for the presence of gunpowder residues: temperature to vaporise the metallic elements 1. On the skin (Dorsum of the hand or site of the wound of the primer residue. of entrance): *This method is quick, sensitive and employs 1. Dermal nitrate test (Paraffin test, Diphenylamin equipment within economic means test, Lung’s test or Gonzales’ test) *Can determine presence of barium, antimony *The presence of small particles and lead containing either nitrate or nitrite will be indicated 4. Use of Scanning Electron Microscope with a Linked X- by a blue reaction of the particles upon contact ray Analyzer with Lung’s reagent. *Adhesive material is used to remove any *Test is not conclusive as to the residue particles from the hand. The material presence of gunpowder because fertilizers, then examined under the scanning electron cosmetics, cigarettes, urine and other microscope with a linked X-ray analyzer. nitrogenous compounds with nitrites and nitrates will give a positive reaction FIREARM IDENTIFICATION *Subjection of suspect is not self- Factors: incriminatory; act purely mechanical 1. Caliber of the weapon 2. On clothing's (Especially coloured ones) 2. Fingerprints Walker’s tes (C-acid test, H-acid test) *may determine if homicidal or suicidal nature of *A glossy photographic paper is fixed death thoroughly in hypo solution for 20 minutes to 3. Fouling of the barrel remove all silver salts and then washed for 45 *recently fired firearm may have a characteristic minutes and dried. door smoke inside the barrel *If unburned powder grains are 4. Serial number present, it will result to production of dark red or orange-brown spots on the prepared paper. Procedure of restoring serial number if tampered: Test for the presence of Primer Components: 1. Cleaning 1. Harrison and Gilroy Test *All oil, dirt, grease and paint should be removed *A cotton swab moistened with 0.1 molar with gasoline, xylol and acetone hydrochloric acid is used to gather antimony, 2. Polishing (Most important) barium and lead. *Whole surface should be smoothly polished *The test does not enjoy substantial utilisation in using a fine file followed by a medium to fine grade forensic laboratory because: carborondum cloth 1. lacks specificity of color reaction *The area should always have the mirror-like 2. inadequately sensitive surface 3. interference of color reaction among three 3. Etching elements themselves *For all iron or steel materials, the following 4. development of instability of color etching may be used 2. Neutron Activation Analysis (NAA) Hydrochloric acid - 80 cc *A sample is obtained from the hands by the use Distilled water - 60 cc of paraffin or washing the hand with dilute acid. It is Ethyl alcohol - 50 cc then exposed to radiation from a nuclear react emitting Copper chloride - 10 grams neurons. *The solution is swabbed until the numbers *The test requires access to a nuclear reactor appear. (very expensive test) 4. Ballistic examination *Unable to detect lead *Ballistics - study of physical forces reaction on *Principle: Barium and antimony are converted projectiles into isotopes by means of neutron *Foreign ballistics - also known as firearm identification; deals with examination of fired bullets

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and cartridge cases in a particular gun to the exclusion of 3. Hand lens all others 4. Sharp pointed instrument for scraping I.D. marks 5. Caliper Three separate and distinct area of Ballistics: 6. Analytical Balance 1. Interior Ballistics - deals with what happened to the cartridge and its bullet from the time trigger is pulled See illustration on page 386 until the bullet exits from the barrel 2. Exterior Ballistics - deals with what happened to the Types of marking on the examination through bullet or projectile from the moment it leaves the gun Comparison Microscope: barrel to the moment of impact on the target or object

3. Terminal Ballistics- concerns with the effect of the bullet on the target or until it comes to rest 1. Impression type Mark (Stamp Mark) – the 4. Medical Ballistics- concerned with the penetration, forcible application of hard surface against the severity and appearance of the wound due to bullet or softer one leaving an impression on the softer missile surface. E.g. striking of the firing pin on the percussion cup. Basic Principles Involved in Firearm Identification: 2. Striation or serration mark – produced by a 1. Quality of metal in the manufacture of firearm is much harder surface scraping, dragging, siding or harder and resistant to deformity than the quality of slipping cross the softer one leaving a series of metal used n the manufacture of cartridge. In the abrasions, serrations and scrapes. E.g. bullet process of contact between the part of the gun surface may show the rifling marks on its surface involved and the cartridge, the surface condition of the of the barrel. part of the gun can easily be impressed on the shell or bullet. When the cartridge is fired from the firearm, the 2. Firearms have certain physical characteristics of following marks are found in the shell and from certain type of caliber which differentiate it from the bullet: others. 3. No two firearms can be manufactured with identical Marks found in the Shell: surface characteristics; referred to as ―individual characteristics‖ a. Marks of firing pin – impressions in the percussion cap Instruments Use in Firearm Identification: b. Marks from the extractor – marks found in front of the rim of the Comparison Microscopes- instrument consists of two 1. shell compound microscopes which allows comparison of c. Marks from the ejector- marks two objects by looking through single eyepiece. The found in the head of the shell individual or accidental characteristics of two objects d. Marks from breechblock: the may be compared. There is an attachment for impact of the shell in the photographic camera to facilitate the taking of pictures bleechblock in the recoil of the findings. impresses the ridges of the 2. Bullet Recovery Box- instrument for the purpose of bleechblock and often gives recovering the test bullet and shell. It is a long identification mark characteristic of cylindrical container filled with cotton and an open a firearm. shooting end. *The test shell e. Marks on the cylindrical surface of and bullet may be used for comparison with the the shell- mark brought about by evidence bullet or shell. the magazine. Other ways of recovering test bullet as used in other countries: 1. Shot may be fired on a box with oil and Marks found in the bullet: sawdust 2. Vertical or horizontal shot on water tank 3. Shot fired on a block of ice

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a. Number of lands and grooves- i. The refling barrel is reflected number of grooves, depth, and in the bullet as it passes width depend upon the through it. manufacturer of the firearm. ii. Firing pin mark: when the b. Direction of the twist of the Rifling base of the cartridge is hit by Marks- the direction of the spiral the firing pi, the pin produces lands and grooves may twist to the distinct markings which can right or to the lest. be reproduced by succeeding shots. iii. Breechblock mark: as the Each manufacturers of firearms make certain marks which bullet is propelled forward by will distinguish firearms manufacturered by them and the force of the expanded makes specific number of spiral grooves and direction of gas, the casing is forcibly the twist in the brrel of the firearm. The bullet recovered moved backward against the from the ody may show those marks in the examination breech force or recoil plate. and the examiner may have the presumption where the The backward force transfers firearm came. the marking on the breechblock to the base of In fire Arm Identification the Examiner must take into the cartridge. consideration the following: iv. Extractor mark: mark made by the extractor on the 1. gross examination or examination with cartridge rim when pulled magnifying lense: away from the firing a. caliber of the bullet chamber. b. presence or absence of deformity or v. Ejector mark: mark produced loss part by the ejector in the process c. presence of foreign elements. E.g. of throwing away the spent blood, flesh shell. d. identity marks placed by previous possessor. GUNSHOT WOUNDS IN DIFFERENT PARTS OF THE BODY 2. Examination with the use of comparison

microscope: this is the comparison between Head and Neck evidence shell or bullet with the test shell or

bullet 1. Cranium:

a. Determination of the clss Close or near contact fire in the characteristics: physical characteristics head may produce marked of certain caliber of firearm used by the laceration of the skin, burning and manufacturer: tattooing of the surrounding skin. i. Number of rifling The skull is fractured without any ii. Direction and rates of rifiling definite shape with the linear marks extensions to almost all of the iii. Dimension of the lands and bones comprising the cranial box. grooves

iv. Depth of the grooves Fire from distance with the v. Style of the cannelure bullet having a right angle of

approach to the skull, the fracture b. Determination of individual or is oval at the outer table. There accidental characteristics: will be radiating linear fractures from point of entrance. The wound exit will be clean-cut oval round 53 By 4D2014-2015

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opening at the inner table with 4. Neck beveled fracture at the outer table. The bullet may pierce the front Grazing approach of the bullet portion of the neck and may may produce an elongated gutter- involve the cervical portion of the like depressed fracture of the spinal cord; causing instantaneous cranium. The tangential impact death if the upper portion is of the bullet may cause it to split involved. If involve the carotid or and it is not uncommon to see a jugular vessel and death may be fragment lodging in the brain due to profused hemorrhage. substance while the other ricochet Injury to trachea and upper outside hitting other objects bronchi may cause asphyxia or nearby. aspiration pneumonia.

2. Brain Substance: 5. Chest: 1. Chest wall: usually has an upward course and may Usually a rugged tunnel with a involve both sides. The bullet diameter larger than that of the may strike the rib, sternum or caliber of the bullet, with mark the body of the vertebra and ecchymosis of the surrounding may cause deformity or area and filled with fresh and deflection of its course. When clotted blood. Fragments of bones the intercostal or mammary may be felt in the tunneled bullet vessel are injured there will tract. In jury of the brain causes be perfused hemorrhage. sudden loss of consciousness and incapable of voluntary movement. 2. Lungs: it produces a cylindrical tunnel much larger than the diameter of the projectile with the bloody Injury in the cerebral hemispheres contents and ecchymotic is as a rule not immdediately fatal borders. When the and the victim may survive the pulmonary vessel is involved, injury, however if the bullet the profuse hemorrhage is courses the medulla, pons, and observe that produces death other vital centers causes the before medical intervention immediate death. Some victims can be done. If only the lungs may live for a while but developed is involve, the profuse epileptiform convalsions as a hemorrhage may cause sequel. collapse of the lungs, displacement of the heart.

Emphysema is present when 3. Face there is marked injury to the air sacs. The victim may not May noy cause serious trouble die immediately but later may except that it becomes potential develop aspiration avenue for infection that may pneumonia or cerebral cause deformity. embolism.

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3. Heart: wound may be the spinal cord may be due circular or stellate with to: subepicardial hemorrhage in a. Bullet affects the the surrounding tissue. As a canal and the general rule does not prevent spinal cord causing the victim from running, either partial or walking or to do other forms complete of volitional acts for death is severance not usually instantaneous. b. Injury in the body of wound of the auricle is more other parts of the rapidly fatal as compared vertebra and with the would of the ventricle contusion, on the account of thickness concussion or of the musculature of the compression on the latter which produces account of impact. temporary closure of the Injury of the upper wound. cervical spinal cord 4. Abdomen: wounds are quite may cause frequent but not as serious immediate death as those of the chest and because the vital head because of its ability to nerve tracts may surgical operation. It is be involved. Lower limited to one or several spinal cord injury organs. Bullet wound of the may cause motor liver and other or sensory parenchymatous abdominal paralysis and may organs may cause stellate later succumb to perforations which are hypostatic usually larger than the caliber pneumonia, of the bullets that causes suppuration or them. The tunnel may other contain fragmented tissue, complications. fresh and clotted blood. Loss 6. Extremities: it may show the of function, of the kidney, characteristic lesion of pancreas, etc may lead to gunshot wounds. Usually the fatal resuls. Bullet wounds in wound is not so serious the stomach and other hollow except when it involves the areas are usually small on principal blood vessels and the account of he contractility nerves. The bony tissue may of the walls. The wound involves the principal blood entrance is smaller than the vessels and nerves. exit wound. Timely surgical intervention may prevent untoward complications. However, death due to CHAPTER XVII peritonitis is not rare on the DEATH BY ASPHYXIA account of the spilling of its contents into abdominal cavity. 5. Spine or Spinal Cord: injury Asphyxia – general term applied to all forms of of the spine may not involve violent death which results primarily from interference with the spinal cord but injury of the process of respiration or the condition in which the

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supply of oxygen to the blood or to the tissues or both has 3. Apneic Phase: is due to the paralysis of the been reduced below normal level. respiratory center of the brain. The breathing shallow and gasping and the rate becomes Types of death by Asphyxia: slower till death. The heart later fails.

1. Anoxic Death: associated with failure of the arterial blood to become normally saturated with Classification of Asphyxia: oxygen may be due to : a. High altitude 1. Hanging b. Traumatic crush asphyxia 2. Strangulation: c. Paralysis of the respiratory centerdue a. By ligature to poisoning, injury or anesthesia, etc. b. Manual strangulation or throattling d. Mechanical interference with the c. Special forms of strangulations: passage of air into or down the i. Palmar strangulation respiratory tract due to: ii. Garroting i. Closure of external iii. Mugging or yoking respiratory ortifice iv. Compression of the neck with ii. Obstruction of air passage stick iii. Respiratory abnormalities 3. Suffocation: e. shutting blood from the right side of the a. Closing the mouth and nostrils by solid heart to the left without passage object through the lungs b. Choking or closing of the air passage 2. Anemic Anoxic Death: this is due to a by the obstruction of its lumen decreased capacity of the blood to carry oxygen. 4. asphyxia by submersion or drowning. This condition may be due severe hemorrhage, 5. Asphyxia by pressure on the chest poisoning, or low hemoglobin level in the blood. 6. Asphyxia by irrespirable gases 3. Stagnant Anoxic Death: this is brought about by the failure of circulation which may be due to heart failure, shock, or arterial and venous Asphyxia By Hanging: is a form of violent death brought obstruction. about by the suspension of the body by a ligature which 4. Histotoxic Anoxic Death: this is due o the encircles the neck and the constricting force is the weight failure of the circulation of the cellular oxidatives of the body. The victim may be sitting or lying with the face process, although the oxygen is delivered to the down provided that the pressure is present in front or in the tissues, it cannot be utilized properly. Cyanide side of the neck. and alcohol is common agents responsible. Classification of asphyxia by hanging:

Phases of Asphyxial Death: 1. as to location of the ligature and knot: a. typical: ligature runs from the midline 1. Dyspenic Phase: symptoms due to lack of above the thyroid cartilage oxygen and retention of carbon dioxide in the symmetrically encircling the neck on body tissue. Breathing becomes rapid and deep, both sides to occipital region. pulse rate increase and rise of blood pressure. b. Atypical: the ligature is tied or noosed 2. Convulsive phase: this is due to simulation of and present on one side of the neck, in the cntral nervous system by carbon dioxide. The front or behind the ear or on the chin. cyanosis becomes more pronounced and yes 2. as to amount of constricting force: becomes staring and pupils are dilated. Visceral a. complete: body is completely organs shows petechial hemorrhages known as suspended and he constricting force is Tardieu Spots (caused by the hemorrhage the whole weight produced by the rapture of the capillaries on b. partial: body is partially suspended as account of the increase if intra-capillaries when the victim is sitting, kneeling, pressure). The victim may become unconscious reclining, prone or in any other in the convulsive stage. positions.

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3. as symmetry: There may be no sliding noose at the end of the a. symmetrical: the knot or noose is at the ligature. It may be tightened after it has been midline of the body either at the occiput encircled around the neck and the pressure on or just below the chin. the air passage, blood vessels and nerves of the b. Asymmetrical: knot or noose is not is neck is established when the body is suspended. not in the midline but on the one side, with the head tilted to the side opposite 3. Mode of Application of the Ligature the location of the noose or knot. The ligature may be placed around the neck with a single loop or with two or more hoops. This can be distinguished on the nature of the ligature Mechanism of Death: marks. In single loop, there is but one ligature furrow, but if there are several, there will be There is a ligature around the neck with a knot or several ligature marks with an intervening with a sliding noose and the other end is fastened to an redness between the furrow. There is more elevated object like peg, nail, window casing, door knob, pressure in a single loop ligature on account of tree, etc.. concentration of force at the weight compare to several loops. Upon suspension of the body, the weight causes the noose or band to tighten, producing pressure at the 4. Position of the Knot region of the neck. The knot or joint is usually located on either side of the neck. The head is flexed opposite the The pressure of the band will cause the air location of the knot. The level of the ligature passage to constrict, the larynx is pushed backwards and around the neck may differentiate hanging from its opening is closed by the contact of the anterior to the strangulation by ligature. In hanging, the ligature posterior laryngeal wall producing asphyxia. is usually pull of the constricting force, while in case of strangulation by ligature, the loop is Pressure of the ligature may also cause found below the thyroid cartilage. It is not easy to compression of the superior laryngeal nerve, ceratoid retain the knot beneath the chin. arteries and jugular veins producing cerebral anoxia. 5. Course of the ligature around the neck Forms of furrow that develops in the neck The usual appearance is that the groove or depends upon the type of ligature, the number of loops ligature mark is deepest opposite the location of around the neck and the point of suspension. the knot. However, if the not is just underneath the chin, the groove at the back of the neck is not Protrusion of the tongue depends upon how deep on account of the firmer skin and muscular pressure is applied around the neck. If above the larynx tissue. and in an upward direction, the tongue will be pushed outward and will protrude from the mouth but if the Symptoms pressure is below, the tongue is kept inside the buccal cavity. 1. Gradual loss of sensibilities 2. Sensation of constriction of the neck Ligature in Hanging 3. Loss of consciousness and muscular power 4. Numbness of the legs and clonic convulsion 1. Materials used in Ligature. 5. Sensation of ringing inside the ear The thinner the ligature and the tougher the 6. Sensation of flash of light before the eyes material, the more pronounced will the the mark 7. Face becomes red with eyes prominent and on the skin of the neck. If the material is soft and feeling of heat in the head. broad the ligature impression on the neck is less

marked. The rope is commonly used as ligature because it is easily available and strong. Other If the victim is timely rescued and revived after artificial materials includes beddings, belts, electric wire respiration, he will suffer the following symptoms: etc. 1. Whistling sensation insede the ear 2. Noose 2. Watering of the eyes 57 By 4D2014-2015

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3. Difficulty of breathing and swallowing c. Place the patient where there is free 4. Sensation of number ness of both legs. current of fresh air All the above symptoms may last for 12 days after rescue. d. Electrical stimulation of the phrenic nerve Cause of Death in Hanging e. Administration of respiratory stimulant, like ammonia. 1. Simple asphyxia by blocking the air passage 2. Stimulate the heart to renew action if it ceases to 2. Congestion of the venous blood vessel in the beat. brain a. Apply heat at the region of the 3. Lack of arterial blood in the brain due to pressure precordium on the carotid arteries b. Hypodermic injection of coramine, 4. Syncope due to pressure on the vagus and strychnine, or other stimulants carotid sinus which leads to reflex irritation and c. Administration of brandy. paralysis of the medullary autonomic centers 3. Maintain the natural body temperature 5. Injury on the spinal column and spinal cord. a. Cover the body with blanket 6. Any combination of the above b. Place the patient in a warm room

Time Required in the Process of Death Post mortem findings in death by hanging

Time is influenced by the following: 1. General External Appearance a. Neck elongated and stretched with the 1. Severity of the constricting force head inclined on the side opposite the If the constricting force is only sufficient to knot or noose occlude the windpipe, death may be delayed; but b. Eyes closed or partially opened with if the pressure is sufficient to occlude the carotid pupils usually dialted on one side and arteries, jugular veins and vagus nerve, then small on the other side (facies unconsciousness develops immediately and sympathetic) death is accelerated. c. Lividity or pallor of the face with swelling and protrusion of the tongue 2. Point of application of the ligature d. Hands are clenched firmly and purple When the ligature is made below the larynx, colored fingernails death is almost instantaneous, but when applied e. Lips livid or blue above the larynx, death may not occur for three f. Saliva dribbled from the mouth with to five minutes. Hanging with the knot situated on froth one side of the neck may delay death because of g. State of erection or semi erection of the closure of cerebral vessels cannot be penis with seminal flued in the urethral maintained. If knot is below the jaw, maximum meatus pressure is at the back of the neck cause merely h. Post mortem lividity with ecchymosis partial occlusion of the windpipe and blood are mostly marked at the legs vessels of the neck, thereby delaying death. i. Urination or defecation due to the loss 3. Other factors of power of sphincter muscles. a. Physical condition of the subject 2. Internal Findings: b. The rate of consumption of oxygen in a. Engorgement of the lungs the blood and tissues. b. Venous system contains dark-colored Treatment fluid blood. c. Right side of the heart and the big 1. Induce the natural act of respiration blood vessels connected with it are a. Ligature must be loosened and mouth distended with blood. msut be wiped to remove all obstacle d. Blood vessels of the brain is generally to free air. congested. b. Tongue must be pulled forward and the e. Kidneys are congested. body must be laid on back rest. 58 By 4D2014-2015

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f. Sub-pleural, sub-pericardial punction It is advisable to look for other injuries which are capable of hemorrhages producing death to eliminate the possibility of hanging as 3. Findings on the neck: the cause of death. a. Neck is flexed opposite the side where the knot is located. Determinations whether hanging is accidental, homicidal or b. Ligature mark which forms groove is suicidal about or rather leass than the knot. c. The course of the ligature is inverted v- 1. Evidence in support of homicidal hanging shape with the apex of the v at the site a. Nature of windows and doors - whether of the knot. entrance was forcibly opened or have d. The skin at the site of the ligature is been used as an escape by the hard with red line of congestion and offender in homicide case hemorrhage in some points. b. Presence of signs of struggle- furniture e. Ecchymosis of the neck depends upon and beddings may be disturbed the width and softness of the ligature. whenever there is a previous struggle. f. There may be rapture of the underlying c. Presence of stains, bodily injuries in blood vessels, muscles and other soft the body of the victim tissue d. Presence of defense wounds in the g. The lining membrane of the blood body of the victim vessels may be lacerated. h. Fracture of the hyoid bone or tracheal rings. ―Lynching‖ a form of homicidal hanging usually found in southern states of US. Usually practiced by Americans against the Negros who commit Different diagnosis: crime against the white American. Whenever colored offenders are apprehended, they are 1. Fold markings on the neck of an obese individual hanged by means of a rope on a tree or some – the marks are not continuous and removed on similar objects. The Negroes are executed stretching the skin of the neck without due process of the law. 2. Marks of tight neckwear – the location and history will differentiate this from ligature marks. B. Asphyxia by Strangulation

Strangulation by Ligature: Determinations Whether Hanging is Ante Mortem or Post It is produced by compression of the neck by Mortem means of a ligature which is tightened by a force other than the weight of the body. The principal criterion is the vital reaction. But, It may be observed in infanticide using the hanging made immediately after death may also show to a umbilical cord as the constricting material. This must be certain extent vital reaction, while hanging of a living differentiated from accidental strangulation during child subject whose bodily resistance has been markedly birth, the umbilical cord is abnormally long and there is no weakened may show slight vital reaction disturbance in the wharton's jelly. Strangulation by ligature is commonly observed in rape cases, but the presence of findings in the genitalia and other physical injuries are distinctive findings. The following finding show that hanging is ante mortem Causes of Death in Strangulation by Ligature 1. redness or ecchymosis at the site of ligature 1. Asphyxia due to the occlusion of the windpipe. 2. ecchymosis of the pharynx and epiglottis 2. Coma due to arrest of cerebral circulation. 3. line of redness or rupture if the intima of the 3. Shock or syncope. carotid artery 4. Inhibition of the respiratory center due to the pressure 4. subpleural, subepicardial punctiform on the vagus and sympathetic nerves. hemorrhages Accidental, Homicidal or Suicidal Strangulation by Ligature

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Homicidal strangulation is the most common of This is a form of strangulation with the assailant the three forms of strangulation by ligature. Aside from the standing at the back and the forearm is applied in front of ligature mark in the neck, there are evidence of struggle or the neck. marks of violence in other parts of the body. 4. Compression of the Neck with a Stick Suicidal strangulation by ligature is quite rare. It The victim may be forced to place his back may be done by placing a ligature around the neck and behind a post. tightened by means of twisting a piece of stick. There are a few instances of strangulation which C. Asphyxia by Suffocation are accidental and most of the victims are children or epileptics who are helpless and incapable of extricating Asphyxia by suffocation is exclusion of air from themselves. the lungs by closure of air openings or obstruction of the air passageway from the external openings to the air sacs. Manual Strangulation or Throttling This is a form of asphyxial death whereby the Smothering constricting force applied in the neck is the hand. This is a form of asphyxial death caused by the closing of the external respiratory orifices, either by the use Methods of Throttling of the hand or by some other means. The nostrils and 1. Using one hand mouth may be blocked by the introduction of foreign 2. Using both hands with assailant in front substances, like mud, paper, cloth, etc. 3. Using both hands with assailant at the back Suicidal smothering by means of his own hand is not possible Manners of Death in Manual Strangling Homicidal and accidental smothering is frequent. 1. The air passage may be blocked and death is due to It may occur when a person is under the influence of asphyxia alcohol, epilepsy or in any other helpless state. It is 2. The pressure on the neck may cause compression of common among children. the blood vessels and disturb the blood supply of the Examples: overlaying, accidental smothering of epileptic, brain gagging, plastic bag suffocation 3. The nerves of the neck may be traumatized especially the superior laryngeal branch of the glossipharyngal, Choking hypoglossal nerves and the plexus surrounding This is a form of suffocation brought about by the Bifurcation of the common carotid artery or of the impaction of foreign body in the respiratory passage. Most vagus producing shock. of suffocation by choking is accidental, although it may be utilized in suicide or in homicide. Accidental, Homicidal or Suicidal Manual Strangulation 1. Suicidal throttling is impossible because of the D. Asphyxia by Submersion or Drowning pressure of the person's own hand must be maintained for sometime but when unconsciousness This is a form of asphyxia wherein the nostrils begins, the hands are relaxed and the victim recovers. and mouth has been submerged in any watery, viscid or 2. Accidental throttling may occur but the victim never pultaceous fluid for a time to prevent the free entrance of died of asphyxia but of other causes. air into the air passage and lungs. 3. Homicidal manual strangulation is the most common. It is a method of choice in infanticide. Time Required for Death in Drowning Submersion for 1-1/2 minutes is considered fatal, Special Forms of Strangulation if ordinary efforts for respiration is made, however, a 1. Palmar Strangulation person may survive even after 4 minutes of submersion. The palm of the hand of the offender is pressed The average time required for death in drowning is 2 to 5 in front of the neck without employing fingers. minutes. 2. Garroting A ligature, a metal collar or a bowstring is placed Emergency Treatment in Drowning around the neck and tightened at the back. Remove the bodily clothings especially the tight 3. Mugging (strangle-hold) ones and wrap the body with blanket. Place the face down and perform artificial respiration, using any of the following methods: Schaefer's Method or Sylvester's Method. 60 By 4D2014-2015

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Administration of stimulants as ammonia, and charcoal used in heating or cooking, or gasoline aromatic vinegar, etc. engine in cars. Injection of strchnine, coramine, caffeine, etc. Accidental and suicidal death by carbon Inhalation of oxygen combined with 5% to 8% monoxide poisoning is common. Victims may be carbon dioxide to stimulate respiration. accidentally imprisoned or deliberately enclose themselves in a room or garage with motor engine running or slow Floating of the Body in Drowning burning is present. The body may not immediately be recovered after drowning because it is under water. The specific Qualitative Test for Carbon Monoxide in the Blood gravity of human body is slightly more than of the water. 1. Kunkel's Test Within 24 hours, on account of the decomposition which 2. Potassium Ferrocyanide Test causes the accumulation of gas in the body, the body 3. Examination Through a Spectroscope floats. The floating of the body is markedly influenced by 4. Gas Chromatograph the weather, condition of the fluid medium where drowning 5. Infrared Analysis took place, presence of wearing apparel, age, sex and body built. The body when recovered, floats usually with Carbon Dioxide (Carbonic Gas Acid) flexed extremities. The head is submerged because it has a higher specific gravity than the rest of the body. Carbon Dioxide is the gas blown out of the lungs during respiration, product of complete combustion of "tete de negri" - the bronze color of the head and neck of a carbon containing compounds, and the end result of person who died in water during the process of fermentation and decomposition of organic matters. decomposition.

E. Compression Asphyxia (Traumatic or Crush Asphyxia) HYDROGEN SULFIDE (SULPHURETTED HYDROGEN, H2S) This is a form of asphyxia whereby the free exchange of air in the lungs is prevented by the immobility NATURE and CHARACTERISTICS of the chest and abdomen due to external pressure or crush injury.  COLORLESS, Transparent gas, sweetish taste In homicidal cases, the assailant may kneel on and emitting an odor similar to a rotten egg. the chest of the victim or squeeze the victim between the  Formed during a decomposition process of arms and legs as in wrestling. organic substances containing sulphur. In accidental cases, the body may be pinned  Found in large quantities in a sewer, septic tanks, between two big objects or collapsing building on the drainage pipes, and deep wells. ground. Very rarely is traumatic asphyxia attempted in EFFECTS suicide.  A dilute solution produces irritation of the eyes, Burking nose, throat and air passages, followed by This is a form of traumatic asphyxial death dizziness, headache, nausea, vomiting, invented by Burke and Hare for the purpose of murdering abdominal pain, cyanosis, dilated pupils, cold people to be sold to medical schools for dissection. extremities, and labored breathing  Prolonged exposure on a diluted atmosphere Death by Crucifixion may cause tetanic convulsion, delirium, stupor, When person is nailed on a cross the weight is coma and death. supported by the nailed feet. Classified as traumatic POST-MORTEM FINDINGS asphyxia. F. Asphyxia by Breathing Irrespirable Gases  Putrefaction sets rapidly.

 Offensive odor is noticed on opening the body. Carbon Monoxide (Carbonic Oxide Gas, Co "Silent Killer") Blood in fluid state, dark brown in color is due to Carbon Monoxide is formed from the incomplete  combustion of carbon fuel. The fatal carbon monoxide conversion of hemoglobin to sulmethemoglobin. poisoning usually involves burning wood, oil,coal, kerosene  Lungs are congested and edematous. 61 By 4D2014-2015

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 Other organs are congested and dark colored. POST-MORTEM FINDINGS

 Not characteristics but there may be cyanosis HYDROGEN CYANIDE with signs of asphyxia

NATURE and CHARACTERISTICS WAR GASES

 One of the most toxic and rapid acting gases. ESSENTIAL CHARACTERISTICS  Formed by addition of acid to potassium or sodium salt of cyanide.  Heavier than air  Found in leaves of cherry-laurel, in bitter almond,  Capable of spreading rapidly on the area where in kernels of common cherry, plum, peaches, in the chemical effects is desired ordinary bamboo shoots, and in certain oil seeds  Capable of producing effect even in low and beans. concentration on a specified area  May be a true gas, smoke, volatilized liquid or EFFECTS finely divided solid  Manufactured in big quantity in a relatively cheap  Loss of muscular power, giddiness, slow and price stertorous breathing with loss of consciousness  Stable substance or not easily made non-toxic by which may or not be preceded by convulsion rapid chemical reaction before death  Capable of storage for an ample length of time

POST-MORTEM FINDINGS CLASSIFFICATION BASED ON THE PHYSIOLOGICAL ACTION  Body is livid or violet in color  Post-mortem lividity is bright red or pink due to LACRIMATOR or TEAR GAS the formation of cyanmenthhemoglobin  Fingers are clenched, fingernails are blue and KINDS: jaws firmly closed  Eyes are bright and glistening and pupils are  Chloracetophenone (C.A.P.) dilated  Bromobenzyl Cyanide (B.B.C.)  Odor of the acid may be noticed on opening the  Ethyl Iodoacetate (K.S.K.) body  Heart is engorged with bright red blood EFFECTS:  Mucous membrane of the esophagus and the stomach may be congested and covered with  Irritation of the eyes with copious flow of tears froth.  Severe lacrimation, spasm of the eyelids, congestion of the conjunctivae and temporary SULFUR DIOXIDE blindness  Irritation of the respiratory passages and lungs, NATURE and CHARACTERISTICS burning sensation in the throat and discomfort on the chest  COLORLESS gas  Vomiting, nausea, bronchitis and blistering of the  Employed as a disinfectant, bleaching agent skin  Found in eruption of volcanoes PREVENTIVE MEASURES EFFECTS  Wearing of Gas mask  Irritation of the respiratory passage, thus causes  Washing of the affected eyes with boric acid sneezing, coughing, spasm of the glottis and solution suffocation  Sodium bicarbonate solution may be applied in  Irritates the eyes and caused congestion and other affected areas lacrimation

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VESICANT or BLISTERING GAS  Hydrocyanic Acid (Hydrogen Cyanide or Prussic Acid) KINDS  Hydrogen Sulfide (Sulphurated Hydrogen)  Carbon Monoxide (Carbonated Oxide, C0)  Mustard Gas (Dichlordiethyl Sulfide, Yellow Cross, ―Ypertite‖)  Lewisite (Chlorovinyl-dichlorarsine) CHAPTER XVIII EFFECTS DEATH OR PHYSICAL INJURIES DUE TO AUTOMOTIVE CRASH OR ACCIDENT  Contact with the skin may cause bleb or blister formation AUTOMATIVE CRASH:

LUNG IRRITANTS (Asphyxiant or Choking Gas) FACTORS RESPONSIBLE TO AN AUTOMOTIVE CRASH KINDS 1. HUMAN FACTOR  Chlorine (CL2) a. Mental Attitude – ex. Reckless driving,  Phosgene (COCL2) showing of, inattention, fatigue, inexperience  Chloropierin b. Perceptive Defect – ex. Defective vision,  Diphosgene defective hearing c. Delayed or Sluggish Reaction Time – EFFECTS  Reaction Time – the space of time the driver perceives an impending danger and the actual  When inhaled, they cause dyspnea, tightness of application of the brake. chest and coughing, varying degree of d. Disease – the driver may develop an conjunctival irritation, vomiting, coma and death epileptic fit or suffer from a heart attack while on the steering wheel STERNUTATOR (Nasal Irritants or Vomiting Gases) e. Chemical Factor – ex. Driving under KINDS influence of alcohol or drugs (depressant drugs, marijuana, psychotrophic drugs) ,  Diphenyl chlorarsine (D.A.) leak in the exhaust system of the vehicle  Diphenylamine chlorarsine (D.M.)  Diphenyl cyanarsine (D.C.) 2. ENVIRONMENTAL FACTOR – ex. Roads, weather, absence of road signs, blind EFFECTS intersections, stiff and slippery road may prolong the sked time  Nausea, stricken with coryza, malaise,  Sked time – the space of time between the headache, vomiting, salivation and pain in the actual application of the brake and the stopping chest, and prostration of the car

PARALYSANTS (Nerve Gas) 3. MECHANICAL FACTOR – ex. Defect in the steering wheel, poor brake, transmission failure, EFFECT worn out tires, unstable body

 Paralysis at the myoneural junction 4. SOCIAL FACTOR – ex. Speed, Insurance – develop ―devil may care‖ attitude on the driver inasmuch as he will not be financially held liable for damages as a consequence of a crash BLOOD POISONS 5. PEDESTRIAN KINDS INJURIES AND DEATH ON THE DRIVER AND PASSENGERS

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KINDS OF COLLISIONS IN AUTOMOTIVE CRASH  With the impact at the rear, the head moves backward or hyperextended, then the head will 1. First Collision – the impact of the moving vehicle move forward until the chin strikes the front with another vehicle or a fixed object portion of the chest and with the neck 2. Second Collision – the impact of the unrestricted hyperflexed. occupants with the interior of the vehicle  The backward and forward movement of the head is known as ―acceleration-deceleration FACTORS RESPONSIBLE FOR PASSENGERS AND injury‖ or ―whiplash‖. It may result to muscle DRIVER INJURY spasm or injury to the ligament of the neck resulting to pain. 1. Displacement of the occupants within the vehicle with impact against structures ROLL OVER CRASH (Turn-turtle Impact) 2. Ejection 3. Distribution of the passengers in the  In the process of rolling, the occupants may be compartment resulting in direct impact injuries pinned, crushed or may be thrown away and fall on the ground. FRONT IMPACT CRASH  On account of the ling period of the process of 1. Driver rolling, the passenger does not sustain severe a. Severe impact of the driver’s head on the injuries. The rolling process causes the different windshield may cause laceration of the sides of the vehicle to absorb the force of the scalp, face or neck. impact. b. Impact of the lower extremities against the EJECTION OF THE OCCUPANTS dashboard may cause fracture of the tibia, fibula, femur, or pelvis as well as lacerations  The primary impact of the vehicle may forcibly and abrasion of the skin of the area. open the unlocked door. c. The impact of the face to the circular rim of  Ejection may increase further the injury sustained the steering wheel may cause fractures of by the occupant. the teeth, jaw and facial bones. 2. Front Seat Passenger MEANS EMPLOYED TO MINIMIZE INJURY TO DRIVER a. Abrasion of the face and scalp. AND PASSENGER b. Laceration of the face and scalp. c. Fracture of the skull. 1. Use of soft padded dashboard, windshield safety d. Laceration or rupture of the heart. glass, dashboard with perforation to allow metal e. Crashing injury of the neck. to deform easily, enlarged and padded central f. Fracture of the ribs and sternum. steering wheel hub and collapsible steering g. Laceration of the liver and/or spleen. column 3. Rear Seat Occupants – they may strike the back 2. The interior of the passenger compartment, of the front seat, the pillar between the front and including the steering wheel, dashboard, side rear side doors, or may be propelled over the doors are prevented from intruding into the front seat striking the front seat passenger and passenger compartment and strike the driver, dashboard or windshield. occupants. 3. The fender, bumper and other parts of the car SIDE IMPACT CRASH commonly involved in the impact are made of metal which can absorb energy, dissipate such Common impact in street intersections  force and prevent its transmission to the driver  The lateral impact to the chest may cause and passengers. fracture of the ribs, contusion with laceration of 4. Special restraints to the occupants are being the lungs. applied to reduce the severity of the second  Laceration of the spleen and kidneys and pelvic collision in the forms of lap and shoulder belt and may also be observed. air bag. But the use of seat belt is not absolutely considered as a safety device. It may cause REAR IMPACT CRASH

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injuries to the abdominal wall, visceral organs  Accounts for the multiple abrasions and and vertebral column. contusions on the body of the pedestrian-victim Seat belt Syndrome – the acute flexion of the trunk (jackknifing) with the belt as the central 3. RUN OVER INJURIES fulcrum may cause fracture of the trunk with the visceral organs in forward motion, may stretch  The pedestrian may be run over by the moving the mesentery and causes injury to the intestine vehicle during the initial impact or thereafter and mesentery itself. There may be abrasion,  Usually, the victim dies of shock contusion and hematoma of the lower portion of  Crash fracture, skid or tire marks, rupture of the abdomen. organs and internal hemorrhage may be seen at autopsy SUICIDAL CRASH 4. HIT-AND-RUN INJURIES Usually a single vehicle and single occupant  crash  A fast moving vehicle may run over, hit or side-  Head on collision with roadside object, pole or swipe a pedestrian or collide with another vehicle bridge support at a high speed. or fixed object and get away from the scene  No evidence of any effort to apply the brake or to without regard to the unfortunate victim avoid striking the object (foot still on the  This usually happens when the driver is drunk or accelerator pedal) ―high‖ at night time, in an isolated road and with HOMICIDE BY MOTOR VEHICLE no eyewitnesses or someone who could take note of the identity of the vehicle  The simulation of a crash may occur to conceal a EVIDENCE IN VEHICULAR CRASH prior homicide  Victim of other means of violent death may be 1. FROM THE SCENE OF THE CRIME placed on the road to simulate that he is a victim of ―hit and run‖.  The area of the road – a photograph sketch must be taken to determine who violated the traffic PEDESTRIAN – VEHICLE COLLISION rules and regulation DEATH OR PHYSICAL INJURIES TO PEDESTRIAN  The skid and tire marks on the road – for identification of vehicle and whether the driver 1. PRIMARY IMPACT stepped on the brake immediately before the crash  First violent contact between the pedestrian and  Condition and position of the victim – whether the motor vehicle pedestrian or occupants  The severity of the injury depends on the position  Condition of the vehicle and of other structures in of the victim when the impact occurred, speed of the vicinity the moving vehicle, and the amount of bodily  Blood, paint strains, pieces of clothing that may support (clothing and other apparel) be found in the body of the victim, ground or on  The movement of the body after the primary the vehicle impact depends on the location of the impact  Narrations of witnesses as to how the incident  Bumper Fracture – Fracture of the leg bones as took place including the identity of the vehicle a consequence of the primary impact and the victims

2. SECONDARY IMPACT 2. FROM THE DRIVER

 The subsequent impact of the pedestrian to the  Fitness to drive – capacity to manipulate the ground after the first impact steering wheel, step on the brake and  The injury sustained by the pedestrian depends accelerator, visual and hearing perception, reflex mostly on the force of the ground impact, nature time, heart condition, history of epileptic seizure, of the road and part of the body involved etc.

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 Alcoholic drunkenness – a person with at least 1. There are so little crushable materials to absorb 0.15% alcohol in the blood is considered drunk the impact that the motorist himself is subjected  Injuries due to second collision – like steering to the severe force. hub imprint, fractured skull, multiple abrasions 2. No restraint system is available to keep the and laceration of the face and scalp, fracture of operator and the passenger on the bike and as a the leg bones, ribs and sternum result, ejection from the motorcycle is common.

3. FROM THE VICTIM IN VEHICLE-PEDESTRIAN Inasmuch as the cyclist is exposed to crashes, the only COLLISION alternative approach is the protective wearing apparel.

1. Leather jacket, thick pants, and gloves to protect  Crush injury the skin from injuries that result from ejection  Tire Thread Marks 2. Leather boots to protect from injuries of the Abrasion Marks  bones of the feet and legs.  Paint Marks 3. Motorcyclist helmet which must be buckled to  Blood, hair or Clothing of the Victim protect the head.  Physical Defects of the Victim  Inebriation of the Victim – the victim might have been under the influence of alcohol and other CHAPTER XXI depressant drugs MEDICO-LEGAL ASPECTS OF SEX CRIMES

PURPOSES OF THE AUTOPSY OF VICTIMS OF VIRGINITY AND DEFLORATION VEHICULAR ACCIDENTS A. Virginity- is a condition of a female who has not experienced sexual intercourse and whose 1. Determine deceased’s position on the vehicle or genital organs have not been altered by carnal the pattern of injuries connection. 2. Determine whether death occurred as a result of A woman is a VIRTOUS FEMALE if her the crash and not due to natural disease, body is pure and if she has never had poisoning, gunshot wound or other causes prior any sexual intercourse with another, to the crash though her mind and heart is impure. 3. Question of survivorship when more than one member of the family died in a crash There is a presumption that a woman is virgin whenever it 4. Size of monetary reward in a civil suit may is shown that she is single and continuous until overthrown depend on the nature and extent of the injuries by proof to be contrary. suffered KINDS OF VIRGINITY MOTORCYCLE CRASH 1. Moral Virginity- the state of not knowing the REASONS WHY THERE IS A HIGH PERCENTAGE OF nature of sexual life and not having experienced MOTORCYCLE CRASH sexual relation. 2. Physical Virginity- a condition where a woman is 1. A motorcycle can attain a high speed compared conscious of the nature of the sexual life but has with other ordinary road vehicle. not experienced sexual intercourse. 2. It has a small profile that the driver of other a. True Physical Virginity- the hymen is vehicles may fall to see it. intact. 3. At high speed and frequently in curves, the b. False Physical Virginity- hymen is cyclist may lose control of the brake. it may hit a unruptured but the orifice is wide and fixed object, the tire may skid, or the cyclist may elastic. be drunk. 3. Demi-Virginity- condition of a woman who permits any form of sexual liberties as long as Whenever the motorcycle strikes another vehicle or a fixed they abstain from rupturing the hymen by sexual object the injuries is quite severe because: act.

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4. Virgo Intacta- a truly virgin woman. There are no lacerate without pain or structural changes in her organ to infer previous appreciable bleeding. sexual intercourse and that she is a virtuous c. As to number of opening: woman. i. Single orifice ii. Septate- two openings PARTS OF THE FEMALE BODY TO BE CONSIDERED iii. Multiple- several openings IN THE DETERMINATION OF THE CONDITION OF iv. Imperforate- no opening VIRGINITY. Virginity is NOT synonymous with Chastity. 1. Breast 2. Viginal Canal A woman may resort to many forms of 3. Labia Majora and Labia Minora homosexual as well as heterosexual practices without 4. Fourchette (present a V-shape appearance as losing her virginity, yet she may be unchaste. the two labia minora unite posteriorly.) 5. Hymen B. DEFLORATION a. As to the shape and size of the opening: Defloration is the laceration or rupture of the hymen as a i. Annular or Circular- the result of sexual intercourse. opening is oval or circular located at the center of the Parts of the female genitalia that must be examined to hymen. determine defloration: ii. Infantile- the opening is 1. Condition of the Vulva small. 2. Fourchette iii. Semilunar or crescentric- the 3. Viginal canal concavity may be facing 4. Hymen- the fact that hymen is intact does either side or upwards or not prove absence of previous sexual downwards. intercourse and the presence of laceration iv. Linear- the opening is slit-like does not mean defloration. and usually running vertically. a. Other causes of hymenal v. Cribiform- the hymen laeration: presents several openings i. Passage of clotted blood instead of a single one. during menstruation vi. Stellate- hymenal opening is ii. Ulceration due to like a star. disease vii. Septate- there are two iii. Jumping or running openings separated by a iv. Falling on hard and bridge of hymenal tissue. sharp object viii. Fimbriated- the border of the v. Medical instrumentation opening shows small vi. Local medication irregular protrusiontowards vii. Self-scratching due to the opening. irritation ix. Imperforate- no opening in viii. Masturbation the hymen. ix. Insertion of foreign b. As to structure and consistency: bodies i. Firm and with strong x. Previous operation connective tissue and plenty of blood vessels. IN THE MEDICAL EXAMINATION OF THE HYMEN, THE ii. Thick yielding hymen with FOLLOWING FACTS MUST BE INCLUDED; scarce blood vessels. iii. Membranous hymen- hymen a. General condition of the hymen is parchment like, may be b. Original shape of the orifice (opening) transparent and may be c. If lacerated, the following must be noted: 67 By 4D2014-2015

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i. Degree of laceration DEATH RELATED TO SEXUAL ACT (complete, incomplete or complicated laceration) A. Death by male partner ii. Location of laceration a. Death from natural cause- because of iii. Duration of laceration(fresh increased blood pressure, tachycardia bleeding, fresh healing, and hyperventilation due to emotional healed with sharp coaptible response and muscular exertion. borders without congestion or b. Death may be due to the defensive act healed laceration with of the woman-victim. rounded non-coaptible B. Death by female partner borders and retraction of the a. The sexual intercourse might be done edges.) in a relatively confined space like the iv. Complications of laceration back of the seat of a car. b. In case of oral sex (fellatio) wherein the PSYCHOLOGICAL CONSIDERATION male penis is placed in the mouth of the female partner. The Size and the A. During sexual excitement length of the penis may cause total or a. Local Changes – the parasymphatetic partial block of the air passage, innervations of the sex organ is from causing asphyxia. the 2nd , 3rd and 4th spinal sacral c. In case of cunnillingus (a prevented segments, and the sympathetic sexual act wherein the male licks the innervations is from the 11th thoracic female genital organ) the male partner down to the 1st lumbar. Brrr brrr brrr may blow air in the vulva and may b. Sysmetic effects: cause embolism especially when the i. Increase of pulse rate woman is pregnant. ii. Marked increase in blood d. Sadist who may not be sexually pressure making its peak satisfied by sexual intercourse but by during orgasm inflicting physical injuries to the partner iii. An increase of peripheral . flow of blood experienced as e. In concealing the crime. an increase of body warmth f. The female may die of shock as a iv. Tumescence- consequence result of the extreme trauma in case of of this peripheral flow rape. concentrating on erectile g. Hemorrhage. tissue h. Infection v. Increased respiration C. Death of BOTH partners vi. A decrease in bleeding a. May be due to the performance of the during arousal sexual act in an enclosed place with vii. A decrease of sensory carbon monoxide or asphyxiant gas. perception b. Homicide-suicide pact. Brrrr brr brr B. During Orgasm In the male, orgasm is the sensation Character of the Offended Party: resulting from the contraction of the smooth muscles of the genital and the -The person is guilty of rape if force and violence were striated muscles of the pelvic floor used regardless of the good or bad morals of the offended coinciding with ejaculation. party. In the female, during orgasm, there is contraction of the smooth muscles of Evidences of Force or Intimidation: or the uterus and rhythmic contraction of the viginal sphincter, the -Mere initial reluctance of the offended party or verbal ischiocavernousus and the pelvic floor refusal alone will not prove force. Must be a manifested musculature. Brrr brr brr and tenacious resistance.

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-Force, as an element in rape, need not be irresistible as c. Sexual act on a woman under the influence of long as it brings the desired result. sex stimulating drugs

-If the offender is the father of the girl who is of a tender -if did not deprive her of reason, not age, it is not necessary that there are signs that she put up rape (US v. Lung), BUT local courts a determined resistance. would consider this as rape because actually deprived her of reason -Employment of force is established not only by testimony of the injured girl but also by the signs of finger grips on the 2. The woman-victim is unconscious front part of her neck, on the arms and the fact that the garments worn at the time were torn and heavily stained a. Sexual act committed while the woman is on with blood. her natural sleep

- Strong evidence of force is the presence of physical b. Sexual act on a woman suffering from sleeping injures found on the person of the victim in the course of sickness - because woman is unconscious medical examination. The victim may suffer all types of physical injuries depending upon the resistance offered by c. Sexual act on a woman who is unconscious her and the degree of force applied by the offender. because she was knocked-out

Rape Committed by Employment of Intimidation -if offender inflicted physical injuries on a woman sufficient to make her - Application of threat will cause fear in the victim of the unconscious before the sexual act was done untoward consequence. If she will not accede to the will of the offender, the crime may constitute intimidation. d. Sexual act after administration of narcotics or other "knock out" drugs -Intimidation purely subjective, cannot be proven by medical evidence. 3. When the woman is under 12 years of age

Rape Committed by Depriving the Victim of Her -called statutory rape Reason or Otherwise Made Unconscious -regardless of whether or not force or intimidation 1. Deprival of Reason is applied or the child is not deprived of her reasons or otherwise unconscious a. Rape committed on insane or mentally deficient woman -even if child consented or even if child a prostitute -victim: woman, 14 years of age, feeble-minded and can only speak -reason: one must not take advantage of the mono-syllables meager intelligence and incomplete physical development of a child below the age of 12 -sexual intercourse with insane woman -multiple rapes committed by each accused was -BUT, sexual intercourse with a deaf- independent to others mute woman is not rape in the absence of proof that she is an imbecile -victim and accused must immediately be examined by the physician to have a strong -proof of mental condition of the victim medical evidence of rape, BUT lack of medical by medical findings of the physician examination of victim NOT an who needed indispensable element in the prosecution of rape. WON it will prosper depend upon the b. Rape committed while the woman is under the evidences offered. influence of alcohol or other depressant drugs -complaint for rape NOT valid unless it is a -in the absence of decided cases, also complaint by the offended party. Information not rape signed by the offended party is insufficient to 69 By 4D2014-2015

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confer jurisdiction on the court. Filing of complaint e. physical and mental development of by father of a girl who is only 14 years old, the victim sufficient compliance with RPC. -height, strength and degree Instances When Rape is Punishable by Death of muscular development of woman must be 1. When by reason or on the occasion of the rape, the noted to determine whether victim becomes insane she has capacity to resist unlawful resistance 2. When the rape is attempted or frustrated and a homicide is committed by reason or on the occasion thereof -describe mental state of victim 3. When by reason or on the occasion of the rape, a homicide is committed f. examination of the body for signs of violence Medical Evidences in Rape -signs of physical violence on 1. Evidences from the victim the body if actual force was applied -written consent from victim or guardian if not of age, if confined on correctional institution by the head of -whole body subjected for the institution inspection

-short history of the rape in writing -may use xray for bone lesions -the following must be recorded by the physician: -determine of probable age of a. date, time and place of the alleged the physical injuries-- does it commission of rape correspond to the alleged date of commission? -to determine how long has elapsed g. examination of the genitalia, after alleged including the breast commission of crime before filed -breast roughly handled or complaint or presence of finger marks, subjected herself to nipples bitten, vulva medical swelling, hymen fresh examination lacerations etc.

-place: determine which court -in the pubic hair the ff may can acquire jurisdiction be gathered:

b. date, time and place of the 1. pubic hair of examination offender

-material to the determination 2. semen and of the possible findings of the spermatozoa physician on the victim 3. blood stains c. condition of the clothings 4. body louse d. physician must observe the gait, the facial expression and the bodily and 2. Examination of the alleged offender mental attitude of the subject 70 By 4D2014-2015

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a. physical development, mental condition and 1. Disturbances in the place of commission may infer or strength affirm the statement of victim that she did offer resistance

-won offender can overpower the 2. Strands of hair, blood, seminal and other stains may be resistance offered by the victim recovered to prove consummation and struggle

b. evidence of physical injuries 3. Pieces of personal belongings of offender and/or victim may be recovered to prove consummation and struggle -whole body must be examined 4. Investigation of witnesses who may possibly be material -victim in the course of struggle may to the prosecution of the case may be conducted have inflicted injurie upon him EXAMINATION FOR SEMINAL FLUID AND c. condition of the sex organ SPERMATOZOA

-blood, seminal stain, vaginal - Semen: the viscid, albuminous fluid with faint grayish- epithelium and doderleins bacillus, yellow color, having the characteristic fishy odor, and urethral meatus moist containing spermatozoa, epithelial cells, lecithin bodies and other substances d. evidence from pubi hair -Spermatozoon: living organism, normally present in the -matted together due to blood stains or seminal fluid consisting of a head, neck and tail. From 50- seminal fluid discharge 55 microns in length. The head is ovoid and flattened when viewed in front and pearshape when viewed on the profile. -presence of body louse -The ff specimens may be examimed for seminal fluid and e. potency of the offender spermatozoa:

- defense that he is impotent 1. wearing apparel of the victim and alleged accused f. evidence of genital infection 2. vaginal smear from victim 3. Evidences form the companion of the victim 3. stains on the body of the victim and accused a. history of the incident, won they are consistent with narration of facts of victim 4. stains found at the site of the commission of the offense b. if companion helped victim when force was applied by offender, companion must be PROCEDURE: subjected to physical and medical examination for physical injuries 1. Gross Examinations

c. examination of clothings a. Inspection by means of the naked eye or with the use of the hand lens d. to determine whether the companion might have participated as an accomplice -stain is grayish-white to faint yellow in color e. mental condition, physical power, age and emotional state to determine capacity to resist b. Inspection by means of Ultraviolet light unlawful aggression from offender -to make visible small seminal stains or f. presence of alcohol or other depressants patches

Investigation of the Crime Scene: -shows bluish fluorescence

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2. Micro-chemical Examinations -test of unknown semen in the same way as blood precipitin is done -moisten portion of stained fabric with diluted hydrochloric acid solution and let soaking stay for 1/2 to 5 hrs b. Seminal Grouping depending on age of stain. Allow the liquid portion to dry on the side. Perform any of the following: -test is of value for elimination

a. Florence Test: produced by the action of -positive result does not definitely imply iodine on choline, not a proof of seminal fluid but only of that the person is owner of sperm in the presence of some vegetable or animal substance, question, negative result: totally positive result: merely presumptive evidence of small fluid, exclude alleged accused as possible negative result: in all probability it is not that of the seminal owner of semen fluid How long after sexual intercourse can spermatozoa be b. Berberio's Test: some allege this test is found in the vaginal canal? Short period of time in vagina specific for spermatic fluid, reaction probably depends on but in uterus, differing views (2 or 3 days at most, 43 hours, the presence of spermatic secretion 17 days, more than 2 weeks, 48 hrs after intercourse)

c. Puramen Reaction: based on the presence of Can a woman be raped while she is on her natural spermine in the prostatic fluid, Puramen reaction is found sleep? Occasionally it may happen, but highly improbable. to be very reliable and rather characteristic of seminal fluid Normal virgin: hard to conceive such could be committed, BUT possible to woman who had several sexual d. Acid Phosphate Test: semen produces a very intercourse and to those who have given birth high phosphate activity as compared with other body fluids Can a woman commit the crime of rape on a man? the ff are needed: "commited by having carnal knowledge of a woman" thus, no. BUT, under present laws, WOMAN CAN COMMIT 1. citrate buffer solution CRIME OF RAPE ON A MAN. (See crim :p)

2. suitable substrate Can rape cause death? Although not usual, introduction of matured male sex organ into vagina of young girl may 3. diazonium salt produce injury sufficient to produce death. Death may be due to hemorrhage brought about by laceration of vaginal 3. Microscopic Examinations canal, shock, subsequent infection such as gangrene or peritonitis. -presence of complete spermatozoon will undoubtedly infer presence of seminal fluid, although Laceration of vagina with accompanying hemorrhage can semen may be present without spermatozoa, such also occur even in adult women if man's sex organ is as in cases of aspermia (semen without exceptionally big and sexual act was done roughly. spermatozoa) or oligospermia (semen with few spermatozoa) Can husband commit the crime of rape on his wife? NO. Marriage is a license of the husband to have sexual a. Dr. Hankin's Method intercourse with his wife. Purpose of marriage is procreation and there can be no procreation if there is no b. Gaguli's Method: best way to stain sexual intercourse. spermatozoa in India However, if there is a decree of legal separation by the 4. Biological Examinations court, husband may be guilty of rape on wife. Legal a. Precipitin Test (Biological test of Farnum) separation does not dissolve the matrimonial tie between husband and wife, but merely separation in bed. -to determine whether semen is of human origin or not The husband may also be guilty of rape on his wife if he is a principal by cooperation or by inducement for the act committed by another man.

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OTHER CRIMES AGAINST CHASTITY 2. Incestuous Qualified Seduction -

A. SEDUCTION a. Brother who seduces his sister

b. Ascendant who seduces his descendant

A. QUALIFIED SEDUCTION -seduction where there is blood relationship between the seducer and the seduced. Father Art. 337, Revised Penal Code - The seduction of a virgin seducing daughter or other descendants, or over twelve years and under eighteen years of age, brother seducing sister. committed by any person in public authority, priests, house servant, domestic, guardian, teacher or any person who, in -In this type of seduction, woman seduced need any capacity, shall be entrusted with the education or not be a virgin or may be more than eighteen custody of the woman seduced, shall be punished by years of age and the penalty is higher prision correcional in its minimum and medium periods. basis: father and brother The penalty next higher in degree shall be imposed upon obliged to lead the any person who shall seduce his sister or descendant, descendant or sister to the whether or not she be a virgin or over eighteen years of path of rectitude and age. morality, but instead virtually persuader her to become Under the provisions of this Chapter, seduction is immoral or be a party to the committed when the offender has carnal knowledge of any condemnable act of the persons and under the circumstances described therein. B. SIMPLE SEDUCTION:

Types of Qualified Seduction Art. 338. Simple seduction. — The seduction of a woman who is single or a widow of good reputation, over twelve 1. Ordinary Qualified Seduction but under eighteen years of age, committed by means of deceit, shall be punished by arresto mayor. a. offended party must be a virgin Elements: b. offendede party must be over twelve years and under eighteen years of age 1. The offended party is over 12 but less than 18 years of age; c. there must be sexual intercourse between the offender and the offended party; and 2. The offended party must be single or a widow of good reputation; d. the sexual act was done through abuse of authority or confidence 3. There must be sexual intercourse done by the offender with her; and (1) those who acted with abuse of authority 4. The sexual act must be committed by means of deceit.

(a) Person in public authority  The statute making simple seduction a crime is not to punish illicit intercourse, but to punish the (b) Guardian seducer who by means of his promise of marriage, destroyed the chastity of an unmarried (c) Teahcher - need not be female of previous chaste character, and who teacher, but same school draws her aside from the path of virtue and (d) Person who, in any rectitude, and then fails or refuses to fulfill his promise. (People v. Iman) capacity, is entrusted with the

education or custody of the woman seduced

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Medical Evidences in the Crime of Seduction Art. 339. Acts of lasciviousness with the consent of the offended party. — The penalty of arresto mayor shall be  Medico-legal investigation of a victim of imposed to punish any other acts of lasciviousness seduction is practically the same as in the case committed by the same persons and the same of rape. circumstances as those provided in Articles 337 and 338.

Elements:  Medical proofs on account of the application of force, and conditions that will cause the victim to 1. The offender commits acts of lasciviousness; be deprived of her reason or otherwise unconscious are no longer relevant. 2. The offended woman must be over 12 but under 18 years of age, except when the victim is the sister or descendant of the offender;  When the issue of age of the victim becomes a problem and its determination may be proved 3. The offender commits the act by abuse of authority, through medical proofs confidence, relationship or deceit;

4. The victim must be a woman, virgin, single, or widow of  When the alleged criminal act developed into good reputation, except when she is the sister or pregnancy and birth of the child, the question of descendant of the offender where virginity is not required. paternity may be necessary. Medical Evidences in the Crime of Acts of Lasciviousness

B. ACTS OF LASCIVIOUSNESS  Like in the crimes of rape and seduction, medico-legal investigation is Acts of Lasciviousness are acts which tend to excite lust; involved in proving the lascivious act conduct which is wanton, lewd, voluptuous or lewd itself and the other elements to emotion. constitute the crime.

A. ACTS OF LASCIVIOUSNESS:  Physical injuries may be suffered by Art. 336. Acts of lasciviousness. — Any person who shall the victim on the part of the body where commit any act of lasciviousness upon other persons of the lascivious act was committed. either sex, under any of the circumstances mentioned in the preceding article, shall be punished by prision correccional.

Elements: C. ABDUCTION

1. The offender commits any acts of lasciviousness; Abduction is the carrying away of a woman by an abductor with lewd design. 2. The lascivious act is done under any of the following circumstances: Lewd design is the intent of the abductor to have sexual intercourse with the woman abducted. a. By using force or intimidation. A. FORCIBLE ABDUCTION: b. By depriving her of her reasons or otherwise unconscious; Art. 342. Forcible abduction. — The abduction of any woman against her will and with lewd designs shall be c. When the woman is under 12 years of age; punished by reclusion temporal. The same penalty shall be imposed in every case, if the female abducted be under 3. The offended party must be a person of either sex. twelve years of age.

B. ACTS OF LASCIVIOUSNESS WITH THE CONSENT Elements: OF THE OFFENED PARTY: 74 By 4D2014-2015

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1. The victim abducted is a woman; B. CONCUBINAGE:

2. The abduction is against her will; Art. 334. Concubinage. — Any husband who shall keep a mistress in the conjugal dwelling, or shall have sexual 3. The abduction is with lewd design. intercourse, under scandalous circumstances, with a woman who is not his wife, or shall cohabit with her in any B. CONSENTED ABDUCTION: other place, shall be punished by prision correccional in its minimum and medium periods. Art. 343. Consented abduction. — The abduction of a virgin over twelve years and under eighteen years of age, carried Ways of Committing the Crime: out with her consent and with lewd designs, shall be punished by the penalty of prision correccional in its 1. Keeping a mistress in the conjugal dwelling; minimum and medium periods. 2. Having sexual intercourse, under scandalous Elements: circumstances, with a woman not his wife; or

1. The offended party must be a virgin; 3. Cohabiting with her in any other place.

2. The offended party must be over 12 but under 18 years PROSTITUTION old; Prostitutes are women who, for money or profit, habitually 3. The carrying away of the offended party is with her indulge in sexual intercourse or lascivious conduct. consent; and Reasons why some women become prostitutes: 4. The taking away must be with lewd design.  Physiological and psychological traits; D. ADULTERY AND CONCUBINAGE  Economic factors;  Home and neighborhood; A. ADULTERY:  Influence of contraceptives Art. 333. Who are guilty of adultery. — Adultery is committed by any married woman who shall have sexual Medico-legal Aspects of Prostitution intercourse with a man not her husband and by the man who has carnal knowledge of her knowing her to be  Prostitution is one of the venues in spreading married, even if the marriage be subsequently declared venereal and other diseases void. Adultery shall be punished by prision correccional in  Evidences may be gathered to prove sexual or its medium and maximum periods. lascivious acts

If the person guilty of adultery committed this offense while Types of Prostitutes: being abandoned without justification by the offended 1. Call girl; spouse, the penalty next lower in degree than that provided in the next preceding paragraph shall be imposed. 2. Hustler:

Elements: a) Bar or tavern ―pick-up:

1. The woman is married; b) Street walker

2. She has had sexual intercourse with a man not her 3. Door knocker; husband; and 4. Factory Girl 3. The man with whom she had sexual intercourse knows her to be married even if the marriage has subsequently Effects of Prostitution been declared void.

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 Arrest and imprisonment; a superior officer;  Venereal infection;  Social ostracism; 2. Any warden or other public officer  Poor personal hygiene; directly charged with the care and custody of  Excessive use of alcohol; prisoners or persons under arrest who shall  Irregular habit of eating and sleeping; solicit or make immoral or indecent advances to  Demoralization and physical deterioration a woman under his custody.

If the person solicited be the wife, daughter, sister of Medical Evidence in Prostitution- Genital examination relative within the same degree by affinity of any person in required is the same as in any other sexual offense the custody of such warden or officer, the penalties shall be prision correccional in its minimum and medium periods Methods of Control: and temporary special disqualification.

1. Legalized but regulated; or Ways of Committing Abuse of Chastity:

2. Strict prohibition 1. By soliciting or making immoral or indecent advances to a woman interested in matters pending before the OTHER PERSONS INVOLVED IN THE BUSINESS OF offending officer for decision or with respect to which he is PROSTITUTION ARE PUNISHED BY THE FOLLOWING required to submit a report to, or consult with a superior PROVISIONS OF THE RPC: officer;

A. Corruption of Minors: 2. By soliciting or making immoral or indecent advances to a woman under the offender’s custody; Art. 340. Corruption of minors. — Any person who shall promote or facilitate the prostitution or corruption of 3. By soliciting or making immoral or indecent advances to persons underage to satisfy the lust of another, shall be the wife, daughter or relatives with the same degree by punished by prision mayor, and if the culprit is a pubic affinity of any person in custody of the offending warden or officer or employee, including those in government-owned officer. or controlled corporations, he shall also suffer the penalty of temporary absolute disqualification. (As amended by UNNATURAL SEXUAL OFFENSES AND SEXUAL Batas Pambansa Blg. 92). ABNORMALITIES

B. White Slave Trade: Unnatural Sexual Offenses are not only a deviation to the normal course of nature but also commonly observed Art. 341. White slave trade. — The penalty of prision mayor manifestations of sexual perversion. Most of those persons in its medium and maximum period shall be imposed upon suffering from the conditions do not exhibit criminal intent any person who, in any manner, or under any pretext, shall but manifesting aberrations which may be a subject-matter engage in the business or shall profit by prostitution or shall for the psychiatrist to treat. enlist the services of any other for the purpose of prostitution (As amended by Batas Pambansa Blg. 186.) Provisions of the Penal Code which may be Applicable to Unnatural Sexual Offenses: C. Abuse Against Chastity: 1. Grave Scandal: Art. 245. Abuses against chastity; Penalties. — The penalties of prision correccional in its medium and Art. 200. Grave scandal. — The penalties of arresto mayor maximum periods and temporary special disqualification and public censure shall be imposed upon any person who shall be imposed: shall offend against decency or good customs by any highly scandalous conduct not expressly falling within any 1. Upon any public officer who shall other article of this Code. solicit or make immoral or indecent advances to a woman interested in matters pending before 2. Immoral doctrines, obscene publications and exhibitions: such officer for decision, or with respect to which he is required to submit a report to or consult with Art. 201. Immoral doctrines, obscene publications and 76 By 4D2014-2015

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exhibitions and indecent shows. — The penalty of prision mayor or a fine ranging from six thousand to twelve 4. Any person who, not being included thousand pesos, or both such imprisonment and fine, shall in the provisions of other articles of this Code, be imposed upon: shall be found loitering in any inhabited or uninhabited place belonging to another without (1) Those who shall publicly expound any lawful or justifiable purpose; or proclaim doctrines openly contrary to public morals; 5. Prostitutes.

(2) (a) the authors of obscene literature, published with their knowledge in any 4. Unjust vexation or any other coercion: form; the editors publishing such literature; and the owners/operators of the establishment selling Art. 287. Light coercions. — xxx xxx xxx the same; xxx xxx xxx xxx xxx

(b) Those who, in theaters, fairs, Any other coercions or unjust vexations shall be punished cinematographs or any other place, exhibit, by arresto menor or a fine ranging from 5 pesos to 200 indecent or immoral plays, scenes, acts or pesos, or both. shows, whether live or in film, which are prescribed by virtue hereof, shall include those SEXUAL ABNORMALITIES which (1) glorify criminals or condone crimes; (2) As to the Choice of Sexual Partner: serve no other purpose but to satisfy the market for violence, lust or pornography; (3) offend any 1. Heterosexual- sexual desire towards opposite sex. race or religion; (4) tend to abet traffic in and use of prohibited drugs; and (5) are contrary to law, 2. Homosexual- sexual desire towards same sex. public order, morals, and good customs, established policies, lawful orders, decrees and a) Overt- persons who re conscious o their edicts; homosexual cravings, and who make no attempts to disguise their intention. (3) Those who shall sell, give away or exhibit films, prints, engravings, sculpture or b) Latent- persons who may or may not be aware literature which are offensive to morals. (As of the tendency in that direction but are inclined to amended by PD Nos. 960 and 969). repress the urge to give way to their homosexual 3. Vagrants and Prostitutes: yearning.

Art. 202. Vagrants and prostitutes; penalty. — The 3. Infantosexual- sexual desire towards an immature following are vagrants: person.

1. Any person having no apparent means of subsistence, who has the physical a) Pedophilia- a form of sexual perversion ability to work and who neglects to apply himself wherein a person has the or herself to some lawful calling; compulsive desire to have sexual intercourse 2. Any person found loitering about with a child of either sex. public or semi-public buildings or places or A Pedophile may be: trampling or wandering about the country or the streets without visible means of support; a. Homosexual pedophile- may attempt either oral or anal intercourse with his 3. Any idle or dissolute person who victim. ledges in houses of ill fame; ruffians or pimps and those who habitually associate with b. Heterosexual pedophile- may prostitutes; attempt either oral, vaginal, anal, 77 By 4D2014-2015

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intracrural intercourse as well as cunnilingus, but 6. Gerontophilia- sexual desire with elder person. attempts at vaginal penetration are most common. 7. Necrophilia- a sexual perversion characterized by erotic desire or actual sexual intercourse with a corpse. Theories Why Adults become Interested in Children: 8. Incest- sexual relations between persons who, by reason a. Emotional congruence- Children are sexually attractive of blood relationship cannot legally marry. to adult: As to Instinctual Strength of Sexual Urge:  Children are non-dominant;  Adults have low self-esteem, immaturity, 1. Over Sex: socialization to male dominance or narcissism; and a. Satyriasis- excessive desire of men to intercourse;  Unconscious impulse, compulsively to repeat child-adult sex contact to master, and his or her b. Nymphomania- strong sexual desire of women own early experience of child-adult sexual abuse. 2. Under Sex (Sexual frigidity): b. Conditioning Modeling- behavioral modeling begins with a. Sexual anesthesia- absence of sexual desire the early childhood experience, positive or negative, and is or arousal during sexual act in women. conditioned by hormonal abnormalities, child pornography and the misattribution of arousal as being only from b. Dyspareunia- painful sexual act in women. children. c. Vaginisimus- painful spasm of the vagina c. Blockage- alternative sexual gratification may become during sexual act. blocked due to poor social skills with adults of the opposite sex, anxiety about sex, unresolved oedipal conflicts, d. Old age- weakening of sexual feeling in the unavailability of or conflict with a committed partner, as well elderly. as repressive social sexual norms. As to Mode of Sexual Expression or Way of Sexual d. Disinhibition- sexual controls may become disinhibited Satisfaction: due to senility, dementia, mental retardation, psychosis, drug or alcohol, impulse disorders, situational stress, failure 1. Oralism- the use of the mouth as a way of sexual of incest avoidance, a general cultural acceptance. gratification.

4. Bestosexual- sexual desire towards animals.

a. Fellatio (Irrumation)- The female agent receives the penis of a man into her mouth and by 5. Autosexual (Self-gratification or maturbation)- it is a form friction with the lips and tongue coupled with the act of of ―self-abuse‖ or ―solitary vice‖ carried without the sucking initiates orgasm. cooperation of another person. b. Cunnilingus- sexual gratification is attained by Types of Masturbation: licking or sucking the external female genitalia

a. Conscious Type- the person deliberately c. Anilism (anilingus)- a form of sexual perversion resorts to some mechanical means of producing sexual wherein a person derives excitement by licking the excitement with or without orgasm; anus of another person of either sex.

b. Unconscious Type- the release of sexual 2. Sado-masochism (Algolagnia)- pain or cruel act as a tension may come about via the mechanism of factor for gratification. nocturnal stimulation with or without emission, which may also be considered as ―masturbation Sexual Abnormalities equivalent‖.

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As to Instinctual Strength of Sexual Urge:  Necrosadism (Lust murder) – victim dies; deviate has a strong homicidal 1. Over Sex: urge, suffering from organic brain a. Satyriasis – excessive sexual desire of men disease, a schizo, epileptic or a to intercourse psychopath b. Nymphomania – strong sexual feeling of c. Masochism (Passive algolagnia) – pain or women; ―hot‖ or ―fighter‖ humiliation from opposite sex is the primary  Both are general expressions of compulsive factor for sexual gratification neurosis. 3. Fetishism – real or fantasied presence of an object or bodily part is necessary for sexual 2. Under-sex or Sexual Frigidity: stimulation and/or gratification a. Sexual anesthesia – absence of sexual a. Anatomic – particular portions of the body arousal during intercourse in women (ex. breasts, buttocks) b. Dyspaureunia – painful sexual act in women b. Clothing – shoes, handkerchiefs, c. Vaginismus – painful spasm of the vagina undergarments, etc. during intercourse c. Necrophilic – near a dead body; may or may d. Old age – weakening of sexual feeling in the not violate dead person elderly; there is desire, but accomplishment d. Odor (Ospresiophilia) – pleasant or foul is difficult; accompanied by odd behaviour odor like exhibitionism, incest, homosexuality i. Urolagnia – sight of women urinating; sometimes, even a desire to drink the urine As to Mode of Sexual Expression or Way of Sexual ii. Coprolognia – sight of women Satisfaction: defecating iii. Mysophilia – filth or excretion 1. Oralism – use of mouth e. Pygmalionism – statues a. Fellation (Irrumation) – female receives the f. Manikinism – manikins penis into her mouth, by friction with the lips g. Narcissism – extreme admiration and love of and tongue, coupled with the act of sucking, one’s self; looking at the mirror and initiates orgasm appreciating oneself b. Cunnilungus – licking and sucking the h. Negative fetish – marked dislike for things external female genitalia i. Saboteur fetish – deviate does damage c. Anilism (Anilingus) – licking the anus of while he gets satisfaction (ex. cutting clothes another; form of sexual perversion or hair)

j. Incendiarism – from setting fire 2. Sado-masochism (Algolagnia) – pain or cruel act k. Vampirism – sight of blood a. Flaegellation – act of whipping or being whipped As to the Part of the Body: b. Sadism (Active algolagnia) – infliction of pain on another is necessary or sometimes 1. Sodomy – sexual act through anus the sole factor in sexual enjoyment 2. Uranism – fingering, fondling with breast, licking i. Cannibalism – biting without flesh- parts of the body, etc. eating, but with presumed unconscious 3. Frottage – compulsive desire of a person to rub wish to consume his sex organ against some body parts of another ii. Love bites – superficial punctuate (ex. rubbing or pressing organs against women’s contusions seen usually at the side of buttocks in crowded places and pretends it is the neck, breast, other body parts ―accidental‖) caused by forcible sucking of the 4. Partialism – special affinity to certain part of the mouth (teeth guarded by the lips) female body; usually, intercourse is merely applied to the loose tissue secondary to satisfy the sexual desire; differs

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from frottage in that there may not only be 1. Transvestism (Sexo-esthetic inversion; Psychical rubbing but actual intercourse hermaphroditism; Metamorphosis sexualis paranoia) – male derives pleasure from wearing female apparel and vice versa; generally As to Visual Stimulus: harmless insofar as they have no desire to assault anyone, but merely to attract attention 1. Voyeurism – compulsion to peep to see persons 2. Transexualism – identify themselves with the undress or perform other personal activities and opposite sex as completely as possible and to usually, masturbates in excess afterwards; discard forever their anatomical sex; hate their ―Peeping Tom‖ genitalia that sometimes they attempt to castrate 2. Mixoscopia (Scoptophilia) – watching a couple or mutilate themselves, take sex hormones or undress or during their sex intimacies subject themselves to surgery 3. Intersexuality – genetic defect wherein an individual shows intermingling of the As to Number: (sexual deviation because more than two characteristics of both sexes including physical persons are participating) form, reproductive organs, sexual behaviour a. Gonadal agenesis – testes or ovaries have 1. Troilism (Menage a trois) – three persons are never developed; determined very early in participating in sexual orgies where the usual fetal life activity may be fellatio, kissing the buttock, b. Gonadal dysgenesis – external sexual ―suixante-neuf‖ or 69, coitus; ―eternal triangle‖ structures are present but at puberty fail to 2. Pluralism – group of persons participate in sexual develop orgies; two or more couples perform intercourse i. Klenefetter’s syndrome – male type in one room and may agree to exchange for where the anatomical structure is male, ―variety’s sake‖ during the ―sexual festival‖ but the nuclear sexing is female

(Chromatin positive); XXY Other Sexual Deviates: chromosomes ii. Turner’s syndrome – structurally and 1. Coprolalia – need to use obscene language to phenotypically female but the ovaries obtain gratification; sometimes, go beyond are small; sterility with the absence of uttering by making some writings and sketches the second X chromosomes on the walls of toilets c. True hermaphroditism – bisexuality, having 2. Don Juanism – applied by psychiatrists to both ovaries and testicles; nuclear sex is describe characteristics of promiscuity and usually female; sex character may be making seduction of many women as part of his neutral or whichever is dominant career; cannot find anyone to be a permanent d. Pseudohermaphrodite – anatomically of one companion sex but the sex character is that of the 3. Indecent exposure (Exhibitionism) – wilful opposite sex exposure in a public place of one’s genital organ i. Male pseudohermaphrodite – in the presence of others, usually of the opposite gonads are testicles but the character sex; with or without masturbatory act; women is effeminate may expose themselves as in ―bubble and fan‖ ii. Female pseudohermaphrodite – dances and the ―strip tease‖ acts in night clubs gonads are ovaries but the character is  People v. Aparici (G.R. 13375): Dancer in a masculine burlesque show in a night club was apprehended and charged for immoral exhibition because her act of dancing only CHAPTER XXII wearing nylon panties and patches on her PREGNANCY breasts corrupted those minds which were susceptible to immoral influence. Introduction

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Commencement: from time egg cell is fertilized and Instances Why Some Women Claim Pregnancy Even if terminates at the time such product is expelled or delivered None Exists:

Duration: 270-280 days from first day or onset of last 1. Ground for suspension of death sentence in a menstruation; inasmuch as some authorities consider more woman than two weeks as the life span of the spermatozoa in the 2. Lawful plea in mitigation when charged with theft vaginal canal, it is hard to ascertain the exact date of the – kleptomania may be brought about by her fertilization; no synchrony between coitus and fertilization temporary insanity due to conception 3. Ground for widow’s larger claim  Abnormally Prolonged Gestation – extends to 300 4. Claim for the posthumous child days 5. For black-mailing purposes or inducing a man to  Minimum Period of Gestation Compatible with marry her Viability of Child – a child born at 180 days of gestation may live; child born before this period may be born alive but is not viable or capable of Instances Why Some Women Deny the Existence of living Pregnancy:  Methods of Estimating the Date of Expected Delivery: 1. No ground to become pregnant – unmarried, 1. From the date of the first day of the last divorced, living separately from husbands; to menstruation, add seven days and count three defend moral and social reputation months backward. 2. Defense when accused of infanticide or abortion 2. Count forward nine calendar months from the 3. Marriage inducement date of the first day of the last menstruation and add one week. Medical Evidences of Pregnancy: 3. Count forty weeks or ten lunar months from the date of the first day of the last menstruation. A. Presumptive or Probable Signs and 4. Determination of the level of the fundus of the Symptoms uterus 1. Cessation of menstruation – it must be noted that 5. MacDonald Method – distance from the a woman is capable of menstruating even during symphysis pubis up to the fundus of the uterus pregnancy during the first three months; nursing in centimters divided by 3.5 gives the age in mother may not menstruate month gestation 2. Morning sickness 6. Date of the quickening – count ahead in 24 3. Changes in the breast weeks multigravidas and 22 weeks in 4. Progressive enlargement of the abdomen – at primagravidas from date of quickening; found the end of the third month, the fundus of the not to be reliable uterus is at the level of the brim of the pubic bone 5. Changes in color of the vagina and softening of the cervix Legal Importance:  Different Signs to Show Changing of Color: 1. Pregnancy is a ground for the suspension of the a. Jacquemin-Chadwick’s Sign – pale violet execution of the death sentence in a woman. discoloration of the anterior wall of the (Art. 83, RPC) vagina 2. A conceived child is capable of receiving b. Hegar’s Sign – bi-manual examination of donation. (Art. 742, NCC) the gravid uterus shows extreme 3. A conceived child may exercise civil rights. (Arts. softening of the cervix 40-41, NCC) c. MacDonald’s Sign – softening of the 4. Concealment of the woman that she is pregnant isthmus, fundus of the uterus is anteflex at the time of the marriage is a ground for d. Goodell’s Sign – cervix of the uterus feels annulment of the marriage. (Arts. 85-87, NCC) as hard as the tip of the nose, no pregnancy; but when as soft as the lips, uterus is gravid

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6. Funic soufflé or Umbilical soufflé – whistling d. Read the results after two sound synchronous with the fetal heart minutes. 7. Ballottement – feeling perceptible to the fingers 4. Interpretation of results: on giving sudden impulse to the child through the a. No agglutination (homogeneous) – neck of the uterus; hand placed on abdomen pregnant 8. Braxton-Hick’s Sign – rhythmical contraction and b. Agglutination (granular) – not pregnant relaxation of the uterus, perceptible to the hand 5. Sensitivity – often possible within 5 days on the abdomen after missed menstrual period; pregnancy 9. Bladder irritability or Frequent urination – usually will be diagnosed 12 days after the missed at second month menstrual period 10. Capricious appetite 6. Remarks – fresh morning urine is preferable 11. Abnormality in pigmentation – especially in and suitable; if result is doubtful, repeat test abdomen and perineum after a few days 12. Easy Fatigability – due to weight of the gravid uterus and insufficiency of nutrient and oxygen supply to the tissues due to a deviation of a B. Gravindex HCG Slide Test – same principle and portion to the growing fetus procedure involved as PST; Gravindex is merely a trade name

B. Positive Signs and Symptoms of Pregnancy: 1. Hearing of the fetal heart sounds (Mayor’s Sign) Signs of Pregnancy in the Dead: (additional findings to – compared to ticking of a watch under a pillow; the objective signs already mentioned) rate is 120-140 beats per minute 2. Outlining of the fetal parts – through palpation 1. Presence of ovum or fetus 3. Movement of the fetus (Quickening) – at the fifth 2. Findings on the uterus itself month 3. Corpus Luteum – usually well-developed at the 4. X-ray Examination time of delivery

Laboratory Test for Pregnancy: Proofs of Pregnancy: 1. Laxity of abdominal wall. A. Pregnancy Slide Test (PST) 2. Presence of Striae of pregnancy on the 1. Principle – an agglutination-inhibition abdominal wall. reaction is used to demonstrate the 3. Perineum is lax with a scar if there was previous hormone human chorionic gonadotropin laceration. Fourchette is markedly restracted. (HCG) which is excreted into the urine 4. Vestige only of the hymen is present. during pregnancy 5. Breast is lax with enlarged nipples. 2. Regeants: 6. Vaginal examination showed previous laceration a. Pregnancy Slide Test antiserum – of cervix. human HCG antiserum from rabbit b. Pregnancy Slide Test antigen – HCG - Superfecundation is the fertilization made by latex suspension, chemically-bound separate intercourses of two ova which have 3. Procedure: escaped at the same act of ovulation. a. Place 1 drop of urine then 1 drop of - Superfoetation is the fertilization of two ova PST antiserum 1 in one of the circles which have escaped at different acts of ovulation. on the test slide and mix thoroughly. - Spurious Pregnancy is an imaginary pregnancy b. Add 1 drop of PST antigen 2. usually observed among women nearing Shake well and mix well. menopause or younger women who are very c. Carefully agitate the slide with a desirous of having children. The patient may circular motion to ensure that the imagine fetal movement which is in reality a fluid revolves slowly within the muscle contraction. circle. Diagnosis of Fetal Death (Proof of Fetal Death):

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1. The size remains stationary even after the lapse 10. Cervix is the uterus is flabby, patulous and may of a number of weeks or months. be torn. 2. Endocrine test for pregnancy is negative on more 11. Presence of lachial disahcrage. than one occasion. 12. Evidence of placenta, umbilical cord and new- 3. Cessation of fetal movement after they have born child. been felt. 13. Positive pregnancy slide test. 4. Absence of fetal heart sounds after repeated and prolonged examination. CHAPTER XXIV 5. Palpation of softened macerated fetal head with ABORTION bones freely movable on each other and the scalp hanging over a loose sac. - Abortion is the expulsion of the contents of a 6. Breasts cease to be enlarged and become soft gravid uterus anytime before full term while and flabby. others consider it as the forcible expulsion of the product of conception anytime before the age of - In the Philippines, menstruation begins at the age viability. Viability is at the point at which the of 12-14 years old and ceases at the age of 45. fetus is potentially able to live outside of the As long as the woman starts menstruating, she mother’s womb, albeit with respiratory aid. has the potential of becoming pregnant. Principal Elements of Abortion: CHAPTER XXIII 1. That the expulsion of the product of conception is DELIVERY induced. 2. That the fetus dies either as an effect of the - Delivery is the process by which a woman gives violence used, drug administered or the fetus birth to her offspring. was expelled before the term of its viability. - The study of delivery is important because proof of delivery is necessary in judicial action on: Clinical Types of Abortion: legitimacy, abortion, infanticide, concealment of 1. Missed Abortion – an ovum destroyed by birth, and in slander or libel. hemorrhage into the choriospace usually before the 4th month of the pregnancy. Methods of Delivery: 2. Threatened Abortion – hemorrhage without 1. Natural Route – expulsion of the products of dilatation of the internal os. conception through the normal passage, that is 3. Inevitable Abortion – hemorrhage with dilatation through the vaginal canal. if the internal os and the presence of rhythmical 2. Surgical Route – expulsion of the products of pain. conception is not through normal openings of the 4. Incomplete Abortion – not all products of female generative tract but through some artificial conception had been expelled from the uterus; openings brought about by surgery. fragments or portions of which is retained. 5. Complete Abortion – the whole product of Signs of Recent Delivery: conception is expelled. 1. Languid look, with pulse and temperature slightly increased. Causes of Abortion: 2. Peculiar odor which is present up to the 10th day 1. Death of the fetus of confinement. 2. Abnormality of the uterus 3. Changes in the breast (sensation of tightness in 3. Emotional condition breasts and milk may be expressed). 4. Aborifacent drugs 4. Flaccidity of the abdominal wall. 5. Trauma whether direct or indirect 5. Linea Albicantes (Striae of Pregnancy) present in 6. Hormonal deficiency the abdominal wall. 7. Acute specific fever and high temperature 6. Presence of Linea Negra. 7. Uterus is enlarged and palpable. Provisions of the RPC on Abortion: 8. Laxity of the perineum with possible tear. 1. Intentional Abortion (Elements) 9. Vaginal canal is lax and with possible lacerations. a. That the woman is pregnant.

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b. That violence was applied, or drug was woman brought about by the post-mortem administered, or a person acts upon such contraction of the uterine muscles. pregnant woman. c. That the effect of such violence, drug, or Reasons why some people procure Abortion: acts of the offender, the fetus dies or is 1. Preserve the life and health of the pregnant expelled. woman. d. That the offender has the intention to abort 2. Terminate prematurely illegitimate pregnancy in the pregnant woman. order to conceal the dishonor of the woman. 3. Financial difficulty. 2. Unintentional Abortion (Elements) 4. To preserve body form. a. The woman must be pregnant. b. Violence was applied on such pregnant How Abortion is Induced or Procured: woman without the intention of aborting her. 1. By General Violence – includes intentional c. The woman aborted as a result of the violence, exerting strong physical efforts and violence. other forms of strenuous and exhaustive exercises. 3. Abortion practiced by the woman herself or by 2. By Local Violence – violence is applied in any her parents (Elements) portion of the generative organ. This is usually a. The woman is pregnant. resorted to when general violence and the use of b. Abortion is intended to be committed. drugs fails to give the desired result. Local c. Abortion is induced by: violence may be applied by the pregnant woman (1) The pregnant woman herself. herself, by the physician, midwife or the parents. (2) Other persons with the consent of the 3. By the Use of Drugs pregnant woman herself. 4. By Surgical Intervention (3) The parents of the woman, or either of 5. Modern Methods like Amniocentesis and them for the purpose of concealing her Vacuum Suction dishonor and with the consent of the Complications of Abortion woman herself. 1. Immediate Untoward Effects: 4. Abortion practiced by a physician or midwife and dispensing abortive (Elements) a. Shock – may be due to the laceration a. The woman is pregnant. of the uterus or the adjacent organ like the bladder, rectum, intestine or blood b. The physician induced or assisted in vessels. The injury may be due to the causing the abortion with the use of introduction of instruments or the scientific knowledge. c. The acts done by the physician or midwife application of hot fluid or corrosive was intended to cause abortion. substances. b. Hemorrhage and Anemia – Adherent Kinds of Abortion: placental tissue, infection, presence of 1. Spontaneous Abortion – occurs without any foreign bodies and atony of the uterus form of inducement or intervention. may cause hemorrhage for failure of 2. Induced Abortion – this will not take place had it the uterine muscles to contract. not been for some form of inducement or intervention. Induced abortion may be: c. Embolism: (1) Air Embolism (2) Fat a. Therapeutic Abortion – abortion purposely Embolism (3)Thrombo-Embolism (4) done to preserve the life of the mother. Bacterial Embolism b. Criminal Abortion – done without d. Infection – Pathogenic organism may therapeutic indication but with criminal intent be introduced into the uterus and is punishable by law. produce systemic symptoms. If death occurs, signs of toxemia may be - Post-mortem Abortion is the expulsion of the observed at autopsy. product of conception after death of the pregnant

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e. Poisoning – Lysol, corrosive 2) Examine the external os sublimate, iodine solution are for softness, tear and frequently used for vaginal douche and discharge. may cause systemic poisoning. 3) Note the size of the f. Vaginal Inhibition – Sudden dilatation uterus, its consistency of the cervix due to the introduction of and location. some objects may cause sudden c. Examination of the instrument used for collapse due to reflex inhibition of the the presence of blood, placental tissue vagus nerve. or fetal parts. g. Perforation of the bladder or any of d. History – Note the state of health the neighboring organs beforehand after abortion. Inquire as to 2. Delayed Untoward Effects the motive of the abortion and history of having ingested with abortives. a. Infection – The infection may originate from the vaginal canal or from the e. Signs of previous pregnancy: blood stream coming from a focus of 1) Condition of the breasts infection in the body. 2) Laxity of the abdominal b. Fistula Formation – Communication wall between the vagina or the uterus with the rectum or bladder may be an after 3) Paleness of integument effect of perforation due to instrumentation. 4) General body weakness 5) Presence of c. Sterility – Plugging of the fallopian characteristic lochial tubes, infection of the ovaries may discharge and odor cause sterility. d. Pelvic Adhesion – Infection and 6) Palpability of the uterus trauma may cause the uterus or vagina and laceration of the cervix and perineum to become adherent to the surrounding organs or tissues. f. Examination of the expelled product of conception Medical Evidences of Abortion 1) Blood examination for 1. Medical Evidences of Abortion in the Living maternity and paternity a. Presence of external signs of violence in the form of contusions, abrasions, 2) Marks of instrumentation hematoma, open wounds of whatever 3) Signs of physical form on the body surface if induced by violence general violence. If violence is applied locally in the generative tract, injuries of 4) Proof of viability or non- whatever form or description may be viability of the fetus seen therein 5) Presence of abortives b. Examination of the generative tract: and other toxic materials in the fetal blood 1) Appearance of the external genitalia and 6) Presence or absence of vagina may show malformation laceration, contusion, 7) Completeness of the abrasions and other placenta marks of instrumentation. 8) Other identifying marks

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g. Laboratory test for pregnancy following: (1) infection (2) stage of pregnancy (3) other h. Testimony of the physician who complication of abortion. completed the abortion or of other persons who witnessed the criminal act e. Biological test 2. Medical evidence of abortion in the dead: 1) Paternity test  Aside from the evidences of abortion in 2) Test for the living which may be found in the pregnanc dead, the following may be observed at f. Examination of some autopsy: untoward effects of a. Evidence of abortion: (1) infection, instrumentation toxemia or bacteremia (2) embolism (3) fistulae  This will include the formation (4) pelvic presence of adhesions. punctured wounds in the placenta, Therapeutic Abortion presence of  An abortion which the law allows under remnants of the some justifications placenta inside the uterine cavity, Legal Justification to Therapeutic Abortion presence of Art. 11, No. 4, Revised Penal Code perforation of the  uterus. o Any person who, in order to avoid an evil or injury, does b. Examination of stomach and its contents: an act which causes damage to another, provided that the  Abortifacent drugs following requisites are and other irritants present: (1) that the evil may be found sought to be avoided actually inside the stomach exists; (2) that the injury upon chemical feared be greater than that examination. done to avoid it; (3) that there be no other practical and less c. Examination of the kidneys harmful means of preventing and other organs for it. irritants  In the performance of an abortion, two  Like the stomach lives are involved, namely, the life of and its contents, the mother and the life of the fetus. other organs like One life must be sacrificed to save the the kidneys, liver, life of another in case of therapeutic spleen must be abortion. subjected to a qualitative and  The evil sought to be avoided is the quantitative danger on the life of the mother if such examination for the pregnancy will be allowed to continue. presence of irritant Such evil may be infection, organic poisons. condition or abnormality existing on the person of the woman and which under d. Examination of uterine ordinary course of event will cause contents - Remnant of the death. product of conception for the

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 In the evaluation as to whose life must 2. Abortion in order to be justifiable must be be spared, it is a common concept that performed to save the life or to preserve the the life of the mother must be preferred health of the mother. But modern advancement than that of the unborn child. A of medical science has reduced the number of conceived child is not definitely sure of diseases which will endanger the life and health if its independent existence while the pregnancy is allowed to progress to full term. A mother has already manifested real life. physician must exercise due diligence in considering a disease or a combination of Grounds for Therapeutic Abortion: diseases or conditions as grounds for the 1. Cardio-vascular conditions as congestive heart therapeutic abortion. failure, auricular fibrillations, repeated 3. Abortion must be performed openly in a hospital hemoptysis, paroxysmal tachycardia. to avoid suspicion that it was done for some 2. Renal conditions as chronic nephritis, previous cause other than to save the life of the mother. eclampsia, pyelitis, tuberculosis Abortion performed in a private clinic wherein 3. Pulmonary conditions as advanced tuberculosis. there are no sufficient facilities to cope with 4. Blood condition as severe anemia. emergency which may arise in the course of the 5. Gynecological conditions as refractory chorea operation may be a ground for malpractice. gravidarum. 6. Organic nervous conditions as psychosis. 4. It is advisable to have the opinion of other 7. Miscellaneous conditions as diabetes, competent physicians as to the justifiability of exophthalmic goiter. such therapeutic abortion. The opinion of one 8. Hereditary conditions as insanity. might be influenced by prejudice and misjudgment. Is the eminent danger of committing suicide on account of her existing pregnancy be a ground to induce therapeutic 5. Enlightened and expressed consent must be abortion to save the life of the woman? obtained from the woman herself if she has no impediment to give consent. It is advisable to  Hatchard v. State (48 N.W. 380 Wis.) a woman have also the consent of the husband, inasmuch who threatened to commit suicide unless she as abortion will affect marital relationship. could be relieved of the child with which she was pregnant does not present such a necessity for Reasons Why It Is Difficult to Prosecute Physicians the performance of the operation to save the life Committing the Crime of Abortion of the woman. The intention of the law applies 1. The crime is performed clandestinely by an only to cases where death of the mother might intelligent being who is fully aware of his criminal reasonably be anticipated from natural causes act. unless the product of conception is destroyed. 2. The physician has several medical reasons to  In a case cited by Camp and Purchase (Practical justify his act. There is no hard and fast rule in Forensic Medicine, p. 32, 1957), a married medicine. He may claim that there is medical woman with unstable character finding herself justification to such abortion because the woman pregnant, threatened to commit suicide. The is suffering from a disease which might imperil physician whom she repeatedly made her threat her life if pregnancy will be allowed to progress to during her unexpected visits referred her to a full term. psychiatrist who recommended abortion. The operation was carried on by a reputed 3. In most cases, the products of conception gynecologist but unfortunately, the patient died of removed which may be utilized as corpus delcti gangrene of the uterus. The coroner did not in the crime is lost. recommend prosecution because the operation 4. The pregnant woman herself is in connivance was done to save the life of the mother. with the physician and it is quite difficult to let her Safeguards to be Observed by Physician in Performing testify truthfully as to the actual happening. She, Therapeutic Abortion: herself, is in pari delicto to the crime of criminal abortion. 1. The lawful abortion must be performed by a licensed physician or surgeon. 87 By 4D2014-2015

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5. Medical society seems to have a lukewarm a. Still Birth – when the child has not breathed or attitude in helping the state prosecute the has not shown any sign of life after being abortionist. completely born.

CHAPTER XXV  Causes of Still Birth BIRTH 1. Immaturity 2. Congenital diseases Legal Importance of the Study of Birth or malformation 3. General debilitating 1. Birth determines personality: diseases (acute  Art. 40,Civil Code: Birth determines specific infection, personality; but the conceived child toxemia, kidney shall be considered born for all disease, acute liver purposes that are favorable to it, disease, septicemia) provided it be born later with the 4. Local disease of the conditions specified in the following generative organ article. (syphilis; ablation  Art. 41, Civil Code: For civil purposes, placenta, intra- the foetus is considered born if it is placental alive at the time it is completely hemorrhage, or delivered from the mother’s womb. extensive infarction; However, if the foetus had an intra- kind of the cord; uterine life of less than seven months, placenta previa it is not deemed born if it dies within 5. Accidents in the twenty-four hours after its complete delivery delivery from the maternal womb. 6. Violence, either 2. Appearance of a child is a ground for the deliberate or revocation of donation: accidental at birth.  Art. 760, Civil Code: Every donation b. Live-Birth – the child after birth exhibited clear inter vivos, made by a person having signs of vitality and viability is not necessary. no children or descendants, legitimate or legitimated by subsequent marriage,  In law, the presumption is every newborn or illegitimate, may be revoked or child found dead was born dead. The reduced as provided in the next article, burden of proof lies on those who declare by the happening of any of these otherwise. To have a child acquire a events. (1) if the donor, after the personality distinct as that of the mother, donation has legitimate or legitimated there must be proof of life after complete or illegitimate children, even though separation from the mother’s womb. they be posthumous. 3. Proof of live-birth must first be shown before  Proofs of Live Birth death of the child by the prosecution in the case 1) Presence of Heart Action and of infanticide: Circulation  Art. 255, RPC – Infanticide: The 2) Movement of the Child and Crying penalty provided for parricide (reclusion perpetua to death) in article 246 and for 3) Presence of Respiration murder (reclusion temporal in its maximum period to death) in article 4) Examination of the Stomach and 248 shall be imposed upon any person Intestine who shall kill any child less than three 5) Changes in the Middle Ear days of age. (Wredin’s Test: The middle ear of Birth may be: the a child before birth is filled with gelatinous, embryonic connective

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tissue. This disappears after the birth of the child.)) 6) Condition of the Skin 7) Marks of Violence 8) Changes in the Umbilical Cord 9) Condition of the Heart and Blood Vessels Proof of Live-Birth can be deduced in the following: 1) Well-developed signs of breathing 2) Presence of air or food in the stomach 3) Changes having taken place in the region of the umbilicus If born alive, how long did the child survive? If Born Alive, How Long Did the Child Survive?  It is not possible to determine the exact  It is not possible to determine the exact length of length of time the child has lived after birth, time that the child has lived after birth. but an approximate idea may be formed  An approximate may be formed after after consideration of the following points: consideration of the following points: 1. Changes in the skin 1) Changes in the skin a. At birth – body of the child is 2) Presence of caput succedaneum bright-red in color; covered with vernix caseosa which 3) Changes in the umbilical cord may be present up to 2 days 4) Changes in the circulation b. At a week’s time – normal color of the skin Signs of Maturity of the Child at Birth c. First 3 days after birth – 1. Length of the fetus – 50 centimeters exfoliation of the skin in the abdomen 2. Weight – 3.0 kilos 2. Presence of Caput Succedaneum 3. Lanugo hair almost disappeared a. If present – the child was born with head presentation 4. Limbs and body plump b. There are color changes in 5. Face lost its wrinkles the course of its absorption c. The Caput lasts up to the 7th 6. Skin covered with vernix caseosa day 7. Head covered with hair about 2 inches long

Proof of Live-Birth can be deduced in the following:

1. Well-developed sings of breathing 2. Presence of air or food in the stomach 3. Changes having taken place in the region of the umbilicus

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If the crime penalized in this article be committed 3. Changes in the Umbilical Cord by the mother of the child for the purpose of a. Mummification of the cord concealing her dishonor, she shall suffer the does not occur if the child is penalty of prision correccional in its medium and submerged in water after maximum periods, and if said crime be birth committed for the same purpose by the maternal b. A mummified cord may again grandparents or either of them, the penalty shall be soft after continuous be prision mayor. soaking in water 4. Changes in the Circulation Penalties a. Umbilical artery begins to contract – about 10 hours  If killing done by parents, grandparents, or other after birth direct ascendants  penalty: parricide b. Umbilical vein and ductus  If killing done by any other person  penalty: venosus obliterate – 4th and murder 5th day  If killing done by mother or maternal c. Ductus arteriosus – on the 3rd grandparents for the purpose of concealing her day dishonor  lenient penalty d. Foramen ovale closes on the 2nd or 3rd month Problems:

Signs of maturity of the child at birth 1. Infancy is the period in the life of a child from birth up to one year. 1. Length of the fetus – 50 cm a. Why is the crime of infanticide applied 2. Weight – 3 kg only to kiiling of less than 3-day old 3. Lanugo hair almost disappeared infant rather than within the 1st year of 4. Limbs and body plump the life of the child? 5. Face lost its wrinkles 2. When the head and neck of the child are already 6. Skin covered with vernix caseosa (waxy or out of the birth canal and the child has breathed cheese-like white substance found coating the through the lungs but the child is not yet capable skin of newborn human babies) of independent existence and it was deliberately 7. Head covered with haird about 2 inches long put to death, is it considered infanticide? 8. Nails project from the fingers; toe-nails reach 3. When a child was born less than 7 months of only to the end uterogestaton. With modern neonatal 9. One or both testes are in the scrotum, or labia management, the child had all the chances to have close the vulva live. After a few hours after birth, the chold was 10. Lower end of femur may show center of deliberately killed. Is the killing a case of ossification about 0.6 cm in diameter infanticide? Can the crime of infanticide be committed on someone who is not yet a person as contemplated by law? CHAPTER XXVI INFANTICIDE (NEONATICIDE) Motives for committing infanticide Infanticide - The killing of a child less than 3 days old. 1. To conceal dishonor (single, widowed, estranged RPC. Art. 255. Infanticide. — The penalty from husband, living separately from husband) provided for parricide in Article 246 and for 2. Financial reason murder in Article 248 shall be imposed upon any 3. Desired number of children has already been person who shall kill any child less than three attained (substitute for ineffective family days of age. planning) 4. Congenital abnormality of the child 5. Mental abnormality of the parent

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6. Belief that child will bring bad luck to the family a. Presence of marks of physical violence (fingernail marks at the neck) b. Abrasion Criminological Characteristics of infanticide c. Contusion d. Hematoma 1. Most often committed by the mother e. Lacerated wounds 2. Almost always committed at home f. Ligature or pressure marks on the neck 3. Crime scene: no manifest disturbance, no 2. Examination of mouth and upper portion of the witnesses, no noise, no outcry alimentary tract (the tubular passage extending 4. Trauma applied is so minimal from the mouth to the anus, through which food 5. A newly born child found dead was born dead. is passed and digested) Burden of proof that a living child has been killed a. Can show signs of poisoning is placed on the prosecution 3. In case of poisoning, the organs must be preserved and sent to a competent toxicologist for proper analysis What must be proven by evidence 4. Laceration or other injury of the upper portion of air passage 1. That the child was born alive 5. Lungs may show signs of drowning 2. That the child was deliberately killed 6. Fracture of the bones, laceration of the internal 3. That the child killed was less than 3 days old organs

How Infanticide is committed

1. By omission or neglect CHAPTER XXVII a. Failure to ligate the umbilical cord (if PATERNITY AND FILIATION not cut or not tightly ligated, child may

bleed to death) Paternity – civil status of the father with respect to the b. Failure to protect the child from heat child begotten by him and cold (depriving the child of necessary clothing) Filiation – civil status of the child in relation to its mother or c. Failure to take the necessary help of a father midwife or a skilled physician d. Failure to supply the child with proper Legal importance of determining paternity and filiation food (child starved to death) e. Failure to remove the child from the 1. For succession mother’s discharge which resulted to a. Right of legitimate children is different suffocation from that of illegitimate childrem 2. By commission 2. For enforcement of naturalization and a. Inflicting physical injuries (use of immigration laws kitchen utensils, hard or sharp objects) a. Naturalized citizens give ipso facto b. Suffocation Philippine citizenship to their minor c. Strangulatioin children. Thus, the minors must prove d. Drowning (child disposed in a that they are legitimate children of the sewerage disposal in a creek) naturalized citizen. e. Poisoning b. A minor child of a naturalized or f. Burning permanent resident alien may be given g. Delibreate exposure to heat cold (direct the right to land in the Philippines upon sunshine, basin of cold water) proof that he is a legitimate child of the latter.

Post-mortem findings in cases of infanticide

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(Hello blockmates, the book used provisions from the Civil legitimacy or may have been sentenced as an Code re: Paternity and Filiation but I think we now use the adulteress. Family Code for this so I will put here the relevant FC d. If the marriage is terminated and the mother provisions instead. Thanks.) contracted another marriage within three hundred days after such termination of the former Kinds of Children marriage, these rules shall govern in the absence of proof to the contrary: 1. Legitimate Children i. A child born before one hundred eighty days after the solemnization of the a. Who are considered legitimate children subsequent marriage is considered to i. Children conceived or born during the have been conceived during the former marriage of the parents marriage, provided it be born within three ii. Children conceived as a result of artificial hundred days after the termination of the insemination of the wife with the sperm of former marriage; the husband or that of a donor or both are ii. A child born after one hundred eighty likewise legitimate children of the days following the celebration of the husband and his wife, provided, that both subsequent marriage is considered to of them authorized or ratified such have been conceived during such insemination in a written instrument marriage, even though it be born within executed and signed by them before the the three hundred days after the birth of the child. The instrument shall be termination of the former marriage. recorded in the civil registry together with e. The legitimacy or illegitimacy of a child born after the birth certificate of the child. three hundred days following the termination of b. Grounds to impugn legitimacy of a child: the marriage shall be proved by whoever alleges i. That it was physically impossible for the such legitimacy or illegitimacy. husband to have sexual intercourse with f. The action to impugn the legitimacy of the child his wife within the first 120 days of the shall be brought 300 days which immediately preceded the i. Within 1 year from the knowledge of the birth of the child because of: birth or its recording in the civil register, if 1. the physical incapacity of the the husband or, in a proper case, any of husband to have sexual his heirs, should reside in the city or intercourse with his wife; municipality where the birth took place or 2. the fact that the husband and was recorded. wife were living separately in ii. If the husband or, in his default, all of his such a way that sexual heirs do not reside at the place of birth as intercourse was not possible; or defined in the first paragraph or where it 3. serious illness of the husband, was recorded, the period shall be two which absolutely prevented years if they should reside in the sexual intercourse; Philippines; and three years if abroad. ii. That it is proved that for biological or iii. If the birth of the child has been other scientific reasons, the child could concealed from or was unknown to the not have been that of the husband, husband or his heirs, the period shall be except in the instance provided in the counted from the discovery or knowledge second paragraph of Article 164; or of the birth of the child or of the fact of iii. That in case of children conceived registration of said birth, whichever is through artificial insemination, the written earlier. authorization or ratification of either g. The heirs of the husband may impugn the filiation parent was obtained through mistake, of the child within the period prescribed in the fraud, violence, intimidation, or undue preceding article only in the following cases: influence. i. If the husband should died before the c. The child shall be considered legitimate although expiration of the period fixed for bringing the mother may have declared against its his action;

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ii. If he should die after the filing of the (3) continuous years prior to the filing of complaint without having desisted the application for adoption and maintains therefrom; or such residence until the adoption decree iii. If the child was born after the death of the is entered, that he/she has been certified husband. by his/her diplomatic or consular office or any appropriate government agency that 2. Legitimated Children he/she has the legal capacity to adopt in a. Children conceived and born outside of wedlock his/her country, and that his/her of parents who, at the time of the conception of government allows the adoptee to enter the former, were not disqualified by any his/her country as his/her adopted impediment to marry each other may be son/daughter: Provided, Further, That the legitimated. requirements on residency and  Legitimation shall take place by a certification of the alien's qualification to subsequent valid marriage between adopt in his/her country may be waived parents. The annulment of a voidable for the following: marriage shall not affect the legitimation. 1. a former Filipino citizen who  Legitimated children shall enjoy the same seeks to adopt a relative within rights as legitimate children. the fourth (4th) degree of  The effects of legitimation shall retroact to consanguinity or affinity; or the time of the child's birth. 2. one who seeks to adopt the  The legitimation of children who died legitimate son/daughter of before the celebration of the marriage his/her Filipino spouse; or shall benefit their descendants. 3. one who is married to a Filipino  Legitimation may be impugned only by citizen and seeks to adopt those who are prejudiced in their rights, jointly with his/her spouse a within five years from the time their cause relative within the fourth (4th) of action accrues. degree of consanguinity or affinity of the Filipino spouse; or iii. The guardian with respect to the ward 3. Adopted Children after the termination of the guardianship a. Who may adopt and clearance of his/her financial i. Any Filipino citizen of legal age, in accountabilities. possession of full civil capacity and legal iv. Husband and wife shall jointly adopt, rights, of good moral character, has not except in the following cases: been convicted of any crime involving 1. if one spouse seeks to adopt moral turpitude, emotionally and the legitimate son/daughter of psychologically capable of caring for the other; or children, at least sixteen (16) years older 2. if one spouse seeks to adopt than the adoptee, and who is in a position his/her own illegitimate to support and care for his/her children in son/daughter: Provided, keeping with the means of the family. The However, that the other spouse requirement of sixteen (16) year has signified his/her consent difference between the age of the adopter thereto; or and adoptee may be waived when the 3. if the spouses are legally adopter is the biological parent of the separated from each other. adoptee, or is the spouse of the adoptee's v. In case husband and wife jointly adopt, or parent; one spouse adopts the illegitimate ii. Any alien possessing the same son/daughter of the other, joint parental qualifications as above stated for Filipino authority shall be exercised by the nationals: Provided, That his/her country spouses. has diplomatic relations with the Republic b. Who may be adopted of the Philippines, that he/she has been living in the Philippines for at least three 93 By 4D2014-2015

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i. Any person below eighteen (18) years of age who has been administratively or a. Adulterous Children: judicially declared available for adoption; - children conceived in an act of ii. The legitimate son/daughter of one adultery or concubinage. spouse by the other spouse; iii. An illegitimate son/daughter by a qualified b. Sacrilegious Children: adopter to improve his/her status to that -children born of parents who have of legitimacy; been ordained in sacris (priest and nun). iv. A person of legal age if, prior to the adoption, said person has been c. Incestuous Children: consistently considered and treated by -children born by parents who are the adopter(s) as his/her own child since legally incapable of contracting valid marriage minority; because of their blood relationship. v. A child whose adoption has been previously rescinded; or d. Manceres: vi. A child whose biological or adoptive -children conceived by prostitutes. parent(s) has died: Provided, That no proceedings shall be initiated within six Civil Liability of Persons Guilty of Crimes Against Chastity: (6) months from the time of death of said  Art. 345, Revised Penal Code: parent(s). Persons guilty of rape, seduction or abduction shall also be sentenced: 4. Illegitimate Children 1. To indemnify the offended woman. a. Children conceived and born outside a valid 2. To acknowledge the offspring, marriage are illegitimate, unless otherwise unless the law should prevent him from provided in this Code. so doing. 3. In every case to support the offspring. B. Illegitimate Children  Those who were born out of lawful wedlock or  The adulterer and the concubine may also be after a competent time after its dissolution. sentenced, in the same proceeding or in a separate civil proceeding, to indemnify for 1. Natural Children: damages caused to the offended spouse.  In cases of multiple rape, the offenders may not a. Natural Children (Proper): be required to recognize the offspring. -those born outside wedlock of parents who, at the time of the conception of the former,  If the woman abused is married, the child born were not disqualified by any impediment to marry subsequently cannot be recognized and support each other (Art. 269, Civil Code). cannot be demanded from the offender.

b. Natural Children by Legal Fiction: -those children born out of void Evidence of Paternity and Filiation marriages or those born of voidable marriages after the decree of annulment. A. Medical Evidences

c. Natural Children by Presumption: 1. Parental Likeness: -those natural children acknowledged -Heredity transmits traits and by the father or the mother separately if the characteristics from parents acknowledging parent was legally competent to to the offsprings. contract marriage at the time of conception. -There must be some gross manifestation of the children 2. Spurious Children: which may be in common  Illegitimate children who are not natural. with the father.

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2. Blood Grouping Test: 4. Evidences from the Father: -blood type of the child is a a. Proof of Physical Potency possible product of the and Fertility: parents  not conclusively -medical show that the child is born by examination must such parents. be done whether -blood type of the child is not husband is capable the possible product of the of erection. parents  conclusively show -examination of that the child is not that of the spermatozoa in the husband. seminal fluid is necessary to 3. Evidences from the Mother: determine fertility. a. Proofs of Previous -presence of Delivery: disease, congenital -supposed mother or acquired may be subjected abnormalities, etc. to an examination may be factors that to determine the may bring about presence of signs impotency or of previous sterility. childbirth and b. Proof of Access: which are -physician must compatible with the determine the age of the child. health and vigor of b. Proofs of Physical Potency the father, the and Fertility: presence of -the woman may disease, which may be manifesting bring about his some acquired or incapacity to congenital defect perform sexual wherein impotency intercourse. may be inferred. -fertility may be B. Non-medical Evidences inferred from the presence of other 1. Record of birth in the Civil Registrar, pregnancies and or by an authentic document or a final the absence of judgment (Art. 265, Civil Code). organic 2. Continuous possession of the status abnormalities of the of a legitimate child (Art. 266, Civil generative system. Code). c. Proof of Capacity to have 3. Any other evidences allowed by the Access with the Husband: Rules of Court and special laws (Art. -general physical 267, Civil Code). examination of the woman is CHAPTER XXVIII necessary to PATERNITY AND FILIATION ON NON-CONVENTIONAL determine whether METHODS OF PROCREATION she is physically capable of having  The standard method of reproduction is the sexual intercourse introduction of the male sperm into the with her husband. generative organ of a female through sexual intercourse followed by fertilization, growth and 95 By 4D2014-2015

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development of the conceptus and its Selection of Donor of Semen: subsequent delivery.  In A.I.D., the selection of the appropriate donor of  However, modern advancement of medicine semen resides in the physician. modified the conventional method as a solution  If the child born becomes defective which can be to some specific problems of reproduction. traced from a physician’s negligence or carelessness in choosing the donor, the A. Artificial Insemination physician may be held liable.  A medical procedure by which the semen is  Obligations imposed on a physician in the introduced into the vagina by means other than selection of donors: copulation for the purpose of procreation. 1. Proper screening must be made of  ―therapeutic insemination‖ – more suitable term the donor. for the procedure. 2. Donor must have the racial characteristic and physical proportion Artificial Insemination Classified According to the as those of the husband and wife and Source of Semen: the blood type must be compatible with A.B.O. and Rh genotype of the wife. 1. A.I.H. (Artificial Insemination Homologous, 3. Physician must ensure that the Artificial Insemination Husband) – Sperm comes identity of the donor is not known to the from the husband. parents and vice versa. 4. Complete physical examination with 2. A.I.D. (Artificial Insemination Donor, Artificial standard test for syphilis and Insemination Heterologous) – Sperm comes from gonorrhea is obtained not more than 1 a donor other than the husband. week before the seminal fluid is collected. 3. A.I.H.D. (Artificial Insemination Husband Donor, Polled Donor Semen) – Donor semen Precautions to be Observed by the Physician in Performing comes from the husband and a third party donor. Artificial Insemination:

Medical Indications for Artificial Insemination: 1. Physician should make certain by reasonable testing that the procedure is medically indicated 1. For A.I.H.: for the couple. Husband is infertile and such a. When the deposition of the condition is permanent. husband’s semen within the vagina is by coitus; b. When the infertility is due to poor 2. Physician should establish by proper motility, paucity or otherwise defective evaluation that the couple is emotionally stable sperm cells or too small a volume of and psychologically suited for this type of the ejaculant. parenthood.

2. For A.I.D. or A.I.H.D.: 3. Physician must use all reasonable precautions a. Absolute male sterility in selecting the donor. (Azoospermia); b. Oligospermia – Less than 10-15 4. Physician must, under no circumstances million sperm per cc. of semen with except by court order, reveal the fact of artificial infertility of long duration; insemination or the identity of the donor or of the c. Hereditary disease in the husband couple to each other or to other persons. making propagation inadvisable for eugenic reason; or 5. Physician must use freshly donated sperm or d. An Rh blood incompatability is frozen semen. expected to cause an abnormal baby on situations where other techniques to 6. The insemination procedure must be overcome such incompatability are not performed by the physician in accordance with applicable. the currently accepted techniques.

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7. Full and valid consents and releases should be  Process begins with injections into the oocyte obtained in writing from all parties involved, and (ovum) donor of a hormone known as each consent must be an ―informed consent.‖ gonadotropin, which induces super-ovulation.  Approximately 30 hours later, the oocytes are Status of the Child Born by Artificial Insemination: removed from the ovary by laparoscopy, a surgical procedure accomplished by inserting two 1. In A.I.H. – child is a legitimate child of the thin glass tubes into the ovary through a small husband. incisiom in the abdomen. 2. In A.I.D., with consent of the husband – child is  The removed oocytes are placed in a Petri dish legitimate although the fertilization semen is not or a test tube containing growth medium from the husband. simulating the environment of the woman’s body. 3. In A.I.D., without consent or against the will of  The oocytes are then fertilized by a sperm which the husband – child is illegitimate has been held in vitro.  The resulting conceptus, after it divides and Consent on A.I.D.: grows for a few days until it reaches the  The consent and release for any future claim blastocyst stage (stage at which the embryo must be obtained by the physician from all normally enters the uterus), is then inserted parties in writing. through the vagina and cervix into the uterus  Consent of wife is necessary to avoid being held where it is implanted at a proper time in liable for an assault. menstrual cycle.  Consent of husband is necessary to avoid the  After successful transplantation, the woman wife being charged with adultery carried the blastocyst to term.  Consent and release of the donor should be obtained for the unrestricted use of the semen Possible Situations in In Vitro Fertilization: supplied  Donor should also certify in writing that he will 1. The ovum removed from the wife is fertilized make no effort to ascertain the identity of the by the husband’s sperm and the resulting zygote couple involved. is implanted into the wife’s uterus.  If the donor is married, consent of the wife must also be obtained 2. The ovum removed from the wife is fertilized by the sperm coming from a third party (sperm B. In Vitro Fertilization donor) and is implanted into the wife’s uterus.  Also known as test tube baby, it is the fertilization of the egg cell by the sperm cell extracted from 3. The ovum coming from a third party (ovum the respective donors placed in an artificial donor) is fertilized by the husband’s sperm and medium and after reaching a certain stage of the blastocyst is implanted into wife’s uterus. cellular division and development: 1. Implanted into the woman’s uterus, 4. The ovum taken from the ovum donor is or fertilized by the sperm coming from the sperm 2. Gestation (development of the donor and the blastocyst is implanted into the embryo to a child) in an artificial womb. wife’s uterus. o Ectogenesis (extra corporeal 5. The ovum removed from a single woman is gestation) – fertilized by the sperm taken from a male donor, whenever the the blastocyst is implanted into the single embryo is allowed woman’s uterus. to develop in an artificial womb 6. The ovum removed from the wife is fertilized by the husband’s sperm and the blastocyst is Procedure of In Vitro Fertilization: implanted to a ―host‖ or surrogate.

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7. The ovum coming from the wife is fertilized Problems in In Vitro Fertilization: artificially by the sperm coming from the sperm donor and the blastocyst is implanted into the 1. The probability that the child to be born will be surrogate’s uterus. defective. -Some of the probable causes of the 8. The ovum coming from the ovum donor is birth of a defective child: fertilized by the sperm coming from the husband a. Administration of hormone and the blastocyst is placed into the surrogate’s to the prospective source of uterus. ovum b. Mechanical manipulation 9. The ovum coming from the ovum donor is of the oocyte and embryo fertilized by the sperm coming from the sperm c. Mistake in the ―screening donor and the blastocyst is implanted into the process‖ or selection of the surrogate’s uterus. best ovum for fertilization d. Defective donors (sperm Basis of Legality of In Vitro Fertilization: or ovum)

 No person shall be deprived of life, liberty, or -A physician need not fear too much of property without due process of law, nor shall the possible liability on account of a any person be denied the equal protection of the defective child because: laws. (Art. III, Sec. 1, 1987 Constitution) a. The plaintiff will find  From the term ―liberty‖ emanates the right of difficulty in proving privacy negligence because birth  The right of privacy means the right to be left defects are well known to alone. It is the right of an individual to the occur in normal or natural possession and control of his own person, free pregnancies. from all restraints or interference of others, b. Prospective parents are unless by clear and unquestionable authority of normally briefed of the law. It is the right of parents or guardians to potential risks of the establish their family life as they see fit. procedure before their  Other implication of the right of privacy which consent is obtained. may be the basis of legality of in vitro fertilization: c. In vitro fertilization has yet o Right of procreation – A ban on the use to evolve a clearly defined of in vitro fertilization would prevent an standard of care by which to individual from using means to fulfill his determine whether the action or her procreative mission. of the physician is negligent. o Right of marital privacy – Prohibition of d. The plaintiff is required to in vitro fertilization as a way to have meet the difficult task of children will mean government proving negligence. intrusion into the marital bedroom in search of evidence for violating the law. -Social Problem in In Vitro Fertilization: o Right to decide whether to bear or  The progress of science beget – The right of a person to must be geared towards determine whether to carry or not to improvement in the quality of carry a product of conception, to be or men and not towards not to be a mother or to raise or not to retrogression or deterioration. raise a family. o Right of self-determination – ―Every 2. Problem of surrogate mother: human being of adult age and of sound -Reasons why the services of a mind has the right to determine what surrogate mother may be necessary: shall be done on his own body.‖ a. Necessity

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 Genetic mother is unable refused to take the child from to carry the child to term the surrogate mother. because of disease or injury. e. Can the couple enforce the  Genetic mother may contract in the event that the believe either that she is too surrogate mother committed old to safely carry a child to other breaches? term, or that the child may be f. Is there a need to go born with abnormalities. through the procedure of  Genetic mother may adoption in order to possess deleterious genetic legitimatize the child at birth? traits which may be passed on to the child. -Potential solution to the problems of  Couple is unable to adopt surrogate mother: a child. a. By contract – There must be a contract specifically b. Convenience mentioning the rights and  A woman may not want to duties of each party. interrupt her career during b. By legislation – The court the gestational period. is bound to enforce the legislation unless found to be -Motivation of a woman to become a unconstitutional. (better surrogate mother: solution) a. Altruistic motive b. Material consideration 3. Problem of the status of the child born by in  If the surrogate mother vitro fertilization (please refer to possible merely receives all expenses situations in in vitro fertilization portion above) incurred in carrying the fetus a. Situation 1 – Child is legitimate to term and then delivered: b. Situation 5 – Child is illegitimate altruistic motive c. Situation 2 and 3 – Child may still be If payment is beyond the legitimate if there is consent of the reasonable cost of sterile party to the in vitro fertilization. If pregnancy, it is tantamount to child is not considered legitimate, ―rental‖ for the use of the adoption may be done uterus. The status that the child may be a problem may -Problems that may arise in the change if the in vitro agreement in the use of surrogate fertilization was done with the mother for gestational purpose: knowledge and consent or a. If the surrogate mother against the will of the sterile decided to abort the child spouse. contrary to the wish of the d. Situation 4, 6, 7, 8 and 9 – Genetic genetic parents. parents are different from the b. The surrogate mother may gestational mother. Adoption may be a decide to keep the child after legal remedy provided there is no birth rather than surrender impediment to the application of the him to the genetic parents. procedure, otherwise a special c. The parents may decide to legislation may be necessary. abort the child because of the fear that abnormality may be C. Other Non-Conventional Methods of Procreation present but the surrogate mother refuses to do so. 1. Artificial Inovulation – The removal of an d. If the child was born with unfertilized egg from a woman and placing it on abnormality and the parents the reproductive tract of another woman. 99 By 4D2014-2015

Summary of Legal Medicine FROGLETS NOTES Book by Solis

2. Embryo Transplantation – The removal of a fertilized egg from a woman’s uterus to transfer to that of another woman’s uterus. 3. Parthenogenesis (―Virgin Birth‖) – A type of sexual reproduction whereby the unfertilized egg with 23 chromosome compliment doubled its content to become a diploid cell that starts dividing as if it is a fertilized egg without the

intervention of a male sperm cell, the resulting offspring is a female. 4. Cloning – A type of sexual reproduction whereby the nucleus of a female egg is removed (enucleation) which contains the genetic material and replaced with the nucleus of a body (somatic) cell of the same or another woman (renucleation). The renucleated egg is then placed in a uterus for gestation and normal development. Resulting offspring is genetically identical to the parent.

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