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Legal Medicine LEGAL MEDICINE -Legal medicine is the professional and academic discipline which concerns itself with legal aspects of medical science, medical practice, and other health care delivery problems (American College of Medicine). -In some jurisdiction, legal medicine is synonymous with forensic medicine, but strictly legal medicine should include both forensic medicine and medical jurisprudence. FORENSIC MEDICINE -Forensic medicine is a specialized area of medical practice, concerned with the relationship between medicine and the law. More specifically, forensic medicine is the scientific use of medical and paramedical specialties, as well as various dental, psychological, biological, chemical, and mechanical techniques, in investigating the causes of a person’s death, disability, injury, or disease. -In some jurisdiction, forensic medicine is interchangeable with medical jurisprudence or legal medicine. - In the Philippine jurisdiction, forensic medicine and medical jurisprudence are branches of legal medicine. - It compasses several specialties, such as forensic pathology, odontology and psychiatry. A major focus is medicolegal death investigation, but medical forensic specialist also work in areas such as malpractice, investigation of human rights violations, violence against women and children, and litigation related to occupational and environmental health issues. (United States National Library of medicine, National Institute of Health). - Forensic medicine is the branch of medical science that uses medical knowledge for legal purposes; it is the application of medical knowledge of questions of law. In order to practice forensic medicine, one must first be a medical doctor and then must have special post-graduate training in forensics. MEDICAL JURISPRUDENCE -Medical jurisprudence is a specialized area of legal practice concerned with the relationship between the medicine and the law. - It is the application of principles of law as they relate to the practice of medicine, to the obligations of the practitioner to his patient, and to the relations of physicians to each other and to society in general.(Dorland’s illustrated Dictionary, 1994.) FORENSIC MEDICINE MEDICAL JURISPRUDENCE - That branch of medicine dealing with the - That branch of law dealing with the application application of medical knowledge to the of medical knowledge to the purposes of the purposes of the law law. - It refers to medicine as it relates to the practice - It covers legislation and civil suits (malpractice, of law such as the application of medical consent and others) being an application of knowledge in identification or criminal legal principles in medical practice. investigations. FORENSIC PATHOLOGY -Forensic Pathology is the subspecialty of pathology that focuses on the medicolegal investigation of sudden or unexpected death. Note: FORENSIC PATHOLOGIST -They are medical doctors who serve as medical examiners and sometimes as coroners. -They determine the cause and manner of death through autopsies and death investigation which include, however not limited to violent deaths such as homicides, accidents and suicides. Other categories are suspicious deaths, sudden and expected deaths, deaths in children and infants, prisoners, persons under the care of an institution, situations where illicit drugs or alcohol may have contributed to the death, deaths occurring during or in close proximity to surgical procedure, deaths in individuals not under the care of a physician or when the private physician is unavailable or unwilling to certify the death certificate, and death when there is suspicion or a public health threat. They are licensed physicians who have completed medical school, medical internship, three years of pathology residency, and one year of forensic pathology fellowship. - They have passed general medical certification exams as well as pathology (anatomic pathology and/or clinical pathology) and forensic pathology board examinations administered by the Board of Pathology or in case of the Philippines, Philippine Society of Pathologists, Inc. - He is also an expert witness in the court of law, testifying in variety of civil and criminal cases involving death or injury. BRANCHES OF PATHOLOGY -Pathologist is a specialized type of physician whose studies a vast variety of natural diseases and works in a hospital, a laboratory of a private setting. TWO TYPES OF PATHOLOGY: A. ANATOMIC PATHOLOGY A.1. Surgical Pathology -Surgical pathologist examines organs and tissues for the purpose of making a diagnosis to assist the primary physician caring for the patient. A.2. Autopsy Pathology (Forensic pathology) -Autopsy Pathologist performs autopsy examinations on individuals, usually in the hospital setting. Purpose: To determine the cause of death and to answer questions raised by the treating physicians and family members. Most hospital deaths are from natural causes. -A Forensic Pathologist is often called to investigate the possibility of an unnatural death, one not caused exclusively by natural disease. A.3. Diagnostic Cytology -Cytologist examines individual cells and groups of cells under the microscope to diagnose various benign and malignant conditions. B. CLINICAL PATHOLOGY - It includes the various laboratory departments such as clinical microscopy, hematology, microbiology, immunology, serology, clinical chemistry, toxicology and transfusion medicine (the blood bank). Note: CLINICAL PATHOLOGIST - is commonly the director of the hospital laboratory. Pathologists tend to specialize in one or a few areas because there is simply too much to know for one person to be an expert. FORENSIC SCIENCE - Forensics science may be generally defined as the application of scientific, technical or other specialized knowledge to assist courts in resolving questions of fact in civil and criminal trials. - Its primary objective is the even-handed use of all the available information to determine the facts and ultimately the truth no matter who they are instructed by. CRIMINALISTICS - It is the science and profession dealing with the recognition, collection, identification, individualization, and interpretation of physical evidence, and the application of the natural sciences to law-science mtters.( Barnett, Criminalistics, 2002) - It is based on the theory of transfer: when two objects meet, some evidence of that meeting generally can be established and verified at a later time. - The following may be included under the criminalistics umbrella: a. Biology ( includes biochemistry, molecular biology and DNA analysis) Forensic Biochemistry and Molecular biology is important in the identification of fluids and their chemical composition. Forensic biochemist and Molecular biologist are responsible for the analyses of evidentiary material of biological origin (ie. Body fluids, human tissue and hair) with the aim of accomplishing the highest possible degree of human identification. Purpose: To link an individual’s presence on a crime scene and link relevant items containing genetic material related to crime scenes. They also attend post mortems for evidence and present expert evidence in court. DNA (DEOXYRIBONUCLEOTIDE) ANALYSIS -It is the fundamental building block for an individual’s entire genetic makeup. It is a component of virtually every cell in the human body. It is a powerful tool because each person’s DNA is different from every other individual’s except for identical twins. b. Chemistry c. Toxicology d. Microscopy e. Analysis of controlled substances f. Fire debris g. Explosive residues h. Hairs i. Fibers j. Glass k. Soil l. Paint and other materials m. Fingerprints and other impressions (footwear and tire tracks) FINGER PRINT ANALYSIS -It includes Automated Fingerprint identification System (AFIS) technologies methods for developing latent fingerprints, and fingerprint comparison and identification. n. Questioned documents -It is sometimes called “Forensic Document Examination” which includes several different types of examinations like comparing handwriting with the known handwriting samples to determine whether or not a document was written by a specific individual; o. Tool mark and Firearms identification -refers to the use of class and individual markings made by tools or firearms to attribute markings to specific tools or bullets and/or cartridge cases to specific weapons. p. Reconstruction patterns -It uses physical evidence and its analysis to help put together past events in time and/or space. It typically requires the documentation and analysis of patterns such as bloodstain or glass fracture patterns. FORENSIC ENTOMOLOGY -It specifically deals with the study of insects and related arthropods in relation to legal evidence. Forensic Entomologist use insect to help reconstruct the circumstances ( e.g. time of death, movement of the body) surrounding human death. FORENSIC ODONTOLOGY -Forensic Odontologists are dentists and oral pathologists who most often consult for medical examiner offices. They identify people from dental structures and analysis/comparisons of bite marks. FORENSIS TOXICOLOGY -Forensic Toxicologists are scientists who provide services in postmortem cases (support death investigations), human performance cases (driving under the influence of alcohol and/or drugs) and workplace testing ( mandatory job-related alcohol/drug testing). FORENSIC ANTHROPOLOGY -Forensic Anthropology is the study of human bones to determine the factors that will help understand who the victim is and how the death occurred. The forensic anthropologist
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