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REVIEW NOTES IN FORENSIC MEDICINE

I. INTRODUCTION:

This handout is intended to familiarize the participants with the principles of medicine as applied to law, and to correlate the same to other
scientific investigative procedures leading to the solution of crimes.

HISTORICAL BACKGROUND (Philippines)

 1858 – The first textbook in Legal Medicine and its practice by Dr. Rafael Genard Y Mas, who is a Spanish chief army physician was
published and is entitled “Manual deMedecina Domestica.”
 1871 – Legal medicine was included in the curriculum of the college of medicine in the University of Santo Thomas.
 March 31, 1876 – The “ medico titulares” which took charge of the public sanitation and medico-legal aid for the purpose of justice
was created by the King of Spain in his Royal Decree No. 188.
 1894 – The “Medico Titulares of Forensic” which is about the regulation and its practice was published.
 1895 – A medico-legal laboratory was established in Manila to handle medico-legal cases.
 1898 – During the American regime, the Spanish Forensic Medicine System was preserved.
 1901 – The provincial, insular and municipal board of health (Acts 157, 307, 308) was created by the Philippine Commission which is
about the medico-legal duties of “medico titulares” of the Spanish regime and its assignment to the health officers of the respective
areas.
 1908 – Legal Medicine was taught in all medical schools in the Philippines.
 1919 – The Department of Legal Medicine and Ethics of the University of the Philippines was created under Dr. Sixto de Los Angeles
as the chief.
 January 10, 1922 – The Department of Legal Medicine and Ethics of the University of the Philippines with its Department head was
incorporated to the Philippine General Hospital.
 March 10, 1922 – The Philippine Legislature enacted Act No. 1043 which became incorporated in the administrative code as Section
2465 and provides that the Department of Legal Medicine and Ethics of the University of the Philippines became a branch of the
Department of Justice.
 December 10, 1937 – The creation of the Division of Investigation under the Department of Justice was done by the Commonwealth
Act 181 in which a medico-legal section was under the division with Dr. Gregorio T. Lantin as the head.
 March 3, 1939 – The Department of Legal Medicine and Ethics of he University of the Philippines was abolished and its functions
were transferred to the medico-legal section of the Division of Investigation.
 July 4, 1942 – A medico-legal section of the Manila Police Department was created under Dr. Pablo Anzures.
 1945 – The Provost Marshall of the United States Army created the criminal investigation laboratory with the Medical Examiner as an
integral part under Dr. Mariano Lara as the Chief Medical Examiner.
 June 28, 1945 – the Division of Investigation was reactivated under the Department of Justice.
 June 19, 1947 – The Bureau of Investigation was created by the Republic Act 157. then, the Bureau of investigation was made the
National Bureau of Investigation by the Executive Order from the President of the Philippines. The medico-legal section was created
under the National Bureau of Investigation with its head Dr. Enrique V. de Los Santos.

The existence of the medico-legal division in the criminal laboratory of the G-2 of the Philippine Constabulary also occurred.

At that time, all provincial, municipal and city health officers, physicians of hospitals, health centers, asylums, penitentiaries and colonies
became the ex-officio medico-legal officers.

In remote places, the service of a “Cirujano Ministrante” or the Sanitary Inspector may perform the medico-legal work if a registered physician
is not available.

The Medico-Legal System

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The medico-legal system adopted in a particular country depends upon the laws of such country. The ones commonly used are the Medico-
legal Office System, Medical Examiner System and the Coroner System. Some countries employed the three systems at the same time but other
countries preferred two or a certain system.

A. Medico-legal Office System

This is the medico-legal system used in the Philippines at present which is handled by a Medical Jurist or Medico-legal Officer who is a
registered physician duly qualified to practice medicine in the Philippines. The National bureau of Investigation, Manila Police Department and
the Philippine Constabulary had their own medico-legal offices with their own respective Medico-legal Officers. The Medico-Legal Officer is
the one who investigates medico-legal cases of death, physical injuries, rape and other sexual crimes. His duty is to examine the victim of
assistant, to make a report and to appear in court as expert witness when summoned by the proper authorities.

In spite of several medico-legal cases in the Philippines, the medico-legal investigation is still insufficient because of the following reasons:

1. Look of proficiency by the physician in medico-legal work

2. Inadequate facilities
3. inadequate means of transportation and communication
4. Lack of sufficient training in medico-legal work by the police investigator and other law enforcement agent
5. Insufficient physician and personnel to handle medico-legal cases

B. Medical Examiner System

In some parts of the United States, the Medical Examiner System is the preferred, although the Coroner System is still used in some states.
The Medical Examiner System is handled by the Chief Medical Examiner who is a Doctor of Medicine and appointed by the Mayor from the
classified lists compiled by the Civil Medical Examiner is on a 24-hour work with clerical staff always present.

The duty of the Medical Examiner is to investigate the cause of death especially violent death or other circumstances leading to the death of
the victim. The Medical Examiner on duty after being informed by the police officer of a certain crime that needs to be investigated will go to
the place of the crime, interview witnesses, examine the victim and then take specimens if any, for examination.

During trial, the Medical Examiner will then present his medical report to the court.

C. Coroner System

The Coroner System probably originated in England, although there are no records of its actual origin. In common law, the office of the
Coroner is a very ancient one. The name “Coroner” is probably derived from the title “Custodes Placitorum Coronne” or “Keeper of he King’s
Pleas” as mentioned in Articles of Eyre of 1194. Magna Charta (1215) refers to the coroner as “Coronator”. A report although there is evidence
that coroner existed in Australia, United States and other colonies of England.

II. GENERAL CONSIDERATION:

a. Evidence – is the means, sanctioned by law, of ascertaining in a judicial preceding the truth respecting a matter of fact.
b. Forensic Medicine – is a branch of medical science which deals with application of medical knowledge to elucidate legal problems.
c. Law – Criminal Law – Civil Law – Remedial Law -
d. Legal -
e. Legal Medicine – is a branch of medicine which deals with application of medical knowledge to the purposes of law and justice.
f. Medical -
g. Medical Jurisprudence – is a branch of law which deals with the organization and regulation of the medical profession.
h. Medicine - Internal Medicine – Surgery – Pathology – Gynecology – Obstetrics –

1. Forms of medical Evidence:

a. Real or autopic
b. Testimonial

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c. Experimental
d. Documentary

2. Methods of Processing Evidence:

a. Photography and sound recording
b. Sketching
c. Description
d. Testimony of witnesses

3. Kinds of Evidence Necessary for Conviction

a. Direct Evidence
b. Circumstantial evidence

Kind of Witnesses:

1. Expert witnesses - opinion of a witness regarding a question of science, art or trade, when he is skilled therein, may be received in
evidence.

2. Ordinary Witnesses - all persons who, having organs of sense, can perceives, and perceiving, can make their their perception to others.,
may be witnesses.

III. Medico-legal Aspect of Identification

A. When an unknown body is found, the following should be noted by the unvestigator to facilitate idebtifcation.
1.. Place where body is found
2. Time when found
3. Cause of Death
4. Time when death occurred
5. Approximate age
6. Supposed profession
7. Description of the body

B. Points of Identification applicable to both living and dead before onset of decomposition.

1. Occupational marks
2. Race .
a. Color of skin
b. Shape of skull
c. Shape of skull .
3. Stature
4. Teeth
5. Tattoo marks
6. Weight
7. Deformities
8 Birth marks
9. Injuries leaving permanent result
10. Moles
11. Scars
12. Tribal marks
13. Sexual organ
14. Blood group
15. Fingerprints

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IV. MEDICO LEGAL ASPECTS OF DEATH (CRIM)

A. DEATH – is the termination of life. It is the complete cessation of all the vital functions without possibility of resuscitation.

B. TYPES OF DEATH:

1. Brain death – death occurs when there is irreversible coma absence of electrical brain activity and complete cessation of all
the vital functions without possibility of resuscitation.
2. Cardio-Respiratory Death – death occurs when there is continues and persistent cessation of hearth action and respiration.

C. KINDS OF DEATH:

1. Somatic or Clinical Death – state of the body in which there is complete, persistent and continues cessation of the vital functions
of there brain, hearth and lungs which maintain life and health.
2. Molecular or Cellular Death – 3-5 hours later death of individual cells.
3. Apparent Death or State of Suspended Animation – not really death but merely a transient loss of consciousness or temporary
cessation of the vital functions of the body on account of disease, external stimulus, it may arise especially in hysteria, uremia,
catalepsy and electric shock.

D. SIGNS OF DEATH:

1. Cessation of heart action and circulation.

2. Cessation of respiration.
3. Cooling of the body (Algor Mortis)
 Post-mortem caloricity – is the rise of temperature of the body due to rapid and early putrefactive changes or some
internal changes. (Observed in the first two or some internal changes. (Observed in the first two (2) hours after death)
4. Insensibility of the body and loss of power to move.

5. Changes in the skin:

a.) Livid discoloration due to the gravitation of blood.

b.) Loss of elasticity of the skin:
 Post –mortem Contact Flattening – body becomes flattened on areas which are in contact with the surface it rests.
c.) Opacity of the skin.
d.) Effect of application of heat.

6. Changes in and about the eye:

a.) Loss of corneal reflex.

b.) Clouding of the cornea.
c.) Flaccidity of the eyeball.
d.) Pupil is in the position of rest, (non-reactive)
e.) Ophthalmoscopic Findings.

“Tache Noir de la Sclerotique - a spot which maybe oval or round triangular with the base towards the cornea and may appear in the
selera a few hours after death. (yellowish-black ) due to thin.

E. Changes in the Body Following \death

1. Stage of Primary flaccidity

2. Stage of Rigor Mortis (post-mortem rigidity cadaveric or death struggle of muscles
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3. stage of secondary flaccidity

4. Putrefaction or decay
5. Cadaveric

F. Changes in the Blood

1. Coagulation of blood
2. Post mortem lividity
a. Hypostatic lividity- inside blodd vessels
b. Diffusion lividity - outside the blood vessels in the tissue of the
body
G. Causes of Death

1. Natural Death
2. Violent Death - a. Accident, b. Negligent, c. Infanticidal, d. Parricidal ,
e. Murder, f. Homicidal
3. Judicial Death

V. Medico-Legal Aspect of Physical Injuries

A. Physical Injuries - effects of the application of stimulus to the body

B. Causes of Physical Injuries
1. Physical Violence
2. Heat or cold
3. Electrical energy
4. Chemical energy
5. Radiation
6. Change in the atmospheric pressure

C. Injuries brought about by physical violence - lead to production of wound

1. Wound - the solution of the natural continuity of tissue of the living body
2. Vital reaction - sum total of all reactions of tissue tissue and organs for which activities of living cells are necessary.
3. Defense wounds - result of instinctive reaction of self-protection

D. Classification of Wounds:

1. As to severity
a. Mortal wounds
b. Non-mortal wounds

2. As to Kinds of Instruments Used

a. Brought about by blunt instrument
b. Brought about by sharp instruments
1. Sharp-edge instrument
2. Sharp-pointed
3. Sharp-edge and pointed
c. Brought about by tearing force
d. Brought about by change of atmospheric pressure
e. brought about by heat and cold
f. brought about by infection

3. As to manners of Inflection
a. Hit by means o9f bolo, blunt instrument, etc.

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b. thrust stab
c. Tearing or stretching
d. Gunpowder explosion
e. Sliding or rubbing

4. As regards the Depth

a. Superficial
b. Deep - 1. penetrating, 2. Perforating

5. As regards the relation of the site of the application of force and location of
injury
a. Coup injury - injury found at site of the application of force
b. Contre Coup - injury found opposite the site of the application of
force.
c. Coup Contre Coup - injury found at the site and also opposite the
application of force
d. Locus minoris resistancia - injury found both at the site or opposite
the site of the application of the force but in some areas offering least
resistance to the force applied.
e. Extensive Injury - injury involving a greater area beyond the site of
the application of force.

6. As to Regions of Organs

7. Legal Classification
a. Mutilation - intentional act of lapping or cutting of any part of the
living body
b. Serious Physical Injury - injury that will incapacitate the subject
for more than 90 days
c. Less Serious Physical Injury - Injury that will require medical
attendance for 10 days or more but not more than 30 days
d. Slight Physical Injury & Maltreatment - Injury that will
incapacitate subject and require medical attendance from 1 to 9 days

8. As to the Types of Wounds:

a. Closed Wounds - when there is no breach of continuity of skin or
mucous membrane.
1. Superficial Closed Wounds
a. Epithelia - extraversion of blood in the subcutaneous tissue
or mucous membrane
b. Contusion or bruise - wound not on the surface of the skin
but in the substance of the true skin and the substance of
cellular tissue-color is red and sometimes purple soon after
the injury.

2. Change in the Color of Contusion:

a. 4-5 days color changed to green
b. 7-10 days it becomes yellow & gradually disappear on the
14th or 15th day

Note: The ultimate disappearance of color varies from 1 to 4 weeks

depending upon the severity and constitution of the body.
c. Hecatomb(blood tumor) - extravasations of blood in a newly
formed cavity

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d. Ecchymosis - a form of hematoma only that the extent of

extravasations of blood is wider but thinner.

3. Deep Closed Wounds:

a. Simple fracture
b. Sprain - subcutaneous separation or tearing of the articular
tendons, ligaments or muscles.
c. Strained – tearing or rupture of muscle fibers
d. Dislocation – displacement from each other of the articular
surfaces of bones entering into the formation of a joint.
e. Cerebral or brain concussion – the jarring or of the brain
leading to some commotion of the cerebral substance.
f. Internal Hemorrhage
1. Intracranial
2. Rupture of organs
3. Laceration of organs

4. Open Wounds – when there is communication with the

outside or break in the skin or mucous membrane.

a. Abrasion – characterize by the removal of the superficial

layer of the skin brought about by friction against a hard
rough surface.

1. Forms of Abrasion
a. Linear
b. Multi-linear
c. Confluent – almost indistinguishable due to severity of
friction and roughness of the object.
d. Multiple - several abrasion noted on the body surface
of a person.
2. Types of Abrasion:
a. Scratches c. Impact or imprint abrasion
b. Grazes d. Pressure or friction
abrasion

b. Incised wound - produced by forcible contact

c. Lacerated Wound - produced by forcible contact of the body with a blunt instrument.
d. Stab Wound - produced by a sharp-pointed and sharp edge instrument.
e. Punctured Wound - produced by a sharp-pointed instruments
f. Wound produced by powder explosion
1. Firearm
2. Granade, dynamite, etc.
g. Mutilation
h. Avulsion

E. Medico-Legal Aspect of Wounds:

1. The ff. rules must be always observed.
a. All injuries must always be described however small for it may be important later.
b. The description of wounds must be comprehensive.

2. General Investigation of Surroundings

a. Place where crime was committed

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b. Examination of clothing, stains, cuts, hairs and other foreign bodies that may be found in the scene of the crime.
c. Investigation of those persons who may be witnesses to the incident or which could give light to the case.
d. Examination of the wounding instrument.
e. Photography, sketching, or accurate description of the scene of the crime for purposes of preservation.

3. Examination of the Wounded Body:

Examination applicable to the living and dead victim:
a. Age of the wound from the degree of healing
b. Determination of the weapon used in the commission of the offense.
c. Determination whether the injury is accidental, suicidal or homicidal.
d. Reason for the multiplicity of wounds in cases where there are more than one wound.

4. Examination of the Wound:

a. Characteristic of the wound
b. Location of the wound
c. Direction of the wound
d. Number of the Wound
e. Extent of the Wound
f. Condition of the surrounding of the wounds
g. Condition of the locality
1. Degree of hemorrhage
2. Evidence of struggle
3. Information as to the position of the body
4. Presence of letter or suicide note
5. Condition of the weapon

5. Determination whether the wounds were inflicted during life or after death:
a. Hemorrhage - more profuse when wound was inflicted during lifetime of the victim
b. Signs of inflammation - there may be swelling of the area surrounding the wound. Other vital reaction maybe present
whenever the wound was inflicted during life.
c. Signs of repair - fibrin formation, scab or scar formation conclusively show that wound was inflicted during life.
d. Retraction of the edge of the wound - Owing to the vital reaction of the skin and contractility of the muscular fibers, the
edges of the wound inflicted during life retract and cause gaping.

6. Points to consider in the determination whether the wound is homicidal, suicidal or accidental:

a. External signs and circumstances related to the position and attitude of the body when found.
b. Location of the weapon or the manner in which it is held.
c. The motive underlying the commission of the crime or the like.
d. The personal character of the deceased.
e. The possibility of the offender to have purposely changed the truth of the condition.
h. Other information:
1. Signs of struggle
2. Number and directions of wounds
3. Nature and extent of the wound
4. State of the clothing

7. Length of time of survival of the victim after infliction of wound:

a. Degree of healing
b. Changes in the body in relation to the time of death
c. Age of the blood stain
d. testimony of witnesses when the wound was inflicted.

8. Possible instrument used by the assailant in inflicting the injuries:

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a. Contusion - by blunt instrument

b. Incised wound - by sharp-edged instrument
c. Lacerated wound - produced by blunt instrument
d. Punctuated wound - by sharp pointed instrument
e. Stab - by sharp-edged and pointed instrument
f. Gunshot wound - the diameter of the wound entrance may approximate the caliber of the wounding firearm.

9. Which of the injuries sustained by the victim caused death?

This can be ascertained by examining by examining individually the wounds and noting which of them involved injury to
some vital organs or large vessels or led to secondary result causing death.

10. Which of the wounds was inflicted first?

The ff. must be taken into consideration:

a. Relative position of the assailant and the victim when the first injury was inflicted on the latter
b. Trajectory or course of the wound inside the body of the victim.
c. Organs involved, degree of injury sustained by victim.
d. Testimony of witness.
e. Presence of defense wounds on the body of the victim if the victim tried to make defense act during the initial attack, then
the defense wounds must have been inflicted first.

11. Relative Position of Victim and Assailant when Injury was inflicted:
The ff. has to be considered:
a. Location of the wound in the body of the victim
b. Direction of the wound
c. Nature of the instrument used in inflicting the injury
d. Testimony of witnesses

F. Death or Physical Injuries Brought About by Powder Propelled Substances:

1. Production of Combustions:
a. Bullet - Gunshot wound
b. Flame - Singeing
c. Smoke -smudging
d. Gun powder residue - tattooing
e. Grime - tattooing

2. Firearm Wounds:
a. Gunshot Wound

Difference Between Entrance and Exit

ENTRANCE EXIT
1. Appears to be smaller than missile owing to elasticity of 1. Always bigger than missile
tissue except contact fire.
2. Edges inverted 2. Edges averted
3. Usually ovaloid or rounded 3. Variable shape
4. Contusion collar present 4. Contusion collar absent
5. Other product of combustions when firing is near 5. Always absent
6. Paraffin test may be positive 6. Always negative

3. Determination of Relative Position of Victim & Assailant:

a. Contusion Collar - the wider side points to the source of the missile.
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b. Smudging & Tattooing - the side with more or intense deposit points to the source of the missile.

4. Determination of the probable caliber of the firearm used in the infliction - measure in centimeter of the cross diameter of the
gunshot wound fro collar to collar - the shortest is the probable caliber.

5. Determination of the distance of fire:

a. Contact fire - intense laceration & undermining of the point entrance. Normal bigger than exit.
b. Distance of six(6) inches presence of smudging, singeing and tattooing.
c. Beyond six(6( inches but within thirty six(36) inches - presence of the tattooing.
d. Beyond thirty six(36) inches only the gunshot wound will be present

G. Shotgun Wound

1. Kinds of bore of shotgun

a. Unchoked bore or straight bore
b. Choked bore
1. Improved cylinder - narrowing of the bore from rear to the muzzle is 3-5 thousandth of an inch.
2. Half Chock - narrowing of the barrel is 15-20 thousandth of an inch.
3. Full Chock - narrowing of the barrel is 35-50 thousandth of an inch.

2. Characteristics of shotgun wounds

a. Contact fire - entrance of wound is irregular with severe destruction of the underlying tissue. There is singeing and
smudging.

b. Near shot up to six(6) inches.

1. Mark laceration of skin.
2. Gunpowder maybe driven into the deeper area of the wound.
3. mark smudging of the skin & deeper portion of the wound of entrance.
4. Mark tattooing.
5. Hair is singe.
6. Wad may be found inside the wound of entrance.

c. Distance of about one(1) yard

1. Pellers enter as one mass thus making entrance wound with irregular edges.
2. Surrounding skin may be blacken with light burning & tattooing.

d. Distance of 2 to 3 yards –
1. The wound of entrance has big central hole with rugged edges with few stray wound of entrance wound.
2. Smudging & tattooing – no longer evident

e. Distance of 4 yards – pellets may enter skin area of about 6 to 8 inches diameter although there may be a central care where
a group might have entered.

H. Death by Asphyxia – all forms of violent death which results primarily from the interference with the process of respiration or to
condition in which the supply of oxygen to the blood or tissue or both has been reduced below normal level.

1. Hanging
2. Strangulation
a. by ligature
b. manual or throtting
c. special forms of strangulation
c.1. palmer
c.2. garroting
c.3. mugging or yoking

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c.4. compression of neck with stick

3. Suffocation –
a. smothering – closing mouth and nostrils by solid objects
b. choking

4. Asphyxia by submersion in water (drowning)

5. Asphyxia by pressure on the chest
6. Asphyxia by irrespirable gases

I. Death or Physical Injuries Due to Vehicular Accidents

1. Kinds of injuries in vehicular accident cases

a. sustained by the pedestrian
a.1. impact injuries
1. primary impact injuries
2. subsequent impact injuries
a.2. Secondary injuries
a.3. Run over injuries

b. Sustained by driver & passengers

1. impact injuries
2. turn-turtle injuries

2. Medical Evidence in Vehicular Accident Cases

a. Evidence from the victim
o Crash injury
o Tire thread marks
o Abrasion prints
o Blood, hair or clothing of victim may be found sticking on the part of the vehicle which hit the victim.
o Physical defects of the victim like poor eyesight
o Inebriation of the victim – like under the influence of alcohol
b. Evidence from the driver
* Physical defect like poor eyesight
* Under the influence of alcohol or drugs by drive
* History of grudge between the driver and the victim.

VI – MEDICO-LEGAL ASPECTSEXUAL CRIMES:

A. VIRGINITY – is a condition of a female who not experienced sexual intercourse.

KINDS OF VIRGINITY:
a. Moral virginity
b. Demi-virginity
c. Virgo-Inacta
d. Physical virginity
1. True physical virginity
2. False physical virginity

POINTS TO BE CONSIDERED IN THE DETERMINATION OF THE CONDITION OF VIRGINITY

a. Breast
b. Vaginal canal
c. Labia majora minora
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d. Fourshette & perineum

e. Hymen
f. Rougosites

B. DEFLORATION – laceration or rupture of the hymen as a result of sexual intercourse

CALSSIFICATION PF HYMENAL LACERATION

a. Incomplete Laceration
* Superficial
* Deep
b. Complete
c. Complicated

HEALING TIME HYMENAL LACERATION

a. superficial – 2 to 3 days
b. extensive tear – 7 to 10 days
c. complicated – if with intervening infection will require longer to heal

DURATION OF LACERATION OF THE HYMEN

a. fresh bleeding laceration – rupture quite recent

b. healing – after 24 to 7 days
c. recently healed – 7 days to 3 months
d. old healed – 3 mos to years

MEDICAL EVIDENCE TO CONSIDER IN SEXUAL CRIMES:

a. Evidence from the victim
1. Alleged time and place of the commission of the crime.
2. Date, time and place of the examination.
3. Condition of clothing.
4. Physical and mental development of victim.
5. Gait, facial expression etc.
6. Examination of body for sign of violence
7. Examination of genetalia: a. hymen, b. hymental orifice, c. vaginal canal, d. rougosites, e. fourshette, f. pubic hair, g.
labias, h. presence of spermatozoa

b. SEXUAL CRIMES

1. rape
2. seduction : qualified - simple
3. Acts of lasciviousness
4. Abduction : forcible, consented
5. Corruption of minors
6. White slave trade
7. Adultery
8. concubinage
9. Unnatural sexual offenses

VII. MEDICO LEGAL ASPECT OF PREGNANCY

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PREGNANCY – is a state of a woman who has within her body the going product of conception.

a. Legal importance of the study of pregnancy

* Pregnancy ground for the suspension of the execution of the death sentence in a women.
* A conceived child is capable of receiving donation.
a. Archeim – Zondel Test
b.Friedman test
c. Xenopus of Hogben Test
d. Qualitative color test for pregnandial
e. Estrone Administration

b. Duration of pregnancy – 270-280 days from onset of last menstruation.

c. Abnormally prolonged gestation – beyond 300 days.
d. Minimum period of gestation – compatible with viability of the child born at 180 days may live.
e. Super fecundation – fertilization made by separate intercourse of two ova which have escaped at the same act of ovulation.
g. Pseudocysis or spurious pregnancy – imaginary pregnancy

VIII. MEDICO LEGAL ASPECTS OF DELIVERY

1. Delivery is the process by which in a woman gives birth to her offspring.

2. Puerperium – is the interval between the termination of labor (delivery) to the complete return of the reproductive organ its normal
pregnant state-last from 6 to 8 weeks.
3. The study of delivery is important because proof delivery is necessary in judicial action on the following:

a. Legitimacy
b. Abortion
c. Infanticide
d. Concealment of birth
e. In slander or libel

4. Methods of delivery

a. Natural Route – the normal passages

* Spontaneous
* Surgical intervention
* Instrumentation

b. Surgical Route –
* Abdominal caesarian section
* Vaginal caesarian section
* Post-mortem caesarian section

IX. MEDICO LEGAL ASPECT OF ABORTION

Willful killing of the fetus in the uterus, or violent expulsion of the fetus from the natural womb and which results to the death of the
fetus.

A. Principal elements of crime:

1. That the expulsion of the product of conception is induced.

2. That the fetus dies either as an effect of the violence used, drug administered or fetus was excelled before the term of its viability.

B. Provision of the Revised Penal Code on Abortion

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1. Intentional Abortion Elements:

a. That the woman is pregnant
b. Violence was applied on such pregnant woman without the intention of abortioning her.
c. The woman aborted as result of the violence.

2. Unintentional Abortion Elements:

a. The woman must be pregnant
b. Violence was applied on such pregnant woman without the intention of abortioning:
c. The woman aborted as aborted as result of the violence.

3. Abortion Practiced by the woman herself or by her parents

Elements:
a. The woman is pregnant
b. Abortion is intended to be committed
c. Abortion is induced by
1. The pregnant woman
2. Other person with consent of the pregnant woman
3. The presents of the woman, or either of them for the purpose of concealing her dishonor and with the
consent of the woman herself
4. Abortion practiced by a physician or midwife and dispensing of abortions, Elements:
a. The woman is pregnant
b. The physician induced or assisted in causing the abortion
c. The acts done by the physician or midwife intended to cause an abortion.

There must be intention of the physician to produce abortion and the absence of intention will not make the physician criminally liable.

C. Kinds of Abortion
1. Spontaneous or natural
2. Induced
a. therapeutic
b. criminal

IX. MEDICO LEGAL ASPECT OF BIRTH

a. Legal importance of the study of birth

1. Birth determines personality.

2. Appearance of a child is ground for the revocation of donation.
3. Proof of live birth must first be shown before of the child by the prosecution in the case of infanticide

XI. MEDICO LEGAL ASPECT OF INFANTICIDE:

INFANTICIDE – is the killing of a child less than three (3) days old.

How the crime committed:

a. By omission or neglect
* Failure to litigate the umbilical cord
* Failure to protect the child from heat and cold
* Omission to take the necessary help of a midwife or skilled physician.
* Omission to supply the child with proper proof food.
* Omission to remove the child from the mother’s discharge with resulted to suffocation.

b. By commission

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* By inflicting physical injuries

* By suffocation
* By strangulation
* By drawing
* By poisoning
* By burning
* By deliberate exposure to heat and cold

c. Other allied causes

* Abandoning a minor
*Abandoning a minor by person entrusted with custody indifference of parents.

XII. MEDICO-LEGAL ASPECT OF PATERNITY AND FILIATION

PATERNITY – is the civil of the father with respect to the child begotten him.

FILIATION – is the civil status of the child in relation to its mother or father.

a. Legal importance of determining Paternity & Filiation

1. For succession
2. For enforcement of the naturalization and immigration laws.

b. Kinds of children
1. Legitimate children (proper) – born in lawful wedlock or within 300 days after the dissolution of marriage.

Presumption of Legitimacy – children born after 180 days following the celebration of marriage, and before 300 days following its
dissolutions or the separation of the spouses shall be presumed to be legitimate.

Against their presumption no evidence shall be admitted other than that of the physical impossibility of the husband’s having access to
his wife within the 180 days of the 300 which preceded the birth of the child.

This physical impossibility may be caused by:

a. The impotence of the husband;
b. the fact that the husband and wife were living separately in such a ay that access was not possible.
c. By the serious illness of the husband.

Requisites of the presumption:

a. There is a valid marriage
b. the birth of the child took place after 180 days following the celebration of marriage or within 300 days following its dissolution or
separation of spouse;
c. There is no physical impossibility of the husband having access to the wife during the first 120 days of the 300 proceeding the birth of
the child.

2. Legitimate Children

Legitimation – is defined as a remedy or process by which a child born out of lawful wedlock and are therefore considered
illegitimate are by fiction of law considered by subsequent valid marriage of the parents.

Children that can be legitimated:

1. Natural children (proper)

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Natural children are those born outside lawful of parents who, at the time of the conception of the former were not disqualified by any
impediment to marry each other.

C. Adopted Children

ADOPTION – is defined the act or proceeding by which of paternity and filiation are recognized as legally existing between persons not so
related by nature.

Persons who may be adopted:

a. The natural child by the natural father or mother;
b. Other illegitimate children, by the father or mother;
c. A step-child, by the step-father or step-mother;
d. Any person, even if age provided adopter is sixteen years older

2. Illegitimate Children

A. Natural Children

a. Natural Children (proper)

b. Natural children by legal fiction – natural children by legal fiction are those born of void degree of annulment.

3. Natural children by presumption - are those natural children acknowledge the father or the mother separately if the acknowledging parent
was legally competent to contact marriage at the time of conception.

b. Spurious Children

Illegitimate who are not natural are considered spurious children may be:

1. Adulterous Children – conceived in an act of adultery or concubinage.

2. Sacrilegious Children – children born of parents who have been ordained in sacris.
3. Incestuous Children – children born by parents who are legally incapable of contracting valid marriage because of their blood
relations as marriage between brothers and sisters, father and daughter, etc.
4. Manceres – children conceived by prostitute. It is very difficult to determine the father because of the nature of the work.

ARTIFICIAL INSEMINATION – is the introduction of seminal fluid with spermatozoa in the generative of a woman by any means of
springe, pipette, irrigator, etc.

Status of Children born by artificial Insemination:

a. If the donor is the husband, the child must be unquestionable legitimate.
b. If the semen came from a donor than the husband, with the consent of the later, the child may also consider legitimate in as much as it
born lawful wedlock and there is consent of the husband.
c. If the semen came from a third party and introduced to the wife without consent or against the will of the husband, the child is
illegitimate (adulterous).
EVIDENCES OF PATERNITY AND FILLETING

1. Medical Evidences

a. Parental likeness
b. Blood grouping

c. Evidence from the mother

* Proof of previous delivery

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* Proof of physical potency & fertility

* Proof of capacity to have access with the husband
*Evidence from the father
a. Proof of physical [potency and fertility
b. Proof of access

2. Non-Medical Evidences:

a. Record of birth in the civil registrar, or by an authentic document or a final judgment.

b. Continuous possession of the status of a legitimate child.
c. Any other allowed by the Rules of Court and Special Laws.

XIII. MEDICO-LEGAL ASPECT OF IMPOTENCY AND STERILITY

IMPOTENCY – is the physical incapacity of either sex to allow or grant to the other legitimate sexual gratification.

a. Legal importance of impotency

1. Impotency, if proven, will overthrow the presumption of legitimacy.
2. Impotency maybe ground for the annulment of marriage

b. Cause of impotency
1. General or functional, unconnected directly with the sexual organs:
* age
* Illness
* Emotion
* Hormonal dysfunction
2. Local or organic, in direct connection with the sexual organs:
* Congenital defects
a. In males
* Non-development of the penis
* Mal development of the penis
* Penis adherent to the scrotum
* Duplex organ

b. In females
* Absence of vagina
* Vagina ill-developed
*Vagina occluded by intra-uterine disease

* Disease of Accident
a. In males
*Penis
- acute disease of the penis as gonorrhea
- chronic disease of the penis as epithelioma
- complete amputation of the penis

*Testes
- removal of the testes
- sexual abuse

b. In the females
- Vaginal laceration
- Disease of the vulvae
- Obstruction of the vaginal canal due to tumor cyst or fibroid

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STERILITY – is the loss of power procreation and is absolutely independent of whether or not impotency is present. A man or a woman maybe
sterile and yet impotent impotent yet not sterile.

A. General functional, unconnected directly with the sexual organs.

B. Local cause of sterlity
a. congenital
1. in the male
o Absence of testicle
o Absence of penis
o Mal-development of the testicle
o Mal-development of the testes in uterus
o Misplacement of the testes
o Mal-formation of the penis, as epipadias or hypospadias
o
2. in the female
o Absence or mal-development of the ovary
o Absence or mal-development of the uterus
o Absence of the vagina

b. Acquired conditions:
1. in the male
o Complete amputation of the penis
o Excision of the testicle
o Diseases of the testicle
o Atrophy of the testicle

2. in the female
o Excision of the ovary
o Diseases of the ovary
o Occlusion of the vagina from the diseases
o Diseases of the vagina
o Occlusion of the fallopian tubes

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