Frances Angelie Nacepo

Final Examination in Legal Medicine

1. Discuss the value/importance of Legal Medicine in

        a)  Criminal cases (4)
        b) Civil cases (3)
        c) Administrative cases (3)
 Answer:
1.a The legal system widely recognizes the role of forensic evidence in the trial of criminal
offenders. This is because when scientific techniques and methods are used, there is not much
scope for bias or injustice. That is why DNA profiling and a host of other forensic evidence are
widely accepted in courts across the world. Interestingly, the first forensic technique ever used
involving finger and palm print identification dates back to the Chinese (650 A.D.).

Criminal law is that branch or division of law which defines crimes, treats of their nature and
provides for their punishment.

It is a body of specific rules regarding human conduct which have been promulgated by political
authority, which apply uniformly to all members of the classes to which the rules refer, and
which are enforced by punishment administered by the state. Penal laws and those of public
security and safety shall be obligatory upon all who live or sojourn in the Philippine territory,
subject to the principles of public international law and to treaty stipulations (Art. 14 Civil
Code).

The Philippine criminal law is codified in the Revised Penal Code and may also be found in the
penal provisions of the special laws.

Legal medicine is applicable in the following provisions of the penal code:

a. Circumstances affecting criminal liability (Title I);

Article 4 of the Revise Penal Code define criminal liability, it state that criminal liability shall
be incurred by; any person committing a felony/delito although the wrongful act done be
different from that which he intended, and by any person performing an act which would
be an offense against person or property, were it not for the inherent impossibility of its
accomplishment or on account of the employment of inadequate or infection means.
Criminal Liability define circumstances and incidents under the Revise Penal Code where
most of the time legal medicine is involved, the justifying, exempting, mitigating,
aggravating, and alternative circumstances are often been supported by legal medicine.
b. Crimes against person (Title VIII),
Murder, homicide, physical injury are the most common crimes against person where
autopsy, and medical certification are being use in the court as evidence. Autopsy and
medical certificate are one of most common professional practices of providing evidences in
legal medicine.

c. Crimes against chastity (Title XI).

In rape cases, legal medicine is also being used in order to prove that there are actually rape
that happened through the insurance of medical certificate from a medico legal
practitioner.

1.b Civil law is a mass of precepts that determines and regulates the relation of assistance,
authority, and obedience between members of a family and those which exist among members of
a society for the protection of private interest (Sanchez Roman).
Our civil laws are scientifically and systematically compiled in the Civil Code of the Philippines
(Republic Act No. 386).
In civil law, knowledge of legal medicine may be useful on the following:
a. The determination and termination of civil personality (Art. 40 and 41),
b. The limitation or restriction of a natural person's capacity to act (Art. 23 and 39);
c. The marriage and legal separation (Book I, Title III & IV);
d. The paternity and filiation Book I, Title VIII); and
e. The testimentary capacity of a person making a will (Book III, Title IV).
1.c Legal medicine is very important in administrative cases, in sense that Principles
Governing Application and Effects of Laws state that “Administrative or executive acts,
orders and regulations shall be valid only when they are not contrary to the laws or the
constitution”, it only means Administrative or executive acts, orders and regulations are
considered valid when they are not in contravention with the existing laws.
2. What is the role/place of DNA testing/ forensic processes in:
       a)Criminal investigation (4)
       b)Establishing paternity/ filiation (3)
       c)Establishing identity in emergency cases (3)
Answer:
2.a  DNA is generally used to solve crimes in one of two ways.  In cases where a suspect is
identified, a sample of that person’s DNA can be compared to evidence from the crime scene. 
The results of this comparison may help establish whether the suspect committed the crime.  In
cases where a suspect has not yet been identified, biological evidence from the crime scene can
be analyzed and compared to offender profiles in DNA databases to help identify the
perpetrator.  Crime scene evidence can also be linked to other crime scenes through the use of
DNA databases. 

        For example, assume that a man was convicted of sexual assault.  At the time of his
conviction, he was required to provide a sample of his DNA, and the resulting DNA profile was
entered into a DNA database.  Several years later, another sexual assault was committed.  A
Sexual Assault Nurse Examiner worked with the victim and was able to obtain biological
evidence from the rape.  This evidence was analyzed, the resulting profile was run against a
DNA database, and a match was made to the man’s DNA profile.  He was apprehended, tried,
and sentenced for his second crime.  In this hypothetical case, he was also prevented from
committing other crimes during the period of his incarceration.

2.b DNA paternity testing is the use of DNA profiles to determine whether an individual is
the biological parent of another individual. Paternity testing can be especially important when the
rights and duties of the father are in issue and a child's paternity is in doubt. Tests can also
determine the likelihood of someone being a biological grandparent. Though genetic testing is
the most reliable standard, older methods also exist, including ABO blood group typing, analysis
of various other proteins and enzymes, or using human leukocyte antigen antigens. The current
techniques for paternity testing are using polymerase chain reaction (PCR) and restriction
fragment length polymorphism (RFLP). Paternity testing can now also be performed while the
woman is still pregnant from a blood draw. DNA testing is currently the most advanced and
accurate technology to determine parentage.

As a rule, illegitimate children may establish their illegitimate filiation in the same way and on
the same evidence as legitimate children, that is, through their record of birth appearing in the
civil register or a final judgment, or by an admission of legitimate filiation in a public document
or a private handwritten instrument and signed by the parent concerned. In the absence of the
foregoing, filiation can be proved by the open and continuous possession of the status of a
legitimate child, or by any other means allowed by the Rules of Court and special laws (Article
175 in relation to Article 172, Family Code of the Philippines).

While deoxyribonucleic acid (DNA) testing is not specifically mentioned under the law, such
procedure, in view of the changing times and the inflow of technology, has become an
acceptable method of determining, among others, paternity and filiation. The Supreme Court has
acknowledged the vital role of DNA testing and even espoused A.M. No. 06-11-5-SC (2 October
2007), otherwise known as the Rule on DNA Evidence.
In a ruling laid down by the Supreme Court in the case of the Estate of Rogelio G. Ong vs. Diaz
(G.R. No. 171713, December 17, 2007, Ponente: Associate Justice Minita Chico-Nazario), thus:
“Amidst the protestation of petitioner against the DNA analysis, the resolution thereof may
provide the definitive key to the resolution of the issue of support for minor Joanne. Our
articulation in Agustin v. Court of Appeals is particularly relevant, thus:
Our faith in DNA testing, however, was not quite so steadfast in the previous decade. In Pe Lim
v. Court of Appeals (336 Phil. 741, 270 SCRA 1), promulgated in 1997, we cautioned against the
use of DNA because “DNA, being a relatively new science, (had) not as yet been accorded
official recognition by our courts. Paternity (would) still have to be resolved by such
conventional evidence as the relevant incriminating acts, verbal and written, by the putative
father.”

2.c DNA analysis is the gold standard for identifying human remains and may be the only
available method, when other methods, such as birthmarks, dental records, or fingerprints are not
available. If sufficient DNA can be recovered, forensic DNA typing can identify biological
samples—even when the human remains are fragmented and the DNA is degraded, as with the
World Trade Center victims.

Identifications are made by comparing the DNA profile of reference samples with those from the
human remains. The reference samples can be obtained from: (1) personal items used by the
victim (a toothbrush, hairbrush, or razor); (2) banked biological samples (sperm or biopsy tissue
from the victim); (3) biological relatives of the victim; and (4) human remains previously
identified by other methods or other already-DNA-typed fragmented remains.

 
3. Discuss the steps in presenting an expert witness particularly a medico-legal officer or
histopathology expert (10)

 Answer:
Justinian (483-565 A.D.), in his Digest, made mention that a physician is not an ordinary witness
and that a physician gives judgment rather than testimony. This led to the recognition of expert
witness in court.
A physician may be presented in court as an ordinary witness and/or as an expert witness:
a. Ordinary Witness:
A physician who testifies in court on matters he perceived from his patient in the course of
physician-patient relationship is considered as an ordinary witness.
Sec. 18, Rule 130, Rules of Court — Witnesses. Their qualification — Except as provided in the
next succeeding section, all persons who, having organs of sense, can perceive, and perceiving,
can make known their perception to others, may be witnesses. Neither parties nor other persons
interested in the outcome of a case shall be excluded; nor those who have been convicted of
crime; nor any person on account of his opinion on matters of religious belief.
One of the exceptions to the ordinary witness rule is the privilege of communication
(confidential) between physician and patient. Although the physician perceived something
through his organ of sense and has the power to transmit to others what he perceived, he is not
allowed to disclose those informations to others as regards to matters he perceived from his
patient during the physician-patient relationship.
Sec. 21(c), Rule 130, Rules of Court — Privileged communication — A person authorized to
practice medicine, surgery or obstetrics cannot in a civil case, without the consent of the patient,
be examined as to any information which he may have acquired in attending such patient in a
professional capacity, which information was necessary to enable him to act in that capacity, and
which would blacken the character of the patient.
A medical witness can only testify on matters derived by his own perception. Hearsay
informations are as a rule not admissible in court. Hearsay evidences are those not proceeding
from the personal knowledge of the witness but from mere repetition of what he has heard others
say. It is a "second hand" evidence which rest mainly on the veracity and competence of its
source.
Sec. 30, Rule 130, Rules of Court — Testimony generally confined to personal knowledge — A
witness can testify only to those facts which he knows of his own knowledge; that is, which are
derived from his own perception, except as otherwise provided in these rule:
One of the exceptions to the non-admissibility of hearsay evidence is dying declaration. The
declaration of a dying person under the consciousness of his impending death as regards
circumstance regarding his impending death is admissible in spite of the fact that it is a hearsay,
it is made so because of necessity and it is trustworthy.
Exceptions to the hearsay rule. Sec. 31, Rule 130, Dying declaration — The declaration of a
dying person, made under a consciousness of an impending death, may be received in a criminal
case wherein his death is the subject of inquiry, as evidence of the cause and surrounding
circumstances of such death.
Physicians are frequent recipients of dying declaration in the medical clinics and emergency
rooms of hospitals. To be admissible it must be shown that the declarant was conscious of his
impending death, that the declaration must be with regards to his impending death; that the
declarant was in full possession of his mental faculties when he made the declaration; and that
such evidence is presented in court in a case of homicide, murder or parricide wherein the
declarant was the victim,
b. Expert Witness:
A physician on account of his training and experience can give his opinion on a set of medical
facts. He can deduce or infer something, determine the cause of death, or render opinion
pertinent to the issue and medical in nature. Sec. 42, Rule 130, Rules of Court — Opinion Rule
— General Rule — The opinion of witness is not admissible, except as indicated in the following
section. Sec. 43, Rule 130, Rules of Court — Expert Evidence — The opinion of a witness
regarding a question of science, art or trade, when he is skilled therein, may be received in
evidence. The probative value of the expert medical testimony depends upon the degree of
learning and experience on the line of what the medical expert is testifying, the basis and logic of
his conclusion, and other evidences tending to show the veracity or falsity of his testimony

4. What areas of medico-legal report like autopsy report/ histopath results/medical

certificate should be dissected when presenting a medical evidence/ medico-legal expert to
support the theory of the case? (10)

Answer:

The autopsy findings will have a Cause of Death, which will include any factors directly
contributing to or causing the death (i.e. blunt force trauma or a cardiac event); and Manner of
Death, which include Natural, Accident, Suicide, Homicide and Undetermined. The Mechanism
of Death, or the instrument or action causing death, is often overlooked. This notation may
include stab wounds, gunshot wounds, ligature strangulation, drug overdose, etc. The autopsy
may support the pre-autopsy investigation and medical records, or possibly make a
determination that seems unrelated to the event. An example of this is a motor vehicle collision
caused by the driver having a sudden cardiac event which caused death before the accident. This
is a natural death which caused the accident. Often we see deaths caused by blunt force injuries
as a result of the accident, which is ruled an ‘Accident’.

The least desirable or used finding, ‘Undetermined’ is used when there has been no definitive
finding as to the Manner, and possibly Cause, of death at the conclusion of the complete autopsy
protocol and concurrent investigation(s). This is often seen in cases where the preponderance of
one Manner does not prevail, but is consistent with or equal to another. One example of this
might be a hunting incident where the decedent was alone, had suicidal history and a thorough
autopsy and investigation was inconclusive as to the totality of ‘Accident’ versus ‘Suicide’.

Autopsy reports are not casual or interesting reading material. They are very informative when
reviewed with all concurrent investigative reports and evidence. All autopsy reports follow a
general format as approved by the National Association of Medical Examiners (thename.org).
Although they may differ in appearance, the general content format consists of:

1. Diagnoses
2. Toxicology
3. Opinion
4. Circumstances of Death
5. Identification of the Decedent
6. General Description of Clothing and Personal Effects
7. Evidence of Medical Intervention
8. External Examination
9. External Evidence of Injury
10. Internal Examination
11. Samples Obtained – Evidence, Histology and Toxicology
12. and Microscopic Examination

When the autopsy report is reviewed by the lay person their focus is on the first four items, as
these are the summary of the remaining medical details of the report. It is important to review the
report and all of the information contained therein for the complete picture. It is also important to
understand what is in an autopsy report before we can begin to decipher all the latent and patent
information it contains.

In a webinar conducted by Dr. Owen Lebaquin, it was discussed that a report contains not only
the injuries sustained by the victim, but also the circumstances such victim had experienced. It is
not sufficient that only what had happened to the victim the medico-legal officer will take into
account in the report. It is also vital that circumstances attending to the crime, location of where
the crime had happened and effects of such injuries sustained by the victim will be considered in
order to help aid and support the theory of the case in order to lead in the conviction of the real
offender. In addition, location of injuries sustained by the victim shall be also noted in order to
determine what crime or crimes had been committed by the offender against the victim. Lastly,
damages may also be taken into consideration which can help in the determination of the degree
of the crime committed by the offender.
5. What is the weight and admissibility of polygraph examinations in lie detection? Discuss
why polygraph test is not conclusive of one’s veracity? (10)

Answer:
Polygraph test is also called a lie detector test, but this term is a misnomer. The theory behind
polygraph tests is that ability of subject is more likely to be concerned with lying about the
relevant facts about the crime, which in turn produces a hyper arousal state which is picked up by
a person trained in reading polygraph results. Measurement of hyper arousal state is based on a
number of parameters such as heart rate, blood pressure, respiratory rate, skin conductance and
electromyography. The brief idea underpinning the use of the polygraph is that deceptive
answers tend to produce physiological responses that can be differentiated from those associated
with non-deceptive answers. There are, however, no specific physiological reactions associated
with lying, making it difficult to identify factors that separate liars from truth tellers. Polygraph
examiners also prefer to use their own individual scoring methods, as opposed to computerized
techniques, as they may more easily defend their own evaluations.
Polygraph examinations in lie detection has said to be 75% accurate base from the previous
studies conducted, there are several reasons why polygraph examinations are said to have
margin of 25% percent error. The following are the the reasons:

1. Nervousness or extreme emotional tension experienced by a subject who is telling the

truth regarding the offense in ques tion but who is nevertheless affected by:

a. Apprehension induced by the mere fact that suspicion or accusation has been directed
against him

b.Apprehension over the possibility of an inaccurate lie-detector test result;

c. Over-anxiety to cooperate in order to assure an accurate test result

d. Apprehension concerning possible physical hurt from the instrument;

e. Anger resentment over having to take a lie-detector test;

f. Over-anxiety regarding serious personal problems unrelated to the offense under

investigation

g. Previous extensive interrogation, especially when accom- panied by physical abuse; and

h. A guilt-complex or fear of detection regarding some other offense which he had

committed.

2. Physiological abnormalities such as:

a. Excessively high or excessively low blood pressure;

b. Diseases of the heart; and

c. Respiratory disorder.
3. Mental abnormalities such as:

a. Feeblemindedness, as in idiots, imbeciles and morons;

b. Psychosis or insanities, as in manic-depressives, paranoids, schizophrenics, paretics, etc.

c. Psychoneurosis and psychopathia, as among the so-called "peculiar" or "emotionally

stable" persons — Those who are neither psychotic or normal, and those from the border-
line between these two groups.

4. Unresponsiveness in a living or guilty subject, because of:

a. No fear of detection

b. Apparent inability to consciously control response by means of certain mental sets of

attitudes;

c. A condition of "sub-shock" or "adrenal exhaustion" at the time of the test

d. Rationalization of the crime in advance of the test to such an extent that lying about the
offense arouses little or no emotional disturbance.

e. Extensive interrogation prior to the test.

5. Attempt to "beat the machine" by controlled breathing or by muscular flexing.

6. Unobserved application of muscular pressure which produces ambiguities and misleading

indications in the blood pressure tracing. However, the results of the lie detector test may
be admissible if there is a stipulation of the parties and counsels that they will accept said
results. The reason is that if the defendant agrees to the admission of the polygraph result,
then he should not be able to object if the subsequent result turns out to be unfavorable to
him.The judge may have the discretion as to whether it is to be admitted or not. For
example, it may not be admitted if done by an incompetent polygrapher.

In recent studies conducted the polygraph techniques is said to be in the experimental

stage and have not received the degree of standardization of acceptance among scientists.

In a series of decisions of the state supreme courts in the United States (Fyre v. U.S., State v.
Bonner (Wis.), People v. Becker (Mich.), People v. Forte, State v. Cole (Mich., (Beech v. State
(Neb.), People v. Wechnick (Calif.), etc.), non-admissibility of the lie detector test was
uniformly ruled. The common reason given was that, according to physiological and
psychological authorities, the test has not gained a degree of development beyond the
experimental stage. Until it is established that reasonable certainty follows from such a test,
it would be an error to admit the results as evidence. The test is useful in the investigation
of a crime but it has no place In the courtroom.

Here are also a few more reasons:

1.The trier of fact is apt to give almost conclusive weight to the polygraph expert's opinion.
2. There is no way to assure that a qualified examiner admin- istered the test. The polygraph
is capable of a high degree of accuracy only when conducted under controlled conditions
by an examiner who is highly qualified due to his ability, ex- perience, education and
integrity.

"The important areas that may affect the accuracy of the reported test result. . . .would be
(1) his polygraphy training (2) the extent of his experience with respect to the years and
number of tests he has conducted, (3) the operation of the polygraphy instrument itself (4)
the accuracy of the polygraph technique. In addition, special consideration should be given
to the number of tests and the number of questions asked during the test. . . (Modern Legal
Medicine, Psychiatry and Forensic Sciences, by Curran, et. al, p. 1203).

3. Since the polygraph involves a certain unconscious quality of the examinee, he may
unwittingly waive his or her right against self-incrimination. It becomes necessary to
determine the scope of the defendant's waiver if he voluntarily submits to the test. (Am. J.
of Trial Advocacy, Vol. 4, p.593).

4. The test itself cannot be relied upon because it has many errors.

6. Being a future forensic expert how do you go about in preserving and collecting pieces of
evidence in the crime scene? Discuss the steps and processes. (10)

Answer:
Once a crime scene has been established it is important that all evidence is collated, catalogued
and recorded for further reference. This task is normally performed by the Scenes of Crime
Officer (SOCO) and is carried out using a variety of methods.
Evidence that is loose and perhaps lying on the ground should be bagged up and catalogued;
each piece of evidence is given an individual identification number so that it can be cross-
matched against corresponding investigative reports. The evidence is bagged in clear plastic
bags, which are sealed airtight so that no contamination can take place.
Each of these bags is accompanied by a 'custody chain' document; this document is to be filled
out by any officer who wishes to use or view the evidence. This is necessary to reduce the loss of
evidence and/or cross contamination by individuals who should not have contact with it.
The area is photographed in meticulous detail and any signs of injury such as bloodstains are
marked, numbered and photographed. These photographs are often important in the piecing
together of an event so that officers who were not able to attend the scene can get an
understanding for how it looked. Nowadays with the advent of technology digital technology
such as video cameras are also used to record the nature of the scene. SOCO may also make
audio recordings as to their findings while they go.
Fingerprints are taken where possible and if the crime scene is outdoors the area is marked out
and searched; these searches can take the form of a linear search (a single row of officers moving
in unison in a straight line), a grid search (a single row of officers moving in unison in a series of
squares), a quadrant search (one officer is allocated a particular area of ground to search) or a
spiral search (officers start from the middle of the crime scene and work their way outwards in a
spiral pattern so as to identify possible pieces of evidence that have spread further than the crime
scene itself.
Soil samples are also taken as the chemical make up of soil will vary from place to place; a
corpse may have soil on the soles of their feet or under their fingernails, which may not have
been gathered at the location where the body was found.
It is sometimes necessary for dogs to be used at a crime scene; this is done so that evidence that
may not be visible to the naked eye can be detected.
Internal crime scenes are photographed, blood spatter patterns are measured and documented,
and bloodstains on carpets and floors are measured for radius.
Regardless of the location of a crime scene it is imperative that all of those personnel involved in
the recording and preserving of it are dressed correctly in protective clothing. This clothing
which normally takes the form of plastic trousers and jacket; protective hat (to minimize the
possibility of the hair of those personnel investigating; contaminating a scene), and shoe covers
which are used to reduce the risk of bringing materials from other locations to the scene of the
crime.

7. Discuss the significance of the point of entry and point of exit in gunshot wounds.
Explain the features of gunshot wounds and how this will aid in making conclusions for
medico- legal investigations? ( 10 )

Answer:
Gunshot wounds can provide a lot of information about what happened in a shooting, such as the
make and model of gun, the range of fire, and the sequence of fire patterns, the path travelled
between entrance and exit wounds, the likelihood of survival and the specific manner of death.
The size, depth, and width of the wound may indicate the size and type of weapon used to create
the injury. Similarly, examining the characteristics of the wound can provide information to
allow the pathologist to offer an expert opinion on the direction of a laceration or cut wound by
illustrating the start point and the termination point. This information can be helpful for
investigators in reconstructing or confirming the actual actions and weapons used in a criminal
event.
It may be useful in the determination as to which is the point of entry and of exit of the bullet:
The direction of the fibers will be inward or inverted at the point of entry, while it is outward or
everted at the point of exit. Care must be exercised in making the inference inasmuch as
improper handling may change the direction of the fibers.
7. Always present after fire
8. Paraffin test may be positive.
Exit Wound
1. Always bigger than the missile.
Entrance Wound 2. Edges are everted.
1. Appears to be smaller than the missile 3. It does not manifest any definite shape.
owing to the elasticity of the tissue.
2. Edges are inverted.
4. "Contusion collar" is absent.
3. Usually oval or round depending upon the
angle of approach of the bullet. 5. Always absent.

4. "Contusion collar" or "Contact ring" is 6. Underlying tissues may be seen

present, due to invagination of the skin and protruding from the wound.
spinning of the missile. 7. May be absent, if missile is lodged in the
5. Tattooing or smudging may be present body
when firing is near. 8. Paraffin test always negative.
6. Underlying tissues are not protruding.

The point of entry and the point of exit are actually the wounds that are produce when a
gun is fired and hit a victim. These wounds significantly tell the distance and direction of
shooting , also it affect the characteristics of the wound, including the shape, invagination
of tissue, the effects of accompanying components including flame, smoke, gas, unburnt
particles, metal scraps, and grease. Gunshot wounds can produce two types of wounds,
depending on the direction of travel of the projectile. These are entry wounds and exit
wounds entry wounds are generally smaller and more regular than exit wounds. Entry
wounds show invagination of tissue into the wound, while exit wounds show outward
beveling of tissue. The skin surrounding the entry wound will show the characteristics,
depending on the distance, this includes the presence of flame burns and singeing, soiling
and redding from gas as well as tattooing from unburnt particle and metal scraps. Similarly,
the presence of an abrasion rim and grease collar around the wound also indicate that it is
an entry wound. An abrasion rim may, however, also be present on the exit wound, where
the skin is shored against a hard surface. Exit wounds, in comparison, are larger and more
irregular. They show outward beveling of the soft tissue and the margin. Entry wounds will
be free of characteristics, including flame burns and singeing, soiling and redding from gas
as well as tattooing from unburnt particle and metal scraps. Also, they do not have an
abrasion rim or grease collar, except when the skin is shored against a hard surface.

This only means that that base on the point of entry and point of exit we will be able to
know if the shooter is near or far from the body of the victim, in medico legal investigation
the distance of the shooter from the victim may mean the intent of the shooter which can
be a ground for a mitigate or aggravate the case.

8. Differentiate the nature of accidental, suicidal and homicidal wound? How do you
present medico-legal evidence in support of the prosecution’s theory? (10)

Answer:

Evidences that tend to show that the Gunshot(s) Wound is Suicidal.

1. The shot was fired in a closed or locked room, usually in the office or bedroom. If in the
bedroom, the shot was fired while the victim was lying in bed and the weapon covered with
pillow or bedding to muffle the sound. It may be committed in an open isolated or uninhabited
place.

2. The death weapon is almost always found near the place where the victim was found. When a
light, low caliber hand firearm was used and the shot was made in parts of the body where death
may develop almost instantaneously, the victim may be seen with the grip of the firearm firmly
held in the palm of the wounding hand (cadaveric spasm).

3. The shot was fired with the muzzle of the gun in contact with the part of the body involved or
at close range. The wound of entrance may show signs of muzzle impression, burning, smudging
and tattooing.

4. The location of the gunshot wound of entrance is in an accessible part of the body to the
wounding hand. It may be at the temple, roof of the mouth, precordial or epigastric region. A
person committing suicide will do the act in his most convenient way, unless he has the intention
of deceiving the investigator.

5. The shot is usually solitary. If the shot is made on the head involving the brain, the shocking
effect of the injury will not make him capable of firing another shot. However, shots in some
parts of the body which may not produce immediate death or sudden loss of consciousness, the
possibility of additional shots is not remote. The victim may be determined to die and had fired
additional shots to insure realization of his intention.

6. The direction of the fire is compatible with the usual trajectory of the bullet considering the
hand used and the part of the body involved. A shot on the temple is usually directed towards the
opposite temple and upwards, while a shot in the precordium and epigastrium is usually
backwards and downwards.

7. Personal history may reveal social, economic, business or marital problem which the victim
cannot solve. He may have history of mental disease, depression, severe frustration or previous
attempt of self-destruction.

8. Examination of the hand of the victim may show presence of gunpowder.

9. Entrance wound do not usually involve clothings.

10. Fingerprints of victim on the butt.

11. Search of the place where the shot took place may reveal a suicide note which usually
mentions among other things the reason why the victim committed suicide.

12. No disturbance in the place of death.

Evidences to show that the Gunshot Wound is Homicidal:

1. The site or sites of wound of entrance has no point of election.

2. The fire is made when the victim is usually at some distance from assailant.

3. Signs of struggle (defense wounds) may be present in the victim.

4. There may be a disturbance of the surroundings on account of previous struggle.

5. Wounding firearm usually is not found at the scene of the crime.

6. Testimony of witnesses.

Evidences to show that the Gunshot Wound is Accidental:

1. Usually there is but one shot.

2. There is no special area of the body involved.

3. Consideration of the testimony of the assailant and determination as to whether it is possible

to be accidental by knowing the relative position of the victim and the assailant.

4. Testimony of witnesses

Determinations whether the wounds are homicidal, suicidal or accidental:

1. As to the Nature of the Wound Inflicted:

a. Abrasions: Extensive abrasions on the body are always suggestive of accidental death,
especially in death due to traffic accident. In suicidal death, abrasions are rarely observed. In
case of murder, abrasions are not common except when the body is dragged on the ground. In
homicide, abrasions may commonly be observed especially when the victim offered some degree
of resistance to the attacker.

b. Contusion: Contusion is rarely observed in suicidal death, except when the suicidal act was
done by jumping from a height. A person contemplating to commit suicide will not choose a
blunt instrument. Contusion in accidental death may also be found in any portion of the body. It
is often due to a fall and due to a forcible contact with some hard objects.

c. Incised Wounds:. Incised wounds are commonly observed in suicide and homicide. The depth,
location and other surrounding circumstances will differentiate one from the other. Accidental
cuts are frequent everyday occurrences, but rarely as a cause of death.

Points to be Considered in the Determination as to whether the Wound is Homicidal, Suicidal or

Accidental:

1. External signs and circumstances related to the position and attitude of the body when found.

2. Location of the weapon or the manner in which it was held.

3. The motive underlying the commission of the crime and the like.

4. The personal character of the deceased.

5. The possibility for the offender to have purposely changed the truth of the condition.

6. Other information:

a. Signs of Struggle: Absence of signs of struggle is more in suicide, accident or murder.

Contusion or abrasion may indicate trauma due to fist, finger or feet of the assailant.

Presence of hair or portion of the skin (epidermis) on the nails of the assailant or deceased may
be a clue in the determination whether death is suicidal, homicidal or accidental.

b. Number and Direction of Wounds: Multiple wounds in concealed portions of the body are
generally indicative of homicide. Single wound located in a position that the deceased could
have been conveniently inflicted is usually suicidal.

c. Direction of the Wound: This is important in the case of cut-throat. It is generally transverse in
case of homicide while it is oblique in case of suicide.

d. Nature and Extent of the Wound: Homicidal wounds may be brought about by any wounding
instrument. Suicidal wounds are frequent due to sharp instruments. Accidental physical injuries
may be of any kind.
e. Stare of the Clothings: There is usually no change in the condition of the clothings in suicide
case. In homicidal death, on account of the struggle which took place before death, the clothings
of the victim are in a disorderly fashion.

Evidence is the means, sanctioned by the Rules of Court, of ascertaining in a judicial proceeding
the truth respecting a matter of fact (Sec. 1, Rule 128, Rules of Court). It is the species of proof,
or probative matter, legally presented at the trial of an issue by the act of the parties and through
the medium of witnesses, records, documents, concrete objects, etc., for the purpose of inducing
belief in the minds of the court as to their contention (Black's Law Dictionary, 4th ed.). If the
means employed to prove a fact is medical in nature then it becomes medical evidence. Same
rules in all cases — The rules of evidence shall be the same in all courts and on all trials and
hearings, whether civil or criminal (Sec. 2, Rule 128, Rules of Court).

It is considered relevant when it has the tendency to prove any matter of fact. It is something
which by the process of logic, an inference may be made as to the existence or non-existence of a
fact at issue. Relevancy of evidence (collateral matters) — Evidence must have such a relation to
the fact in issue as to induce belief in its existence or non-existence; therefore, collateral matters
shall not be allowed, except when they tend in any reasonable degree to establish the probability
or improbability of the fact at issue (Sec. 4, Rule 130, Rules of Court).

From its recovery and from becoming a part of the investigation report, a preliminary
investigation will be made by the prosecuting fiscal to prove that there is a prima facie evidence
to warrant filing of the case in court. While in court, the case further suffers delays because of
postponement of the hearings, preferential trials of other cases, raising of prejudicial issues to
higher courts, etc. Preservation of evidence is indeed vital in medico-legal investigation.

9. In sex crimes particularly rape, how do you go about presenting medical evidence in
support of your theory? ( 10 )

 Answer:
Medical Evidences in Rape:
1. Evidences from the victim: Before actual examination is made on the subject, it is necessary to
have a written consent from the subject herself or from her guardian if the victim is not of age. If
the woman is confined in a correctional institution the consent may be given by the head of the
institution. A short history of the alleged rape must be taken and it is advisable to reduce it in
writing. The history must include all the circumstances leading to the abuse, the age of the victim
at the time of the alleged commission of the offense and also the menstrual history. It may be
used as a guide to the examining physician as to the different points that must be emphasized in
the course of the examination. Aside from the history, the following points must also be recorded
by the physician.
a. Date, time and place of alleged commission of rape:
This is necessary in order to determine how long a time has elapsed after alleged commission of
the offense before the victim filed the necessary complaint or subjected herself to the medical
examination. If several days have gone by before the filing of the complaint, let her explain the
cause of the delay. The place where the alleged offense was committed is necessary to determine
which court can acquire jurisdiction over the case.
b. Date, time and place of the examination:
The date of the examination is material to the determination of the possible findings of the
physician on the victim. A long interval of time between tha date of commission and the
examination will remove the possibility of finding the effects of a recent sexual intercourse.
c. Condition of the clothings:
If force is applied in the commission of the offense, there will be tearing, staining with blood and
semen, and soiling of the clothings. The clothings must be preserved after they have been
thoroughly dried for further laboratory examination.
d. The physician must observe the gait, the facial expression and the bodily and mental attitude
of the subject. If the victim suffered from genital injuries she may walk with legs apart and
slowly, with the face manifesting signs that she is suffering from pain.
e. Physical and mental development of the victim:
The height, strength and degree of muscular development of the woman must be noted to
determine whether she has the capacity to resist any unlawful aggression. If the victim is a child,
examination of the physical condition is usually not necessary because it is apparent to the age.
In most cases, children are "bribed" or lured by attractive articles such as candies by the
offender.
The examiner must observe the mental state of the victim. She may be in the state of mental
shock, under the influence of depressant drugs, alcohol or sex stimulants. The offender might
have taken advantage of her insanity or mental deficiency.
The victim may appear exhausted, despondent on account of the public humiliation she will
suffer, or may be hostile to the investigator. Care and more psychologic approach is necessary in
order to get her full cooperation and consent.
f. Examination of the body for signs of violence:
If actual force was applied in the commission of the crime, there must be signs of physical
violence on the body of the victim. Her whole body must be subjected to inspection. Physical
injuries must be described and the exact location must be determined. Areas of tenderness or
swelling must not be overlooked and if necessary X-ray pictures must be taken to determine
bone lesions. Determination of the probable age of the physical injuries found is material. Does it
correspond to the alleged date of commission?
g. Examination of the genitalia, including the breast:
The breasts must be examined for the presence of finger marks or application of pressure. They
might have been roughly handled or the nipples bitten. The vulva may show swelling,
tenderness, contusion, abrasion, laceration or may be smeared with blood, semen and other
foreign bodies. The hymen may show fresh laceration, swelling or bruising. There may be healed
lacerations or signs of physical virginity.
In the pubic hair, the following medical evidence may be gathered: (1) Pubic hair of the offender.
(2) Semen and spermatozoa. (3) Blood stains. (4) Body louse.
Abrasion which is normally found in the posterior commissure is usually brought about by
friction or a violent attempt of insertion. The vaginal canal may show obliteration of the
rugosities or even purulent discharge.
2. Examination of the alleged offender:
a. Physical development, mental condition and strength:
The relative physical development and strength of the victim and the offender must be compared
to determine whether the offender can overpower the resistance offered by the victim.
b. Evidence of physical injuries:
The whole body must be examined. The victim, in the course of the struggle, may inflict bodily
harm to the offender.
Fingernail marks on the neck, arms and chest may be found. The frenum of the penis may be
abraded or lacerated on account of the violent insertion on a relatively small vulvar or vaginal
opening.
c. Condition of the sex organ:
Aside from the examination of the frenum, washing from the surface of the penis may reveal
blood, seminal stain, vaginal epithelium and doderleins bacillus. The urethral meatus may be
moist on account of the recent discharge.
d. Evidence from the pubic hair:
The pubic hair may be matted together due to blood stains or from seminal fluid discharge.
Examine carefully for the presence of body louse.
e. Potency of the offender:
The offender may put up a defense that he is impotent and that it could have been hardly possible
that he had committed the crime. It may be necessary to subject the offender to a strong sex
stimulus sufficiently under normal condition to produce erection.
f. Evidence of genital infection — If the offender is suffering from venereal disease which is
transmitted to the victim during the criminal act, the crime committed is rape with physical
injuries because infection in law is a physical injury.
3. Evidences from the companion of the victim:
a. A history of the incident must be taken from the companion of the victim. Try to see whether
they are consistent with the narration of facts by the victim.
b. If the companion helped the victim when force was applied by the offender, the companion
must be subjected to a physical and medical examination for physical injuries.
c. Examination of the clothings may be necessary for signs of struggle.
d. Investigation must be made to determine whether the companion might have participated as an
accomplice to the crime.
e. The mental condition, physical power, age and emotional state must be taken into
consideration to determine the capacity to resist unlawful aggression from the offender.
f. Examination must be made as to the presence of alcohol or other depressants which may
diminish the companion's capacity to defend the victim from the offender.
Investigation of the Crime Scene: 1. Disturbances in the place of commission may infer or affirm
the statement of the victim that she did offer resistance. 2. Strands of hair, blood, seminal and
other stains may be recovered to prove consummation and struggle. 3. Pieces of personal
belongings of the offender and /or victim may be recovered to prove identity and physical
struggle. 4. Investigation of witnesses who may possibly be material to the prosecution of the
case may be conducted.

10. What is the place of legal medicine in marriage cases particularly on annulment/
declaration of nullity and legal separation? Discuss the medico-legal aspect needed in
support of the grounds for such marriage cases ( 10)

Answer:

AS TO ANNULMEN T OF MARRIAGE:

Art. 85, Civil Code: A marriage may be annulled for any of the following causes, existing at
the time of the marriage:
 (1) That the party in whose behalf it is sought to have the marriage annulled was
between the ages of sixteen and twenty years, if male, or between the ages of
fourteen and eighteen years, if female, and the marriage was solemnized without
the consent of the parent, guardian or person having authority over the party,
unless after attaining the ages of twenty or eighteen years, as the case may be,
such party freely cohabited with the other and both lived together as husband and
wife;
(2) ………
(3) That either party was of unsound mind, unless such party, after coming to reason,
freely cohabited with the other as husband or wife;
(4) That the consent of either party was obtained by fraud, unless, such party
afterwards, with full knowledge of the facts constituting the fraud, freely
cohabited with the other as her husband or his wife, as the case may be;
(5) …………………
(6) That either party was, at the time of marriage, physically incapable of entering
into the married state, and such incapacity continues, and appears to be incurable.

Art. 86, Civil Code: Any of the following circumstances shall constitute fraud referred to in
number 4 of the preceding article:

(1) ……………
(2)………………….
(3) Concealment by the wife of the fact that at the time of the marriage, she was pregnant
by a man other than her husband.

There are several grounds for the annulment of marriage which are of medico-legal interest.
A physician may be requested to determine the ages of the contracting parties, if the ground
for the annulment of marriage is age. He may be required to examine the mentality of the
party and to determine whether she or he could have been of unsound mind at the time of the
celebration of marriage. The phrase "physically incapable of entering into married state"
includes impotency of a party. The court or any of the parties in interest to the contract of
marriage must determine whether or not she is pregnant at the time of the celebration of
marriage.

AS TO LEGA L SEPARATION

Our law recognizes only relative divorce but not absolute divorce.

Art. 97, Civil Code: A petition for legal separation may be filed:

(1) For adultery on the part of the wife and for concubinage on the part of the husband as defined
in the Penal Code; or

(2) An attempt by one spouse against the life of the other.

Art. 333, Revised Penal Code — Who are guilty of adultery? Adultery is committed by any
married woman who shall have sexual intercourse with a man not her husband and by the man
who has carnal knowledge of her, knowing her to be married, even if the marriage be
subsequently declared void.

Adultery shall be punished by prision correccional in its medium and maximum periods. If the
person guilty of adultery committed this offense while being abandoned without justification by
the offended spouse, the penalty next lower in degree than that provided in the next preceding
paragraph shall be imposed.

Art. 334, Revised Penal Code — Concubinage: Any husband who shall keep a mistress in the
conjugal dwelling, or, shall have sexual intercourse, under scandalous circumstances, with a
woman who is not his wife, or shall cohabit with her in any other place, shall be punished by
prision correccional in its minimum and medium periods.

The concubine shall suffer the penalty of destierro.