Module 1 – Forensic Medicine
FORENSIC MEDICINE
INTRODUCTION AND PRELIMINARIES
DEFINITION CHARACTERISTIC & NATURE OF FORENSIC MEDICINE, LEGAL MEDICINE & MEDICAL JURISPRUDENCE
FORENSIC MEDICINE is an umbrella term covering the many areas where law and medicine come into contact. The older name was “medical jurisprudence” and in both Europe and America the term LEGAL MEDICINE is more often used
Forensic Medicine is a branch of medicine, which deals and applies medical science in medico-legal cases.
Legal Medicine is the branch of medicine that is applied to law and justice, whether to elucidate legal problems or not.
Medical Jurisprudence – is a branch of law, which deals with the policies, rules or regulations, ethics, and control in the practice of the medical profession
DIFFERENCE BETWEEN FORENSIC MEDICINE AND MEDICAL JURISPRUDENCE
1.ORIGIN:
Forensic Medicine originates from the development of medical science while Medical Jurisprudence emanates from the Acts of Congress, Executive Orders, Administrative Circulars, Customs, and Usages.
2. NATURE:
Forensic Medicine is a branch of medicine, while Medical Jurisprudence is a branch of law.
CHARACTERISTICS AND APPLICATIONS:
Forensic Medicine deals with medical knowledge that is applied to law and administration of justice, while Medical Jurisprudence deals with the policies rules and regulations, and ethics that are applied to the practice of medicine.
PRINCIPLE TO FOLLOW:
Forensic Medicine follows the rules on coordination, while Medical Jurisprudence follows the rules on subordination.
DIFFERENCE BETWEEN PHYSICIAN & MEDICAL JURIST (or Medico-Legal Officer)
1. LINE OF SPECIALTY:
Medical Physician or practitioner (or specialist) in other fields of medicine except for Forensic Medicine, while Medical Jurist is a doctor of medicine specializes in Forensic Medicine.
2. PURPOSE OF EXAMINATION:
The purpose of the examination of a Medical Physician is to find out the cause of illness and institute treatment, while Medical Jurist is to determine the cause for the sake of law and justice.
3. BODY LESIONS:
In Physician, minor lesions in the body are not significant; while in Medical Jurist all body lesions are significant.
You know now the definition very well, and you know also their scope and limitations.
INSTRUCTIONAL OBJECTIVE & IMPORTANCE OF FORENSIC MEDICINE
The medical students, medico-legal officers, and medical practitioners
Occupy the sole responsibility not only in dealing with patients but also in possessing the medical skill to be used for the sake of law and justice.
For the law students and practicing lawyers
The purpose of knowing the subject matter is not only to be acquainted with medical evidence presented in the court but also to understand the medico-legal aspect of the investigation and thus to be guided in the legal proceedings of medico-legal cases.
The criminology students and criminologists
Should be acquainted with the medical aspects of criminal investigation, its importance in court, and its uses in criminal and legal proceedings. Knowledge of the subject will enable the criminologist to apply in the solution of certain medico-legal cases that have confronted in their practices.
SCOPE OF FORENSIC MEDICINE
FORENSIC MEDICINE had a very wide scope comprising many branches of medicine and paramedical science as well as law. Sudden or mysterious death belongs to Internal Medicine; sprain, fracture, and dislocation to Orthopedic Surgery; poisoning to Toxicology; abortion and injuries to the genital organs in rape and other sexual related cases are within the scope of Gynecology and Obstetrics.
The branches of law such as Criminal law. Civil law, Remedial Law, and other special laws utilize FORENSIC MEDICINE in its dealing with crime against persons and property.
A MEDICO LEGAL OFFICER HAS THE FOLLOWING FUNCTIONS & CAPABILITIES.
« Perform autopsies;
« Establishes the cause of death whether suicide, homicide, or murder, and approximate time of death;
« Identifies human remains to determine sex, approximate age and height, and the possible cause of death;
« Perform examination on victims of physical/crimes against chastity and suspected dope addicts.
« Perform forensic odontological and pathological examinations;
« Perform examination for sexually transmitted disease
« Conducts forensic psychiatry, and determines the paternity of individuals with questionable parentage.
« AND MANY MORE…..
THE HISTORY OF FORENSIC MEDICINE IN THE PHILIPPINES
In the Philippines, the practice of Forensic Medicine started several years ago, although the records showed that it started sometime in 1858 during the Spanish Regime. From that time up to the present, the following events in the practice of Forensic Medicine occurred with the corresponding dates:
● 1858 – The first textbook in Legal Medicine and its practice by Dr. Rafael Genaro Y Mas, who is a Spanish chief army physician was published and is entitled “Manual de Medicina Domestica”.
● 1871 – Legal Medicine was included in the curriculum of the College of Med. of UST.
● 1876 – March 31, the “Medico-Legal Titulares” which took charge of public sanitation and medico-legal aid for the purpose of justice was created by the King of Spain by virtue of Royal Decree 188.
● 1894 – The Medico-Legal Titulares or Forensic Medicine which is about the regulation and its practices 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, and 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 schools in the Philippines.
● 1919 – The Department of Legal Medicine and Ethics of UP was created under the leadership of Dr. Sixto Delos Angeles.
● 1922 – January 10, the Department of Legal Medicine and Ethics of UP with its head was incorporated to PGH.
● 1922 – March 10, the Philippine Legislature enacted Act 1043 which was incorporated in the Administrative Code as Section 2465 and provides that the department of legal medicine and ethics of UP became a branch of DOJ.
● 1937 – December 10, the creation of a Division of Investigation under the DOJ was created by Commonwealth Act 181 in which the medico-legal section was under the division with Dr. Gregorio T. Lantin as the head.
● 1939 – March, the Department of Legal Medicine and Ethics of UP was abolished and its function was transferred to the Medico-Legal division of the Dept. of Investigation (now NBI)
● 1942 – July 4, 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.
● 1945 – June 28, the Dept. of Investigation was reactivated under the DOJ.
● 1947 – June 19, the Dept. of Investigation was created by RA 157. The Bureau of Invest. was renamed into National Bureau of Investigation (NBI) by Executive Order No. 963. The Medico-Legal section was created under the NBI with Dr. Enrique V. Delos Santos as its head.
The existence of the Medico-Legal division in the criminal laboratory of G-2 of the Philippine Constabulary (PC/INP Crime Lab) also occurred. All provincial, municipal, and city health officers, physicians of hospitals, health centers, asylums, penitentiaries, and colonies became the ex-officio medico-legal officers of the country.
In remote places, the services of a “Cirujano Ministrante” of the Sanitary Inspector may perform the medico-legal work if a registered physician was not available.
Added to this is the UP-Medicine Pathology Department traces its origins in 1907 as one of the very first departments of the erstwhile Philippine Medical School, initially called the Department of Pathology and Bacteriology, servicing nearby hospitals of Old Manila. It found its physical home when the medical school building was built in 1910, the same year the Philippine General Hospital opened.
Its first faculty of American physicians were gradually replaced in the late 1920s by Filipinos, the latter representing the first formally trained pathologists of the country. The second half of the 20th century saw the department’s faculty broadening its expertise as subspecialists were added to its roster after training abroad in fields like Gynecologic Pathology, Neuropathology, Bone Pathology, Renal Pathology, Hematopathology, Pediatric Pathology, Microbiology, Clinical Chemistry, Head and Neck Pathology, Cytopathology, and Forensic Pathology. To this day, the department continues the tradition of academic excellence as its faculty teaches medical students and pathology residents in training.
The fully equipped morgue offers both medical and forensic autopsy services. Bodies accepted 24 hours but autopsies are done 8 am to 5 pm only. The clinical mortalities at the Philippine General Hospital and other centers, along with medicolegal cases from far and wide that seek the expertise of the only two forensic pathologists in the country, have made the Department of Pathology Morgue the busiest and most capable of its kind in the delivery of these services in the Philippines.
As of this date both also the NBI and the PNP is still on their way to further strengthen their forensic services especially in the field of medical and pathological science.
THE MEDICO LEGAL SYSTEM
The Medico-Legal Office System
This system is used in the Philippines and is handled by a Medical Jurist or Medico-Legal Officer who is a registered physician duly qualified to practice medicine in the Philippines. The NBI and the Philippine National Police (PNP) as a whole have their own medico-legal officers and offices. The medico-legal office is the one that investigates the medico-legal cases of deaths, physical injuries, rapes, and other sexual crimes to name a few. His duty is to:
(a) Examine the victim or assailant
(b) Make a report, appear in court as an expert witness when summoned by 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] Lack of proficiency by the physician in medico-legal work.
[2] Inadequate facilities
[3] Lack of sufficient training in medico-legal work by the police investigator and other law enforcement agents.
[4] Insufficient Physicians and personnel to handle medico-legal cases.
[5] Inadequate means of transportation & communication especially in remote places.
The Medical Examiner System
In some parts of the United States, the Medical Examiner system is the one 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 list compiled by the Civil Service on the basis of competitive examination.
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 of a certain crime that needs to be investigated will go to the place of crime, interview witnesses, examine the victim and then take specimens if any, for examinations. During the trial, the medical examiner will then present his medical report to the court.
Coroner System
This system is originated in England, although this is still confirmed. In common law, this office is a very ancient one. The name “Coroner” is probably derived from the title “CUSTODES PLACITORUM CORONAE” or the keeper of the king’s pleas as mentioned in Articles of Eyre of 1194, and Magna Carta of 1215 refers to the coroner as Coronator. A coroner is a government or judicial officer who is empowered to conduct or order an inquest into the manner or cause of death and to investigate or confirm the identity of an unknown person who has been found dead within the coroner’s jurisdiction.
A report of an inquest held in 1265 is one of the oldest reports of an English inquest although there is evidence that coroners existed in Australia, the United States, and other colonies of England. The coroner system is handled by the County Coroner or Borough Coroner who may be a barrister, solicitor, or a legally qualified medical practitioner of not less than five years standing in his profession and is elected by the County Council or Borough Council.
In spite of the role played by the coroner, there is a gradual disappearance or phasing out of this system because of the following reason:
(a) Insufficient medico-legal training of coroner
(b) The tenure of office of the coroner is short
(c) Insufficient payment or salary of the coroner
(d) Overlapping of duties of the coroner with Medico-legal office and Examiner.
End of Introduction and Preliminaries!
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