medico-legal aspects of death

8/11/2019 Medico-legal Aspects of Death

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MEDICO-LEGAL ASPECTSOF DEATH


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IMPORTANCE OF DEATH

DETERMINATION

Civil personality of a natural person is extinguished by

death;

The property of a person is transmitted to his heirs at the

time of death;

The death of a partner is one of the causes of

dissolution;

The death of either the principal or agent is a mode of

extinguishment of agency;

The criminal liability of a person is extinguished by

death; and

The civil case for claims which does not survive is

dismissed upon death of the defendant.


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Legal Presumption of Death:

If absent without explanation from his or her usual or last

place of residence for a long continuous period.

Circumstantial proof of death

- Ex. a passenger on an airplane that crashed isconsidered to have died even if no remains can be

recovered.

Rules of Evidence in Rule 131, section 5 paragraph X,paragraph JJ, and paragraph KK.

In common law the presumption of death does not arise

until the expiration of seven years of continuous

absence.


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Civil Code Provisions

PRESUMPTION OF DEATH

Art. 390. After an absence of seven years, it being

unknown whether or not the absentee still lives, he shall

be presumed dead for all purposes, except for those of

succession.

The absentee shall not be presumed dead for the purpose

of opening his succession till after an absence of ten

years. If he disappeared after the age of seventy-five

years, an absence of five years shall be sufficient inorder that his succession may be opened. (n)


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Civil Code Provisions

Art. 391. The following shall be presumed dead for all

purposes, including the division of the estate among the

heirs:

(1) A person on board a vessel lost during a sea voyage, or

an aeroplane which is missing, who has not been heard

of for four years since the loss of the vessel or

aeroplane;

(2) A person in the armed forces who has taken part in war,

and has been missing for four years;

(3) A person who has been in danger of death under other

circumstances and his existence has not been known for

four years. (n)


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What is DEATH?

Termination of life

Complete cessation of the vital functions withoutpossibility of resuscitation


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Events which produces uncertainty of the

moment of death

The increasing use of mechanical resuscitative devices

There is an increasing demand of organs for

transplantation

Coma following administration of excessive doses ofmodern sedatives and hypnotics


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Death maybe

A. Brain Death occurs when there is a deeply irreversible

coma, and absence of electrical brain activity.

B. Cardio Respiratory Death

occurs when there iscontinuous and persistent cessation of heart action and

respiration.

C. Alternative or eclectic way based on a legislative

enactments where states provide both brain and cardio-

respiratory bases in the determination of the moment of

death.


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BRAIN DEATH

Harvard Criteria of Brain Death (1968)

1. Unreceptivity and unresponsivity.

2. No movements (observe for 1 hour).

3. Apnoea (3 minutes off ventilator).4. No reflexes - fixed dilated pupils

- No brainstem reflexes

- No spinal reflexes

5. Flat EEG (of great confirmatory value) at 5 uv/mm

6. No change after 24 hours


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BRAIN DEATH

Philadelphia Protocol (1969)

1. Lack of responsiveness to internal and external

environment

2. Absence of spontaneous breathing movements for 3minutes

3. No muscular movements

4. No reflexes and responses

5. Falling arterial pressure6. Flat EEG

7. Criteria present in 2 hours and certified by 2 physicians

other than the physician of organ recipient


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Other set of criteria to establish brain deaths

1. The Council of Ministers in France (1968)

2. Mohandas and Chou (1971)

3. Ottawa General Hospital (1979)


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KINDS OF DEATH

1. Clinical or Somatic Death

2. Molecular or Cellular Death

3. Apparent Death or State of Suspended Animations


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Somatic or Clinical Death

The state of the body in which there is a complete,

persistent and continuous cessation of the vital functions

of the brain, heart, and lungs which maintain life and

health.

The clinical death is verifiable only by a physician after

he observes that the patient no longer has a heart beat

no pulse rate, no spontaneous breathing and movement,

with the pupils of the eye widely dilated and not reactive

to light and accommodation.


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Molecular or Cellular Death

The death of the different parts of the body occurs at

different times and stages.

State in which the tissues and their constituent cells are

dead

They no longer have metabolic activity

Is a process, not an event.

This is the reason why such organs as the corneas and

the kidneys can be removed immediately after biologicaldeath and transplanted successfully.


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SIGNS OF DEATH

1. Cessation of heart action and circulation

2. Cessation of respiration

3. Cooling of the body ( Algor Mortis )

- The temperature of 15

20 degrees Fahrenheit isconsidered as a certain sign of death.

4. Loss of motor power

5. Loss of sensory power

6. Changes in the skin7. Changes in and about the eye

- There is loss of corneal reflex

8. Action on the heat of the skin


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End of Presentation

medico-legal aspects of death

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