Legal medicine involves the intersection of law and medicine, concerning facts that have legal consequences.
Legal phenomena are events to which laws connect legal consequences, such as purchase, loss, or modification of a right. These facts can be natural or human.
These include involuntary occurrences like accidents, calamities, birth, and death.
These are voluntary actions, conducts, or behaviors that can be commissive (actions taken) or omissive (actions omitted). They can be verbal or written and can involve:
Modifications of the external world (material).
Legal transactions (declarations of intent).
Actions compliant with the law include:
Actions of a person (will, donation, adoption, recognition of a child).
Actions of two or more people (marriage, partnership, contracts).
Provisions by public bodies (decisions of the judicial authority, police provisions, administrative or health orders).
Actions not compliant with the law can be:
Penal (crime): Punishment and/or security measures for treatment, education, or neutralization of social dangerousness.
Civil (wrong): Sanctions such as declaration of nullity, legal termination of parental responsibility, restitution, compensation, or reparation.
Procedural.
Administrative.
Other illicit actions extraneous to the juridical system: moral, religious, or social.
The criminal system is a complex of norms (rules) that regulate social relationships and man's actions in social life.
Ubi societas ibi ius à "… Wherever there is society, there is law…"
The norms or rules place the associates of the human consortium in relation to each other:
In conditions of equality (Private Law), regulating relations between citizens.
In conditions of supremacy/dependence (Public Law), regulating the functioning of the State and relations between citizens and the State.
Includes constitutional, administrative, criminal/penal, international, and ecclesiastical law.
Criminal/Penal law involves two parties, one public and one private, confronting each other on personal freedom (detention, imprisonment).
Includes civil, commercial, and labor law.
Civil Law involves two private parties confronting each other for economic reasons.
The main purpose is to guarantee/ensure/preserve the tranquility of the res-publica (the Italian Republic) with a braking action on human acts/ activities through a regulation (the Penal Code).
It aims to protect individual or social assets-interests protected by the State (on the basis of the Constitution of the Italian Republic) such as rights of personality, freedom, safety, security, and life.
“… in other words: "… so far and no further…""
It comprises:
Punishment system.
Security measures (prevention, care, social rehabilitation of the offender).
A crime is defined as:
"… the violation of the criminal law".
"any act to which the legal system associates a penalty as a consequence".
The classification of rules involves considering their:
Contents.
Characters.
Parts.
Species.
Types.
Command rule: Provision of law that prohibits (art. 575 p.c.).
Guarantee rule: Provision of law which prescribes (art. 365 p.c.) to protect the “right/interest”.
Imperative rule: Mandatory impositions.
Taxative rule: Expressly and exactly determined and sanctioned (art.1 p.c. "the principle of legality; art. 25 Cost.").
Imperative law is a set of rules that people must follow because an authority enforces them, including all the laws made by the government, courts, and accepted legal principles. Ignorance of the law is not an excuse.
Incriminating rules (precept + sanction).
Discriminatory rules (causes of non-punishment, of justification).
Declarative or Explanatory rules (definitions, explanations…, notions of: Public Official, weapon, habitual drunkenness, next of kin…).
Interpretative and Referral rules (… the meaning and scope of the rule; “combined provisions”).
Precept: Rule of conduct to be followed, whether a command or prohibition.
Sanction: Consequence of the infraction, such as imprisonment or a pecuniary penalty.
Perfect rules: Precept + sanction.
Imperfect rules: Separate precept and sanction interpreHtve reconstrucHonal.
The application of criminal law is based on principles:
Art. 1 criminal code (guarantee of the law with limits to JUDICIAL power in relation to the determinacy/taxativity).
Principle of the RESERVE OF THE LAW: Art.25 of the Constitution (guarantee of the law with limits to the EXECUTIVE power; there is no law that indicates the time limits of the provision as the Parliament is the only body with the LEGISLATIVE power).
Principle of ANALOGY (prohibition of…) only in relation to cases regulated by the law or favorable to the agent (“ANALOGY in bonam partem”).
Art.5 p.c. (Presumption of knowledge of the law).
Explanation of the logic of the law with respect to:
Subjects:
Authenticate (Legislator) → binding.
Judicial (Jurisprudence) → not binding.
Doctrinal (Scholars) → authoritative or not.
Means:
Grammatical (literal-syntactic… objective).
Logical (“ratio legis”).
Results:
Extensive (expansion of the principle, beyond words… for “practical purpose”).
Restrictive (limitation-concentration of the principle… for “practical purpose”).
The effectiveness of the criminal law has limits:
Time.
Space.
People.
Art. 2 criminal code; 25 of the Constitution (the law provides for the future… to guarantee the citizen against the LEGISLATIVE power).
Articles 3, 4, 6 p.c.
Art. 13 pc; 10 Const.
No privileges (concerns the institutional office*).
Immunity is not a personal privilege of members of Parliament, but it ensures that each of them can freely exercise their mandate without being exposed to arbitrary political persecution. Parliamentary immunity as such therefore ensures the independence and integrity of Parliament as a whole.
Crimes are classified by:
Intent / Negligence / Preterintention.
Damage / Danger.
Commissive / Omissive.
Consumed / Tempted (art. 56 p.c.).
Uni / Pluri-subjective.
Common /Exclusive (art.365 p.c.).
of Conduct / of EVENT (Material).
Prosecuted by "COMPLAINT" (art. 336 p.p.c.) / by the "OFFICE" (arrt. 330, 331 p.p.c.).
According to the intention, against the intention, or beyond the intention.
Damage (art. 582 p.c. Personal injury) or Danger (art. 622 p.c. Disclosure of professional secrecy; art. 728 p.c. Treatment suitable to suppress the consciousness or the will of others).
Commissive (art. 575 p.c. Homicide) or Omissive [Proper (art. 328 p.c. Omission of office duties) / Improper (or commissive by omission: mother who kills her child by not feeding him; doctor who determines the death of a patient by not making the correct diagnosis of a heart attack, not allowing life-saving treatment (coronary angioplasty)].
Consumed (when the event occurs: homicide… injury…) or Tempted (art. 56 p.c. when the action does not take place or the event does not occur: the gun jams… the victim manages to dodge the gunshots…).
Uni / Pluri-subjective (art. 588 p.c. Brawl: when several people fight each other…).
Common / Exclusive (for healthcare professionals: art. 365 p.c. failure to report) of
Conduct (art. 593 p.c. "Omission of Rescue") / of Event (Material)… all the others.
Prosecuted by:
"Complaint" (art. 336-337 p.p.c.) or
"ex Officio" (arrt. 330, 331 p.p.c.).
"Anyone who performs suitable acts, aimed in an unequivocal way to commit a crime, is liable for an attempted crime if the action is not performed or the event does not occur.
The perpetrator of the attempted crime is punished:
with imprisonment of not less than twelve years, if the penalty established is life imprisonment
in other cases, with the penalty established for the crime, reduced by between one third and two-thirds à prison penalty reduced by 1/3 to 2/3, not less than 12y if life.
If the offender voluntarily desists from the action, he shall be subject only to the penalty for the acts performed, if these constitute a different offence in themselves.
If he voluntarily prevents the event, he shall be subject to the penalty established for the attempted crime, reduced by a third to a half [62 n. 6]”.
A complaint shall be submitted by means of a statement in which the complainant requests the prosecution of an act deemed an offence by law. Such statement may be submitted personally or by means of a proxy.
The statement of complaint shall be submitted, as set forth in Article 333, paragraph 2, to either the authorities to whom a report may be submitted or a consular officer abroad. If it bears an authenticated signature, the statement may also be delivered by an appointed person or sent by mail in a registered envelope.
If the statement of complaint is submitted orally, the record in which it is reported shall be signed by the complainant or his proxy.
The statement of complaint submitted by the legal representative of a legal entity, an organisation or an association must contain the specification of the source granting him the power of representation.
The authority receiving the complaint shall certify the date and place of submission of the complaint, check the identity of the person submitting it and forward the case file to the Office of the Public Prosecutor.
The Public Prosecutor and criminal police shall acquire notitiae criminis on their own initiative and receive notitiae criminis that are submitted or forwarded according to the following Articles.
Without prejudice to the provisions of Article 347, public officials and persons in charge of a public service who receive information about an offence subject to prosecution of the Public Prosecutor’s motion, while carrying out or because of their functions or their service, must report it in writing, even if the alleged perpetrator of the offence is not identified…
The report shall be submitted or forwarded without delay to the Public Prosecutor or a criminal police official.
If several persons are to report the same offence, they may also draw and sign one single document.
If, during civil or administrative proceedings, an act emerges which may constitute an offence subject to prosecution of the Public Prosecutor’s motion, the proceeding authority shall draw and forward the report to the Public Prosecutor without delay.
Crime:
classification;
constituent elements;
aggravating and mitigating circumstances;
felonies and misdemeanors (delitti e contravvenzioni)
Criminal responsibility (subjective, objective, cases of non-punishability of the crime)
Failure to assist. Abandonment of a minor or incapacitated person. Abuse of means of correction or discipline. Mistreatment against family members or cohabitants;
Imputability and social dangerousness.
The subjective or psychological element
Intentional (according to the…) / Culpable (against to the…) / Preterintentional (beyond to the…)
The objective or material element (the "fact", the "event" that may be missing in the attempted crime)
Intent (according to* the…) / Negligence (against to** the…) / Preterintention (beyond to*** the…)
to use a weapon appropriately, load and shoot toward vital organs (head, heart)…
to act foreseeing that the behavior could determine the event, but exclude it due to negligence, imprudence, incompetence (malpractice)…
headbutting the chest (with the intention of beating, hurting), but producing the death of the victim by rupturing an aortic arch aneurysm of which the offender was unaware that the victim was a carrier…
**to act foreseeing that the behavior could determine the event, but exclude it due to negligence, imprudence, incompetence (malpractice)…
BUT
… if the offender accepts…
Throwing stones from the overpass on the motorway means accepting the risk (eventuality) of injuring or killing someone (the behavior is qualified as "negligent", "culpable") and, therefore, the behavior will be punished by way of intentional misconduct (intent).
The acceptance of the risk represents the intent (eventual), the exclusion of the risk represents the fault (negligent… culpable).
Having unprotected sexual contacts, knowing you are carrying HIV, represents the acceptance of the risk (eventual) of infecting the partner and then is an intentional conduct
"…violation of the criminal law"
"any act to which the legal system attaches a penalty as a consequence"
"No one may be punished for an act that is not expressly* provided for crime by law**, nor with punishments that are not established by it."
*determinacy/taxativity and prohibition of analogy.
**law’s reservation art. 2 p.c.. (Succession of criminal laws)
No person shall be punished for an act which, according to the law of the time in which it was committed, did not constitute a crime*** [25 art. Constitutional Law]
No person may be punished for an act which, according to a later law, did not constitute a crime; and, if there has been a conviction, its execution and penal effects shall cease.
If there has been a sentence of imprisonment and the subsequent law provides only for a fine, the imprisonment sentence imposed shall be immediately converted into the corresponding money/fine…
If the law of the time when the offense was committed and the later laws are different, the law whose provisions are more favorable to the offender shall apply, unless an irrevocable judgment has been rendered…"
***no retro-activity
"Crimes are distinguished into Crimes and misdemeanours, according to the different species of punishment for them respectively established by this Code".
"The principal penalties established for crimes are:
???;
all life imprisonment (“life sentence”)[22];
imprisonment [23];
payment [24].
The main penalties established for misdemeanours are:
arrest [25];
fine [26].
"Under the name of custodial penalties or penalties restricting personal freedom the law includes: life imprisonment, imprisonment and arrest.
Under the designation of pecuniary penalties the law includes: the payment and the fine”.
"The accessory penalties for Crimes are:
disqualification from public office [32];
disqualification from a profession or an art [30];… no longer be able to practice the profession
legal disqualification [32];
disqualification from the executive offices of legal persons and companies [32a];
the inability to contract with the public administration [32b, 32c];
5a) the termination of the employment or work relationship;
disqualification or suspension from parental liability (authority) [34]
The accessory Penalties for misdemeanours are:
suspension from exercising a profession or art [35];
suspension from the executive offices of legal persons and companies [35a].
Accessory penalty common to crimes and contraventions is the publication of the judgement conviction [36; Code of Criminal Procedure 543]…”
The subjective or psychological element
Intent (according to the…) / Negligence (against to the…) / Preterintention (beyond to the…)
The objective or material element (the "fact", the "event" that may be missing in the attempted crime)
The aggravating circumstances
The mitigating circumstances
… the judge will weigh the crime on a scale, putting the aggravating factors on one plate and the mitigating factors on the other… for a decision
"Aggravating the offence, when they are not its constituent elements or special aggravating circumstances [578 3, 579 3], the following circumstances:
acted with abject or futile motives
to execute or conceal another offence, or in order to obtain or ensure for oneself or others the product or profit or the price or the impunity of another offence
in culpable offences [43], acted despite foreseeing the event;
torture, cruelty to persons
against public official or person of public service or priest/religious minister or diplomat of foreign state
)under 18 or pregnant
having committed, in non-culpable offences against life and individual safety, against personal liberty as well as in the offence referred to in Article 572 of the Criminal Code, the act in the presence of or to the detriment of a person under eighteen years of age or to the detriment of a pregnant person
health facilities
having committed, in non-culpable offences, the act to the detriment of persons admitted to health facilities or to residential or semi-residential social-health facilities, public or private, or to social-educational facilities
sporting event
having committed the act at or on the occasion of sporting events or during transfers from or to places where such events are held (16).
health professional, auxiliary care
having acted, in offences committed with violence or menace, to the detriment of persons practicing the health and social-health professions, as well as of any person carrying out auxiliary care, health assistance or rescue activities, functional to the performance of such professions, on account of or in the exercise of such professions or activities".
"The following circumstances shall mitigate the offence, when they are not constituent elements or special mitigating circumstances:
having acted for reasons of particular moral or social value;
having acted in a state of anger, brought about by an unjust act of another;
having acted by suggestion of a crowd in an uproar, when it is not a question of meetings or assemblies prohibited by law or by the Authority, and the offender is not a habitual or professional offender or a delinquent by tendency
the offender's willful act together with the offender's act or omission having contributed to the event
having, before the sentence, repaired the damage in full, through compensation for it…"
"Criminal responsibility (liability) is personal.
A defendant shall be considered not guilty until a final sentence has been passed.
Punishments may not be inhuman and shall aim at re-educating the convicted
Death penalty is prohibited (1)".
(1) Article amended by Constitutional Amendment Law no. 1 of October,2, 2007
"No one may be punished for an act or omission provided for by law as a criminal offence, if he or she did not commit it consciously and with intentionality.
No one may be punished for an act provided for by law as a crime, if he has not committed it with intentionality, except in cases of preterintentional or negligent crime expressly provided by law.
The law determines the cases in which the event is otherwise charged to the agent, as a consequence of his action (commissive or omissive behaviour)…"
"The crime is intentional, or according to the intention, when the harmful or dangerous event, which is the result of the action or omission and on which the law makes the existence of the offence depend, is foreseen and intended (wanted) by the agent as a consequence of his action or omission;
it is preterintentional, or beyond the intention, when a more serious harmful or dangerous event than that intended (wanted) by the agent results from the commission or omission;
it is culpable, or against the intention, when the event, even if foreseen, is not intended (wanted) by the agent and occurs as a result of negligence or recklessness (imprudence) or unskillfulness (malpractice), or as a result of failure to comply with laws, regulations, orders or disciplines…"
… doctrine (scholars) and jurisprudence (magistrates, judges) distinguish the
generic negligence, produced by the carelessness, or imprudence, or unskillfullness (in committing/omitting), from the
specific negligence, determined by the failure to (specifically) observe laws, regulations, orders, or disciplines…
The key word is… "intention" (intentionality)!
Intent (according to* the…) / Negligence (against to** the…) / Preterintention (beyond to*** the…)
to use a weapon appropriately, load and shoot toward vital organs (head, heart)…
to act foreseeing that the behavior could determine the event, but exclude it due to negligence, imprudence, incompetence (malpractice)…
headbutting the chest (with the intention of beating, hurting), but producing the death of the victim by rupturing an aortic arch aneurysm of which the offender was unaware that the victim was a carrier…
"Whoever abuses the means of correction or discipline to the detriment of a person subject to his authority, or entrusted to him for reasons of education, instruction, care, supervision or custody, or for the exercise of a profession or an art, shall be punished, if the danger of illness in body or mind results from the act, with imprisonment for up to six months. à prison up to 6m
If personal injury results from the human action, the punishments set forth in Articles 582 and 583 shall be applied, reduced to one third; if death results, imprisonment from three to eight years shall be applied." à prison 3-8y if death
"Whoever, outside the cases specified in the preceding article, mistreats a person of the family , or a child under fourteen years of age, or a person subject to his authority, or entrusted to him for the reason of education, instruction, care, supervision or custody, or for the exercise of a profession or art, shall be punished by imprisonment from one to five years. à prison 1-5y
If serious bodily injury results, imprisonment from four to eight years shall be imposed; if very serious bodily injury results, imprisonment from seven to fifteen years shall be imposed; if death results, imprisonment from twelve to twenty years shall be imposed."
Serious injury à prison 4-8y
Very serious à 7-15y
Death à 12-20y
"Whoever abandons a person under fourteen years of age, or a person who is incapable, by reason of sickness of mind or body, old age, or other cause, of providing for himself, and for whom he has custody or is to have care, shall be punished by imprisonment from six months to five years. à prison 6m-5y
To the same punishment is subject whoever abandons abroad an Italian citizen under the age of eighteen years, entrusted to him in the territory of the State for reasons of labor.
The punishment is imprisonment from one to six years if personal injury [582] results from the act, and is from three to eight years if death results.
The penalties shall be increased if the act is committed by the parent [540], child, guardian [346] or spouse, or by the adopter or adoptee [291]."
"Whoever, finding abandoned or lost a child under ten years of age, or another person incapable of providing for himself/herself, due to sickness of mind or body, old age or other cause, fails to give immediate notice to the Authority shall be punished by imprisonment of up to one year or a fine of up to two thousand five hundred euros.
To the same punishment shall be subject whoever, finding a human body that is or appears to be inanimate, or a person injured or otherwise in danger, fails to render the necessary assistance or to give immediate notice to the Authority.
If personal injury results from such conduct of the offender, the punishment shall be increased; if death results, the punishment shall be doubled."
general:
arrt. 45-54 p.c.
special:
art. 365 p.c.
arrt. 384 p.c.
arrt. 728 pc.
"Those who committed the crime because they were forced to do so by the need to defend their own or another's right against the current danger of an unjust offense are not punishable, provided that the defense is proportionate to the offense…"
"Without prejudice to the provisions contained in the two previous articles, the public official who, in order to fulfill a duty of his office, uses or orders the use of weapons or other means of physical coercion, when forced to do so by need to reject violence or to overcome resistance to the Authority and in any case to prevent the perpetration of the crimes of massacre, shipwreck, submersion, aviation disaster, railway disaster, voluntary homicide, armed robbery and kidnapping, is not punishable…
"Anyone who violates (infringes) or endangers* a right with the consent of the person who can validly dispose of it**, is not punishable (579-580 p.c.; 5 c.c.)."
*Crimes (Damage / Danger)
**Rights (Available and Unavailable)
Assessing capacity
Children and young people and…
Consent to treatment means a person must give permission before they receive any type of medical treatment, test or examination.
This must be done on the basis of an explanation by a clinician.
Consent from a patient is needed regardless of the procedure, whether it's a physical examination or something else.
The principle of consent is an important part of medical ethics and international human rights law.
https://www.nhs.uk/conditions/consent-to-treatment/
Legally valid consent (requirements
FREE, EXPLICIT, UNEQUIVOCAL
ACTUAL and REVOCABLE
given by the ENTITLED PERSON on "AVAILABLE" RIGHTS (goods)
the entitled person… the "RIGHT HOLDER"
The patient if capable:
major age (adult)
mental capacity (to understand) and will
The legal representative of the patient if incapacitated (c.c. and art.37 cod. deont.):
chronological immaturity (minor age)
mental incapacity (pathological causes)
For the minor: Those exercising parental responsibility or the legal representative
For the adult: the legal representative
the constitutional reading (of the right)… the "key"
"highly debated all over the world"
Art. 2 Const.
"The Republic recognises and guarantees the inviolable rights of the person, both as an individual and in the social groups where human personality is expressed.
The Republic expects that the fundamental duties of political, economic and social solidarity be fulfilled.”
Art. 3 Const.
"All citizens have equal social dignity and are equal before the law, without distinction of sex, race, language, religion, political opinion, personal and social conditions.
It is the duty of the Republic to remove those obstacles of an economic or social nature which constrain the freedom and equality of citizens, thereby impeding the full development of the human person and the effective participation of all workers in the political, economic and social organization of the country.”
Art. 32 Const.
"The Republic safeguards health as a fundamental right of the individual and as a collective interest and guarantees free medical care to the indigent.
No one may be obliged to undergo any health treatment except under the provisions of the law.
The law may not under any circumstances violate the limits imposed by respect for the human person"
CONSTITUTION DE L’ORGANISATION MONDIALE DE LA SANTÉ (WHO)
Signée à New York le 22 juillet 1946
Approuvée par l’Assemblée fédérale le 19 décembre 1946
Instrument de ratification déposé par la Suisse le 29 mars 1947
Entrée en vigueur pour la Suisse le 7 avril 1948
“THE STATES Parties to this Constitution declare, in conformity with the Charter of the United Nations, that the following principles are basic to the happiness, harmonious relations and security of all peoples:
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.
The health of all peoples is fundamental to the attainment of peace and security and is dependent upon the fullest co- cooperation of individuals and States”
Legally valid consent
and the "AVAILABLE GOODS" (which ones? of the RIGHT HOLDER."
(psycho)physical integrity
Life? Art. 13 Const. "Personal liberty is inviolable."
Art. 610 p.c. (Private violence) à prison up to 4y
"Whoever, with violence [581] or threat, compels others to do, tolerate or omit something is punished with imprisonment of up to four years…"
Art. 609 bis p.c. (Sexual violence) à prison 6-12y
"Whoever, with violence or threats or through abuse of authority, forces someone to perform or suffer sexual acts is punished with imprisonment from six to twelve years…"
art. 5 civil code (Acts of disposition of one's own body)
“The acts of disposing of one's body are prohibited when they cause a permanent decrease in physical integrity*, or when they are otherwise contrary to the law (579 criminal code), public order or morality (32 of the Constitution)"
Questions?
Tattooing the face… the neck… whole body?
Sterilization (male/female): ligation (closure)… sealing (cutting) fallopian tubes in women; ligation of the vas deferens (vasectomy) in men?
the constitutional reading (… of the right) the "key" is the art. 32 Const.
Art. 32 Const.
"The Republic safeguards health as a fundamental right of the individual and as a collective interest…
a state of complete physical, mental and social, relational and spiritual well-being and not merely the absence of disease