Legal Medicine: Exam Notes

Legal Medicine Intro

• Criminal Law: Deals with crimes and punishments; offenses against the public, society, or the state (e.g., murder, theft).
  • Criminal/Penal Code: Laws to control criminal behavior; sets punishments for those who break the code.
• Civil Law: Concerns civil or private rights; injury or damage to an individual's property through negligence.
  • Civil Code: Deals with financial penalties and orders to change behavior in civil cases.

Italian Constitution & Fundamental Rights

• Article 3, para. 1: All citizens have equal social dignity and are equal before the law, without distinction.
• Article 13: Personal liberty is inviolable; no detention, inspection, or personal search without reasons stated by a judicial authority.
• Article 30: Parents have the duty and right to support, educate, and raise their children.
• Article 32: The Republic safeguards health as a fundamental right and guarantees free medical care to the indigent; no forced medical treatment unless provided by law.

General Principles of the Penal Code

• Principle of Formal Legality: No act is a crime without a previously published legal text describing it.
  • Affirmed by Article 1 p.c and Article 25 of the Italian Constitution Law.
• Principle of Non-Retroactivity: A law applies only to acts committed after the law was adopted.
  • Affirmed by Article 2 p.c (succession of criminal laws).
• Principle of Favorable Retroactivity: A law can be applied to an act even before its enactment if more favorable to the offender.
  • Affirmed by Article 2 p.c (succession of criminal laws).
• Principle of Criminal Liability: Legal responsibility of an individual for voluntary actions/omissions resulting in punishment.
  • Constitutional basis: Article 27 Italian Const. law; valid when a new offense is created or an existing one is defined more severely.

Preconditions to Criminal Liability

• Imputability: Capacity to understand and want.
  • Article 85 p.c: No punishment if the person lacked capacity to understand and want at the time of the act.
• Awareness of Penal Law: Ignorance of the Penal Code is not an excuse.
  • Article 5 p.c.
• Objective Liability: Liability for fraud, negligence, or unintentional crime.
  • Article 42 p.c: No punishment unless the act was committed consciously and intentionally.

General Principles of the PENAL CODE

• Application Of The Penal Code: Based on principles
  • Principle of Formal Legality
  • The principle of the non - retroactivity of criminal law
  • The principle of favourable retroactivity of criminal law
  • The principle of Criminal liability

Cases of Strict Liability

• General Part: Article 42 p.c - punishment unless committed consciously and intentionally, except in cases of unintentional/negligence expressed by law.
• Special Part: Article 571 p.c - Abuse of means of correction/discipline resulting in danger of illness.
• Article 584 p.c - Unintentional homicide resulting from certain crimes.
• Article 591 p.c - Abandonment of minors or incapacitated persons.

Classification of the Penal Code

• According to Contents:
  • Command rule
  • Guarantee rule
• According to Characters:
  • Imperative rule
  • Taxative rule
• According to Species:
  • Incriminating rules
  • Discriminatory rules
  • Declarative/Explanatory rules
  • Interpretative and Referral rules
• According to Parts:
  • Precept
  • Sanctions
• According to Types:
  • Perfect rules
  • Imperfect rules

The Crime

• Violation of criminal law associated with punishment.

Classifications of Crimes

• According to Intent:
  • Intentional: Damage/dangerous event foreseen and intended.
  • Negligence: Damage/danger not intended but occurs due to generic or specific negligence.
  • Beyond Negligence: Act results in more serious damage/danger than intended.
• According to Danger/Damage:
  • Danger: Revelation of professional secrecy (Article 622 p.c), suppression of consciousness (Article 728 p.c).
  • Damage: Personal injury (Article 582 p.c).
• According to Act:
  • Commissive: Intentional Homicide (Art. 575 p.c).
  • Proper Omissive: Omission of official acts (Article 328 p.c).
  • Improper: Commissive by omission.
• According to Manifestation:
  • Consumed: Event has already occurred.
  • Attempted: Attempt to commit a crime where action is incomplete (Article 56 p.c).
• According to Subjects:
  • Uni-subjective
  • Pluri-subjective (e.g., Brawl - Article 588 p.c).
• Report by Healthcare Professionals:
  • Common
  • Exclusive (Omission of referral - Article 365 p.c).
• According to Report by General Conduct / of Event:
  • Conduct (Omission of rescue - Article 593 p.c).
  • Event (Failure to report a crime by public official Article 361 p.c, public employee 362 p.c, citizen 364 p.c).
• According to Prosecution:
  • Prosecuted by Complaint (Articles 336-337 p.p.c).
  • Ex Officio (Articles 330, 331 p.p.c).

Elements of Crime

• Subjective Element: Psychological element & Intention.
  • Presumption of capacity > 18, rebutted by infirmity (Articles 88, 89 p.c).
  • Absolute Liability: No need to prove intention (Article 42 p.c, para 3).
• Objective/Material Element: Event/consequence of behavior.
  • Conduct: Action or Omission.
  • Causation: Relationship between conduct and event (Articles 40, 41 p.c).

Circumstantial Crimes

• Essential Elements- Essential for existence of a crime.
• Accessory Element- Merely affect the seriousness and penalty of a crime.

Classifications/Types

• Aggravating circumstances
• Mitigating Circumstances

Criminal Offences

Criminal offences are divided into two main categories:

• Crimes punishable by *life sentence
  • prison sentence
    *Heavy fines
• Misdeamnours
  *Arrest
  *Lighter fines

Types of Punishment and Offenses

• Principal Penalties (Article 17 p.c):
  • Crimes: Life imprisonment, imprisonment, fine.
  • Misdemeanors: Detention/arrest, amends.
• Naming and Classification of Major Penalties (Article 18 p.c):
  • Custodial: Life imprisonment, imprisonment, arrest.
  • Pecuniary: Payment, fine.
• Accessory Penalties (Article 19 p.c):
  • Crimes:
    • Disqualification from public office (Article 32 p.c)
    • Disqualification from profession (Article 30 p.c)
    • Legal disqualification (Article 32 p.c)
    • Inability to contract with public administration (Article 32 b, c p.c)
    • Termination of employment
    • Disqualification from parental responsibility (Article 34 p.c)
  • Misdemeanors:
    • Suspension from profession (Article 35 p.c)
    • Suspension from management offices (Article 35a p.c)

Cases of NO Punishment

• General
• Special

Special Cases of No Punishment

• Omission of Referral/report (Article 365 p.c), shall not apply when exposes assisted person to criminal proceedings .
• Ending of life / disposing of life; Article 579 p.c : (murder of the consenting person )
• [art. 580 p.c : (incitement or assistance to suicide)
• Aggravating circumstances: artt. 576, 577

Personal Injuries - Individual Safety

The Protected as a legal right - offense of which constitutes (mainly) three hypotheses of crime act:

• Beatings [art. 581 p.c ]
• Personal Injuries [art. 582,583,585 p.c ] & [art. 590 p.c ]
• Homicide

Medical Certificates

Requirements for a Medical Certificate

• Clarity
• Completeness
• Truthfulness
• Protection of pt. confidentiality
• Secrecy

Types :

• Mandatory certificate
• None mandatory certificate

Ethical Deontological Code

• Article 3 e.c : duties & responsibilities of doctor
• Article 4 e.c (freedom & independence of profession autonomy Responsibilities )
• Article 13 e.c

Off Label Drugs

• Use in clinical practice of drugs already registered but used in a manner not in accordance with the authorized Summary of Product Characteristics (SPC… the data-sheet).

Conditions for Granting (art. 700 c.p.c)

• Emergency measures
  *No alternatives (no off label drugs)
• Informed Consent

Age extimation (Diagnosis)

Age extimation (Diagnosis)

• multiparametric determination (with an expert of foreinsic exp.)
• near certainty of age

AGFAD - Age estiamtes carried out for the purpose of criminal proceedings should consist of;

• Physical Examination
• X-ray of the left hand
• Dental examination

BAYES Theorem - how a new piece of information relevant to an uncertain event modifies a previous estimate about the probability of that event.

• a priori probability
• a posteriori probability
• neutral a priori probability [e.g., paternity hypothesis (X) = nonpaternity hypothesis (Y)]

Thanatology & Age Determination in Cadavers

• Death
• Forensic Thanatology
  • Bodily changes after death:
• CADAVERIC PHENOMENA
• COMMON or DISTRUCTIVE;