Legal Medicine Notes

Italian Criminal System

• Criminal Law: Offense against the public, society, or state (e.g., murder, theft).
• Criminal Code: Laws established by the state to control criminal behavior and set punishments.
• Civil Law: Injury/damage to an individual or private party through negligence.
• Civil Code: Financial penalty or an order to change behavior.

Italian Constitution & Fundamental Rights

• Article 3: All citizens are equal before the law.
• Article 13: Personal liberty is inviolable; no detention or search without judicial authority.
• Article 30: Parents have a duty 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

1. Principle of Formal Legality:
   • No act is a crime without a previously published legal text describing it. Affirmed by [art. 1 p.c] and [art. 25 Italian const. Law].
2. Principle of Non-Retroactivity of Criminal Law:
   • A law applies only to acts committed after its adoption. Affirmed by [art. 2 p.c].
3. Principle of Favorable Retroactivity of Criminal Law:
   • A law can be applied even before its enactment if more favorable to the offender. Affirmed by [art. 2 p.c].
4. Principle of Criminal Liability:
   • Legal responsibility for voluntary actions/omissions that result in punishment. Constitutional basis in [Article 27 italian Const. law].
   • Criminal liability is personal.
   • Defendant not guilty until final judgment.
   • Punishment aims at rehabilitation and must not be inhuman.

Preconditions to Criminal Liability

1. Imputability:
   • Capacity to understand and want. [Article 85 p.c.]
2. Awareness of Penal Law:
   • Ignorance of the P.C. is not an excuse. [art.5 p.c.]
3. Objective Liability:
   • No punishment without conscious and intentional actions/omissions. [art.42 p.c.]

Cases of Strict Liability

I. General Part:

• [art. 42 p.c]: Unintentional/negligent acts resulting in more serious harm.

II. Special Part:

• [art. 571 p.c]: Abuse of means of correction/discipline resulting in danger of illness or injury.
• [art. 584 p.c]: Unintentional homicide resulting from crimes est. in [art. 581 p.c] or [art. 582 p.c].
• [art. 591 p.c]: Abandonment of individuals <14yo/incapacitated persons.

Classification of the Penal Code

1. According to Contents:
   • Command rule
   • Guarantee rule
2. According to Characters:
   • Imperative rule: enforced rules
   • Taxative rule: legalizations and sanctioned
3. According to Species:
   • Incriminating, Discriminatory, Declarative/Explanatory, Interpretative/Referral rules
4. According to Parts:
   • Precept: rule of conduct
   • Sanctions: consequence of infraction
5. According to Types:
   • Perfect rules: precepts and sanctions
   • Imperfect rules: either precepts or sanction

The Crime

Violation of criminal law associated with punishment.

Classifications of Crimes

1. According to Intent:
   • Intentional: Damage/dangerous event foreseen and intended [art. 43 p.c].
   • Negligence: Damage/dangerous event not intended but results from generic or specific negligence [art. 43 p.c].
   • Beyond Negligence: Act results in more serious damage than intended [art. 43 p.c].
2. According to Danger / Damage:
   • Danger: [art. 622 p.c], [art. 728 p.c].
   • Damage: [art. 582 p.c].
3. According to Act:
   • Commissive: [ art. 575 p.c].
   • Proper Omissive: [art. 328 p.c].
   • Improper: Commissive by omission.
4. According to Manifestation:
   • Consumed.
   • Attempted: [art. 56 p.c].
5. According to subjects:
   • Uni-subjective / Pluri-subjective: [art. 588 p.c].
6. According to report by Healthcare professionals:
   • Common / Exclusive: [art. 365 p.c].
7. According to report by general:
   • Conduct / of Event: [art. 593 p.c] / [art. 361 p.c].
8. According to Prosecution:
   • Prosecuted by Complaint: [art. 336-337 p.p.c.].
   • By ex-Officio: [art. 330, 331 p.p.c.].

Elements of Crime

• Subjective/Psychological Element: intention
• Objective/Material Element: conduct (action/omission) & causation [Art. 40 p.c] & [ Art. 41 p.c].

Circumstantial Crime

1. Essential elements
2. Accessory element: affect the seriousness and penalty of a crime.

Aggravating circumstances:

[art. 61 p.c and on]

Mitigating circumstances:

[art. 62 p.c and on]

Types of Punishment and Offenses

• Crimes: Life sentence, imprisonment, fine [art. 17 p.c].
• Misdemeanors: Detention/arrest, amends [art. 17 p.c].
• Custodial Penalties: life imprisonment, imprisonment and arrest. [art. 18 p.c].
• Pecuniary Penalties: the payment and the fine. [art. 18 p.c].

Accessory penalties for Crimes (art. 19 p.c):

• disqualification from holding public office [art. 32 p.c]
• disqualification from a profession or an art [art. 30 p.c]
• legal disqualification [art. 32 p.c]
• disqualification from holding managerial positions in legal entities and companies [art. 32a p.c]
• the inability to contract with the public administration [art. 32 b, c p.c]
• the termination of the employment or work relationship
• disqualification or suspension from parental responsibility [art. 34 p.c]
• suspension from exercising a profession or art [art. 35 p.c]
• suspension from the management offices of legal entities and companies [art. 35a p.c]

Cases of NO Punishment

General:

Causes of Justification (legally sufficient reasons).

1. Consent of the entitled person [art. 50 p.c].
2. Exercise of a right/fulfilment of a duty [art. 51 p.c].
3. Legitimate defense [art. 52 p.c].
4. Legitimate use of Weapons [art. 53 p.c].
5. State of necessity [art. 54 p.c].

Special

1. [art. 365 p.c]: Omission of Referral / report.
2. [art. 384 p.c]: Cases of non-punishability.

Ending of life / disposing from life.

• [art. 579 p.c]: Murder of the consenting person.
• [art. 580 p.c]: Incitement or assistance to suicide.
• [ art. 576 p.c]: Aggravating circumstances. Life imprisonment.
• [ art. 577 p.c]: Other aggravating Circumstances. Life imprisonment

Personal Injuries - Individual Safety

Protected as a legal right; three crime hypotheses:

1. Beatings [art. 581 p.c].
2. Personal Injuries: Intentional [art. 582, 583, 585 p.c] / Culpable [art. 590 p.c].
3. Homicide: Intentional, culpable, preterintentional.

[art. 581 p.c , (Beatings)]
[art. 582 p.c , (personal injury ) ]
[art. 583 p.c , (Aggravating Circumstances. Personal injury) ]
[art. 585 p.c , (Aggravating Circumstances) ]
[art. 590 p.c , (culpable personal injury ) ]
[art. 590 bis p.c , (Serious or very serious road personal injuries)]
[art. 590 sexies p.c , (Culpable liability for death / personal injury in health care settings)]

Medical Certificates

• Requirements: Clarity, Completeness, Truthfulness, Protection of patient confidentiality, Secrecy.
• Types: Mandatory, Non-Mandatory
• Art. 1 e.c & Art. 4 e.c : Reporting of cause of death and verification of the deaths.

Registration of death certificate

Medical Certificates

• Mandatory vaccinations
• Certificate of attendance at childbirth
• Anamnestic Certificate

Secrecy and confidentiality

• [art. 10 e.c]: (secrecy of personal data).
• [art. 11 e.c]: (Confidentiality of personal data).
• [art. 622 p.c]: (Revelation of professional secret).
• [art. 326 p.c]: (Revelation and use of official secrets).

Ideological falsity

• [art. 359 p.c]: (committed by person exercising a service of public necessity)
• [art. 358 p.c]: (Comitted by Person in charge of a public service)
• [art. 357 p.c]: (committed by Public Official)

Ethical Deontological Code

• [ art 3 e.c ]: duties & responsibilities of doctor
• [ art 4 e.c ]: responsibilities/freedom
• [ art 13 e.c ]: prescription considerations and requirements
• [ art 15 e.c ]: treatment considerations
• [ art 16 e.c ]: treatment from which a benefit to the patient health &/or improvement in quality of life cannot be expected

OFF Label DRUGS

• art. 1 d.c , para. 4 and on

• Clinical trials in the field of oncology and other measures in health care.

• Emergency measures, Conditions for granting (art. 700 c.p.c)

• Informed Consent rules

Age Estimation (diagnosis)

• AGFAD: age estimates carried out for the purpose of criminal proceedings
• Bayes Theorem

Physical Examination

v 1. Anthropometric Measurements & Body constitutional type

2. Signs of sexual maturity
3. Radiological examination of the hand
4. Radiologial examination of the clavicles of medial epiphysis
5. Dental examination

Thanatology & Age Determination in Cadavers

• Death definition criteria and examination
• Forensic Thanatology
• Bodily changes after death: Cadaveric phenomena (primary/abiotic and secondary/necrological)
• RELATIVE OR CLINIC DEATH
• ABSOLUTE DEATH/ DECOMPOSITION
• Special or Conservative like mummification, corification, saponification