MIDTERM (LESSON 1) SPECIALIZED CRIME INVESTIGATION 2 WITH INTERVIEW AND INTERROGATION INTRODUCTION Special crime investigation deals with the study of major crimes based on the application of special investigative technique. The study concentrates more on physical evidence, its collection, handling, identification and preservation in coordination with the crime laboratory. Special crime investigation involves a close relationship between the prober in the field and the crime laboratory technician. They work together as a team, reacting to and extending one another’s theories and findings both working patiently and thoroughly to solve a crime from their investigative discoveries. The present criminal justice system in our country, the court relies more on physical evidence rather than extra-judicial confession. WHAT IS INTERROGATION? Interrogation is a process of questioning by which police obtain evidence. The purpose of an interrogation is to elicit from the suspect or from his or her relatives or associate's information that they may be suppressing in order to protect the suspect from being subjected to criminal prosecution (Galero-Muftuoglu, 2017, p. 187). Interrogation process is largely outside the governance of law except for rules concerning the admissibility at trial of confessions obtained through interrogation and limitations on the power of police to detain the suspected persons against their will. THREE OBJECTIVES OF INTERROGATION Aside from obtaining information detrimental to a suspect’s case, the following are the three objectives of interrogation: 1. Establish the innocence of a suspect by clearing up facts that seem to point to guilt; 2. Obtain from the suspect or relatives and friends of the suspect: A. The names of accomplices; B. The facts and circumstances surrounding the crime; C. Follow-up leads provided unwittingly, or with ulterior motive, such as faking an alibi; D. The location of stolen goods; E. The location of physical evidence, such as documents, a weapon, or a burglar’s tool. 3. Obtain from the suspect alone: A. Admission – it refers to the express or implied statement tending to support the suspect’s involvement in the crime, but insufficient by itself to prove guilt; B. Confession – it pertains to an oral or written statement acknowledging it. WHAT IS AN INTERVIEW? Interview is defined as a structured conversation where one person or “interviewer” seeks to gather information from one another or the “interviewee” as part of any investigation or intelligence operation. The objective is to obtain accurate and reliable information while respecting human rights; eliciting facts is the aim, not confession. In the process of interviewing the suspects there is the added potential goal of obtaining an admission of guilt or a confession. However, this must not be the primary or sole purpose of interview as even a confession must be substantiated by information and evidence. This will reduce the likelihood of a false accusation and will also enable officers to present stronger case against the suspect, should a confession later be retracted. WHAT IS AN INVESTIGATIVE INTERVIEW? Investigative Interviewing, is a technique developed by practitioners to respond to the large body of scientific evidence that abusive and coercive techniques elicit unreliable information. It uses building rapport with the interviewee, which prevent abusive practices, and also improves the collection and reliability of information. It is a non-coercive approach using open questions to improve the flow of communication and information (Norwegian Center for Human Rights, 2017). GOALS OF INVESTIGATIVE INTERVIEW 1. Eliciting more accurate and reliable information during interviews. 2. Strengthening the capacity, efficiency, and professionalism of interviews. 3. Eliminating reliance on unlawful, ineffective, and counterproductive coercive questioning techniques. 4. Providing successful, affordable, and accessible methods and practices with minimal resources. 5. Delivering more effective information-gathering operations. 6. Fostering greater public trust in and cooperation with criminal justice institutions. 7. Ensuring that no person is subjected to coercion, torture or other forms of ill treatment. 8. Protecting the physical and mental integrity of all persons who interact with public authorities. REID METHOD Reid Method is also known as The Reid Technique of Interviewing and Interrogation, is the interrogation technique widely used by police departments. The Reid Technique involves three components namely: 1. Factual Analysis 2. Behavioral Analysis Interview 3. Interrogation (Nine Steps) FACTUAL ANALYSIS It is an inductive approach where each individual suspect is evaluated with respect to specific observations relating to the crime. It relies not only on crime scene analysis, but also on information learned about each suspect. Its goal is establishing an estimate of a particular suspect’s probable guilt or innocence based on such things as the suspect’s biosocial status like: gender, race, occupation, marital status, etc., opportunity and access to commit the crime, and evaluation of physical and circumstantial evidence. It is also intended to identify characteristics about the suspect and the crime which will be helpful during an interrogation of the suspect believed to be guilty such as motive or the suspect’s personality type. BEHAVIORAL ANALYSIS INTERVIEW It is a non-accusatory question and answer session, involving both standard investigative questions and structured “behavior provoking” questions to elicit behavior symptoms of truth or deception from the person being interviewed. The investigator first asks background questions, to establish personal information about the suspect and allow the investigator to evaluate the suspect’s normal verbal and nonverbal behavior. The investigator then asks behavior-provoking questions intended to elicit different verbal and nonverbal responses from truthful and deceptive suspects (Inbau, F., Reid, J.E., Buckley, J. et.al., 2013, p.63). The investigator will also ask some investigative questions during this stage. It provides objective criteria to render an opinion about the suspect’s truthfulness through evaluating responses to the behavior-provoking and investigative questions. INTERROGATION (NINE STEPS) An interrogation only occurs when the investigator is reasonably certain of the suspect’s involvement in the issue under investigation (Inbau, F., Reid, J.E., Buckley, J. et.al., 2013, p.99). This is composed of Nine steps, they are: 1. Direct, Positive Confrontation 2. Theme Development 3. Handling Denials 4. Overcoming Objections 5. Procurement and Retention of Suspect’s Attention 6. Handling the Suspect’s Passive Mood 7. Presenting an Alternative Question 8. Having the Suspect Relate Details of the Offense 9. Converting an Oral Confession to a Written Confession NINE STEPS 1. Direct, Positive Confrontation. This is where the investigator tells the suspect that the evidence demonstrates the person’s guilt. If the persons guilt seems clear to the investigator, the statement should be unequivocal. 2. Theme Development. This is where the investigator presents a moral justification(theme) for the offense, such as placing the moral blame on someone else or outside circumstances. The investigator presents the theme in a monologue and in a sympathetic manner. 3. Handling Denials. When the suspect asks for permission to speak at this stage, likely to deny accusations, the investigator should discourage allowing the suspect to do so. The innocent suspect are less likely to ask for permission and more likely to promptly and unequivocally deny the accusation. 4. Overcoming Objections. When attempts at denial do not succeed, a guilty suspect often makes objections to support a claim of innocence, phrases such as I would never do that because I love my job are commonly used. The investigator should generally accept these objections as if they where truthful, rather than arguing with the suspect, and use the objections to further develop the theme. 5. Procurement and Retention of Suspect’s Attention. The investigator must procure the suspect’s attention so that the suspect focuses on the investigator’s theme rather than on punishment. One way the investigator can do this is to close the physical distance between himself or herself and the suspect. The investigator should also channel the theme down to the probable alternative components. 6. Handling the Suspect’s Passive Mood. The investigator needs to intensify the theme presentation and concentrate on the central reasons he or she is offering as psychological justification and continue to display an understanding and sympathetic demeanor in urging the suspect to tell the truth. 7. Presenting an Alternative Question. The investigator should present two choices, assuming the suspect’s guilt and develop as a logical extension from the theme, with one alternative offering a better justification for the crime e.g., “Did you plan this thing out or did it just happen on the spur of the moment?” The investigator may follow the question with a supporting statement which encourages the suspect to choose the more understandable side of the alternative. 8. Having the Suspect Relate Details of the Offense. After the suspect accepts one side of the alternative thus admitting guilt, the investigator should immediately respond with a statement of reinforcement acknowledging that admission. The investigator then seeks to obtain a brief oral review of the basic events, before asking more detailed questions. 9. Converting an Oral Confession to a Written Confession. The investigator must convert the oral confession into a written or recorded confession. The website provides some guidelines, such as repeating Miranda Warnings, avoiding leading questions, and using the suspect’s own language. PEACE METHOD PEACE Model (Planning and Preparation, Engage and Explain, Account, Closure, Evaluation), developed in the United Kingdom in response to a number of documented forced confessions and wrongful convictions in the 1980s and 90s (Norwegian Center for Human Rights, 2017). STEP ONE: PLANNING AND PREPARATION It is one of the most important steps in investigative interviewing; without it, interviews may fall before they even begin. Planning – refers to the process of getting ready to interview, both mentally and strategically. Preparation – covers what needs to be ready prior to the interview such as the location of the interview, the environment, as well as technical and administrative matters. Essential Elements of Good Planning • Obtain as much background information as possible on the incident under investigation, including all relevant information on the person to be interviewed. • Assess what additional information is needed and how can it be best obtained. • Follow the legislation and associated guidelines and rules. • Understand the purpose of interview based on an investigation plan recognizing all the relevant and competing hypotheses to be explored, including the possibility that the suspect is innocent. • Prepare the technicalities of the interview (attending to exhibits, logistics, venue, equipment functioning, seating, lawyer, interpreter, and so on) (Norwegian Center for Human Rights, 2017). STEP TWO: ENGAGE AND EXPLAIN Engaging the interviewee and building rapport is the first step to encouraging a conversation. It is the most influential factor in ensuring productive interviews (Norwegian Center of Human Rights, 2017). At the outset the interviewee must be informed why they have been brought in for questioning and the formalities that apply. Officers must be aware that being interviewed can make people nervous and conversation that calms the interviewee may be needed. However, interviewers shall not work towards a pretend “friendship” with interviewees. The aim is to engage the interviewee so that a cooperative and relaxed relationship (one that stimulates memory and communication) is sustained throughout the interview (Boyle, and Vullierme, 2015, p. 23). In engaging with the interviewee, the officer should seek the following (Norwegian Center for Human Rights, 2017): 1. Create an empathetic and respectful relationship from the outset. 2. Explain the reasons, background, rights, formalities and procedure for the interview, including information about audio/video recording. 3. Establish certain ground rules by telling interviewees: • That what they have to say is important so they need to report everything they can and try their hardest no to leave anything out. • Not to edit as they go even if they believe some information has no relevance to the matter being investigated • That they need to concentrate because striving to retrieve memories can be hard work • That they should feel free to speak up if the officer: asks a question they do not understand; asks a question they do not know the answer to; misunderstand what the interviewee has said; asks a leading or inappropriate question. STEP THREE: ACCOUNT Interviewers should allow the interviewee to present their uninterrupted free account of the case or event under investigation; this is after establishing the ground rules for the interview. It is important that the interviewee is provided with the opportunity to present their side of the story, before more detailed questions are asked (Norwegian Center for Human Rights, 2017). Three main steps in getting the free account from the interviewee: 1. Introduce and explain the form and purpose of the free and uninterrupted account 2. Hand over the initiative (“give the floor”) to the victim, witness or suspect (as applicable) 3. Employ active listening while the interviewee presents the free and uninterrupted account Active listening assists the interviewer to establish rapport and help elicit a full and accurate account. Use TED’S PIE: Tell me, Explain, Describe Show Me-Precisely, In detail, Exactly. Using this approach helps build rapport and prevents the interviewer contaminating the account being given. The TED’S PIE approach makes use of encouragements/invitations to obtain an account (Norwegian Center for Human Rights, 2017). TYPES OF QUESTIONING OPEN-ENDED QUESTIONS Refers to the questions that allow the suspect to reply with longer, more detailed responses and lack direction from the interviewer. These can be questions such as; “What happened?” or questions that begin by asking the suspect to “tell”, “explain” or “describe” some event or situation (Boyle, and Vullierme, 2015, p.26) CLOSED QUESTIONS Refers to the questions that require more definite and distinct answers. Examples include, “What time was that?”, “Who else was present?”, “What is his address?” such questions allow more control over what the suspect says and are useful where the suspect has left out information that you need. However, they can limit the account given (Boyle, and Vullierme, 2015, p. 26) FORCED-CHOICE QUESTIONS Refers to the questions that greatly restrict the possible answers to those that you have determined. The question may be “Was it a rifle or a handgun?” when the weapon may have been a shotgun. The suspect may simply pick one of the choices offered in order to please the interviewer or just move the questioning on. You should avoid these as they don’t suggest an open mind, and because answers may lie outside those conceived of by the interviewer. Do not limit the interview in this way (Boyle, and Vullierme, 2015, p. 26) MULTIPLE QUESTIONS Refers to the questioning where the interviewer asks more than one question at the same time. This can easily confuse an interviewee and make the answers given equally confusing to the interviewer. An example would be to ask, “When did he say that and what did he do and who else was present?” (Boyle, and Vullierme, 2015, p. 26). LEADING QUESTIONS Refers to the questions that induce a particular reply and may be judged to have manipulated the interviewee. An example would be to ask, “You wanted to injure him, didn’t you?” They can lead the suspect to the point where they agree with what was being said even where they are uncertain or have no clear memory (Boyle, and Vullierme, 2015, p. 26). STEP FOUR: CLOSURE As the interview comes to an end, the interviewing officer should explain what will happen next by giving the interviewee appropriate information about the next stages of the process: for example, inform suspects of potential pre-trial detention, tell witnesses whether or not they should expect to attend court, etc. (Norwegian Center for Human Rights, 2017). Finally, the interviewee should be asked if they have any questions for the interviewing officer at this stage. This has little or no real effect if the communication has been coercive. However, if the interview has been conducted as outlined above, this question may add to the interviewee’s perception of having been treated fairly (Boyle, and Vullierme, 2015, p. 26). The goal of the closure are the following (Norwegian Center for Human Rights, 2017): 1. Ensure there is a mutual understanding of the interviewee’s accunt by reviewing and summarizing it 2. Verify that all aspects have been sufficiently covered by checking that interviewees have given all the information they are able and willing to provide 3. Secure the integrity and dignity of the interview, the legitimacy of any subsequent criminal proceedings, and keep channels open for future communication. STEP FIVE: EVALUATION This is the phase wherein the interviewee evaluates the entire process of the interview and determines if his objectives were met. He also evaluates the method he used in acquiring useful statements from the witness, victim, or suspect and the effectiveness of said method. (Galero-Muftuoglu, 2017, p. 186) If the interview is evaluated by a supervisor, senior officer or colleague, make sure that the interviewing officers are given the opportunity to comment on their own performance, before the evaluator gives their points, starting with what was positive, moving on to what could be improved next time (Norwegian Center for Human Rights, 2017) LESSON 2 SPECIALIZED CRIME INVESTIGATION 2 WITH INTERVIEW AND INTERROGATION MENDEZ METHOD The Mendez Principles, also known as the new Principles on Effective Interviewing for Investigations and Information Gathering. It was named after Juan Mendez, the Argentine lawyer, torture survivor and former UN Special Rapporteur. It is a concrete alternative to interrogation methods that rely on coercion to extract confessions. They provide guidance on obtaining accurate and reliable information in full respect of the human rights and dignity of all, including through the implementation of legal and procedural safeguards in the first hours of police custody (IRCT, 2021). The Mendez Method has three parts; Before, During, and After the interview. BEFORE THE INTERVIEW – ENSURING A NON-COERCIVE ENVIRONMENT Creating a non-coercive environment involves the respect and fulfillment of human rights from the first moment of contact between the interviewee and authorities. This allows law enforcement, intelligence, security or military officials to create conditions conductive to gathering accurate and reliable information during the interview, to fulfill State obligations under international law and to protect the lights of the interviewee. Unlawful and unprofessional behavior, and a lack of accountability, at the early stages of contact may taint the overall judicial process irreversibly (Mendez, 2016, p. 14-15). KEEPING THE INTERVIEW INFORMED Showing concern for the interviewee from the initial contact is the first opportunity for creating trust and rapport. This is more likely when an interviewee is given early, explicit explanations of why they have brought in for questioning., which formalities apply, and how the interview will proceed. Explaining procedures and likely activities is an early opportunity to display sincerity, provide predictability, to be respectful and attentive, and promote trust. The right to be informed by the detaining authority about the reasons of arrest applies regardless of manner, or the formality or informality with which an arrest is conducted, and regardless of the reasons for the deprivation of liberty (Mendez, 2016, p.15). Information regarding an interviewee’s rights and how to exercise them should be conveyed verbally, in clear, non-technical, and precise language upon arrest; and it should also be provided in writing by the detaining authority upon arrival at the place of detention in a language and format they understand. NOTIFICATION OR FAMILY OR THIRD PARTY A key safeguard for detainees is their right to promptly notify a family member, friend, or other person of their choice about the fact, place and circumstances of their detention. The detaining authority is responsible for enabling the communication with the third party and recording who has been notified and when the notification took place (Mendez, 2016, p. 16). Foreign nationals who are arrested or detained must be informed immediately of their right to communicate with a consular and diplomatic representative of their country or origin. Asylum seekers should be informed of their right to contact relevant international agencies. Contact is to be facilitated by the detaining authority (Mendez, 2016, p.17). ACCESS TO LAWYER All detained persons being interviewed have a right to a lawyer, including through legal aid, before any questioning by authorities – independent of their status or formal designation. Access to a lawyer is inextricably linked to the protection of rights, prevention of torture and other ill-treatment, and helps to protect against compelled self-incrimination. The interviewee is entitled to a lawyer of their own choosing, or to have one provided for them free of charge when the interests of justice so require. The presence of the lawyer is compulsory for detained children interviewed as suspects (Mendez, 206, p.17). PREPARATION FOR THE INTERVIEWER Once an individual has been identified as a person the authorities wish to interview, the appointed interviewer should start thorough preparations. Being fully prepared increases an interviewer’s ability to effectively communicate with the interviewees, and hence, the likelihood of obtaining reliable information. Before commencing an interview, it is crucial to maximize the investigative and evidentiary value of the information already gathered. When preparing for an interview - and throughout the process – interviewers should exercise caution to avoid ‘confirmation bias’. Interviewers should continually monitor their own emotions about the subject matter and their feelings towards the interviewee, to be able to project calm and self-control throughout the interview (Mendez, 2016, p.19). DURING THE INTERVIEW – ESTABLISHING AND MAINTAINING RAPPORT Effective interviewers are adaptable, listen carefully, communicate empathy, and adopt the ethos that non-coercive, humans, ethical, lawful and appropriate questioning serves the interest of all involved: the interviewer, the interviewee and the information-gathering authorities. They recognize that the interviewer’s role is to acquire the best possible information for decisions to be made. Only courts determine guilt or innocence. The development of rapport is essential in supporting effective information-gathering. During the interview, rapport entails establishing and maintaining a relationship characterized by: respect and trust; a non-judgmental mindset; non-aggressive body language; attentiveness; and patience (Mendez, 2016, p.20). INFORMATION GATHERING TECHNIQUES Active listening helps the interviewer process the information provided by the interviewee. By listening actively, the interviewer shows that they are following what the interviewee is saying and making efforts to understand. The interviewer takes care not to lead the interviewee inadvertently by using verbal or visual cues, including sounds, gestures or questions, which may be interpreted as agreeing or disagreeing with what the person is saying. Accurate summaries of what the interviewee has said may facilitate the positive progression of the interview and assist the interviewer and interviewee in recalling important details (Mendez, 2016, p.21). ENCOUNTERING RELUCTANCE Interviewers may encounter interviewees who are reluctant to talk and therefore should anticipate how they will handle such situations. Not wanting or agreeing to answer questions may be a deliberate choice. This decision must always be respected and has no bearing on the interviewer’s right to the presumption of innocence. Reasons why an interviewee might be reluctant to talk can include general anxiety or uncertainty about the process, especially if the person has never been involved in such a situation before. It is also possible that an interviewee maybe willing to provide information but is unable to do so. This can be because they did not have the relevant information to begin with, or they failed to register the details. Interviewers should not draw negative inferences from the interviewee’s failure or refusal to answer questions and should remain non-judgmental when an interviewee may make admission to crimes or convey embarrassing information (Mendez, 2016, p.21). SUSPENDING THE INTERVIEW It is appropriate and permissible for interviewers to suspend the interview in order to follow-up on information received or conduct additional enquiries. Other reasons to suspend an interview are (Mendez, 2016, p.22): 1. If the interviewee requires medical attention, 2. If a person originally interviewed as a witness becomes a suspect in the course of an interview; and 3. If the lawyer or the interviewee may request a break, for instance in order to rest or to consult in private. A refusal to accept such a request by the interviewer may affect the reliability of information gathered from the interview. AFTER THE INTERVIEW – ASSESSMENT AND ANALYSIS An effective interviewer should always end the interview respectfully and on a professional note. This increases the likelihood of keeping channels open for future communication, avoids possible misunderstandings and can improve trust in public institutions. The interviewer should review the information obtained with the interviewee and the lawyer, if involved; and, where a written record (as opposed to an audio/video recording) has been made, invite them to sign as a confirmation of the record’s accuracy. An amendments should be recorded, and if relevant, any refusal of the interviewee to sign the interview record. Once the interview has been completed, the interviewer ensures that the information provided during the process is subject to the appropriate level of privacy and of data protection. The interviewer should assess and analyze the following (Mendez, 2016, p.23): 1. The value and reliability of the information obtained and how it fits with known evidence, information gaps and other intelligence gathered. 2. What further enquiries are necessary in order to advance the investigation or operation; and 3. Whether all relevant safeguards were applied effectively. KINESIC INTERVIEW METHOD Kinesic Interview Method involves analyzing a person’s behavior to assess deception (Orlando, 2014). The study of kinesics focused on observable outward physical behavior of the body in order to ascertain the person’s current emotional state and the role the body plays in communicating the information. It states that, by understanding the vocabulary of the body language, along with the diagnosis of a person’s verbal output, an interviewer could more easily assess a person’s truthfulness or deception regarding current issues under discussion (Walters, 2002, p.2). It has two phases: the Practical Kinesic Analysis Phase; and the Practical Kinesic Interrogation Phase. PRACTICAL KINESIC ANALYSIS PHASE During the analysis phase, the interviewer uses several techniques to observe and analyze the subject’s behavior in order to determine the subject’s truthful and deceptive behaviors or at least to determine those areas most sensitive to the subject and, therefore, in need of further attention through verbal inquiry. It recognizes the cues of truthful and deceptive behavior generated by the subject through: 1. Verbal Cues – this involves the identification of symptoms of speech quality and content which give the interviewer the most productive body of data necessary to determine truth and deception. 2. Practical Kinesic Statement Analysis – assessment of truth and deception through the use of verbal cues coupled with methods of human recall and symptoms made self-evident in the statement taking process. 3. Body Language Cues – it refers to the observable body language cues of deception that are unbalanced or inconsistent in relation to the speech cues or emotional symptoms generated by the suspect at the same time. 4. Kinesic Subject Control – it refers to the various techniques available to the interviewer to take control and command of the interview environment. From proxemics to mirroring or the use of enhanced information gathering skills. 5. Confession Behaviors – it is the verbal and nonverbal acceptance cues generated by a subject who is prepared to give an admission of confession. PRACTICAL KINESIC INTERROGATION PHASE Practical Kinesis Interrogation Phase involves the interviewer determining the subject’s frame of mind in response to the interview stress. It also helps the interviewer in determining if the subject is suffering from personality disorder or psychosis. It also helps the interviewer determine the subject’s personality type which enables him to understand how the subject thinks and to determine the subjects’ strengths to be avoided and the weaknesses that can be exploited. Lastly it will help the investigator in determining the defense mechanism of the subject which keeps the subject from having to face the reality of his actions; and by identifying and disarming these mechanisms, the interrogator can obtain admission or confession (Walters, 2002, p.3). GUIDELINES OF CUSTODIAL INVESTIGATION According to the PNP Operational Procedures Manual (2011), the duties of the Police during custodial investigation are as follows: 1. The arresting officer, or the investigator, as the case may be, shall ensure that a person arrested, detained or under custodial investigation shall, at all times, be assisted by counsel, preferably of his own choice (PNP, 2011, p.33). 2. The arresting officer, or the investigator, as the case may be, must inform the person arrested, detained or under custodial investigation of the following rights under the Miranda Doctrine in a language or dialect known to and understood by him (PNP, 2011, p.33). a. That he has the right to remain silent; b. That if he waives his right to remain silent, anything he says can be used against him in court; c. That he has the right to counsel of his own; d. That, if he cannot afford one, he shall be provided with an independent and competent counsel; and e. That he has the right to be informed of such rights. 3. If the person arrested, detained, or under custodial investigation opted to give a sworn statement, the arresting officer, or the investigator, as the case may be, must reduce it in writing (PNP, 2011, p.34). 4. The arresting officer must ensure that, before the sworn statement is signed, or thumb marked, if there is inability to read and to write, the document shall be read and adequately explained to the person arrested, detained or under custodial investigation by his counsel of choice, or by the assesting counsel provided to him, in the language or dialect known to him (PNP, 2011, p.34). 5. The arresting officer, or the investigator, as the case may be, must ensure that any extrajudicial confession made by a person arrested, detained or under custodial investigation shall be (PNP, 2011, p.34): a. In writing; b. Signed by such person in the presence of his counsel; or c. In the latter’s absence, upon a valid waiver, and in the presence of any of the parents, elder brothers and sisters, his spouse, the municipal mayor, the municipal judge, district school supervisor, priest, imam or religious minister chosen by him. It is important to note that failure of the arresting officer, or the investigator, to observe the above mention procedures shall render the extrajudicial confession inadmissible as evidence in any proceeding (PNP, 2011, p.34) 6. The arresting officer, or the investigator, as the case may be, must, under established regulations, allow the person arrested, detained, or under custodial investigation visits by or conferences with the following: a. any member of his immediate family, b. any medical doctor, c. priest, imam or religious minister chosen by him or by any member of his immediate family or by his counsel, or by any Non-Governmental Organization (NGO) duly accredited by the Commission on Human Rights (CHR) or by any international NGO duly accredited by the Office of the President. 7. After interrogation, a person under custodial investigation shall have the right to be informed of his right to demand physical examination by an independent and competent doctor of his own choice. If he cannot afford the services of a doctor of his own choice, he shall be provided by the State with a competent and independent doctor to conduct physical examination. If the person arrested is female, she shall be attended to preferably by a female doctor (PNP, 2011, p.34-35). The physical examination of the person under custodial investigation shall be contained in a medical report, which shall be attached to the custodial investigation report. LESSON 3 LEGAL REQUIREMENTS FOR ADMISSION AND CONFESSION Admissions and confessions are only legally valid if made voluntarily, knowingly, and intelligently, with judicial or extrajudicial distinctions affecting their admissibility. DEFINITIONS AND DISTINCTIONS ●ADMISSION – A voluntary acknowledgment of a fact relevant to a case, which does not necessarily imply guilt. It can be judicial (made in court or pleadings) or extrajudicial (made outside court) and may be used as evidence against the declarant, though extrajudicial admissions are not conclusive and require proof of credibility and relevance. ●CONFESSION – A direct acknowledgment of guilt for the offense charged or any offense necessarily included therein. Confessions are always statements of criminal liability and can be judicial or extrajudicial. CORE LEGAL REQUIREMENTS 1. Voluntariness – the statement must be given freely, without coercion, force, intimidation, or inducement. Any confession obtained through threats, violence, or improper influence is inadmissible. 2. Knowledge and Intelligence – the accused must understand the nature and consequences of the statement. This ensures that the confession or admission is made knowingly and intelligently. 3. Assistance of Counsel – during custodial investigation or after arrest, the accused is entitled to competent and independent legal counsel. Extrajudicial confessions made without counsel may be inadmissible as they violate constitutional rights. 4. Judicial vs. Extrajudicial Confessions: Judicial Confession – Made in open court or in pleadings; sufficient for conviction without additional evidence. Extrajudicial Confession – Made outside court; requires corroboration by independent evidence to be admissible. 5. Relevance and Evidentiary Value – the admission or confession must relate to facts in issue and not be excluded by privilege or other legal rules. Judicial admissions are conclusive, while extrajudicial admissions are evaluated for credibility and weight by the court. 6. Corpus Delicti Rule – a confession alone is insufficient for conviction; the prosecution must establish that a crime has actually been committed. LEGAL REQUIREMENTS FOR ADMISSION Admissions can be classified as judicial (made in the course of judicial proceedings) or extrajudicial (made outside of court). For Judicial Admissions: ●Can be made in pleadings, during trial via stipulations/manifestations, or at other stages such as pre-trial. ●Requirements: They do not require formal proof and are conclusive upon the party making them. They can only be contradicted by showing that they were made through a palpable mistake or that no such admission was made. For Extrajudicial Admissions: ●Must be relevant to the issue at hand. ●May be given in evidence against the maker (as an admission against interest), but are generally subject to regular rules of relevance and hearsay exceptions. LEGAL REQUIREMENTS FOR CONFESSION Because confessions directly admit criminal liability and carry heavy penal consequences, they face strict constitutional and statutory safeguards—particularly when made outside of court (extrajudicial confessions). To be admissible as evidence in court, an extrajudicial confession must meet the following mandatory requirements: Voluntariness: ●The confession must be given freely and knowingly. It must not be the product of torture, force, violence, threat, intimidation, or any other influence that vitiates the individual's free will. Observance of Miranda Rights (Custodial Safeguards): ●If a person is under custodial investigation, they must be proactively informed in a clear, understandable manner of their rights: to remain silent, that any statement can be used against them, to have competent and independent counsel preferably of their choice, and to be provided free legal counsel if they cannot afford one. Assistance of Competent and Independent Counsel: ●The confession must be made with the active presence and genuine representation of independent counsel. ●Any waiver of the right to counsel must be made in writing and executed in the presence of the counsel. Form and Language: ● Extrajudicial confessions must ideally be in writing and signed (or thumb marked) by the confessant. ● They must be expressed clearly and interpreted/read to the accused in a language or dialect that they fully understand. The Exclusionary Rule: ● Under constitutional law, any confession obtained in violation of the right to counsel, Miranda rights, or through coercion is inadmissible as evidence in any proceeding (the "fruit of the poisonous tree" doctrine). Corroboration (Corpus Delicti Rule): ● An extrajudicial confession alone is insufficient to sustain a criminal conviction. It must be corroborated by independent evidence of the corpus delicti (proof that the crime actually happened and someone is criminally responsible). CORE REQUIREMENTS FOR ADMISSIBILITY Consciousness of Impending Death: At the time the statement was made, the declarant must have been under the fixed belief that death was near and inevitable. Complete despair of recovery must be apparent, though the exact moment of death does not need to be immediate. Subject Matter: The statement must concern the cause and surrounding circumstances of the declarant's impending death. Statements about unrelated past grudges or matters are inadmissible. Case Type Limitation: Traditionally and under most statutory rules (such as the Philippine Rules of Evidence), dying declarations are admissible primarily in criminal prosecution for homicide, murder, or parricide where the death of the declarant is the subject of the charge. Competency of the Declarant: The declarant must have been a competent witness at the time the statement was made (i.e., possessing the capacity to perceive and communicate the event). Declarant Must Be Deceased: The declarant must have actually died, and their death must be the subject of the inquiry. CONSTITUTIONAL SAFEGUARDS ●The accused has the right to remain silent and cannot be compelled to confess. ●Any admission or confession must respect due process and fundamental rights under the Philippine Constitution DYING DECLARATION VS. INDEPENDENT RELEVANT STATEMENT Dying declaration and independent relevant statement are both types of statements made by individuals that are considered to be reliable evidence in court. However, the key difference between the two lies in the circumstances under which they are made. A dying declaration is made by a person who believes they are about to die, and their statement is considered to be particularly trustworthy due to the belief that they have no reason to lie. On the other hand, an independent relevant statement is made by a person who is not in imminent danger of death, but their statement is still considered to be reliable because it is made independently of any external influence or coercion. Both types of statements play a crucial role in the legal system in determining the truth of a matter. PRINCIPLES OF A DYING DECLARATION ●A dying declaration is an out-of-court statement made by a victim regarding the cause and surrounding circumstances of their impending death. Under the rules of evidence, it serves as an exception to the hearsay rule and is admissible because of the principle of necessity (since the declarant is dead and cannot testify) and the trustworthiness presumption (that a person at the point of death has no motive to fabricate the truth). INDEPENDENT RELEVANT STATEMENTS ●An independent relevant statement (sometimes referred to as verbal acts or statements relevant independent of the truth of the facts stated) is an out-of-court statement offered in court not to prove the truth of the matter asserted, but simply to prove that the statement was made, heard, or that it had a legal effect. ●These statements are admissible in court if they meet the requirements of relevance and reliability. The declarant must have personal knowledge of the facts stated in the statement, and the statement must be relevant to the issues in the case. ●Because the truth of the utterance does not matter, these statements are not hearsay at all and are freely admissible. CATEGORIES AND EXAMPLES Statements as Verbal Acts / Constitutive Facts: Words that legally constitute a crime, contract, or civil wrong. ●Example: Words of defamation in a libel case, or words offering a bribe in a corruption case. The statement is proven just to show it was uttered. Statements Showing State of Mind / Knowledge / Notice: Words used to establish what someone knew, their belief, or their mental state. ●Example: Telling a defendant that a specific machine is dangerous. This is admissible not to prove the machine is dangerous, but to prove the defendant had notice or knowledge of the danger. Statements Showing Effect on the Hearer: Words that explain why a listener acted the way they did. ●Example: Threats made to a victim to explain why the victim acted in self-defense or fled in fear. Identifications: Out-of-court statements identifying a person (e.g., a witness pointing out a suspect in a lineup), which are relevant to establish identification independent of the factual narrative. COMPARISON Dying Declarations are considered highly reliable due to the belief that a person facing imminent death would not lie. On the other hand, Independent Relevant Statements do not carry the same level of reliability, as they are not made under the same circumstances. Dying Declarations are admissible as exceptions to the hearsay rule, while Independent Relevant Statements must meet the requirements of relevance and reliability to be admissible. Dying Declarations are made by individuals who believe they are about to die, and the statements pertain to the cause or circumstances of their impending death. In contrast, Independent Relevant Statements are made by individuals who have personal knowledge of the facts stated in the statement, and the statements are relevant to the issues in the case. Dying Declarations are often used in cases where the declarant's impending death is a central issue, such as murder trials. Independent Relevant Statements, on the other hand, are used to provide additional context or evidence to support a party's case. In some cases, both types of statements may be used in conjunction to strengthen a party's argument.

Arterial Insufficiency

Venous Insufficiency & Wound Dressings

PSYCHOLOGY TEST #1 — COMPLETE STUDY NOTES Test Format (40 Marks) Part A: Fill in the Blank — 10 marks (Knowledge) Part B: Identification — 10 marks (Inquiry) Part C: Short Answer — 10 marks (Communication) Part D: Theory Application — 10 marks (Application) 1. THE PHYSICAL HUMAN BRAIN Frontal Lobe Functions: Controls higher thinking skills, decision-making, problem-solving, planning, attention, intelligence, personality, emotions and voluntary movements. Associated disorders: ADHD, schizophrenia and bipolar disorder. Damage can cause: Paralysis, mood changes, personality changes, difficulty speaking, loss of spontaneity and unusual social behaviour. Remember: Frontal = Thinking and personality. Parietal Lobe Functions: Processes sensory information, especially touch. Helps with spatial awareness, balance, recognizing objects and understanding surroundings. Associated disorders: Alzheimer's disease, ADHD and schizophrenia. Damage can cause: Sensory difficulties, disorientation, poor coordination and difficulty recognizing or locating objects and body parts. Remember: Parietal = Touch and surroundings. Occipital Lobe Functions: Processes visual information, including colours, shapes, movement and objects. Responsible for vision. Associated disorders: Schizophrenia, bipolar disorder, autism and depression. Damage can cause: Blindness, visual hallucinations and difficulty seeing colours or movement. Remember: Occipital = Vision and seeing. Temporal Lobe Functions: Responsible for hearing, recognizing faces and objects, understanding language, learning, memory and emotions. Associated disorders: Schizophrenia, Alzheimer's disease and autism. Damage can cause: Memory loss, speech difficulties, difficulty understanding language, difficulty recognizing faces and objects, and changes in behaviour. Remember: Temporal = Hearing and memory. Cerebellum Functions: Controls balance, posture, coordination, voluntary movements, reflexes, motor skills and timing. Associated disorders: Autism, schizophrenia and dyslexia. Damage can cause: Poor coordination, tremors, dizziness, difficulty walking and slurred speech. Remember: Cerebellum = Balance and coordination. Brain Stem Functions: Controls automatic body functions such as breathing, heart rate, blood pressure and digestion. Also helps regulate sleep, alertness and balance. Associated disorders: Autism and sleep disorders such as insomnia. Damage can cause: Organ problems, sleep difficulties, balance problems and serious problems with automatic body functions. Remember: Brain Stem = Keeps you alive. Quick Memorization: Frontal = Thinking. Parietal = Touch. Occipital = Vision. Temporal = Hearing and memory. Cerebellum = Balance. Brain Stem = Automatic functions. 2. SIGMUND FREUD Who was Sigmund Freud? Austrian neurologist and psychologist. Founder of psychoanalysis. Believed the unconscious mind strongly influences human behaviour. Believed childhood experiences help shape personality. Freud's 7 Main Theories 1. Psychoanalysis A method of studying and understanding the unconscious mind. Freud believed hidden thoughts, feelings and childhood experiences influence behaviour. Used therapy to help people understand their unconscious thoughts. Example: Someone may have a fear without understanding where it originally came from. 2. Three-Part Psyche Freud believed personality was made up of three parts: the Id, Ego and Superego. Id Represents biological wants and desires. Follows the pleasure principle. Wants immediate satisfaction without thinking about consequences. Example: Eating all the cookies because you want them. Remember: Id = Wants. Ego Balances the Id and Superego. Follows the reality principle. Makes realistic decisions and considers consequences. Example: Deciding to eat one cookie instead of all of them. Remember: Ego = Reality. Superego Represents your conscience. Tells you what is right and wrong. Develops through experiences, rules and values. Example: Knowing you shouldn't take someone else's cookies. Remember: Superego = Morals. 3. Oedipus Complex Freud believed young children experience unconscious feelings of attachment toward the parent of the opposite sex and rivalry toward the same-sex parent. Named after the Greek character Oedipus, who unknowingly killed his father and married his mother. Remember: Opposite-sex parent = Attachment; same-sex parent = Rivalry. 4. Sexual Desires (Libido) Freud believed sexual energy, called libido, influences human personality and behaviour. He believed frustration of desires could affect mental health. The term Freudian slip comes from his ideas about unconscious thoughts accidentally appearing in speech. Example: Accidentally saying what you were actually thinking instead of what you meant to say. 5. Examination of Dreams Freud believed dreams were a window into the unconscious mind. He thought dreams revealed hidden thoughts, feelings and desires. Example: A dream might represent a hidden fear or worry. 6. Stages of Development Freud believed personality develops through five stages. Each stage focuses on a different area of pleasure. Oral Stage (0–18 months): Pleasure comes from the mouth, such as sucking and feeding. Anal Stage (18 months–3 years): Focuses on toilet training and control. Phallic Stage (3–6 years): Focuses on the body and awareness of gender differences. Latency Stage (6–puberty): Sexual urges are less noticeable. Children focus more on friendships, school and learning. Genital Stage (puberty–adulthood): Focuses on mature relationships and sexual interests. Remember the order: Oral → Anal → Phallic → Latency → Genital. 7. Defence Mechanisms Freud believed the mind uses defence mechanisms to protect itself from uncomfortable thoughts and feelings. They happen unconsciously. Important examples: Denial: Refusing to accept reality. Example: Saying you didn't fail a test when you did. Repression: Pushing upsetting memories out of awareness. Projection: Blaming others for your own feelings. Example: Calling someone jealous when you are jealous. Displacement: Taking your feelings out on someone else. Example: Being upset at school and snapping at a family member. Rationalization: Making excuses for behaviour. Example: Saying a test was unfair because you didn't study. How Freud Applies to Psychology Helps explain how the unconscious mind influences behaviour. Helps explain how childhood experiences affect personality. Studies how dreams and hidden feelings may affect people. Explains how defence mechanisms protect people from uncomfortable emotions. Influenced the development of psychotherapy and talk therapy. 3. CONDITIONING Conditioning is a type of learning where behaviour changes through experiences and associations. There are two main types: Classical and Operant Conditioning. A. Classical Conditioning Learning through association. Happens when someone connects two stimuli. A person learns to associate something with a natural response. The response eventually becomes automatic. Example: Pavlov's Dogs Pavlov rang a bell before giving dogs food. Food naturally caused the dogs to salivate. Eventually, the dogs started salivating just from hearing the bell. Four Important Terms: US (Unconditioned Stimulus): Something that naturally causes a reaction. UR (Unconditioned Response): The natural reaction to the stimulus. CS (Conditioned Stimulus): Something originally neutral that becomes associated with the unconditioned stimulus. CR (Conditioned Response): The learned reaction to the conditioned stimulus. Example from your notes: Toilet and Shower Every time someone flushes a toilet, the shower becomes very hot. Eventually, the person jumps back just from hearing the toilet flush. US: Hot water. UR: Jumping back. CS: Toilet flushing. CR: Jumping back when hearing the toilet flush. Remember: Classical = Association. B. Operant Conditioning Learning through rewards and punishments. Behaviour changes depending on its consequences. People learn which behaviours lead to positive or negative outcomes. Usually involves voluntary behaviours. Four Types of Operant Conditioning: 1. Positive Reinforcement Adding something pleasant to increase a behaviour. Example: Getting a reward for good grades. 2. Negative Reinforcement Removing something unpleasant to increase a behaviour. Example: Homework stops once you finish your chores. 3. Positive Punishment Adding something unpleasant to decrease a behaviour. Example: Getting extra chores for breaking a rule. 4. Negative Punishment Removing something pleasant to decrease a behaviour. Example: Losing phone privileges for breaking a rule. Important to Remember: Positive = Adding something. Negative = Removing something. Reinforcement = Increases behaviour. Punishment = Decreases behaviour. Positive does NOT mean good, and negative does NOT mean bad. Classical vs. Operant Conditioning Classical = Learning through association. Operant = Learning through consequences. Classical = Usually automatic responses. Operant = Usually voluntary behaviours. Classical example = Pavlov's dogs. Operant example = Getting rewarded for good grades. 4. COGNITIVE BIAS What is Cognitive Bias? The way we personally see and interpret the world. Everyone processes information differently. Our perceptions can influence our behaviour and decisions. Many biases happen unconsciously, without us realizing. Example: Two people experience the same situation but remember and interpret it differently. Confirmation Bias The tendency to look for and remember information that supports what you already believe. People often ignore information that goes against their beliefs. Example: You believe someone is rude, so you only notice when they act rude and ignore when they are nice. Tests That Measure Cognitive Bias 1. Rorschach Inkblot Test People look at inkblots and explain what they see. Their interpretations are recorded and analyzed. Remember: Inkblots = What do you see? 2. Thematic Apperception Test (TAT) People look at a series of pictures and create stories about them. The stories are analyzed to understand their thoughts and feelings. Remember: Pictures = Tell a story. 3. Word Association Test People are given words and respond with the first word that comes to mind. Responses can be analyzed to explore subconscious thoughts. Remember: Words = First thing that comes to mind. 4. Graphology The study of handwriting and how it may relate to personality traits. Remember: Graphology = Handwriting. 5. ETHICS IN PSYCHOLOGICAL STUDIES Ethics are rules that protect people who participate in psychological research. Five Ethical Principles 1. Minimizing Harm - Participants should not experience unnecessary physical or emotional harm. 2. Informed Consent - Participants must understand the study and agree to participate. 3. Confidentiality and Anonymity - Personal information and identities must be protected. 4. Avoiding Deception - Researchers should not mislead participants unnecessarily. 5. Right to Withdraw - Participants can leave the study at any time without being forced to stay. Remember: Harm, Consent, Privacy, Honesty, Withdraw. Controversial Experiments 1. Milgram Obedience Study (1963) Researcher: Stanley Milgram. Purpose: To investigate how far people would obey authority, even when it went against their conscience. What happened? Participants were told they were taking part in a learning experiment. They were assigned the role of the teacher. They were instructed to give increasing electric shocks to a learner for incorrect answers. The learner was actually an actor, and the shocks were fake. Many participants continued because an authority figure told them to. Main takeaway: - People may obey authority even when they believe their actions are wrong. Ethical issues: - Deception and psychological stress. 2. Stanford Prison Experiment (1971) Researcher: Philip Zimbardo. Purpose: To investigate how people behave when placed in positions of power or powerless situations. What happened? Participants were randomly assigned to be prisoners or guards. The experiment was designed to imitate a prison. Some guards began treating prisoners unfairly. The experiment became harmful and was stopped early. Main takeaway: - Situations and social roles can influence human behaviour. Ethical issues: - Psychological harm, lack of protection and insufficient oversight. Difference Between the Two Experiments Milgram = Obedience to authority. Stanford = Power and social roles. Milgram = Stanley Milgram, 1963. Stanford = Philip Zimbardo, 1971. 6. ALFRED ADLER AND CARL JUNG Both were psychologists who studied personality. They were originally influenced by Freud but disagreed with some of his ideas. A. Alfred Adler Who Was Alfred Adler? Austrian psychologist born in 1870. Founder of Individual Psychology. Believed people are motivated by the desire to improve themselves and overcome feelings of inferiority. 1. Inferiority Complex Adler believed people naturally experience feelings of inferiority or not being good enough. People try to overcome these feelings through self-improvement and achievement. Example: Someone who struggles in school works harder to improve their grades. 2. Compensation Trying to overcome a weakness by improving another area of life. Example: Someone who struggles with sports focuses on becoming better at music. 3. Napoleon Complex Describes someone who overcompensates because they feel inferior due to a perceived disadvantage. Often associated with people who are shorter in height. Example: Someone acts overly aggressive to prove themselves. 4. Fictional Finalism (Fictional Story) Adler believed people create an idea or goal about who they want to become at a young age. This imagined goal influences their decisions and behaviour throughout life. Example: A child believes they will become a doctor and makes decisions based on that goal. 5. Birth Order Adler believed birth order could influence personality and behaviour. Being the oldest, middle or youngest child may affect how someone develops. 6. Three Major Life Tasks Occupational Tasks: Career, education and work. Societal Tasks: Friendships and social connections. Love Tasks: Relationships, marriage and family. Remember: Work, Friends, Love. B. Carl Jung Who Was Carl Jung? Swiss psychologist born in 1875. Originally influenced by Freud. Agreed that the unconscious mind influences behaviour. Disagreed with Freud's strong focus on sexuality. Often included spirituality and the soul in his psychological theories. 1. Collective Unconscious Jung believed all humans share a deeper unconscious mind. It contains universal symbols and patterns passed down through generations. These universal patterns are called archetypes. Example: Different cultures have similar ideas about heroes, mothers and villains. 2. Introvert vs. Extrovert - Jung developed a personality theory based on where people direct their mental energy. Introverts: Focus their energy inward toward themselves. Prefer reflecting on their own thoughts and feelings. Draw energy from their inner world. Extroverts: Focus their energy outward toward people and their surroundings. Direct their attention toward the outside world. Important: Introvert does not automatically mean shy, and extrovert does not simply mean outgoing. 3. Psychological Balance Jung believed people need balance between opposite personality traits. Understanding different sides of your personality helps with personal development and mental health. Difference Between Freud, Adler and Jung Freud = Unconscious mind, childhood experiences and sexual energy. Adler = Inferiority, compensation and self-improvement. Jung = Collective unconscious, archetypes and introversion/extroversion. MOST IMPORTANT THINGS TO MEMORIZE If you are short on time, make sure you know these: Brain Parts Frontal = Thinking. Parietal = Touch. Occipital = Vision. Temporal = Hearing and memory. Cerebellum = Balance. Brain Stem = Automatic functions. Freud Id = Wants. Ego = Reality. Superego = Morals. Oral → Anal → Phallic → Latency → Genital. Defence mechanisms = Protect the mind from uncomfortable thoughts and feelings. Conditioning Classical = Association. Operant = Consequences. Positive = Add. Negative = Remove. Reinforcement = Increase behaviour. Punishment = Decrease behaviour. Cognitive Bias Confirmation bias = Looking for information that supports your beliefs. Rorschach = Inkblots. TAT = Pictures and stories. Word Association = Words. Graphology = Handwriting. Ethics Minimizing harm. Informed consent. Confidentiality and anonymity. Avoiding deception. Right to withdraw. Experiments Milgram = Obedience to authority. Stanford = Power and social roles. Adler Inferiority complex = Feeling inferior. Compensation = Overcoming weaknesses. Fictional finalism = Goals that guide behaviour. Three tasks = Occupational, societal and love. Jung Collective unconscious = Shared unconscious patterns. Archetypes = Universal symbols and characters. Introvert = Focuses inward. Extrovert = Focuses outward.

Week 7: Venous insufficiency, Irrigation and Debridement

Week 6 - Arterial Insufficiency

Unit 5.1: Venous Valvular Insufficiency

Chronic Venous Insufficiency & Ulcers

Module 4: Arterial Insufficiency

2. Molar Pregnancy, Cervical Insufficiency

CH 7: MARKET INEFFICIENCIES

11.15 Adrenal Insufficiency and Cushing's Syndrome

PERIPHERAL VENOUS DISORDERS: Chronic Venous Insufficiency

Chapter 19: Venous Disorders, DVT, and Insufficiency

Module 4: Venous insufficiency

ChatGPT flash cards ch11 15. What is urea? Answer: The end product of nitrogen metabolism. Memory trick: Urea is IN urine, but isn't urine. 16. What does the prefix an- mean in anemia? Answer: Without; lack of. Memory trick: Anemia involves insufficient healthy red blood cells or hemoglobin. 17. Which is NOT a function of blood? Answer: Producing albumin. Memory trick: The liver MAKES albumin; blood CARRIES it. 18. Which white blood cell removes bacteria, foreign particles, and dead cells? Answer: Neutrophil. Memory trick: Neutrophils are first responders to bacterial infections. 19. What does hem/o mean in hemoglobin? Answer: Blood. Memory trick: HEMO = BLOOD. 20. What does agglutinate mean? Answer: To stick together to form clumps. Memory trick: Agglutinate = Glue together. 21. Which suffix means destruction or breakdown? Answer: -lysis (as in hemolysis). Memory trick: Hemolysis = destruction of red blood cells. 22. What does -poiesis mean in erythropoiesis? Answer: Formation or production; to make. Memory trick: Erythropoiesis = making red blood cells. 23. What does -penia mean in leukopenia? Answer: Deficiency or decrease. Memory trick: Leukopenia = low white blood cell count. 24. What is hypoxia? Answer: Below-normal oxygen levels in body tissues. Memory trick: HYPO = Low; OXIA = Oxygen. 25. What is disseminated intravascular coagulation Question 1: What is another name for Ig (immunoglobulin)? Answer: Antibody Memory trick: Ig = Immunoglobulin = Antibody Question 2: Which white blood cell produces antibodies in response to bacteria or toxins? Answer: B lymphocyte (B cell), which develops into an antibody-secreting plasma cell. Memory trick: B = Builds antibodies Question 3: Can a patient with type AB blood receive type A red blood cells? Answer: Yes, assuming Rh and other compatibility requirements are met. Memory trick: AB = Accepts A and B Question 4: What happens if a patient with type O blood receives type B red blood cells? Answer: The transfused type B cells can agglutinate and undergo hemolysis. Memory trick: Type O receives only O red blood cells Question 5: What antibodies and antigens does type O blood have? Answer: Anti-A and anti-B antibodies; neither A nor B antigens. Memory trick: O = Zero A/B antigens Question 6: What does neutropenia mean? Answer: Deficiency of neutrophils. Memory trick: -penia = Not enough Question 7: How long does an erythrocyte typically live? Answer: Approximately 120 days. Memory trick: 4 months = 120 days Question 8: Which statement about blood volume is NOT true? Answer: That blood volume is constant regardless of body size. Memory trick: Blood volume varies with body size Question 9: What is the clear, yellowish, noncellular part of blood? Answer: Plasma. Memory trick: Plasma = Liquid part of blood Question 10: What stringy protein forms the mesh of a blood clot? Answer: Fibrin. Memory trick: Fibrin = Fibers forming clots Question 11: What does a CBC (complete blood count) measure? Answer: Red blood cells, white blood cells, platelets, hemoglobin and hematocrit. Memory trick: CBC = Count Blood Cells Question 12: What are substances with a pH below 7.0 called? Answer: Acidic. Memory trick: Low pH = Acid Question 13: What term means maintaining a stable internal environment? Answer: Homeostasis. Memory trick: HOMEostasis = Balanced home Question 15: What is urea? Answer: A waste product formed by the liver from nitrogen metabolism. Memory trick: Urea is IN urine, not the same as urine Question 16: What does the prefix an- in anemia mean? Answer: Without or lack of. Memory trick: AN = WITHOUT Question 17: Which is NOT a function of blood? Answer: Producing albumin; the liver makes albumin. Memory trick: Liver makes it, blood carries it Question 18: What large white blood cell engulfs bacteria, foreign particles and dead cells? Answer: Macrophage. Memory trick: MACRO = Big, PHAGE = Eat Question 19: What does hem/o in hemoglobin mean? Answer: Blood. Memory trick: HEMO = BLOOD Question 20: What term means to stick together to form clumps? Answer: Agglutinate. Memory trick: Agglutinate = Glue together Question 21: What term contains a suffix meaning destruction? Answer: Hemolysis; -lysis means destruction or breakdown. Memory trick: LYSIS = Breaks apart Question 22: What does -poiesis in erythropoiesis mean? Answer: To make, form or produce. Memory trick: POIESIS = Produces Question 23: What does -penia in leukopenia mean? Answer: Deficiency or decrease. Memory trick: PENIA = Not enough Question 24: What term means below-normal oxygen in body tissues? Answer: Hypoxia. Memory trick: HYPO = Low, OXIA = Oxygen Question 25: What condition causes widespread activation of blood clotting, often with severe infection? Answer: Disseminated intravascular coagulation (DIC). Memory trick: DIC = Dangerous Internal Clotting(DIC)? Answer: Widespread activation of blood clotting throughout the bloodstream, often triggered by severe infection or sepsis. Memory trick: DIC = Dangerous Internal Clotting.

Aortic Insufficiency

Exocrine Pancreatic Insufficiency

Active and Passive Insufficiency

Chapter 3. Ethics and Social Responsibility iStock.com/Shaun Learning Outcomes After studying this chapter, you will be able to . . . 3-1 Explain the determinants of a civil society 3-2 Explain the concept of ethical behavior 3-3 Describe ethical behavior in business 3-4 Discuss corporate social responsibility 3-5 Describe the arguments for and against social responsibility 3-6 Explain cause-related marketing 3-1. Determinants of a Civil Society 3-1 Explain the determinants of a civil society Have you ever stopped to think about the social glue that binds society together? That is, what factors keep people and organizations from running amok and doing harm, and what factors create order in a society like ours? The answer lies in social control, defined as any means used to maintain behavioral norms and regulate conflict. Behavioral norms are standards of proper or acceptable behavior. Social control is part of your life at every level, from your family to your local community, to the nation, to the global civilization. Several modes of social control are important to marketing: Ethics: Ethics are the moral principles or values that generally govern the conduct of an individual or a group. Ethical rules and guidelines, along with customs and traditions, provide principles of right action. Laws: Often, ethical rules and guidelines are codified into law. Laws governments create are then enforced by governmental authority. This process is how the dictum “Thou shall not steal” has become part of formal law throughout the land. Law, however, is not a perfect mechanism for ensuring good corporate and employee behavior. Laws often address only the lowest common denominator of socially acceptable behavior. In other words, just because something is legal does not mean that it is ethical. For example, Texas Pete is a hot sauce sold in grocery stores across the country. The packaging for Texas Pete features a lone star, just as the Texas state flag does, and a cowboy holding a lasso. The packaging, along with the name of the product, seems to indicate that the product is made in the state of Texas, or that it is at least made from ingredients sourced in Texas. Texas Pete, however, is produced by TW Garner Foods Company, a company headquartered in North Carolina, more than 800 miles from Texas. A class action lawsuit was filed against the company for false advertising. The lawsuit claimed that consumers were paying a premium price based on their belief that the product originated in Texas, which has a reputation for spicy food. Texas Pete does not explicitly state that the product is manufactured in Texas and actually lists TW Garner Foods’ North Carolina address on the bottle, but the name of the product and the packaging certainly suggest that it is a genuine Texas-based product and could be misleading to consumers. While this presentation is technically legal, is this ethical? What’s your opinion? Here’s another example: In every state, littering is a problem—and has been for many years. Threats of fines and even jail time are shrugged off as people toss food wrappers, plastic straws and cups, and everything else imaginable out the car window. Many companies are implementing new policies to try and curtail the negative effects of littering. For example, Starbucks in California no longer automatically gives straws and plastic cutlery to customers, but, rather, will only provide these items when customers specifically request them. Nicole Glass Photography/Shutterstock.com Formal and Informal Groups: Businesses, professional organizations (such as the American Marketing Association and the American Medical Association), and clubs (such as Shriners and Ducks Unlimited) all have codes of conduct. These codes prescribe acceptable and desired behaviors for their members. Self-Regulation: Self-regulation involves the voluntary acceptance of standards established by nongovernmental entities, such as the American Association of Advertising Agencies (AAAA) or the National Association of Manufacturers. The AAAA has a self-regulation arm that deals with deceptive advertising. Other associations have regulations relating to child labor, environmental issues, conservation, and a host of other issues. The Media: In an open, democratic society, the media play a key role in informing the public about the actions of individuals and organizations—both good and bad. Laundress, a luxury laundry detergent brand that claims to be better for you and better for the environment, came under fire after issuing a safety notice for almost all of its products. The company released the notice on its social media accounts but provided very little information about the reason for the notice. It was later revealed that the majority of the products the brand manufactured between January 2021 and September 2022 contained heightened levels of bacteria that were causing severe skin rashes and other physical ailments. Many major media outlets, including The New York Times and USA Today, published articles to inform the public of this safety notice and the product recall that eventually followed. An Active Civil Society: An informed and engaged society can help mold individual and corporate ethics, as well as socially responsible behavior. Research reveals that 56 percent of U.S. consumers stop buying from companies they believe are unethical. In the United Kingdom, 53 percent of consumers reported that they would completely stop buying from a brand accused of sourcing from unethical suppliers. manufactured between January 2021 and September 2022 contained heightened levels of bacteria that were causing severe skin rashes and other physical ailments. Many major media outlets, including The New York Times and USA Today, published articles to inform the public of this safety notice and the product recall that eventually followed. An Active Civil Society: An informed and engaged society can help mold individual and corporate ethics, as well as socially responsible behavior. Research reveals that 56 percent of U.S. consumers stop buying from companies they believe are unethical. In the United Kingdom, 53 percent of consumers reported that they would completely stop buying from a brand accused of sourcing from unethical suppliers. 3-2a. Ethical Theories People usually base their individual choice of ethical theory on their life experiences. The following are some of the ethical theories that apply to marketing. Deontology The deontological theory states that people should adhere to their obligations and duties when analyzing an ethical dilemma. This theory means that a person will follow their obligations to another individual or society because upholding one’s duty is considered ethically correct. For instance, a deontologist will always keep their promises to a friend and follow the law. A person who follows this theory will produce very consistent decisions because those decisions will be based on the individual’s set duties. Deontological theory is not necessarily concerned with the welfare of others. For example, suppose a salesperson has decided that it is their ethical duty (and very practical) to always be on time for meetings with clients. Today they are running late. How are they supposed to drive? Is the deontologist supposed to speed, breaking the law to uphold their duty to society, or is the deontologist supposed to arrive at their meeting late, breaking their duty to be on time? This scenario of conflicting obligations does not lead us to a clear, ethically correct resolution, nor does it protect the welfare of others from the deontologist’s decision. Utilitarianism The utilitarian ethical theory is founded on the ability to predict the consequences of an action. To a utilitarian, the choice that yields the greatest benefit to the most people is the ethically correct choice. One benefit of this ethical theory is that the utilitarian can compare similar predicted solutions and use a point system to determine which choice is more beneficial for more people. This point system provides a logical and rational argument for each decision and allows a person to use it on a case-by-case basis. There are two types of utilitarianism: act utilitarianism and rule utilitarianism. Act utilitarianism adheres exactly to the definition of utilitarianism as just described. In act utilitarianism, a person performs the acts that benefit the most people, regardless of personal feelings or societal constraints like laws. Rule utilitarianism, however, considers the law and is concerned with fairness. A rule utilitarian seeks to benefit the most people but through the fairest and most just means available. Therefore, added benefits of rule utilitarianism are that it values justice and doing good at the same time. As is true of all ethical theories, however, both act and rule utilitarianism contain numerous flaws. Inherent in both are the flaws associated with predicting the future. Although people can use their life experiences to attempt to predict outcomes, no human being can be certain that their predictions will come true. This uncertainty can lead to unexpected results, making the utilitarian look unethical as time passes because their choice did not benefit the most people, as they had predicted. Another assumption a utilitarian must make is that they can compare the various types of consequences against each other on a similar scale. However, comparing material gains such as money against intangible gains such as happiness is impossible because their qualities differ so greatly. Casuist The casuist ethical theory compares a current ethical dilemma with examples of similar ethical dilemmas and their outcomes. This theory allows one to determine the severity of the situation and to create the best possible solution according to others’ experiences. Usually, one will find examples that represent the extremes of the situation so that a compromise can be reached to include the wisdom gained from the previous situations. One drawback to this ethical theory is that there may not be a set of similar examples for a given ethical dilemma. Perhaps that which is controversial and ethically questionable is new and unexpected. Along the same line of thinking, this theory assumes that the results of the current ethical dilemma will be similar to the results in the examples. This assumption may not be true and would greatly hinder the effectiveness of applying this ethical theory. Moral Relativism Moral relativism is a belief in time-and-place ethics, that is, the truth of a moral judgment is relative to the judging person or group. According to a moral relativist, for example, stealing is not always wrong—if you are a parent and your child is starving, stealing a loaf of bread is ethically correct. The proper resolution to ethical dilemmas is based on weighing the competing factors at the moment and then deciding to take the lesser of the evils as the resolution. Moral relativists do not believe in absolute rules. Their beliefs center on the pressure of the moment and whether the pressure justifies the action taken. Virtue Ethics Aristotle and Plato taught that solving ethical dilemmas requires training—that individuals solve ethical dilemmas when they develop and nurture a set of virtues. A virtue is a character trait valued as being good. Aristotle taught the importance of cultivating virtue in his students and then having them solve ethical dilemmas using those virtues once they had become an integral part of his students’ being through their virtue training. Some modern philosophers have embraced this notion of virtue and have developed lists of what constitutes a virtuous businessperson. Some common virtues for businesspeople are self-discipline, friendliness, caring, courage, compassion, trust, responsibility, honesty, determination, enthusiasm, and humility. You may see other lists of virtues that are longer or shorter, but here is a good start for core business virtues. 3-3. Ethical Behavior in Business 3-3 Describe ethical behavior in business Depending on which, if any, ethical theory a businessperson has accepted and uses in their daily conduct, the action they take may vary. For example, faced with bribing a foreign official to get a critically needed contract or shutting down a factory and laying off a thousand workers, a person following a deontology strategy would not pay the bribe. Why? A deontologist always follows the law. However, a moral relativist would probably pay the bribe. While the boundaries of what is legal and what is not are often fairly clear (e.g., do not run a red light, do not steal money from a bank, and do not kill anyone), the boundaries of ethical decision making are predicated on which ethical theory one is following. The law typically relies on juries to determine if an act is legal or illegal. Society determines whether an action is ethical or unethical. In 2022, Oracle, an information technology company, was forced to pay $23 million to settle charges of violating the Foreign Corrupt Practices Act (FCPA). The U.S. Department of Justice and the Securities and Exchange Commission (SEC) allege that subsidiaries of the company in India, Turkey, and the United Arab Emirates used discount schemes and sham marketing reimbursements to finance funds that were then used to bribe foreign officials. Michael Egbert, corporate communications VP for Oracle, stated that “The conduct outlined by the SEC is contrary to our core values and clear policies, and if we identify such behavior, we will take appropriate action.” Morals are the rules people develop as a result of cultural values and norms. Culture is a socializing force that dictates what is right and wrong. Moral standards may also reflect the laws and regulations that affect social and economic behavior. Thus, morals can be considered a foundation of ethical behavior. Morals are usually characterized as good or bad. “Good” and “bad” have many different connotations. One such connotation is “effective” and “ineffective.” A good salesperson makes or exceeds the assigned quota. If the salesperson sells a new computer system or an OLED TV to a disadvantaged consumer—knowing full well that the person cannot keep up the monthly payments—is that still a good salesperson? What if the sale enables the salesperson to exceed their quota? “Good” and “bad” can also refer to “conforming” and “deviant” behaviors. A doctor who runs large ads offering discounts on open-heart surgery would be considered bad, or unprofessional, because they are not conforming to the norms of the medical profession. “Good” and “bad” also express the distinction between law-abiding and criminal behavior. And, finally, different religions define “good” and “bad” in markedly different ways. A Muslim who eats pork are considered bad by other Muslims, for example. Religion is just one of the many factors that affect a businessperson’s ethics. Academic researchers have examined how consumers react to the trade-offs between highly competent but less moral service providers and less competent but highly moral service providers. Their study found that consumers valued competence more than morality. In other words, purchasers of services want someone who can do the job right . . . even if that person might be a bit shady. For example, a house-painting company that does excellent work but has had some legal problems in the past would be preferred over a mediocre painting company that has never had complaints or legal problems. 3-3a. Morality and Business Ethics Today’s business ethics consist of a subset of major life values learned since birth. The values businesspeople use to make decisions have been acquired through family, educational, and religious institutions. Ethical values are situation specific and time oriented. Everyone must have an ethical base that applies to conduct in the business world and personal life. One approach to developing a personal set of ethics is to examine the consequences of a particular act. Who is helped or hurt? How long do the consequences last? What actions produce the greatest good for the greatest number of people? A second approach stresses the importance of rules. Rules come in the form of customs, laws, professional standards, and common sense. “Always treat others as you would like to be treated” is an example of a rule. 3-3a. Morality and Business Ethics Today’s business ethics consist of a subset of major life values learned since birth. The values businesspeople use to make decisions have been acquired through family, educational, and religious institutions. Ethical values are situation specific and time oriented. Everyone must have an ethical base that applies to conduct in the business world and personal life. One approach to developing a personal set of ethics is to examine the consequences of a particular act. Who is helped or hurt? How long do the consequences last? What actions produce the greatest good for the greatest number of people? A second approach stresses the importance of rules. Rules come in the form of customs, laws, professional standards, and common sense. “Always treat others as you would like to be treated” is an example of a rule. 3-3c. Ethical Guidelines and Training In recent years, many organizations have become more interested in ethical issues. Yet interest and action are not always the same thing. Although some companies are now appointing a Chief Ethics Officer (sometimes called a Chief Compliance Officer), this role is still not present at many companies. It is very common, however, for companies of various sizes to develop a code of ethics as a guideline to help marketing managers and other employees make better decisions. Creating ethics guidelines has several advantages as follows: A code of ethics helps employees identify what their firm recognizes as acceptable business practices. A code of ethics can be an effective internal control of behavior, which is more desirable than external controls, such as government regulation. A written code helps employees avoid confusion when determining whether their decisions are ethical. The process of formulating the code of ethics facilitates discussion among employees about what is right and wrong and ultimately leads to better decisions. Ethics training is an effective way to help employees put good ethics into practice. The Ethics & Compliance Initiative’s State of Ethics and Compliance in the Workplace Report found that 84 percent of employees who work for a company with a strong ethics and compliance program perceived their organization as having a strong ethical culture. Comparatively, only 13 percent of employees working for an organization classified as having an underdeveloped ethics and compliance program felt that their organization had a strong ethical culture. Strong ethical cultures give employees the appropriate guidance to handle situations involving potential wrongdoing and lead to lower rates of misconduct. Still, simply giving employees a long list of dos and don’ts does not really help employees navigate the gray areas or adapt to a changing world market. In Carson City, Nevada, all governmental lobbyists are required to attend a course on ethics and policy before they can meet with lawmakers. The training outlines exactly how and when lobbyists are allowed to interact with lawmakers and how to report any money they spend. A clear understanding of ethical expectations is essential to an industry like lobbying, where illicit—often illegal—actions are taken to promote individual causes. Because artificial intelligence (AI) is becoming so pervasive in marketing interactions with consumers, it must also be taught about ethical decision making. Already Microsoft, Adobe, and IBM, along with smaller firms and start-ups, are developing ethical guidelines and best practices for their AI use. Type “gymnast” into Google’s image search and the vast majority of the top results are female, as are the results for “nurse.” The term “parents” shows almost exclusively heterosexual couples. The results of these searches are driven by AI, which isn’t explicitly taught to discriminate. Rather, these prejudices are the result of the data submitted to the AI algorithm. “There is increasing concern that algorithms used by modern AI systems produce discriminatory outputs, presumably because they are trained on data in which societal biases are embedded,” notes Madalina Vlasceanu, an Assistant Professor of Psychology at New York University, whose research explores biases in internet search algorithms and the potential impact of these biased search results on society. The Most Ethical Companies Each year, Ethisphere magazine (targeted toward top management and focused on ethical leadership) examines more than 5,000 companies in 30 separate industries, seeking the world’s most ethical companies. It then lists the top 100. The magazine uses a rigorous format to identify true ethical leadership. A few of the selected winners are shown in Table 3.1. Table 3.1 Selected Winners of the World’s Most Ethical Companies Company Industry Country 3M Industrial manufacturing USA Accenture Consulting Services Ireland Aflac Accident and life insurance USA Apple Technology USA Colgate-Palmolive Consumer products USA Dell Technology USA EDP Energy and utilities Portugal General Motors Company Automotive USA Illy Food, beverages, and agriculture Italy Kao Health and beauty Japan L’Oreal Health and beauty France Mastercard Payment Services USA Natura Health and beauty Brazil Parsons Engineering and design USA Salesforce Application software USA U.S. Bank Banks USA Workday Software & Services USA Source: “The 2022 World’s Most Ethical Companies Honorees List,” https://worldsmostethicalcompanies.com/honorees/ (accessed January 30, 2023).