CRI 174: Special Crime Investigation 1 with Legal Medicine

Module #12 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Lesson title: Death: types and kinds Materials:

Student Activity Sheets
Learning Targets: Ballpen
1. Classify the kinds of death
2. Compare the different types of death, References:
McLay W.D.S. (2009). Clinical
forensic medicine. 3rd edition.
Cambridge University Press, New
York.

A. LESSON PREVIEW/REVIEW
Introduction
Good day to all! We are already done on the concepts and principles of Criminal Investigation.
Today, we will start on the next chapter of our subject- Legal Medicine. In the first part of our discussion, we will
discuss the Medico-Legal Aspect of death, the introductory part which includes types and kinds of death. As a
future investigator, it is very important to know the signs and symptoms of death considering that you are the
First Responder. With this, you will learn the concepts of the Medico-Legal aspects of death.

B.MAIN LESSON

Death is the termination of life. It is the complete cessation of all the vital functions without the
possibility of resuscitation.
Both the medical and legal professions have traditionally recognized death as the total and
irreversible cessation of heart and lung activity. However, in the early part of the 1970s, a new concept in
the definition of “death” was accepted by the medical profession: brain death, the irreversible cessation
of the electrical activity in the brain as determined by electroencephalograph (EEG). When the brain is
active, the EEG demonstrates the electrical activity as a pattern of vertical zigzag lines. When the brain is
dead, there is no activity and the EEG just shows a straight “flat” line. This concept of death in the
medical community has taken precedence over the “total cessation of heart and lung activity” definition
and most of the legal profession now recognizes the concept of brain death.

This document is the property of PHINMA EDUCATION

 CRI 174: Special Crime Investigation 1 with Legal Medicine
Module #12 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Types of Death

1. Somatic Death: It refers to the death of the entire organism (the person or the animal).
2. Cellular Death: It refers to the death of the cells within the organism.
3. “Apparent Death” or State of Suspended Animation: This is just a temporary cessation of vital organs of
the body that can be attributed to either internal or external stimulus. This is not an actual death since it is only
due to a temporary stoppage of the functions of the body’s vital organs.

Note:
In somatic death or clinical death, the muscles start to relax which results in the dropping of the jaw,
opening of the muscle sphincter, and skin loses its elasticity. Further, the body fluids tend to gravitate to the
most dependent parts of the body; likewise, the body heat gradually assumes the temperature of the
surrounding.
In molecular or cellular death, there is still the individual life of cells. This can be observed due to the
movement, excitability, and irritability of the muscles once the stimulus is applied. However, three to six hours
after death, this will now also result in the death of individual cells.

The cause of death: It refers to the injury, disease or, the combination of both responsible for initiating the
trend or physiologic disturbance, brief or prolonged, which produce the fatal termination (death). These can be
considered as immediate or proximate.
The cause of death usually reflects the physical findings of the autopsy, such as a fatal disease or
process (such as hemorrhage, starvation, or exposure) that caused the death of the individual. The cause of
death helps to answer the question of why death occurred.

The mechanism of death: It is the physiologic derangement or biochemical disturbance incompatible with life
which is initiated by the cause of death.

Based on the Criterion Used in its Determination, (Death maybe)

1. Brain Death
➢ Deep irreversible coma
➢ Absence of electrical brain activity
➢ Complete cessation of all vital functions
➢ No possibility of resuscitation

What is an irreversible coma?

● Unreceptivity and unresponsive
● No movement or breathing
(Covering at least 1 hour)
● No reflexes
● Flat Electro-Encephalogram

2. Cardio-Respiratory Death
➢ Continuous and persistent cessation of heart action and respiration.
➢ Condition in which the physician and the members of the family pronounced a person dead based on
the common sense or intuition

This document is the property of PHINMA EDUCATION

 CRI 174: Special Crime Investigation 1 with Legal Medicine
Module #12 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Modes of Death

1. Coma: Death results primarily from the failures of the vital centers of the brain, the persons become
unconscious and lose all reflexes, after which the heart and lungs slowly cease to function.
2. Syncope: Death occurs primarily as a result of heart failure, possibly due to blood loss, the power loss of
the heart muscle, or neurogenic shock.
3. Asphyxia: Death occurs primarily when the respiratory function of the lungs stops as a result of a lack of
oxygen, failing the heart and brain.

Determining the Manner of Death:

One of the vital functions of the pathologist is to determine the Manner of Death (MOD), which indicates
how the death occurred.

There are five possibilities for how the death occurred:

1. Natural: A natural manner of death refers to a medical problem such as heart attack or stroke that caused
the death of the person.
2. Accident: It is the result of unexpected, unforeseen, and unintended fatal events.
3. Suicide: A suicide (from the Latin “sui”-self and “cidium”- killing) is the intentional taking of one’s own life. b
4. Homicide: (from Latin “homo”- man and “cidium”-killing )result from the intentional killing by another person.
5. Undetermined: when the cause of death or the circumstances surrounding the cause of death cannot be
explained.

As part of determining the manner of death, the forensic pathologist should establish either:

1. Immediate (Primary) Cause of Death: Cases when trauma or disease kill quickly that there is no
opportunity for sequelae or complications to follow
2. The Proximate (Secondary) Cause of Death: The injury or disease was survived for a sufficiently
prolonged interval which permitted the development of serious complications that caused death.

Diseases with no specific findings of disease

1. Sudden Infant Death Syndrome
2. Sudden Unexpected Nocturnal Death

Degree of Certainty as to the Cause of Death

1. Structural abnormalities that are established beyond doubt are the cause of death.
2. Degree of probability amounting to the cause of death
3. History establishes the cause of death and is confirmed by anatomic or chemical findings.
4. When neither history, laboratory and anatomic findings, taken individually or in combination is
sufficient to determine the cause of death but merely speculate as to the cause of death

This document is the property of PHINMA EDUCATION

 CRI 174: Special Crime Investigation 1 with Legal Medicine
Module #12 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

1. All the vital functions of the victim are absent. Given this fact, you concluded that death was
already certain, and according to you, this is what we call somatic and cellular death at the same
time. But one of the members of your team found out that upon stimulation, the muscles of the victim
are still capable of moving even in the absence of all the vital functions, so according to him, there is
life in each individual cell; thus, this death is only considered somatic or clinical death and not cellular
or molecular death. Based on this scenario, who do you think made the right call?

In this scenario, while the initial conclusion regarding somatic and cellular death occurring simultaneously
represents a traditional medical understanding, the observation made by the team member about continued
muscular response suggests a different interpretation, emphasizing cellular activity; thus, determining who made
the right call depends on the context and the purpose of the assessment.

2. What could happen if someone makes a poor decision or judgment in regards to their work? How
are you going to make amends if you made a mistake at work?

If I make a mistake at work, it could result in various consequences, including reduced productivity, financial
losses, or damaged reputation; however, I would take responsibility by acknowledging the mistake, apologizing
to those affected, and taking immediate steps to rectify the situation, collaborating with colleagues or supervisors
to find solutions and implementing corrective measures to prevent similar errors in the future, while also being
open to receiving feedback and continuously striving to improve my performance and decision-making skills.

This document is the property of PHINMA EDUCATION

 CRI 174: Special Crime Investigation 1 with Legal Medicine
Module #12 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

1. It is defined as the termination of life. Death

2. It is the individual death of cells in an organism. Molecular/Cellular Death
3. It is considered as the total unawareness of applied stimuli. Irreversible coma
4. It is the irreversible cessation of the electrical activity in the
brain as determined by the electroencephalogram Brain death
5. This will explain to us how the death occurred to a person. Manner of Death

C. LESSON WRAP-UP

Summary
The death of a human being is neither as simple, or as final, a phenomenon as it might seem.
The development of highly sophisticated artificial life support systems which can maintain organ
function indefinitely, has blurred the medical and common sense line between life and death. It is
theoretically possible to maintain organ function in victims of nearly every imaginable illness and
injury – possible at least, to the extent function could be maintained if there was some justification for
expanding the vast amount of resources that such extension would require. At the same time, the
refinement and growing use of organ transplant techniques has undermined the traditional belief in
death’s finality. At death the soul may be left in peace, but the body is now the subject of a host of
activities and investigations.

Frequently Asked Questions

1. What is medico legal aspect? Medicolegal is something that involves both medical and
legal aspects, mainly: Medical jurisprudence, a branch of medicine. Medical law, a branch of law.

2. What is the medico-legal importance of determining death? The medicolegal death investigation
system is responsible for conducting death investigations and certifying the cause and manner of unnatural
and unexplained deaths.

This document is the property of PHINMA EDUCATION

 CRI 174: Special Crime Investigation 1 with Legal Medicine
Module #12 Student Activity Sheet

Name: _________________________________________________________________ Class number: _______

Section: ____________ Schedule: ________________________________________ Date: ________________

Answer Key
1. Death
2. Molecular/Cellular Death
3. Irreversible coma
4. Brain death
5. Manner of Death

This document is the property of PHINMA EDUCATION