Chapter 10 Abortion
Chapter 10 Abortion
Objectives:
At the end of this chapter students should be able to:
Clinical Types of Abortion
Reasons Why Some Women Procure Abortion
Legal Justification to Therapeutic Abortion
Viability is the point at which the fetus is “potentially” able to live outside the
mother's womb", albeit with respiratory aid. And, later, as when it is capable of
meaningful life outside the mother's womb (The Rights of Doctors, Nurses, and Allied
Health Professionals by Annas and Glantz, p. 202).
In the legal viewpoint, abortion is the willful killing of the fetus in the uterus or
violent expulsion of the fetus from the maternal womb and which results in the death of
the fetus. According to Viada, as long as the fetus dies as a result of violence used or
of the drug administered, the crime of abortion exists, even if the fetus is full term.
Whichever be the definition of abortion, the following are the principal elements
of the crime:
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potential complications.
4. Incomplete Abortion — Not all of the conception has been expelled from
the fragments or portions of which are retained. This will prevent contraction of
the uterus and consequently, uncontrolled bleeding will develop. Removal of the
retained fragment must be done to avoid too much loss of blood and potential
infection.
5. Complete Abortion — The whole product of conception is expelled.
Causes of Abortion:
Intentional Abortion:
1. Any person who shall intentionally cause an abortion shall The penalty of
reclusion temporal if he shall use any violence upon the person of the pregnant
woman.
2. The penalty of prision mayor if, without using violence, he shall act without the
consent of the woman.
3. The penalty of prision correccional in its medium and maxi• mum periods, if the
woman shall have consented.
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Unintentional Abortion:
The penalty of prision correccional in its minimum and medium periods shall be
imposed upon any person who shall cause an abortion by violence, but unintentionally.
The penalty of prision correccional in its medium and maximum periods shall be
imposed upon a woman who shall practice abortion upon herself or shall consent that
any other person should do so.
Any woman who shall commit this offense to conceal her dishonor shall suffer
the penalty of prision correccional in its minimum and medium periods.
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them, and they act with the consent of the said woman to conceal her dishonor, the
offenders shall suffer the penalty of prision correccional in its medium and maximum
periods.
If a woman took poison for committing suicide and because of the timely
intervention of a physician she did not die but instead aborted, she cannot be
guilty of abortion because of the absence of intention to commit abortion.
The penalties provided in article 256 shall be imposed in its maximum period,
respectively, upon any physician or midwife who, taking advantage of their scientific
knowledge or skill, shall cause an abortion or assist in causing the same.
Any pharmacist who, without the proper prescription from a physician, shall
dispense any abortive shall suffer arresto mayor and a fine not exceeding 1,000 pesos.
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Abortion:
Kinds of Abortion:
Induced Abortion:
Abortion will not take place had it not been for some form of inducement or
intervention. Induced abortion may be:
Therapeutic Abortion:
Abortion is purposely done to preserve the life of the mother. Preservation of the
health of the mother may also be a ground to induce therapeutic abortion. The
phrase "to preserve the life of the woman" does not only mean to preserve the
life of the woman from death.
Criminal Abortion:
Abortion done without any therapeutic indication but with criminal intent is
punishable by law.
Post-mortem Abortion:
This is the expulsion of the product of conception after the death of the pregnant
woman brought about by the post-mortem contraction of the uterine muscles. It is
possible during the early stage of pregnancy when the fetus is small. During the later
stage, the contraction of the uterus may cause its rupture and expel its contents of
pregnancy into the abdominal cavity.
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By General Violence:
Local violence may be applied in any portion of the generative organ. This is
usually resorted to when general violence and the use of drug fails to give the desired
result.
Local violence may be applied by the pregnant woman herself, by the physician,
midwife, or by the parents. The most common methods applied
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Complications of Abortion:
Shock:
The shock may be due to the laceration of the uterus or the adjacent organ, like
the bladder, rectum, intestine, or blood vessels. The injury may be due to the
introduction of instruments or the application of hot fluid or corrosive substances.
No definite autopsy findings may be seen, except the presence of the gravid
uterus, remnants of the fetus and placenta, and the laceration or perforation. Secondary
shock may develop later and may be due to hemorrhage, infection, or corrosions.
Occasionally, big pelvic vessels are injured or failure of the uterine wall to
contract is observed in abortion. The rupture of the blood vessels may be due to the
injury of the uterine and vaginal wall of injudicious instrumentation. Adherent placental
tissue, infection, presence of foreign bodies, and atony of the uterus may cause
hemorrhage for the failure of the uterine muscles to contract.
Embolism:
1. Air Embolism:
The air may enter the lacerated vessels of the vagina and uterine wall and
be carried by the blood to the inferior vena cava, heart and block the
pulmonary circulation. In cases wherein the foramen ovale is potent, the
air may escape pulmonary circulation and block the cerebral circulation.
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2. Fat Embolism:
The injection of oily fluid or laceration of the adipose tissue may cause the
formation of fat emboli in the bloodstream which may lodge in the heart,
lungs, and brain. Fat emboli may be observed in the renal glomeruli,
coronary vessels, and also in the vessels of the choroid plexus of the
brain.
3. Thrombo - Embolism
Injury of the uterine wall may cause the formation of thrombus which may
be detached and carried by the circulation to different parts of the body:
4. Bacterial Embolism:
Infection of the uterus after an abortion may cause a lump of bacteria to
enter the circulation in the form of an embolus.
Infection: Pathogenic organisms may be introduced into the uterus and produce
systemic symptoms. If death occurs signs of toxemia may be observed at autopsy.
Poisoning:
Abortifacient Irritants that may be locally applied may be absorbed into the
circulation and produce systemic effects. Lysol corrosive sublimate, iodine solution are
frequently used for vaginal douche and may cause systemic poisoning.
Vagal inhibition:
Sudden dilatation of the cervix due to the introduction of some objects may cause
sudden collapse due to reflex inhibition of the vagus nerve.
In the insertion of the uterine sound to determine the position of the uterus or in
the process of the bladder or the other surrounding organs may be perforated and
which may eventually result in death due to hemorrhage or shock.
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Aside from the evidence of abortion in the living which may be found in the dead,
the following may be observed at autopsy.
Evidence of instrumentation:
This will include the presence of puncture wounds in the placenta, the presence
of remnants of the placenta inside the uterine cavity, the presence of perforation of the
uterus.
Abortifacient. drugs and other irritants may be found inside the stomach upon
chemical examination. It is advisable to submit the whole of the stomach with its
contents to a chemical laboratory examination for such determination.
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Like the stomach and its contents, other organs like the kidneys, liver, spleen
must be subjected to a qualitative and quantitative chemical examination for the
presence of irritant poisons.
1. Infection.
2. Stage of pregnancy.
3. Other complications of abortion.
Biological test:
1. Paternity test.
2. Pregnancy test.
THERAPEUTIC ABORTION
Therapeutic abortion is an abortion which the law allows under some specific
justifications.
Any person who, to avoid an evil or injury, does an act which causes damage to
another, provided that the following requisites are present.
In the performance of an abortion, lives are involved, namely, the life of the
mother and the life of the fetus. One life must be sacrificed to save the life of another in
case of therapeutic abortion.
If both lives can be saved by the present state of medical science, then there is
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no justification for such abortion, hence the physician must be criminally liable.
The evil sought to be avoided is the danger of the life of the mother if such
pregnancy will be allowed to continue. Such evil may be an infection, organic condition,
or abnormality existing on the person of the woman and which under the ordinary
course of the event will cause death.
There is no practical and less harmful way of saving the life of the mother other
than sacrificing the life of the conceived child. If other methods may save both lives,
then abortion cannot be considered justifiable.
The modern diagnostic procedure can determine whether the conceived fetus en
Utero is suffering from a defect or abnormality which may be severed to make
independent existence not possible or ample assistance from another person during his
lifetime is necessary. New drugs (LSD, thalidomide, etc) and non-conventional
methods of reproduction ( in vitro fertilization, artificial ovulation ) may lead to the
development of an abnormal fetus. If it can be proven that the fetus is abnormal, will it
not be a justifiable situation to induce an abortion? If the physician failed to induce
abortion and the child born is abnormal, will it not be a ground for civil action against the
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IUD (intrauterine device) is a method of contraception that allows the fertilization of the
egg cell by the sperm cell but prevents the implantation of the zygote into the uterus
because of the mecha• medical device. Abortion is the premature expulsion of the
product of conception. If it were so, then I.U.D. is abortive. Why is it allowed as a
contraceptive method and not prohibited like another way of committing an abortion?
In the case of Hatchard v. State (48 N.W. 380 Wis.) a woman who threatened to
commit suicide unless she could be relieved of the child with which she was pregnant
does not present such a necessity for the performance of the operation to save the life
of the woman. The intention of the law applies only to cases where the death of the
mother might reasonably be anticipated from natural causes unless the product of
conception is destroyed.
However, in a case cited by Camp and Purchase (Practical Forensic Medicine, p. 32,
1957), a married woman with an unstable character finding herself pregnant, threatened
to commit suicide. The physician whom she repeatedly made her threat during her
unexpected visits referred her to a psychiatrist who recommended abortion. The
operation was carried on by a reputed gynecologist but un• fortunately, the patient died
of gangrene of the uterus. The coroner did not recommend prosecution because the
operation was done to save the life of the mother.
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3. Abortion must be performed openly in a hospital to avoid the suspicion that it was
done for some cause other than to save the life of the mother. Abortion
performed in a private clinic wherein there are not sufficient facilities to cope with
an emergency that may arise in the course of the operation may be a ground for
malpractice.
4. It is advisable to have the opinion of other competent physicians as to the
justifiability of such therapeutic abortion. The opinion of one might be influenced
by prejudice and misjudgment.
5. Enlightened and expressed consent must be obtained from the woman herself if
she has no impediment to giving consent. It is advisable to have also the consent
of the husband since abortion will affect the marital relationship.
1. From the moment of conception, life begins to start and destruction of the
growing product of conception will be contrary to the law of mankind. This is in
line with the philosophy that God created man and only God can destroy it.
Where abortion is illegal, the rich can resort to high-cost and illegal but safe
abortion at home or a pleasure trip abroad combined with an abortion. The poor can
only stay at home and face the consequence of high-risk and illegal abortion. This
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causes discrimination against the poor and favors the rich. It raises the serious issue of
justice and equal protection under the law.
As a general rule, all induced abortions are considered sinful, illicit, and against
the tenets of the Catholic Church even if sanctioned by law. The principal basis is that
every human being, even the child in the mother's womb, has the right of existence
directly from God and that no human being has the right to destroy it. A conceived
child has the right to exist as that of the mother.
However, the Catholic Church classified abortion into two main categories to
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Among the Jews, the destruction of the fetus to save the life of the mother is not
only permissible but obligatory. To the Protestants, abortion is generally considered
sinful.
Abortion https://www.youtube.com/watch?v=e-SYEwE2-0w
Refference:
Solis, P. P. Legal medicine . Manila : Beltran Educational Supply.
Lagonera, M. G. (2010). Legal medicine. Quezon City : Wiseman's Books Trading.
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