In some deaths, the immediate environment does not contribute to death, such as in cases of metastatic breast carcinoma. Hospital pathologists performing forensic autopsies who are not trained to, or able to, attend death scenes should be provided with information on how, when, and where the body was found, by whom, and under what circumstances. Nonattendance at death scenes has been regarded as one of the classical mistakes in forensic pathology. This preliminary information helps the investigative agency to define its perimeter, structure its approach, organize its manpower, secure potentially important evidence, and streamline its efforts. The forensic medicine expert is also able to advise the investigative agency about the nature of the death, whether to confirm a homicide by a specific means, evaluate the circumstances to be consistent with an apparent natural death, or interpret the blood loss from a deceased person as being more likely due to natural disease than to injury. By viewing the body in the context of its surroundings, the forensic medicine expert is better able to interpret certain findings at the autopsy such as a patterned imprint across the neck from collapsing onto an open vegetable drawer in a refrigerator. Why go to the scene? The purpose of having the forensic medicine expert attend the death scene is severalfold.
A thorough and complete investigation commonly leads to the proper diagnosis of the cause and manner of death prior to an autopsy ( Avis, 1993 Dix & Ernst, 1999). In many cases, the scene investigation is more important than the autopsy. This duty is often formalized and made part of a contract of service for those forensic medicine experts who are either full-time or substantially involved in assisting the police, in England and Wales, the 'Home Office Pathologists' are permanently on call for such visits and in many other jurisdictions, such as the medical examiner systems in the USA, and the European State and University Institutes of Forensic Medicine, there is usually a prearranged duty roster for attendance at scenes of death ( Saukko & Knight, 2004). Local practice varies but any doctor claiming to be a forensic medicine expert should always make himself available to accompany the police to the locus of the death.
In homicide, suspected homicide, and other suspicious or obscure cases, the forensic medicine expert should visit the scene of the death before the body is removed. And this interest goes beyond simple curiosity ( Wagner, 2009). In a culture that values life, explaining the death in a public forum (the meaning of “forensic”) is crucial for many reasons. A common question asked is, “Why does it matter? The person is dead.” While it is true that the dead cannot benefit, the value in death investigation is to benefit the living and future generations. ( Spitz, 2006).Īlthough the primary goal of a death investigation is to establish the cause and manner of death, the role of the death investigation extends much further than simply answering these two questions.
The English coroner system was mentioned in documentations around the 12th century B.C. The association of law and medicine dates back to the Egyptian culture as early as 3000 B.C. Death investigation has been performed for centuries in all societies, although not always by medical professionals ( Committee, 2003). The key goal is to provide objective evidence of cause, timing, and manner of death for adjudication by the criminal justice system. It begins with body examination and evidence collection at the scene and proceeds through history, physical examination, laboratory tests, and diagnosis – in short, the broad ingredients of a doctor’s treatment of a living patient. Medical expertise is crucial in death investigations.