Scope of Forensic Pathology[Edit]

Forensic pathology is a sub-specialty of pathology that focuses on determining the cause of death by examining a corpse. The autopsy is performed by a medical examiner, usually during the investigation of criminal law cases and civil law cases in some jurisdictions. Coroners and medical examiners are also frequently asked to confirm the identity of a corpse. Also see forensic medicine. The word forensics is derived from the Latin forēnsis meaning forum.[1] Contents [hide] 1 Scope of forensic pathology 2 Investigation of death o 2.1 Terminology is not consistent across jurisdictions o 2.2 Canadian coroners o 2.3 Coroners and medical examiners in the United States 3 History 4 Education o 4.1 Australia o 4.2 Canada o 4.3 India o 4.4 Indonesia o 4.5 United Kingdom o 4.6 United States 5 See also 6 Notes and references 7 Further reading 8 External links o 8.1 Becoming a pathologist Scope of forensic pathology[edit] Forensic pathology is an application of medical jurisprudence. The forensic pathologist: Is a medical doctor who has completed training in anatomical pathology and who has subsequently sub-specialized in forensic pathology. The requirements for becoming a "fully qualified" forensic pathologist varies from country to country. Some of the different requirements are discussed below. Performs autopsies/postmortem examinations to determine the cause of death. The autopsy report contains an opinion about : The pathologic process, injury, or disease that directly results in or initiates a series of events that lead to a person's death (also called mechanism of death), such as a bullet wound to the head, exsanguination caused by a stab wound, manual or ligature strangulation,myocardial infarction resulting from coronary artery disease, etc.), and The "manner of death", the circumstances surrounding the cause of death, which in most jurisdictions include:[2] Homicide Accidental Natural Suicide Undetermined The autopsy also provides an opportunity for other issues raised by the death to be addressed, such as the collection of trace evidence or determining the identity of the deceased. Examines and documents wounds and injuries, both at autopsy and occasionally in a clinical setting. Collects and examines tissue specimens under the microscope (histology) in order to identify the presence or absence of natural disease and other microscopic findings such as asbestos bodies in the lungs or gunpowder particles around a gunshot wound. Collects and interprets toxicological analyses on body tissues and fluids to determine the chemical cause of accidental overdoses or deliberate poisonings. Forensic pathologists also work closely with the medico-legal authority for the area concerned with the investigation of sudden and unexpected deaths i.e. the coroner (England and Wales), procurator fiscal (Scotland) or coroner or medical examiner (United States). Serves as an expert witness in courts of law testifying in civil or criminal law cases. In an autopsy, he/she is often assisted by an autopsy/mortuary technician (sometimes called a diener in the USA). Forensic physicians, sometimes referred to as 'forensic medical examiners' or 'police surgeons' (in the UK until recently), are medical doctors trained in the examination of, and provision of medical treatment to, living victims of assault (including sexual assault) and those individuals who find themselves in police custody. Many forensic physicians in the UK practise clinical forensic medicine part-time, whilst they also practise family medicine, or another medical specialty. In the United Kingdom, Membership of the Royal College of Pathologists is not a prerequisite of appointment as a Coroner's Medical Expert, i.e. doctors in the UK that are not forensic pathologists or pathologists are allowed to perform medicolegal autopsies, simply because of the vague wording of 'The Coroners Act', which merely stipulates a 'suitably qualified medical practitioner', i.e. anyone on the GMC Register. Investigation of death[edit] Main article: Coroner Deaths where the known cause and those considered unnatural are investigated. In most jurisdictions this is done by a "forensic pathologist", coroner, medical examiner, or hybrid medical examiner-coroner offices. Terminology is not consistent across jurisdictions[edit] In some jurisdictions, the title of "Medical Examiner" is used by a non-physician, elected official involved in medicolegal death investigation. In others, the law requires the medical examiner to be a physician, pathologist, or forensic pathologist. Similarly, the title "coroner" is applied to both physicians and non-physicians. Historically, coroners were not all physicians (most often serving primarily as the town mortician). However, in some jurisdictions the title of "Coroner" is exclusively used by physicians. Canadian coroners[edit] In Canada, there is a mix of coroner and medical examiner systems, depending on the province or territory. In Ontario, coroners are licensed physicians, usually but not exclusively family physicians. In Quebec, there is a mix of medical and non-medical coroners, whereas in British Columbia, there is predominantly a non-physician coroner system. Alberta and Nova Scotia are examples of ME systems [3][4] Coroners and medical examiners in the United States[edit] In the United States, a coroner is typically an elected public official in a particular geographic jurisdiction who investigates and certifies deaths. The vast majority of coroners lack aDoctor of Medicine degree and the amount of medical training that they have received is highly variable, depending on their profession (e.g. law enforcement, judges, funeral directors, emergency medical technicians, nurses). In contrast, a medical examiner is typically a physician who holds the degree of Doctor of Medicine or Doctor of Osteopathic Medicine. Ideally, a medical examiner has completed both a pathology residency and a fellowship in forensic pathology. In some jurisdictions, a medical examiner must be both a doctor and a lawyer, with additional training in forensic pathology. History[edit] In German-speaking Europe, lectures on forensic pathology were regularly held in Freiburg in the mid 18th century and Vienna in 1804. Scientists like Auguste Ambroise Tardieu,Johann Ludwig Casper and Carl Liman made great effort to develop forensic pathology into a science based on empirics. Forensic pathology was first recognized in the United States by the American Board of Pathology in 1959.[5] In Canada, it was formally recognized in 2003,[6][7] and a formal training program (a fellowship) is currently being established under the auspices of the Royal College of Physicians and Surgeons of Canada.[8] Education[edit] Forensic pathology is a subspecialty of anatomical pathology. Training requirements differ from country to country. Australia[edit] There are currently three paths to qualify as a forensic pathologist in Australia. The first is to train solely in forensic pathology (although a significant amount of anatomical pathology knowledge is still required) and pass two examinations for forensic pathology only. The second is to commence training in anatomical pathology, and complete an initial anatomical pathology examination, which takes a minimum of three years; then go on to train solely in forensic pathology and complete a forensic pathology examination, which takes a minimum of two years. The third is to complete a minimum 5 years' training in anatomical pathology to qualify as a fellow in anatomical pathology, then complete a post-fellowship year in forensic pathology (a minimum twelve months further training plus successful completion of an examination).[9] Canada[edit] In Canada,[10] anatomical pathology is a five year residency. Residents who wish to become forensic pathologists must then complete a one year fellowship in forensic pathology. Forensic pathology is a subspecialty by the Royal College of Physicians and Surgeons. Two schools that have training programs are the University of Toronto and McMaster University. India[edit] In India, the speciality is commonly referred to as Forensic Medicine or Legal Medicine. After completion of medical graduation (MBBS), one has to complete three years of study and training including thesis research, which leads to award of degree of MD (Forensic Medicine). One can also alternately pass the board examination conducted by National Board of Examinations, leading to awarding of Diplomate of National Board (DNB). The majority of the specialists are attached to the Department of Forensic Medicine in various medical colleges. The classification of posts includes Assistant Professor (Lecturer), Associate Professor (Reader) and Professor. The work profile of the specialists includes conducting autopsies and clinical forensic examinations; apart from teaching the medical students. They have to regularly appear in the courts as expert witnesses. A typical department in a government institution conducts 100 to 5000 autopsies a year depending upon the jurisdiction. Apart from this the clinical forensic examinations constitute a major part of the work and number of cases can run up to 10000 a year in an average institution. The largest association of the specialty is Indian Academy of Forensic Medicine [1] (IAFM), which also publishes its quarterly Journal of Indian Academy of Forensic Medicine[2] regularly. This association has a specialist member strength of more than 1000. Indonesia[edit] In Indonesia, forensic medicine, also known as legal medicine

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