WEEK 1: INTRODUCTION TO AUTOPSY AND FORENSIC PATHOLOGY

Question 1

Define the term forensic.

Answer 1

Derived from Latin “FORENSIS” ~ “FORUM”
Means: “pertaining to the LAW”, specifically “public debate in Courts of Law”

The application of scientific methods and techniques to the investigation of crime
…. thus, gathering factual scientific evidence to be presented in a Court of Law.

Question 2

What does forensic pathology deal with?

Outline Processes/ activities done in forensic pathology.
What is the purpose of forensic pathology?

Answer 2

Deals with issues relating to all unnatural or sudden unexplained / procedure-related / suspicious deaths.

Includes: death scene investigation, ML autopsy, evidence collection, victim identification, referrals to other FORENSIC SCIENCE experts viz toxicologists, anthropologists, serologists, odontologists, DNA experts etc.

Purpose to establish cause / mechanism / manner of death.

Question 3

What is forensic evidence?

Answer 3

The term FORENSIC EVIDENCE is used to describe the nature by which information is presented to the courts.

Question 4

State the 3 types of evidence and their examples.

Answer 4

3 Main Types of Evidence:

1.VERBAL / TESTIMONIAL EVIDENCE
Statements made under oath eg in Court of Law
E.g. WITNESSES & EXPERTS (who may render OPINION testimony)

PROBLEM: Eyewitness “Misidentification” Testimony = single greatest cause of wrongful convictions in the USA - plays a role in nearly 75% of convictions overturned through DNA testing

2.DOCUMENTARY EVIDENCE – Affidavit/Sworn Affirmation
Reports – Laboratory-, Hospital-, Autopsy Reports
Photographs

3.PHYSICAL EVIDENCE (“real objects”)
Can take any form – large or ‘trace’
E.g. bullets, pill containers, needles, syringes, substances / drugs found at scene OR in tissue / blood samples.

Question 5

What is physical evidence?

Outline what it may be used for.

Give the examples

Answer 5

Any tangible article, small or large that can be used to approve or disapprove a point in question.

1.To reconstruct the crime or circumstance of death
2.To identify the participants
3.To confirm or discredit an alibi

OBJECTS
*Weapons
*Tools
*Firearms
*Displaced furniture
*Notes, letters or papers
*Bullets
*Vehicles
*Cigarretes

BODY MATERIALS
*Blood
*Semen
*Hair
*Tissue
*Spittle
*Urine
*Feces
*Vomit

IMPRESSIONS
*Fingerprints
*Tire Trucks
*Footprints
*Palm prints
*Tool marks
*Bullet holes
*Newly damaged areas
* Dents and breaks

Question 6

What is ana expert witness?
Outline the 3 important characteristics of expert witness.
Who is most likely to be an expert witness?

Answer 6

1.EXPERT WITNESS is someone who is deemed a SPECIALIST IN A FIELD, often technical and/or scientific.

May be called upon to present his/her EXPERT OPINION without having been a witness to any occurrence relating to a case.

2.Expert must be APPROPRIATELY QUALIFIED to render OPINION testimony, by virtue of his/her expertise, training, experience and special knowledge.

Expert expected to adhere to particular FIELD OF EXPERTISE

Expert witness should provide INDEPENDENT ASSISTANCE to the COURT by way of objective, unbiased opinion within his/her FIELD OF EXPERTISE

3.Ultimately expected from FORENSIC SCIENTISTS & -MEDICAL PRACTITIONERS to be called as EXPERT WITNESSES

Question 7

Most countries internationally render medicolegal death investigation services using CORONERS / MEDICAL EXAMINER SYSTEMS.

What is a coroner?

Who is a medical examiner?

Answer 7

A coroner is an elected or appointed official who may have no forensic science qualification in charge of forensic pathology services.

A medical doctor who has specialized in forensic pathology in charge of and rendering forensic pathology services.

Question 8

Outline 5 types of medicolegal deaths.

Answer 8

*All unnatural/violent deaths (Homicides, suicides, accidental)
*Suspicious and sudden unexpected deaths
*Custodial death
*Cause of death in unknown
*Procedure related deaths

Question 9

What is the purpose of medicolegal death investigation? Give 8.

Answer 9

*Detection of crime
*Quality Statistics
*Audit
*Citizen rights
*Investigation certain aspects of death
*Procedure related deaths
*Custodial deaths
*Occupational deaths

Question 10

How does the family value autopsy?

Name 5.

Answer 10

*Shortens the grieving period
*Less likely to suffer from Post Traumatic Stress Disorder (PTSD) and Depression
*Inheritance diseases
*Insurance company
*Motor Vehicle accident fund

Question 11

How do clinicians’ and hospitals value autopsy information?

Answer 11

To improve, through death auditing, the quality of care of patients received in our hospitals.

Question 12

Describe mortality focus.

Answer 12

Mortality is the tip of an iceberg.

Question 13

What are forensic autopsies likely to be done on who?

Answer 13

*Deaths due to violence, suspicious or unexplained cause
*Unexpected/unexplained deaths of infants and children
*Deaths of persons in custody
*Deaths due to acute workplace injury
*Deaths due to electrocution, drowning, intoxication by alcohol, drugs or poison, charred bodies, skeletonized bodies

Question 14

Outline 6 autopsy elements.

Answer 14

*Examination of the scene
*Identification of the decedent
*External and Internal examination
*Toxicological and Histological studies
*Interviews with doctors, witnesses
*Evaluation of relevant records

Question 15

Outline 7 autopsy findings.

Answer 15

*Type of weapon used
*Consistency of wounds and evidence
*Determination of fatal wound
*Length of time of victim survival
*Post-injury abilities of decedent
*Whether body was dragged or dumped
*Vectors of applied force

Question 16

Outline 5 purposes of an autopsy.

Answer 16

*Establish the cause and manner of death
*Identify, recover, and preserve evidence
*Provide factual, objective medical report
*Separate natural deaths from unnatural death
*Provide interpretation and correlation of facts and circumstances

Question 17

Outline the 4 principles of investigation.

Answer 17

1.Expeditious investigation
* FAST and RAPID

2.Thorough examination
*Detailed visual examination by a competent person.

3.Impartial investigation
*Someone who is impartial is not directly involved in a particular situation and is therefore able to give a fair opinion or decision about it.

4.Public rights respected

Question 18

Outline the 4 significant societal goals of conducting an autopsy.

Answer 18

*Accountability for wrongful deaths
*Promote safety and disseminate new knowledge about risk activities
*Helps the family come to terms with a traumatic death
*Results in “systemic” policy, regulative or legislative changes

Question 19

OUTLINE LAWS GOVERNING THE PERFORMANCE OF A MEDICOLEGAL AUTOPSIES IN BW.

Answer 19

1. INQUESTS ACT 1954 (CAP 07:01)
   - Procedures in UNNATURAL deaths + reporting to Police : NO CONSENT required for ML Autopsy
   
   • PM report to Inquest Magistrate / DPP in Criminal Cases (Homicides)
     . BIRTHS & DEATHS REGISTRATION ACT 1968(CAP 30:01)
   • Defines births & stillbirths, their reporting & procedures to be followed
   • Stipulates procedures in completion of “Notice of Death/Stillbirth [CRD-2 AND CRB-2]
   • NATURAL & UNNATURAL deaths

2.Botswana Health Professions Act 2001 (CAP 61:02)
3.Statistics Act 2009
4.Criminal Procedure and Evidence Act
5.Public Health Act 2013

Question 20

Refer to page 30 on notes.

Question 21

What is the task of pathologists in medicolegal death investigation?

Answer 21

Remember Our task as Pathologists is to “strengthen and enhance Medicolegal Death investigation” by doing the right thing for the people of this country, through our expertise”