Medical examiner

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Medical examiner van

A medical examiner is an official trained in pathology that investigates deaths that occur under unusual or suspicious circumstances, to perform post-mortem examinations, and in some jurisdictions to initiate inquests. [1] [2]

Official someone who holds an office

An official is someone who holds an office in an organization or government and participates in the exercise of authority.

An inquest is a judicial inquiry in common law jurisdictions, particularly one held to determine the cause of a person's death. Conducted by a judge, jury, or government official, an inquest may or may not require an autopsy carried out by a coroner or medical examiner. Generally, inquests are conducted only when deaths are sudden or unexplained. An inquest may be called at the behest of a coroner, judge, prosecutor, or, in some jurisdictions, upon a formal request from the public. A coroner's jury may be convened to assist in this type of proceeding. Inquest can also mean such a jury and the result of such an investigation. In general usage, inquest is also used to mean any investigation or inquiry.

Contents

In the US, there are two death investigation systems, the coroner system based on English law, and the medical examiner system, which evolved from the coroner system during the latter half of the 19th century. The type of system varies from municipality to municipality and from state to state, with over 2000 separate jurisdictions for investigating unnatural deaths. In 2002, 22 states had a medical examiner system, 11 states had a coroner system, and 18 states had a mixed system. Since the 1940s, the medical examiner system has gradually replaced the coroner system, and serves about 48% of the US population. [3] [4]

A coroner may conduct or order an inquest into the manner or cause of death, and investigate or confirm the identity of an unknown person who has been found dead within the coroner's jurisdiction.

The coroner is not necessarily a medical doctor, but a lawyer, or even a layperson. In the 19th century, the public became dissatisfied with lay coroners and demanded that the coroner be replaced by a physician. In 1918, New York City introduced the office of the Chief Medical Examiner, and appointed physicians experienced in the field of pathology. In 1959, the medical subspecialty of forensic pathology was formally certified. [5]

Forensic pathology sub-specialty of pathology that focuses on determining the cause of death by examining a corpse

Forensic pathology is pathology that focuses on determining the cause of death by examining a corpse. A post mortem 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 types of death reportable to the system are determined by federal, state or local laws. Commonly, these include violent, suspicious, sudden, and unexpected deaths, death when no physician or practitioner treated recently, inmates in public institutions, in custody of law enforcement, during or immediately following therapeutic or diagnostic procedures, or deaths due to neglect.

Job roles

A medical examiner's duties may vary depending on location. The medical examiners’ job is usually extensive and has a lot that goes into it. Typically, a medical examiner's duties may include:

Death Records is a San Francisco-based Lo-Fi/Outsider Pop record label. Founded by Brian Wakefield & Colin Arlen in 2014, the label was created to "Represent the 'misfits of this city' who have been left behind to fend for themselves". The label has started an annual festival, Deathstock, to celebrate the labels "birthday". Acts such as Gary Wilson, Tomorrow's Tulips & The Memories played the inaugural year.

Law enforcement Enforcement of the law by some members of society

Law enforcement is any system by which some members of society act in an organized manner to enforce the law by discovering, deterring, rehabilitating, or punishing people who violate the rules and norms governing that society. Although the term may encompass entities such as courts and prisons, it is most frequently applied to those who directly engage in patrols or surveillance to dissuade and discover criminal activity, and those who investigate crimes and apprehend offenders, a task typically carried out by the police or another law enforcement organization. Furthermore, although law enforcement may be most concerned with the prevention and punishment of crimes, organizations exist to discourage a wide variety of non-criminal violations of rules and norms, effected through the imposition of less severe consequences.

In some jurisdictions, a coroner performs these and other duties. It’s not uncommon for a medical examiner to visit crime scenes or to testify in court. [6] This takes a certain amount of confidence in which the medical examiner has to rely on their expertise to make a true testimony and accurately testify the facts of their findings. [6] Medical examiners specialize in forensic knowledge and rely on this during their work. [2] In addition to studying cadavers, they are also trained in toxicology, DNA technology and forensic serology (blood analysis). [6] Pulling from each area of knowledge, a medical examiner can accurately determine a cause of death. [2] This information can help law enforcement crack a case and is crucial to their ability to track criminals in the event of a homicide or other related events. [2]

Crime scene location that may be associated with a committed crime

A crime scene is any location that may be associated with a committed crime. Crime scenes contain physical evidence that is pertinent to a criminal investigation. This evidence is collected by crime scene investigators (CSIs) and Law enforcement. The location of a crime scene can be the place where the crime took place, or can be any area that contains evidence from the crime itself. Scenes are not only limited to a location, but can be any person, place, or object associated with the criminal behaviors that occurred.

Court judicial institution with the authority to resolve legal disputes

A court is any person or institution with authority to judge or adjudicate, often as a government institution, with the authority to adjudicate legal disputes between parties and carry out the administration of justice in civil, criminal, and administrative matters in accordance with the rule of law. In both common law and civil law legal systems, courts are the central means for dispute resolution, and it is generally understood that all people have an ability to bring their claims before a court. Similarly, the rights of those accused of a crime include the right to present a defense before a court.

In law and in religion, testimony is a solemn attestation as to the truth of a matter.

Within the United States, there is a mixture of coroner and medical examiner systems, and in some states, dual systems. The requirements to hold office vary widely between jurisdictions.

The dual systems model, also known as the maturational imbalance model, is a theory arising from developmental cognitive neuroscience which posits that increased risk-taking during adolescence is a result of a combination of heightened reward sensitivity and immature impulse control. In other words, the appreciation for the benefits arising from the success of an endeavor is heightened, but the appreciation of the risks of failure lags behind.

Qualifications

United Kingdom

In the UK, formal medical training is required for medical examiners. Many employers also request training in pathology while others do not. In the UK, a medical examiner is always a medically trained professional, whereas a coroner is a judicial officer.

Pilot studies in Sheffield and seven other areas, which involved medical examiners looking at more than 27,000 deaths since 2008, found 25% of hospital death certificates were inaccurate and 20% of causes of death were wrong. Suzy Lishman, president of the Royal College of Pathologists, said it was crucial there was "independent scrutiny of causes of death". [7]

United States

Qualifications for medical examiners in the US vary from jurisdiction to jurisdiction. In Wisconsin, for example, some counties do not require individuals to have any special educational or medical training to hold this office. [8] In most jurisdictions, a medical examiner is required to have a medical degree, although in many this need not be in pathology. Other jurisdictions have stricter requirements, including additional education in pathology, law, and forensic pathology. Medical examiners are typically appointed officers. [9]

Education

In the United States, Medical Examiners require extensive training in order to become experts in their field. [6] After high school, the additional schooling may take 11–18 years. [6] They must attend a college or university to receive a bachelor’s degree in the sciences. [2] Biology is usually the most common. [10] A medical degree (MD) is often required to become a medical examiner. [11] [10] To enter medical school, the MCAT (Medical College Admissions Test) may be required [2] after which Medical school is another four years with the first two dedicated to academics and the rest of the two used to gain clinical experience. [10]

Additional training is required after medical school. The first step is to complete pathological forensic training. [11] This usually consists of anatomic and clinical pathology training which takes anywhere from four to five years to complete. [2] After this, an anatomic pathology residency and/or a fellowship in forensic pathology should be completed. [10] Before practicing, they must also become certified through the American Board of Pathology. [11] [12]

Career

The general job outlook for medical examiners in the United States is considered to be excellent. [6] Remuneration varies by location, but it is estimated to average between $105,000 and $500,000. [6]

Literature

Television

Medical examiners are common characters in many crime shows, especially American shows. The following characters are well known medical examiners:

CSI franchise

Law & Order franchise

NCIS franchise

  • Dr. Donald "Ducky" Mallard in NCIS , is the chief medical examiner for NCIS Major Case Response Team.
  • Dr. James "Jimmy" Palmer in NCIS , is the assistant medical examiner for NCIS Major Case Response Team.
  • Dr. Loretta Wade in NCIS: New Orleans is the Medical Examiner of Jefferson Parish.

Related Research Articles

Frances Glessner Lee was influential in developing the science of forensics in the United States. To this end, she created the Nutshell Studies of Unexplained Death, 20 true crime scene dioramas recreated in minute detail at dollhouse scale, used for training homicide investigators. Eighteen of the Nutshell Studies of Unexplained Death are still in use for teaching purposes by the Maryland Office of the Chief Medical Examiner, and the dioramas are also now considered works of art. Lee also helped to establish the Department of Legal Medicine at Harvard, and endowed the Magrath Library of Legal Medicine there. She became the first female police captain in the United States, and is known as the "mother of forensic science".

A scenes of crime officer (SOCO) is an officer who gathers forensic evidence for the British police. They are also referred to by some forces as forensic scene investigators (FSIs), crime scene investigators (CSIs), or crime scene examiners (CSEs). SOCOs are usually not police officers, but are employed by the police forces. Evidence collected is passed to the detectives of the Criminal Investigation Department and to the forensic laboratories. The SOCOs do not investigate crimes or analyse evidence themselves.To be in SOCO you need to have at least 5 GCSEs at Grade level 9 - 4

Thomas Noguchi American coroner

Thomas Tsunetomi Noguchi is a former Chief Medical Examiner-Coroner for the County of Los Angeles, who served in that position from 1967 to 1982. Known as the "coroner to the stars", he determined the cause of death in many high-profile cases during the 1960s and 1970s. He is most famous for performing autopsies on Marilyn Monroe, Robert F. Kennedy, Sharon Tate, Gia Scala, William Holden, Natalie Wood, and John Belushi.

The Centre of Forensic Sciences (CFS) is a laboratory providing forensic science services to law enforcement agencies in Ontario, Canada. It is part of the government of Ontario Ministry of Community Safety and Correctional Services public safety division.

Georgia Bureau of Investigation

The Georgia Bureau of Investigation (GBI) is a state-wide investigative law enforcement agency within the state of Georgia. It is an independent, statewide agency that provides assistance to Georgia's criminal justice system in the areas of criminal investigations, forensic laboratory services and computerized criminal justice information. Its headquarters is located in unincorporated DeKalb County, near Decatur and in Greater Atlanta.

A crime laboratory - often shortened to crime lab - is a scientific laboratory, using primarily forensic science for the purpose of examining evidence from criminal cases.

The following outline is provided as an overview of and topical guide to forensic science:

Office of Chief Medical Examiner of the City of New York

The Office of Chief Medical Examiner of the City of New York (OCME) is a department within the city government that investigates cases of persons who die within New York City from criminal violence; by casualty or by suicide; suddenly, when in apparent good health; when unattended by a physician; in a correctional facility; or in any suspicious or unusual manner. The OCME also investigates when an application is made pursuant to law for a permit to cremate the body of a deceased person.

The American Board of Medicolegal Death Investigators (ABMDI) is an independent not-for-profit certification board based in Baltimore, MD that works to encourage and enhance professional standards among medicolegal death investigators.

Dr. Vincent J. M. Di Maio is an American pathologist and an expert on the subject of gunshot wounds. He is originally from Brooklyn. Di Maio is a board-certified anatomic, clinical and forensic pathologist, and a private forensic pathology consultant. He attended St. John's University and the State University of New York (SUNY), and received postgraduate training at Duke University, SUNY, and the Office of the Chief Medical Examiner of Maryland.

In many legal jurisdictions, the manner of death is a determination, typically made by the coroner, medical examiner, police, or similar officials, and recorded as a vital statistic. Within the United States and the United Kingdom, a distinction is made between the cause of death, which is a specific disease or injury, versus manner of death, which is primarily a legal determination. Different categories are used in different jurisdictions, but manner of death determinations include everything from very broad categories like "natural" and "homicide" to specific manners like "traffic accident" or "attempted or self-induced abortion". In some cases an autopsy is performed, either due to general legal requirements, because the medical cause of death is uncertain, upon the request of family members or guardians, or because the circumstances of death were suspicious.

Joseph Lawrence Cogan is an American coroner who served as acting Chief Medical Examiner-Coroner for the County of Los Angeles from 1990 to 1992.

Dr. Marcella Farinelli Fierro is a medical examiner and forensic pathologist. She was the former chief medical examiner of Virginia, appointed in 1994 and serving in this position until her retirement in 2008. She was the ninth woman certified in forensic pathology by the American Board of Pathology. Since retirement, Fierro has served as an educator, mentor, and adviser.

A coroner in Washington state is a quasi-judicial, public official principally charged with the certification of human death. It is completely identical in authority to the parallel office of medical examiner, which also exists in the state. Washington uses a "mixed system" of death investigation with some counties employing coroners, and some employing medical examiners.

The International Association of Coroners and Medical Examiners (IAC&ME) is a United States-based professional society composed primarily of coroners, with a smaller number of members who are medical examiners.

Elliot M. Gross was an American forensic pathologist who served as the Chief Medical Examiner of New York City from 1979 until 1989 during the Koch administration.

The National Coronial Information System (NCIS) is a national database of coronial information on every death reported a Coroner in Australia from July 2000 and New Zealand from July 2007.. It assists coroners, their staff, public sector agencies, researchers and other agencies in obtaining coronial data to inform death and injury prevention activities.

References

  1. "Coroner vs. medical examiner". Visible Proofs. Retrieved 12 October 2014.
  2. 1 2 3 4 5 6 7 8 9 "Forensic Medical Examiner Jobs in Forensic Criminal Investigations". www.crimesceneinvestigatoredu.org. Retrieved 2018-03-30.
  3. Jason Payne-James, ed. (2005), "DEATH INVESTIGATION SYSTEMS/United States of America", Encyclopedia of Forensic and Legal Medicine
  4. Randy Hanzlick; Debra Combs (1998), "Medical Examiner and Coroner Systems", JAMA , 279 (11), doi:10.1001/jama.279.11.870
  5. Medicolegal Death Investigation System: Workshop Summary. Institute of Medicine. 2003.
  6. 1 2 3 4 5 6 7 8 "Forensic Pathologist | explorehealthcareers.org". explorehealthcareers.org. Retrieved 2018-03-30.
  7. "Medical examiners help expose patient safety risks". Health Service Journal. 12 February 2015. Retrieved 10 March 2015.
  8. Coroners and Medical Examiners: A Comparison of Options Offered by Both Systems in Wisconsin Jenifer Keach, Rock (WI) County Coroner, April 6, 2010
  9. National Academy of Sciences, Strengthening Forensic Science in the United States: A Path Forward, (2009), pp 241–253.
  10. 1 2 3 4 "How to Become a Medical Examiner in 5 Steps" . Retrieved 2018-03-30.
  11. 1 2 3 "Medical Examiner - Forensic Science Careers". Forensic Science Careers. Retrieved 2018-03-30.
  12. "Becoming a Medical Examiner: Salary Info & Job Description". learningpath.org. Retrieved 2018-03-30.
  13. The real 'Kay Scarpetta' retires - updated 6:37 p.m. ET 1 January 2008 (By Lisa Billings / AP) - TODAY: Books – MSNBC.com

Further reading