Medicolegal Death Investigation System


Book Description

The US Department of Justice's National Institute of Justice (NIJ) asked the Institute of Medicine (IOM) of The National Academies to conduct a workshop that would examine the interface of the medicolegal death investigation system and the criminal justice system. NIJ was particularly interested in a workshop in which speakers would highlight not only the status and needs of the medicolegal death investigation system as currently administered by medical examiners and coroners but also its potential to meet emerging issues facing contemporary society in America. Additionally, the workshop was to highlight priority areas for a potential IOM study on this topic. To achieve those goals, IOM constituted the Committee for the Workshop on the Medicolegal Death Investigation System, which developed a workshop that focused on the role of the medical examiner and coroner death investigation system and its promise for improving both the criminal justice system and the public health and health care systems, and their ability to respond to terrorist threats and events. Six panels were formed to highlight different aspects of the medicolegal death investigation system, including ways to improve it and expand it beyond its traditional response and meet growing demands and challenges. This report summarizes the Workshop presentations and discussions that followed them.




Coroner's Practice in Medical Cases


Book Description




Death Investigation in America


Book Description

Why is the American system of death investigation so inconsistent and inadequate? In this unique political and cultural history, Jeffrey Jentzen draws on archives, interviews, and his own career as a medical examiner to look at the way that a long-standing professional and political rivalry controls public medical knowledge and public health.




Postmortem


Book Description

As elected coroners came to be replaced by medical examiners with scientific training, the American public became fascinated with their work. From the grisly investigations showcased on highly rated television shows like C.S.I. to the bestselling mysteries that revolve around forensic science, medical examiners have never been so visible—or compelling. They, and they alone, solve the riddle of suspicious death and the existential questions that come with it. Why did someone die? Could it have been prevented? Should someone be held accountable? What are the implications of ruling a death a suicide, a homicide, or an accident? Can medical examiners unmask the perfect crime? Postmortem goes deep inside the world of medical examiners to uncover the intricate web of pathological, social, legal, and moral issues in which they operate. Stefan Timmermans spent years in a medical examiner’s office, following cases, interviewing examiners, and watching autopsies. While he relates fascinating cases here, he is also more broadly interested in the cultural authority and responsibilities that come with being a medical examiner. Although these professionals attempt to remain objective, medical examiners are nonetheless responsible for evaluating subtle human intentions. Consequently, they may end—or start—criminal investigations, issue public health alerts, and even cause financial gain or harm to survivors. How medical examiners speak to the living on behalf of the dead, is Timmermans’s subject, revealed here in the day-to-day lives of the examiners themselves.




Legal Medicine in History


Book Description

A collection of essays on the social history of legal medicine including case studies on infanticide, abortion, coroners' inquests and criminal insanity.







The Education of a Coroner


Book Description

An “entertaining” (Booklist) account of the mysterious, hair-raising, and heartbreaking cases handled by the coroner of Marin County, California throughout his four decades on the job—from high-profile deaths and serial killers to inmate murders and Golden Gate Bridge suicides. Marin County, California is a study in contradictions. Its natural beauty attracts celebrity residents and thousands of visitors every year, yet the county also is home to San Quentin Prison, one of the oldest and largest penitentiaries in the United States. Marin ranks in the top one percent of counties nationwide in terms of affluence and overall health, yet it is far above the norm in drug overdoses and alcoholism, not to mention the large percentage of suicides that occur on the Golden Gate Bridge. Ken Holmes worked in the Marin County Coroner’s Office for thirty-six years, starting as a death investigator and ending as the three-term, elected coroner. As he grew into the job—one that is far different from the forensics we see on television—Holmes learned a variety of skills, from finding hidden clues at death scenes, interviewing witnesses effectively, managing bystanders and reporters, and preparing testimony for court to how to notify families of a death with sensitivity and compassion. He also learned about different kinds of firearms, all types of drugs—prescription and illegal—and about certain unexpected and potentially fatal phenomena, such as autoeroticism. Complete with poignant anecdotes, The Education of a Coroner is “riveting and complex…supremely entertaining reading material and…a fascinating and wildly informative dive into the mysterious world of death and decay” (Kirkus Reviews).




Unexplained Pediatric Deaths


Book Description

This publication reviews medicolegal investigation of sudden, unexpected pediatric deaths, focusing on systems and procedures in the United States and those deaths which remain incompletely understood or entirely unexplained. It discusses the evolution of our understanding and practice in the area of sudden, unexpected pediatric death investigation, covering the changing philosophies and medical theories as to causation and changing investigative and certification strategies. Procedural guidance for investigation, autopsy and ancillary testing, certification and reporting, and key considerations for prevention, research and working with family members and other professional team members are provided.The path to production of this publication began in 2016 when the National Association of Medical Examiners received a scientific grant from the SUDC Foundation called "Sudden Death in Pediatrics: Consensus for Investigation, Certification, Research Direction and Family Needs" to convene, in collaboration with the American Academy of Pediatrics, an expert panel to identify and discuss the diverse issues and limitations surrounding these deaths and build a foundation for national consensus. The combined effort of a panel of medical examiners, pediatricians, and federal agency representatives, representing the diverse interests of death investigation, autopsy performance, certification, clinical subspecialties (pediatrics, neurology, cardiology, child abuse, injury prevention, infectious diseases, genetics, and metabolic diseases), family needs, prevention, and epidemiology, culminated in this publication.




Improving Diagnosis in Health Care


Book Description

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.




Deadhouse


Book Description

Deadhouse: Life in a Coroner's Office chronicles the exploits of a diverse team of investigators at a coroner's office in Pittsburgh. Ed Strimlan is a doctor who never got to practice medicine. Instead he discovers how people died. Mike Chichwak is a stolid ex-paramedic, respected around the office for his compassion and doggedness. Tiffani Hunt is twenty-one, a single mother who questions whether she wants to spend her nights around dead bodies. All three deputy coroners share one trait: a compulsive curiosity. A good thing too because any observation at a death scene can prove meaningful. A bag of groceries standing on a kitchen counter, the milk turning sour. A broken lamp lying on the carpet of an otherwise tidy living room. When they approach a corpse, the investigators consider everything. Is the victim face-up or down? How stiff are the limbs? Are the hands dirty or clean? By the time they bag the body and load it into the coroner's wagon, Tiffani, Ed, and Mike have often unearthed intimate details that are unknown even to the victim's family and friends. The intrigues of investigating death help make up for the bad parts of the job. There are plenty of burdens—grief-stricken families, decomposed bodies, tangled local politics, and gore. And maybe worst of all is the ever-present reminder of mortality and human frailness. Deadhouse also chronicles the evolution of forensic medicine, from early rituals performed over corpses found dead to the controversial advent of modern forensic pathology. It explains how pathologists “read” bullet wounds and lacerations, how someone dies from a drug overdose or a motorcycle crash or a drowning, and how investigators uncover the clues that lead to the truth.