Forensic pathology is the subspecialty of pathology that focuses on the medico-legal investigation of sudden or unexpected death. Forensic pathologists split their time at work among 1) performing autopsies, 2) acquiring data from investigating officers, and 3) testifying in court. Occasionally, they may visit scenes of crimes or accidents, but this is uncommon for most pathologists.
Varying combinations of personality characteristics are required in a good forensic pathologist:
* A talent for and the interest in science: This should include not only biology, but physics, chemistry and the social
sciences (anthropology and psychology).
* Good communication skills: Pathologists not only interact with law officers, but with judges and juries, by trying
to convince them that their findings are valid.
* Strong stomach: Pathologists routinely deal with dismembered and/or rotting bodies. From a pure visceral
standpoint, there is no job more disgusting than forensic pathology.
* Thick skin: Pathologists are periodically raked over the coals by the local media, who apparently cannot resist
the urge to armchair-quarterback pathologists' work. Pathologists also have to have some insight into the mind
of a killer.
Forensic pathologists make roughly $60,000 to $180,000 a year, depending on experience, geographical area and level of responsibility. As a government employee, pathologists' fringe benefits (insurance, retirement) are exceptional. If a pathologist is good on the witness stand, they could become one of the corps of elite expert witnesses that fly around the country and command a handsome hourly consultant's fee.
The forensic pathologist is an expert in determining cause and manner of death. The forensic pathologist is specially trained: to perform autopsies to determine the presence or absence of disease, injury, or poisoning; to evaluate historical and law-enforcement investigative information relating to manner of death; to collect medical evidence, such as trace evidence and secretions; to document sexual assault; and to reconstruct how a person recieved injuries. Forensic pathologists are trained in multiple non medical sciences as well as traditional medicine. Other areas of science that the forensic pathologist must have a working knowledge of and the applicability of are toxicology, firearms examination (would ballistics), trace evidence, forensic serology and DNA technology. The forensic pathologist acts as the case coordinator for the medical and forensic scientific assessment of a given death, making sure that the appropriate procedures and evidence collection techniques are applied to the body. When forensic pathologists are employed as death investigators they bring their expertise to bear upon the interpretation of the scene of death, in the assessment of the consistency of witness statements and with injuries, and the interpretation of injury patterns or patterned injuries. In jurisdictions where there are medical examiner systems, forensic pathologists are usually employed to perform autopsies to determine cause of death.
As a physician who specializes in the investigation of sudden, unexpected and violent deaths, the forensic pathologist attempts to determine the identification of the deceased, the time of death, the manner of death (natural, accident, suicide, or homicide), the cause of death and if the death was by injury, the nature of the instrument used to cause the death.
First, the forensic pathologist gathers a history as to how the death occured and often obtains the past medical history of the deceased as well. Next, the forensic pathologist examines the body externally and then internally , taking biopsies of tissues to further examine under the microscope for disease not visible to the naked eye. This postmortem examination is known as an autopsy.
During the course of the autopsy, various laboratory tests maybe taken, including x-rays, retention of body fluids such as blood and urine for toxicologic analysis, and cultures of body fluids and organs for evidence of infection.
When all of the information, including the history, the results of the autopsy and laboratory tests, are completed, the forensic pathologist correlates all the information and draws conclusions as to the cause and manner of death. A report is then prepared summarizing these findings. The forensic pathologist can expect to be subpoenaed to testify before courts and other tribunals about the pathologic findings and conclusions. Coroners, medical examiners, and pathologists provide copies of their official reports to parties, such as the insurers or public agencies, having a legitimate interest in the cause or manner of death of citizens.
The history is the beginning of the investigation and is of utmost importance in making the determination of cause of death. The scene investigation may disclose drugs or toxins which may be related to the cause of death. Some poisonous agents are not detected on routine drug screens therefore the pathologist must have knowledge of medications and toxins in order to request the specific analytical tests needed to detect them. An example would include the "sniffing" of aerosol propellants, a risky activity which has been frequently reported in teenagers. Sniffing of propellant substances can cause sudden death by precipitating lethal cardiac arrhythmias.
A special analysis (gas chromatography by head space analysis) is required to detect the chemicals in the blood. In other cases there may be sufficient natural disease to account for death, but the individual may in fact have died of a drug overdose or other subtle cause. In the case of drowning and suffocation, the autopsy findings may not be specific and police investigation may be critical to the understanding of the death. Data developed by coroners, medical examiners, and pathologists is studied by medical epidemiologists and health and safety agencies to develop strategies to prevent death and injury, thereby saving lives. The data developed about motor vehicle injuries and fire deaths lead to legislation requiring seat belts in vehicles and smoke detectors in building construction.
In the examination of skeletonized or severely decomposed remains, the forensic pathologist needs a working knowledge of multiple methods of identification including forensic anthropology in order to establish identity. If sufficient skeletal parts remain, the pathologist may be able to determine age, race, and sex of the individual and sometimes estimate the length of time since eath. Occasionally, specific markings on the bones may enable the pathologist to come to a conclusion as to the cause of death.