Psychological Autopsy

Linda E. Weinberger PhD , ... Bruce H. Gross PhD, JD, MBA , in Multidisciplinary Doc-Legal Decease Investigation, 2018

Conceptual Framework Used past the USC Institute of Psychiatry, Law, and Behavioral Science

Medical Examiner's/Coroner's offices usually do non use psychological autopsies to assist in making "suicide" and "accident" manner of death determinations ( Jobes et al., 1986). In that location is commonly plenty physical testify or psychological history obtained from law enforcement, coroner investigators, toxicologists, and pathologists that the ME/C does not demand input from mental health professionals. Whenever the ME/C makes a determination of the manner of expiry without mental health collaboration through a psychological autopsy, assumptions are made most the decedent'south intent. A psychological dissection may elicit cloth contrary to the assumptions of the ME/C, e.one thousand., that the self-inflicted gunshot wound to the caput was not intended to exist a suicide, simply was accidental. It is in simply such cases that family members and other relevant parties contest the ME/C'due south finding and may request a psychological autopsy to pass up suicide as the manner of death determination.

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Coroners and Medical Examiners

Ron M. Aryel , Michael 1000. Wagner , in Handbook of Biosurveillance, 2006

2 FUNCTION OF THE MEDICAL EXAMINER

Medical examiners investigate deaths due to homicide, suicide, or accidental violence, and deaths of persons unattended by a physician, or who succumbed to a contagious disease. They as well intervene in cases where expiry occurs amid suspicious circumstances. Examples of the latter include the sudden expiry of persons in apparently good health, or who die while in the custody of police force enforcement officers. The medical examiner is empowered to overrule family members or legal guardians who pass up permission for an dissection; however, in cases where the cause of death becomes obvious upon preliminary review, the medical examiner, at his sole discretion, may reject the instance and allow family members to merits the body without an autopsy.

Medical examiners are licensed physicians. They are most often pathologists by training, merely some medical examiners, specially those for whom the job is a part-time occupation, are family unit practitioners or have other specialties.

The medical examiner investigating a death will conduct an autopsy. The medical examiner must advisedly review and record a history and pertinent past medical history, supplied by witnesses, family members, and medical records obtained from the deceased person's healthcare providers; he/she must so perform a thorough concrete exam, which includes inspection of the body, and examination, or weighing, and dissection of organs. The medical examiner may gild radiological and laboratory tests every bit appropriate. Pathology specimens may be prepared as well. The purpose of this piece of work is to reach a conclusion regarding the crusade of expiry. The cause of death may be considered the deceased person'southward diagnosis.

The medical examiner must gear up a record for a deceased person, not unlike the medical record other physicians prepare for their living patients, which includes previous medical history and the results of the exams and procedures described above.

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DEATH INVESTIGATION SYSTEMS | Us of America

C.H. Wecht , South.A. Koehler , in Encyclopedia of Forensic and Legal Medicine, 2005

The Medical Examiner'south Death Investigation Systems

The medical examiner system was kickoff introduced in the The states in 1877 in Massachusetts. The public was dissatisfied with lay coroners and the system changed to ane of appointed physicians. One medical doctor was appointed in each district (like to a county jurisdiction) to be the public official responsible for the investigation of sudden and unnatural deaths. Medical examinations were a part of the investigation and the term medical examiner has been in use always since. The state was divided into a number of sectors in which a designated physician functioned equally a medical examiner and determined the cause and manner of death. At that time the medical examiner did not have the right to order an autopsy of the deceased. This correct did not appear in the land until the 1940s. The first true medical examiner system came into being in New York City in 1918. An individual was designated as the Chief Medical Examiner and was a physician who was experienced in the field of pathology (forensic pathology did not get a lath-certified subspecialty until 1959) with statutory authority to investigate death. He was provided with a defended facility, support staff, and toxicology laboratory. In the terminal several decades, the medical examiner system has slowly replaced the coroner organisation in the USA.

For example, in the state of West Virginia the land Chief Medical Examiner is appointed past the Director of the Division of Health for a five-year term and appoints the County Medical Examiner for a three-twelvemonth term. The land Chief Medical Examiner must exist a licensed medico and a diplomat of the American Lath of Pathology (ABP) in anatomic and forensic pathology with experience in forensic medicine and pathology. The Deputy Chief Medical Examiner must besides be a licensed doctor and accept completed an ABP-approved fellowship in forensic pathology. The County Medical Examiner must be qualified to practice in the field of medicine as a duly licensed physician, registered nurse, dr.'s assistant, paramedic, or other licensed emergency medical technician, who has received training in the field of medicolegal death investigation and who holds certification from the American Board of Medicolegal Expiry Investigation. A statewide medical examiner arrangement increased the quality of death investigation and forensic pathology services with presumed independence from population size, canton upkeep variation, and politics. A statewide system theoretically creates uniformity, designed to insure credentialing, training, and standing pedagogy of medical examiners, death investigative procedures, and the coding of deaths. These features enhance not only death investigation, simply as well public health, epidemiology, and overall community medical surveillance.

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Personal identification

Angi Chiliad. Christensen , ... Eric J. Bartelink , in Forensic Anthropology (Second Edition), 2019

Both medical examiners and coroners are responsible for investigating suspicious deaths, identifying bodies, notifying side by side of kin, and signing the decease certificate. The qualifications they have and the medicolegal systems in which they work, nonetheless, can be quite unlike. A medical examiner is a physician, ordinarily certified in forensic pathology, who is appointed to their position and performs autopsies. A coroner is an elected official who typically has little to no medical grooming. Different jurisdictions (at the land or county level in the United states) may operate under a medical examiner or coroner system or some other medicolegal system. Some jurisdictions require coroners to be pathologists (often with a further specialty in forensic pathology), just others do not; in such cases, remains may need to be sent to a medical examiner or forensic pathologist if an autopsy is required. Although sometimes contentious, many regime advocate the medical examiner system over the coroner system, or back up nationalizing the medical examiner system in the The states. It is advisable for forensic anthropologists to be cognizant of the medicolegal system and the medicolegal authority in which they do.

Unlabelled Image

Medicolegal systems in the US by state.

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The Forensic Squad

Max M. Houck , ... Terry McAdam , in The Science of Crime Scenes (Second Edition), 2018

Medical Examiner

A medical examiner (1000.E.) is a medical md who is responsible for examining bodies postmortem, to determine the cause of expiry and manner of decease, and the circumstances surrounding the death of an private. Style of expiry is one of five categories listed on a death document: homicide, suicide, natural, accidental, and undetermined. "Undetermined" is used when the mode of death cannot be determined or a distinction betwixt ii categories cannot be made. Thousand.E.s are pathologists, physicians trained in the medical specialty of pathology, the branch of medicine that deals with the diagnosis of affliction and causes of death through laboratory examination. G.Eastward.s and their staff (often chosen "decease investigators") will perform investigations at the scene of decease, work to identify the deceased, and may identify and collect evidence. At the crime scene, the M.E. will locate and view the body, check for pulse, respiration, and reflexes, as appropriate. Then identify and document the private who made the official determination of death, including the date, time, and location of conclusion. In one case death has been determined, rescue/resuscitative efforts end, and medicolegal jurisdiction can be established. Information technology is vital that this occur prior to the M.E./coroner'southward assuming any responsibilities ( National Institute of Justice). Almost M.Due east.s work in urban areas. The titles of an 1000.E. and a coroner are frequently interchanged; however, they are two distinctly unlike professions. M.E.s and coroners have dissimilar training and different job responsibilities. As of 2004 (latest figures available) 16 states had a centralized statewide M.Eastward. organization. fourteen states had a canton coroner system, vii had a county G.E. system, and 13 had a mixed county 1000.Eastward. and coroner system.

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More Pieces of the Puzzle

Richard B. Marx , ... Ann D. Fasano , in Commingled Human Remains, 2014

Medical Examiner/Pathologist/Coroner

The medical examiner/pathologist/coroner role at a crime scene will vary by jurisdiction. Some states and counties are part of the coroner arrangement. The coroner may or may not accept a medical background and may have a staff that includes pathologists or may contract out the work. Information technology is important to be familiar with the system responsible for a crime scene. In some jurisdictions, a pathologist volition respond to the scene; in some jurisdictions, the medical examiner'south office volition ship one of its investigators; and in some jurisdictions, there is no response to the scene. The important indicate to recall in all these scenarios is that the deceased is the responsibility of those medical examiner/pathologist/coroner jurisdictions and that the remains should not be touched without their approving. Regardless of which system is in identify, the medical examiner/pathologist/coroner is responsible for the postmortem examination.

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Mass Fatality Management and the Effects of Commingling

Elissia Conlon , in Commingled Man Remains, 2014

Health and Rubber Plan

ME/C personnel operating at an MFI should non be placed at the same run a risk 1 might if they were engaged in life rubber operations. MFI operations should exist conducted in such a way as to allow for more time to assess the hazards present at a mass fatality incident scene. Thus, planning should include the necessary efforts to identify and mitigate, where possible, any hazards present. For any incident involving potential contaminants, namely chemical, biological, radiological, nuclear, or explosive device or an unstable piece of work site (e.g., building collapse), it is incumbent upon the ME/C to ensure that a Wellness and Safety Plan (HASP) is fully developed prior to initiating operations and observed during operations. A HASP is utilized to clearly identify preparation, medical support, type of personal protective equipment (PPE), and work-residue cycles for all MFI operations not being conducted in a facility (e.yard., decedent recovery in the field).

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IMAGING | Radiology, Overview

W.A. Murphy , in Encyclopedia of Forensic and Legal Medicine, 2005

Scope

Medical examiners and coroners are responsible for investigating all instances of human decease past homicide, suicide, accident, injury, hazardous substance, or during custody, or if unattended by a doctor, or if otherwise sudden or suspicious. Since such circumstances encompass the total range of human behavior and biology, broad expertise is necessary to unravel the facts of each death, to assure the greatest quality in the cess, to interpret those facts in their proper context, and to present the facts and conclusions in a logical and effective manner. Equally a event, many scientific disciplines engage in death investigation.

Forensic radiology is the portion of science that deals with the relation and awarding of medical imaging facts to legal issues. Information technology contributes to death investigation, medical malpractice, paleopathology, and examination of inanimate antiquities such as pottery, paintings, and musical instruments. This commodity just examines forensic radiology in relationship to decease investigation.

Regarding death investigation, forensic radiology is a method that documents the anatomical features of the private who died. It is based upon detailed knowledge of human anatomy, of the medical conditions that affect people, and of the imaging methods that brandish normal and pathological anatomy. Diagnostic radiologists are clinical experts who employ radiological methods to certificate anatomic features present at expiry. There are no subspecialty preparation programs that produce forensic radiologists. Such experts arise after clinical specialty training and certification when individual diagnostic radiologists develop a personal interest in forensic matters and learn by experience. Some medical examiner and coroner jurisdictions have attracted such interested radiologists. Working with volunteer diagnostic radiologists, forensic pathologists provide on-the-job training in death investigation. In render, diagnostic radiologists contribute their specialized expertise.

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Blast and Crash Incidents

Laura A. Regan , Ladd A. Tremaine , in Commingled Human Remains, 2014

Overview of the Armed services Medical Examiner System

The Military machine Medical Examiner Organisation (AFMES) is a tri-service organisation that supports the Department of Defense force (DoD) and other governmental agencies and serves the American people by providing expertise in forensic pathology, forensic anthropology, DNA sciences, forensic toxicology, mortality surveillance, and forensic psychiatry. Through a DoD directive, the AFMES arose out of the Armed Forces Institute of Pathology's (AFIP's) Department of Forensic Sciences in 1988 ( Stone 2011). The Armed Forces Medical Examiner (AFME) derives his or her authorisation from 10 USC §1471, Forensic Pathology Investigations (1999), which governs medicolegal investigations inside exclusive federal jurisdiction and establishes specific secondary jurisdiction authorisation in order to support the interests of the United states of america. Later the closure of the AFIP in 2011, the AFMES relocated to its current location at Dover Air Strength Base (AFB), Delaware. In add-on, the AFMES has regional medical examiners, operating under the authority of the AFME, stationed throughout the continental United States, and in Europe and Asia.

The AFMES is unique in that information technology is the simply medical examiner function in the federal government and the just medical examiner system with jurisdiction in multiple locales throughout the country and overseas. As such, its purview extends beyond the boundaries of the Department of Defense force to include support agreements with the Federal Bureau of Investigation (FBI), Department of Country (DoS), National Transportation Rubber Board (NTSB), National Aeronautics and Infinite Administration (NASA), Peace Corps, and other U.S. federal entities.

In add-on to determining the crusade and manner of death for all electric current combat fatalities and fatalities occurring within exclusive federal jurisdiction, the AFMES partners with multiple DoD agencies to help mitigate gainsay injuries and ameliorate the survivability of combat troops. The AFMES provides full personnel accounting of all current combat and training mishap fatalities, also every bit all mass fatality incidents occurring within the jurisdiction of the AFME. Considering of its unique position within the federal government, the AFMES has been exposed to a diversity of commingling situations where current-mean solar day fatalities experience a high degree of fragmentation, primarily arising from air mishaps and explosive forces. The AFMES has developed standard operating procedures in which to separate, examine, analyze, and identify human being remains resulting from these circuitous conditions.

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Examining Sexual Homicides

B.E. Turvey , J. Freeman , in Behavioral Evidence Analysis, 2016

Deming, Mittleman & Welti (1983)

Medical examiner Charles Wetli, Physician, along with two colleagues, published a study of 41 female victims of proven fatal-sexual assault from Dade County, Florida (Deming et al., 1983). Their aim was to examine the crime scene characteristics from this type of sexual homicide in order to develop a working crime scene profile for use past investigators and forensic examiners. The cases in this written report evidenced the following: a

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The bodies of younger women, averaging 31   years, were about frequently found in canals, fields, or vacant lots.

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The bodies of older women, averaging 51   years, were constitute virtually oftentimes in their residences.

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Death usually resulted from mechanical asphyxiation, and the utilize of firearms was infrequent.

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Various instruments used to damage, restrain, or kill the victim were nigh oft obtained at the scene of death and reflected the emotionality and impulsivity of the incident.

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Ligature bindings, torn habiliment, varying degrees of disrobing, and seize with teeth marks were not infrequent.

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Alcohol was found in the blood of 40% of the victims and averaged 0.14%.

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Blackness victims were represented more oft than their racial distribution in this community.

The study concluded that the scene and autopsy findings of the boilerplate female sexual assault victim class a feature profile that should direct further investigation on a particular example (Deming et al., 1983). For example, according to the testimony of Dr. Wetli in Florida v. Julio Ortiz (2000), this report supported a loftier probability that a deceased woman found in an isolated field, disrobed, with her vesture down her legs, and with her vaginal area exposed, would likely have been the victim of strangulation and sexual assault.

Withal, it must be noted that sexual homicides may take few if whatsoever of the characteristics reported in Deming et al. (1983). It must also be noted that some or all of these characteristics may be evident in a nonsexual homicide. So while the findings in Deming et al. (1983) support the likelihood of a possibility, and even a proficient investigative hypothesis, they are not conclusive. What these findings provide are indicators or "red flags" for investigators and forensic scientists that highlight the possibility of a sexual homicide. That is to say, the existence of any or all of these criminal offence scene characteristics suggests an inductive hypothesis of sexual homicide that requires verification through investigation, examination, and reconstruction.

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