The History of Forensic Pathology

Forensic Pathology
Introduction
Forensic pathology is a field in criminology and medical jurisprudence that focuses on the study of a corpse to determine evidence that can be used in criminal justice or to determine the cause of death. The post mortem conducted by a forensic pathologist serves as the source of information for the autopsy report that is generated at the conclusion of the investigation. Having trained previously in anatomical pathology, the forensic pathologist will be able to determine the cause of death by examining the body and determining the process by which the person died. This paper will discuss forensic pathology in detail and show how it is of use in criminal justice.
Meaning of the Terms
The history of forensic pathology is rooted in the terminology: as Choo and Choi (2012) point out, “forensic” comes from the Latin term “forum,” which means “public.” Pathology is Greek in its origins and refers to suffering; thus, pathology by itself is the study of illness. Today, the term pathologist refers “to a physician who identifies, interprets, and diagnoses changes caused by disease in tissues and body fluids, either before or after death” (Choo & Choi, 2012, p. 20). Its historical terminology, however, indicates that as a science it was concerned with matters of public inquiry related to illness or suffering. Moreover, the main practice associated with forensic science—autopsy—stems from another Greek word, which means “to see for oneself” (Choo & Choi, 2012, p. 16). In forensic pathology, a forensic autopsy is conducted at the request of the state “to satisfy the law in special circumstances such as suspicious death” (Choo & Choi, 2012, p. 16). Thus, forensic pathology today is part of a public process of identifying whether a crime was committed in conjunction with the death of an individual.
Forensic Pathology throughout History
Autopsy has always been interconnected with anatomy and the study of medicine. However, in ancient cultures, such as in Babylon and in Asia, dissection of the human body was forbidden based on religious beliefs: it was considered an act of desecration to dissect a human body for any reason (Newell, 1995). Some exceptions to the rule can be found: the Egyptians, Greeks and Romans all understood the uses of pathologic anatomy and engaged in dissection as a matter of scientific inquiry related to anatomy; but there was still not much use of the technique of forensic pathology (Prayson, 2007). In the Middle Ages, human dissection was not even permitted until the 13th century. In Asia, Muslim communities had by then already begun developing a forensic pathology technique—in the century prior, in fact. Song Ci published the first book on postmortem examination in 1247 and it contained descriptions of “illustrated methods to use during the investigation of suspicious deaths and other forensic issues such as poisoning, decomposition, wounds from various weapons, strangulation, and fake wounds” (Choo & Choi, 2012, p. 17).
In Europe, the written record on forensic pathology did not begin until the 1500s, when Italian scholars began teaching courses on anatomy, dissection and forensic medicine. Benivieni published The Hidden Causes of Diseases in 1507 and later that same century, German courts had made a provision for requiring the testimony of medical experts to determine the cause of death in cases of murder, infanticide and abortion (Choo & Choi, 2012). Thus, it is safe to say, that by the end of the 16th century and in the 17th, forensic pathology was a respected field of science both in the East and in the West.
The founder of modern autopsy is considered to be Morgagni, who was highly influential in directing the field of inquiry. His work led William and John Hunter to teach pathology in England and by the end of the 18th century, Guy’s hospital in London was regularly conducting postmortem examinations (Finbeiner, Ursell & Davis, 2009). As technology became more instrumental in understanding the field, it was introduced with much appreciation. Virchow in Germany, for instance, is hailed as the father of pathology for being the first to use the microscope in pathological inquiries (Choo & Choi, 2012). By the end of the 19th century, all laboratory students would have access to microscopes and by the 1920s, the study of forensic pathology was being used by law enforcement, with the first crime lab constructed in Los Angeles during the era of Prohibition. A decade later, the FBI “made forensic sciences available on a nationwide basis for the first time in the United States” (Choo & Choi, 2012, p. 18). Under the FBI, forensic pathology became a staple in criminal justice in the U.S.
How Forensic Pathology is Managed by the State
In cases where a crime has been suspected, every state in the U.S. has the right to call for an autopsy to be conducted. There are three entities that have legal standing in these cases: the coroner’s office, the medical examiner’s office, and a mixed-system. The majority of states in the U.S. have a medical examiner’s office in charge of conducting autopsies for the state. A dozen states rely on the coroner’s office for its forensic needs, while 16 states used a mixed-system approach with both medical examiners and coroners being utilized.
The role of the coroner as either an elected official or a publicly appointed official is to inspect the cause of any death that it deems suspicious—i.e., unnatural. In the U.S., the coroner is part of the executive branch and thus can both issue subpoenas and hold inquest. As Choo and Choi (2012) note, the “major function of the coroner is to determine cause and manner of death” (p. 20). In the field of forensic pathology, the coroner’s office is something of a problem in that not every coroner is required to by a physician—i.e., while the coroner is required to have some training in pathology, his lack of a medical background could lead to inaccurate findings in autopsies. Additionally, in some states, the sheriff can rule on the cause of death and serve in this capacity as the coroner. This has political ramifications and also social ramifications that bring conflicts of interest to field of forensic pathology (Maio & Maio, 2001).
For that reason, the majority of states in the U.S. have shifted to the medical examiner’s system. The medical examiner is meant to be an independent office that is non-partisan to a political doctrine and is not beholden to any political agenda. The office is meant to be held by physicians only, which helps to ensure that the individual conducting forensic pathology will be properly trained with a medical background. In some parts of the country, it is a stipulation that the medical examiner be a trained forensic pathologist, since this is fundamental to his role.
Forensic Pathology Today
Three years after the FBI essentially instituted forensic science in criminal justice, the American Board of Pathology began allowing pathologists to obtain certification. As a result, today a forensic pathologist is required to receive special training “certification in forensic pathology to serve as medical examiner and to conduct laboratory or postmortem studies of apparently unnatural or crime-related deaths” (Choo & Choi, 2012, p. 20). To obtain certification, forensic pathologists must engage in four years of post-graduate study in the fields of both anatomic and clinical pathology. Following this, a year of strictly forensic pathology studies must follow (Houck & Siegel, 2010). This extensive study in pathology as a post-graduate scholar ensures that the forensic pathologist is well-qualified to serve the state in all its inquests and criminal justice and autopsy needs.
The forensic pathologist is tasked with a number of different responsibilities when fulfilling their role in criminal justice. These jobs include “investigating certain types of deaths, performing forensic autopsies, identifying decedents, determining causes of death, and determining manner of death” (Choo & Choi, 2012, p. 20). Moreover, each of these jobs has multiple parts to it. For example, when investigating a forensic death, the pathologist must examine the scene where the corpse is found to obtain context; then he must study the corpse to determine the stage of death; and finally he must conduct a follow-up inquiry to ensure that no items have been unchecked, missed or admitted later that can serve to assist him in the investigation. Thus, it can be seen that the forensic pathologist of today has a job that is bit more extensive than simply performing a routine autopsy. On the contrary, they must get out into the field whenever a corpse is discovered and engage in gathering and protecting every piece of evidence that might be of some use in the case.
Some states may have different rules in place that govern the duties of the forensic pathologist, but the essential spirit of the job is the same. If the forensic pathologist personally is not required to enter into the field to obtain pieces of evidence, another agent will be required to do so as that information will be required by the pathologist in his work. There may also be some overlap, for example, as forensic entomologists may play a role in determining the time of death based on the study of insects found at the scene or in the corpse (Joseph, Mathew, Sathyan & Vargheese, 2011). Indeed, the study of entomology has been of great assistance in the study of forensics over the years, at least from a criminal justice perspective. Forensic entomologists have assisted in many different cases by knowing what type of insects are likely to be found in corpses in various settings and in various states of decay—all of which helps to determine the time of death, which can then be of use in the prosecution of a criminal case (Catts & Goff, 1992).
Nonetheless, the most important job of the forensic pathologist is to identify the cause of death and the way or manner in which a person died. The cause of death is defined as the means by which the individual died—i.e., poison, bullets, a broken neck, drowning, and so on. By being trained in what to look for, the forensic pathologist will be able to determine cause of death fairly easily. The pathologist is also tasked with determining the way in which the person died—and this can be more complex. The manner of death is not the same thing as the cause of death: manner refers to the events that led to the cause. The forensic pathologist thus will play a part in determining whether the death was the result of homicide, suicide, accident, or natural causes. This will play a significant factor in whether a criminal case is prosecuted.
Over the years there have been many high profile cases in which a famous person died and a forensic pathologist or medical examiner was required to determine the cause and manner of death. The death of singer-songwriter Kurt Cobain, for example, was ruled a suicide by the pathologist, though some speculate that it should have been ruled a homicide. As a suicide, no criminal charges were brought up and no criminal investigation was conducted. Had the pathologist ruled the manner as a homicide, however, the story might have ended differently. Thus, one can see how crucial of an impact the forensic pathologist plays in the field of criminal justice. His inspection of the body and of the crime scene can make all the different in a case being closed and a case being referred for criminal investigation. One can also surmise, for that reason, why it is so important that the forensic pathologist be an independent office that is not beholden to political influence or bureaucratic pressure either from the sheriff or from the local governor.
Conclusion
Forensic pathology is a study that has been in existence in at least a rudimentary form for thousands of years. The ancient Greeks, Egyptians and Romans also had some form of pathology that they studied and pursued through the dissection human bodies and study of human anatomy. The first books on forensic pathology, however, were not published until the modern era. These helped to establish the field and its usefulness in criminal justice. In the U.S., forensic science was identified by the FBI in the early 20th century as having considerable use in assisting in criminal investigations. Indeed, over the decades as numerous cases have shown, forensic pathologists have played a serious role in determining the cause and manner of death, which has then had an impact on whether a case would go on to be investigated or not. For this reason, forensic pathology is a vital aspect of criminal justice today and will remain so for as long as the field of science plays a part in the field of justice.
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