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Sunday, November 5, 2023

Forensic Pathology and Cause and Manner of Death

     Forensic pathologists are physicians educated and trained to determine the cause and manner of death in cases involving violent, sudden or unexplained fatalities. The cause of death is the medical reason the person died. One cause of death is asphyxia--lack of oxygen to the brain. It occurs as a result of drowning, suffocation, manual strangulation, strangulation by ligature (such as a rope, belt, or length of cloth) crushing or carbon monoxide poisoning. Other causes of death include blunt force trauma, gunshot wound, stabbing, slashing, poisoning, heart attack, stroke, or a sickness such as cancer, pneumonia or heart disease.

     For the forensic pathologist the most difficult task often involves detecting the manner of death--natural, accidental, suicidal or homicidal. This is because the manner of death isn't always revealed by the physical condition of the body. For example, a death resulting from a drug overdose could be the result of homicide, suicide or accident. Knowing exactly how the fatal drug got into the victim's system requires additional information, data that usually comes from a police investigation. A death investigator, for example, will try to find out if the overdose victim had a history of drug abuse or if there were signs of a struggle at the scene of the death. Had this victim attempted suicide in the past? Did the victim leave a suicide note? Did someone have a compelling motive to kill this person? Is there evidence of a love triangle, life insurance fraud, hatred or revenge? These are basic investigative leads that could help a forensic pathologist determine the manner of death.

     When the circumstances of a suspicious death are not ascertained or are sketchy, and the death is not an obvious homicide, the medical examiner might classify the manner of death as "undetermined." Drug overdose cases that are only slightly suspicious and therefore not thoroughly investigated often go into the books as either accidents or suicides. This is true of other forms of slightly suspicious death. Because a body is found dead in the water doesn't necessarily mean this person drowned. This victim could have been murdered and then dumped into the water. Even in a death by drowning, the person could have died after being criminally thrown from a boat or off a pier.

     There are more sudden, violent and unexplained deaths in the United States than the nation's four hundred or so board-certified forensic pathologists can handle. This gruesome workload ideally should require at least a thousand forensic pathologists. As a result of this personnel shortage not every death that calls for an autopsy receives one. Because there is also a shortage of qualified criminal investigators, not every death that requires an investigation gets the attention it deserves. This means we don't know exactly how many people in this country are murdered every year. Of the cases known to be criminal homicides about half go unsolved. This is one of the many failures of our criminal justice system. 

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