Steps in Medicolegal Death Investigation

The purpose of Medicolegal Death Investigation is to define responsibility for medicolegal death investigation and to outline the types of cases that are to be investigated by such systems. Investigations can be conducted by inquiry with or without examination. Inquiries are typically conducted via telephone interview, personal interview, or review of records. Examination may include scene investigation, external inspection, and forensic autopsy.

Medicolegal death investigation officers, be they appointed or elected, are charged by statute to investigate deaths deemed to be in the public interest--serving both the criminal justice, civil justice and public health systems. These officials must investigate cooperatively with, but independent from, law enforcement and prosecutors. The parallel investigation promotes neutral and objective medical assessment of the cause and manner of death.

 To promote competent and objective death investigations:

A1.1 Medicolegal death investigation officers should operate without any undue influence from law enforcement agencies and prosecutors.

A1.2 A forensic pathologist or representative shall evaluate the circumstances surrounding all reported deaths.

Step 1:  Initial Inquiry

Medicolegal death investigators assess each death reported to the office to determine whether it falls under their jurisdiction as outlined by statutes, rules, and regulations. The categories below are those which should receive further investigations to protect the public safety and health, and determine the cause and manner of death.

Step 2: Forensic Autopsies

The purpose of this section is to establish minimum standards for the selection of cases requiring forensic autopsy, who should perform the autopsies, need for special dissection or testing, and who is responsible for interpretations and formation of opinions.Medicolegal death investigation officers are appointed or elected to safeguard the public interest. Deaths by criminal violence, deaths of infants and children, and deaths in the custody of law enforcement agencies or governmental institutions-- can arouse public interest, raise questions, or engender mistrust of authority. Further, there are specific types of circumstances in which a forensic autopsy provides the best opportunity for competent investigation, including those needing identification of the deceased and cases involving bodies in water, charred or skeletonized bodies, intoxicants or poisonings, electrocutions, and fatal workplace injuries. Performing autopsies protects the public interest and provides the information necessary to address legal, public health, and public safety issues in each case. For categories other than those listed below, the decision to perform an autopsy involves professional discretion or is dictated by local guidelines. For the categories listed below, the public interest is so compelling that one must always assume that questions will arise that require information obtainable only by forensic autopsy.

Step 3: Forensic Autopsy Performance

Performance of a forensic autopsy is the practice of medicine. Forensic autopsy performance includes the discretion to determine the need for additional dissection and laboratory tests. A forensic autopsy must be conducted by a licensed physician who is a forensic pathologist or by a physician who is a forensic medicine training. Responsibility for forensic autopsy quality must rest with the forensic pathologist, who must directly supervise support staff. Allowing non-forensic pathologists to conduct forensic autopsy procedures without direct.

Step 4: Interpretation and Opinions

Interpretations and opinions must be formulated only after consideration of available information and only after all necessary information has been obtained. As the person directing the investigation, the forensic pathologist must be responsible for these activities, as well as the determination of cause of death and manner of death (for the death certificate).

Autopsies shall be performed as follows:

1. the forensic pathologist reviews and interprets all laboratory results the forensic pathologist requested.

2. the forensic pathologist reviews all ancillary and consultative reports the forensic pathologist requested.

3. the forensic pathologist determines cause of death.

4. the forensic pathologist determines manner of death.