The practice of death investigation calls for many skills and a very broad knowledge of medicine and science. As a death investigator, the forensic pathologist must be knowledgeable of every natural disease process known to medical science. Superimposed on that are all of the non-natural processes that can cause a sudden and unexpected death. Can we do it all alone or should we even try?
Death investigation has become super-skilled, and forensic anthropologists are one of the critical “ologists” we turn to on a regular basis.
If one looks in the NAME accreditation checklist, there is a list of consultant services that an office must have access to avoid a deficiency. These consultants are there to ensure that the office will be able to draw on the appropriate expertise at the right time.
These, and the many other checklist items, such as caseload, are in place to create an environment where the forensic pathologist has the tools to produce high quality results from their investigation.
If administrators looked at the number of investigations an office completes each year and translated that into a public impact picture, they would be very surprised. Approximately 20-25% of all deaths in a jurisdiction are reported to the medical examiner or coroner's office. In Maryland, we are on track to have over 14 000 cases reported to the Office of the Chief Medical Examiner for a population of six million residents. For those of you who have additional reporting requirements by local statutes (such as cremation and hospice deaths), then this number is far larger. Regardless, over a single election cycle, that is about 60 000 families in Maryland. How many voters are there in each of the families that needed the services of the OCME? What is the political cost if any office collapses? They do time after time, so it seems there may be little or no consequence. However, we do see these agencies resuscitated so is it there?
So without looking at impacts on public health and safety, there is a very real personal impact at the individual household level that we all know too well. We need to communicate this to our respective administrations. In reality, we rarely get thanked for doing our investigations properly. However, if a family is unhappy, we certainly hear about it. As the shortage of forensic pathologists worsens, there will be pressure to use nonforensic pathologists and other para-medically trained individuals to the detriment of the quality of the outcome.
So having all of the tools we need is a challenge. So I am looking forward to receiving this issue. This Journal always has focused on high-quality content. Continued updating of our personal knowledge base is critical. Reading AFP is an excellent way to do this. Having the wisdom to know when you need assistance and getting a consultation can only be done if you know what you do not know. Add this to our annual meeting and we will have a very educational month.
Regards to all.