by Dr. Judy Melinek
When a breaking news case involves a sudden, unnatural or violent death, journalists will often get a copy of the autopsy report. Autopsy reports can be daunting to read if you have not been trained in medicine. Because of this, reports in the media can be confusing or misleading to the public. Here, then, are some definitions and guidelines for anyone reading or writing about death investigations, and especially members of the media, should hopefully find useful.
Remember that forensics is complicated, and sound bites are few. Always keep in mind that you are exploring a story about a dead human being. You owe it to that person—and to your audience, and to the public record—to get the details of the death investigation rigorously right.
A coroner is not the same thing as a medical examiner
Both a coroner and a medical examiner perform forensic death investigations—examinations into the circumstances of any death that is sudden, unexpected or violent. The crucial difference is this: A coroner is an administrator or law enforcement officer, and a medical examiner is a doctor. A medical examiner is a forensic pathologist, a physician with specialized training in death investigation. In a medical examiner’s office, a doctor called the chief medical examiner is in charge of both the death investigation and overseeing the autopsies performed by other doctors. Consider whether the office calls itself a “Coroner” or “Medical Examiner.” The terms aren’t interchangeable.
Do not confuse cause and manner of death
Cause of death is the disease or the injury that killed the person: heart disease, appendicitis, stab wound, etc. Manner of death is a classification of the cause of death that is separated into five categories: natural (for disease), accident, suicide, homicide or undetermined. It is incorrect to say “the cause of death was natural” or “a motor vehicle accident” because that means you are conflating cause and manner. It would be better to write “the manner of death was natural” or that “death was caused by trauma from the motor vehicle accident.”
Homicide is not the same thing as murder
Homicide means “death at the hand of another.” Intent is not a factor—only a volitional act is required. It’s up to the district attorney to determine whether it is in the state’s interest to charge the defendant with murder or manslaughter, or not press any charge at all. Even if the DA does not press charges, or the defendant is prosecuted but acquitted, that fatal event is still a homicide. But it is not a murder. Calling a homicide a murder does not fall within the purview of the agency performing the forensic death investigation. That’s a job for the DA, judge or jury.
Don’t confuse the autopsy with the death investigation
The autopsy pathologist can only tell so much from a dead body. Trying to figure out the cause of death from a dead body alone without knowing anything about the scene, circumstances, or medical history of the decedent would be like a surgeon coming in to perform surgery on an unconscious patient without the benefit of a physical exam, medical records or X-rays. So do not expect the release of any information about an autopsy on a high-profile case—especially if it’s a homicide—as soon as the autopsy is done. The autopsy is just one piece of a long process that results in a cause of death determination.
‘Pending’ is not the same thing as ‘inconclusive’
In many news reports when the autopsy is complete but the medical examiner has sent out specimens for additional testing, or needs more time to review the police reports or medical records, the preliminary determination after the autopsy will be that the case is “pending.”
“Pending” means you have to wait for the results. It does not mean “we don’t know.” It does not mean that the autopsy findings were “inconclusive.” Something is inconclusive when you cannot draw conclusions about it after all the information is available. The autopsy itself may be conclusive, but the medical examiner is not going to tell you that—because they are still working to complete the death investigation, and that will take some time.
The autopsy doesn’t ‘show’ or ‘tell’ you anything. The expert does.
“The autopsy showed five gunshot wounds to the body, two at close range, and a single stab wound.” No, the autopsy didn’t show that. The forensic pathologist determined it. It is his or her professional opinion of the autopsy findings. A different forensic pathologist might look at the same evidence and determine, based on the position of the body, that the five gunshot wounds were created by only three rounds. Two were bullet re-entries. And the stab wound isn’t a stab wound. It’s actually a therapeutic artifact—a hole created by the doctors in the hospital, during their attempt to save the decedent’s life.
So when you get your hands on an autopsy report, call a forensic pathologist and ask for professional guidance in putting it into plain English. There’s a good reason that forensic pathologists go to court to interpret their findings to juries—those findings can be obscure to anyone not trained in our very narrow and specialized field, and the conclusions we come to in forensic death investigations are important.
The first legally-mandated autopsy done by the coroner or ME’s pathologist is an independent autopsy. Everything else is not.
“Independent” means not influenced by anything or anyone. During that first autopsy, the forensic pathologist collects trace evidence, has photographs taken, and makes incisions into the body that literally alter the evidence. Even if this pathologist were to face political or bureaucratic pressure to interpret the findings a certain way, the physical evidence of the first forensic autopsy will become public record and will be used in court. Any pathologist hired by attorneys, the decedent’s family, or anyone else to perform a second autopsy is not “independent.” He or she is a retained expert. That means if his findings are not helpful to the family’s attorney, they don’t have to disclose them. At all.
Forensic pathologists are doctors, not police officers and are not in the business of covering up for anyone. While they may rely on good relationships with the police department in order to get the information they need to do their job, they are committed to doing that job properly, for very good reasons—if they do not, they will either lose that job, or ruin their relationship with their own boss (the Coroner or medical examiner) in order to please an outside agency (the police).
“Reprinted with permission of Forensic Magazine, Advantage Business Marketing” September 2015”