Medicolegal Death Investigation
The information on medicolegal death investigation presented below was produced by the U.S. Department of Justice Office. It relates to a study that focused on the establishment of guidelines for conducting death investigations. The principal purpose of this study, that was initiated in June 1996, was to identify, delineate, and assemble a set of investigative tasks that should and could be performed at every death scene.
It was based on the collective knowledge of three multidisciplinary content area expert groups. The focus was on the death scene, the body, and the interactive skills and knowledge that must be applied to ensure a successful case outcome.
This important research is being showcased here as part of an initiative to make important, insightful and engaging public domain works freely available.
"Is it [medicolegal death investigation] an enlightened system? No, it's not. It's really no better than what they have in many Third World countries."
(Dr. Werner Spitz, Former Chief Medical Examiner, Wayne County, Detroit, Michigan)
The first thing one must realize is that the word "system" is a misnomer, when used in the context of death investigation in the United States. There is no "system" of death investigation that covers the more than 3,000 jurisdictions in this country. No nationally accepted guidelines or standards of practice exist for individuals responsible for performing death-scene investigations. No professional degree, license, certification, or minimum educational requirements exist, nor is there a commonly accepted training curriculum. Not even a common job title exists for the thousands of people who routinely perform death investigations in this country.
This report describes a study that focused on the establishment of guidelines for conducting death investigations.
Purpose and Scope of the Study
The principal purpose of the study, initiated in June 1996, was to identify, delineate, and assemble a set of investigative tasks that should and could be performed at every death scene. These tasks would serve as the foundation of the guide for death scene investigators. The Director of the National Institute of Justice (NIJ) selected an independent review panel whose members represented international and national organizations whose constituents are responsible for the investigation of death and its outcomes. The researcher organized two multidisciplinary technical working groups (TWGs). The first consisted of members representing the investigative community at large, and the second consisted of an executive board representing the investigative community at large.
The study involved the use of two standardized consensus-seeking research techniques: (a) the Developing A CurriculUM (DACUM) process, and (b) a Delphi survey.
In this report, the author does not attempt to assign responsibility for task (guideline) performance to any one occupational job title (e.g., Guideline D4 is performed by law enforcement personnel). Research design and selected methodology focused on the establishment of performance guidelines for death-scene investigations. The research design did not allow TWGs to assume investigative outcomes during the development phase of the project; therefore, no attempt was made to assign a "manner" of death to individual guidelines (e.g., Guideline C2 applies to homicide scenes), to maintain objectivity and national practicality.
The author does not claim to be an expert in the science and/or methodology of medicolegal death investigation. This research was based on the collective knowledge of three multidisciplinary content area expert groups. The focus was on the death scene, the body, and the interactive skills and knowledge that must be applied to ensure a successful case outcome.
The balance of this introduction outlines the study design and provides basic background information on the selection of the National Medicolegal Review Panel (NMRP) and TWG memberships and the research methodology, its selection, and application. The study findings (investigative guidelines) follow this introduction.
Identification of NMRP and TWGs
The methodology selected for this occupational research required collection of data from a sample of current subject matter experts, practitioners from the field who perform daily within the occupation being investigated. This "criterion" was used to identify members of the various multidisciplinary groups that provided the data for this research. The following groups were formed for the purpose of developing national guidelines for conducting death investigations.
National Medicolegal Review Panel
NMRP members represent an independent multidisciplinary group of both international and national organizations whose constituents are responsible for investigating death and its outcomes. Each member of NMRP was selected by the Director based on nominations made by the various associations. The rationale for their involvement was twofold: (a) they represent the diversity of the profession nationally, and (b) their members are the key stakeholders in the outcomes of this research. Each organization has a role in conducting death investigations and in implementing these guidelines.
Technical Working Group for Death Investigation (TWGDI)
1. National Reviewer Network
Technical Working Group for Death Investigation (TWGDI) members represent a sample of death investigators from across the country. They are the content area experts who perform within the occupation daily. The following criteria were used to select the members of the TWGDI reviewer network:
A 50-percent random sample (1,512) of death investigators was drawn from the Centers for Disease Control and Prevention database. A letter was sent to each member of the sample, inviting him or her to participate in the national research to develop death investigative guidelines or to nominate a person who participates in death investigations. Two hundred and sixty-three individuals were nominated (17 percent). Nominees were contacted by mail and asked to provide personal demographic data including job title, years of experience, and educational background, in addition to general information (name/address, etc.) necessary for participation in the research.
The TWGDI national reviewer network consisted of 263 members from 46 States. The educational backgrounds of the national reviewer network members were as follows:
The types of investigative systems represented on the reviewer network were as follows:
The average age of TWGDI members was 47.6 years. They had an average of 10.5 years of experience. There were 80.6 percent (212) males and 19.4 percent (51) females in the group.
2. Executive Board
Representatives from each region were selected to maintain consistency within regions across the United States. These representatives made up the TWGDI executive board.
Criteria for selection to the TWGDI executive board were as follows:
TWGDI Executive Board DACUM Workshop
In November 1996, the TWGDI executive board met in St. Louis to begin developing the national Delphi survey. The survey content was to reflect "best practice" for death-scene investigation. DACUM is a process for analyzing an occupation systematically. The 2-day workshop used the investigative experts on the executive board to analyze job tasks while employing modified brainstorming techniques. The board's efforts resulted in a DACUM chart that describes the investigative occupation in terms of specific tasks that competent investigators must be able to perform "every scene, every time. A task was defined as a unit of observable work with a specific beginning and ending point that leads to an investigative product, service, or decision. The DACUM chart served as the outline for the Delphi survey.
This initial process resulted in six major areas of work. In attempts to simplify the survey for the members of the national reviewer network, the areas of work were placed into a logical sequence of events (as they might be performed while investigating a case). Within the five major areas of work (Investigative Tools and Equipment was excluded at this point because tools and equipment are "things," not procedural steps), 29 tasks were identified. Within the 29 identified investigative tasks were 149 discrete steps and/or elements. Theoretically, each step and/or element must be performed for the task to be completed "successfully." The results were placed in survey format for NMRP review and pilot testing.
National Medicolegal Review Panel Meeting
In December 1996, NMRP met in Washington, D.C., to review the DACUM chart and comment on the research methodology proposed by the researcher. The members of the panel recommended modifications to the survey design and approved response selections. Respondents would attempt to rate, by perceived importance, each of the investigative tasks/steps and/or elements on a five-point scale.
The Delphi Survey
The Delphi technique, although it employs questionnaires, is much different from the typical questionnaire survey. Developed by the RAND Corporation as a method of predicting future defense needs, the technique is used whenever a consensus is needed from persons who are knowledgeable about a particular subject. The goal of a Delphi survey is to engage the respondents in an anonymous debate in order to arrive at consensus on particular issues or on predictions of future events.
The Delphi requires at least four rounds in an effort to obtain a well-thought-out consensus. After the first-round results were received, coded, and recorded, a revised questionnaire was developed for round two. The second-round survey provided each member of TWGDI with the national median and mean scores for each of the task statements presented, as well as their first-round responses. Respondents were asked to compare their original ratings with the median and mean scores and to revise their original evaluations as they saw fit. This procedure was repeated for each of the four rounds of the survey. Final membership in the TWGDI national reviewer network was 146. This number represents approximately 56 percent of the originally nominated members.
During the 6 months of the Delphi process, both the TWGDI executive board and NMRP met to review survey data (to date) and to begin the process of moving task-based data into guideline format.
In May 1997, the executive board met for a 2 and a half day working session in New Orleans to begin the guideline development process.The consensus of the board was to establish 29 guidelines based on the national reviewer network data and present them to NMRP for review. Each guideline would have the following content:
In June and July 1997, NMRP met for two, one and a half day working sessions in St. Louis and Chicago to review the draft guidelines developed by the executive board and offer recommendations and changes based on jurisdictional variances and organizational responsibilities. Those sessions resulted in the final draft of the 29 guidelines for conducting death investigations.
The purpose of the second part of the national death investigator guidelines research was to identify training criteria for each of the 29 guidelines. This research is now completed. For each of the guidelines presented in this report,"minimum levels of performance" will be developed and verified by the members of the various TWGs. These "training guidelines" will provide both individuals and educational organizations the material needed to establish and maintain valid exit outcomes for each investigative trainee.
In this initial research, 29 investigative tasks were identified. Each task was developed into a guideline for investigators to follow while conducting a death investigation. Although each TWG believed in the validity of each guideline, no attempt was made to validate actual significance (e.g., if guideline C1 is trained and implemented, a [%] decrease in poor scene photographs should occur). The researcher is currently developing a national validation strategy for the implementation and validation of each guideline.
Medicolegal Death Investigation Guidelines
Medicolegal Death Investigation Guidelines were presented within six categories, all of which can be accessed via the links below.
Essential Medicolegal Death Investigation Reading
Spitz And Fisher's Medicolegal Investigation Of Death: Guidelines For The Application Of Pathology To Crime Investigation
known as the "bible" of forensic pathology to pathologists around the world, Spitz And Fisher's Medicolegal Investigation Of Death has withstood the test of time, recently celebrating its twentieth year of publication. Totally rewritten and updated throughout, the text is oriented to forensic pathologists, criminal investigators, and attorneys.
It embraces all aspects of the pathology of trauma as it is witnessed daily by law enforcement officers, interpreted by pathologists of varying experience and expertise in forensic pathology, and used by lawyers involved in the prosecution and defense in criminal cases as well as those engaged in civil litigation. This authoritative and complete textbook is written by some of the most respected experts in the United States.
The book continues to use a simple and practical approach in keeping with the tradition established by the previous editions. It avoids technical terminology, where possible, in compliance with the aim of addressing not only physicians but all parties with an interest in the study of injury patterns and the practice of pathology as it relates to the law. A large amount of new information and abundant material not previously covered are included in this volume. The many new illustrations, diagrams and sketches showing patterns and mechanisms of injury as well as an inclusive index render this book unique.
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