This assessment of America's medicolegal death investigative process by the National Association of Medical Examiners--the primary professional organization for medical examiners and forensic pathologists in the United States--focuses on personnel and equipment, forensic pathology education, accreditation and professionalism, and collaboration between the Federal Government and State and local forensic laboratories.
The Federal Government should recognize the value of medicolegal death investigations for criminal justice, public health, and homeland security. Support for uniform, quality medicolegal investigations should come from all Federal agencies with a stake in public safety and public health. Toward this end, the U.S. Congress should fully fund the National Forensic Science Improvement Act, and the U.S. Department of Health and Human Services should establish policies and programs to encourage more physicians to enter the field of forensic pathology while providing incentives necessary to retain currently practicing forensic pathologists. Forensic pathologists deal specifically with the investigation of cause and manner of death; they perform medicolegal autopsies and ancillary studies. As of 2003 there were 989 certified forensic pathologists in the United States; however, only approximately 600 were active practitioners, and less than 400 functioned as full-time forensic pathologists within medicolegal death investigation systems. Current estimates indicate that America needs at least 800 full-time, board-certified forensic pathologists to maintain medicolegal autopsy loads at acceptable levels. The limited availability of forensic pathologists suggests that many current practitioners are exceeding recommended caseloads and/or many medicolegal autopsies are being conducted by practitioners who are not forensic pathologists. The potential hazards of this practice are errors, the failure even to perform required autopsies, personnel burnout, and attrition. Appended cost information and 19 references