Forensic Death Investigation Symposium: National Academy of Sciences Report
Jay Siegel, director of the Forensic and Investigative Sciences Program at Indiana University-Purdue University, opened the session with a discussion of the National Academy of Sciences (NAS) report's recommendation 11, which calls for eliminating the coroner system. The report is trying to raise the bar of medicolegal death investigation, Siegel explained, and the field needs more forensic pathologists.
This recommendation does not come in a vacuum, Siegel added. This is a system-wide problem. The NAS report examines the difficulties of the forensic science field, including a lack of research, funding, standards and accreditation. The goal is to improve all of forensic science, he explained.
Lakschmanan Sathyavagiswaran, chief medical examiner-coroner for the Los Angeles County Department of Coroner and past president of the National Association of Medical Examiners, explained that state law dictates medicolegal death investigation. Some states have coroners and some have medical examiners. Medical examiners, who are almost always physicians, are in a better position to educate and improve the quality of forensic death investigation, Sathyavagiswaran said. He then presented two cases highlighting the need for a medical examiner system. Watch Dr. Sathyavagiswaran's presentation or review his slides (pdf, 24 pages) to learn more about these cases.
Only 400 to 500 forensic pathologists currently practice full time, he said, adding that each year there are 15,000 new medical students, but only 47 forensic pathology residents. There is a lack of interest in forensic pathology, and there must be more programs to support education in forensic pathology. Sathyavagiswaran also called for a scientific working group of forensic pathologists and medicolegal death investigators to encourage best practices in the field.
O'Dell Owens, a previously elected coroner and former president of the International Association of Coroners and Medical Examiners, disagreed that an office is best served by a medical examiner. It is not about who runs the office, it is about how well you run the office, Owens said. The public should decide state by state, he added.
Owens expressed amazement that coroners were not on the NAS committee. He questioned how a report that seeks to improve forensic science could evaluate coroners but not have them on the team. Owens asked, Where is the comparison of medical examiners and coroners? Where are the reasons why coroners should be eliminated?
Every day coroners do good work with limited resources, Owens noted. Eighty-four percent of coroners say they want standards and certification, but they lack access to resources and training, he explained. We should work to give coroners education and training opportunities. Let's come together and embrace the tenet that the system needs to be improved, he said.