hannan forensic pathology finished alhamdulillah finished
Post on 08-Apr-2018
227 Views
Preview:
TRANSCRIPT
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
1/31
1
1.0INTRODUCTION : WORLD RECOGNITION
Brodrick Report:
According to the evidence received the basis of forensic pathologyis the small
amount of work which, although it is carried out on behalf of the coroner, is
particularly the concern of the police. Every police force needs to be able to call
on the services of a specially experienced pathologist to help in the
investigation of murder and other serious crimes against the person. Ideally,
this person should be a pathologist with a sound training in morbid anatomy
who has added to this general knowledge some additional skills, most notably
the ability to detect, and give authoritative testimony about, unusual features
of a dead body and the surrounding circumstances which may well be of
evidential value. He should be able to command the facilities of a well
equipped pathological laboratory, be readily available on call to police and
courts, and be prepared to travel at short notice anywhere in the area which
he serves.
Do the police need the services of a special kind of pathologist who can for the
most part be distinguished from a clinical pathologist in a hospital? Do coroners
need the services of the same kind of pathologist as the police ? Our answer to
both questions is an unequivocal
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
2/31
2
2.0DEFINITION : PATHOLOGIST
Pathology is the study and diagnosis of disease. The word pathology is from
Greek , pathos, "feeling, suffering"; and -, -logia, "the study of".
Pathologization, to pathologize, refers to the process of defining a condition or
behavior as pathological, e.g. pathological gambling. Pathologies is synonymous
with diseases. The suffix "path" is used to indicate a disease, e.g. psychopath.
Medical Pathology, Veterinary pathology and Phytopathology are the study of
anatomic, biochemical or microbiological diseases. The related scientific study of
disease processes is called general pathology. Psychopathology is the study of
psychological or mental diseases.
Medical pathology is divided into two main branches, Anatomical pathology
and Clinical pathology. Veterinary pathology is concerned with animal disease,
whereas phytopathology is the study of plant diseases.
Pathologists are biological or medical scientists who study the nature, causes,
and effects of disease in plant and animal life. Pathology is a broad field that
concentrates on the changes in organs, tissues, and cells that are caused by
disease.
Pathologists work in hospitals, medical laboratories, schools, colleges, and
universities. They may teach or do laboratory work or research. They are employed
by government agencies associated with agriculture, public health, law enforcement,
and many other fields. Private companies that make products such as drugs and
insecticides also employ pathologists.
(http://en.wikipedia.org/wiki/Pathology )
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
3/31
3
Pathologists concentrate on plant, animal, or human pathology. Although the
areas of study of these pathologists are very different, they are all scientists who
study disease. Pathology has been called the bridge between basic science and
medicine. Pathologists who are concerned with human disease are usually
physicians who have received specialized training in pathology. They are sometimes
called medical pathologists or are classified according to their subspecialty, such as
oral pathology.
Although medical pathologists do not treat patients of their own, they do
laboratory tests to diagnose disease in the patients of other physicians. They
perform tests on body tissues, secretions, and other specimens to see whether a
disease is present and to determine its stage. They evaluate the e xtent of the
disease, estimate the course it is likely to take, and suggest ways to treat the
disease. Surgeons may consult pathologists if they find unexpected problems during
an operation. Pathologists often stand by during surgery to test specimens taken
from a tumor in a patient's body. The patient may remain under anesthesia until the
pathologist can evaluate the specimens. Based on the pathologist's expert advice,
the surgeon is able to complete the operation in the way best suited to the patient's
condition.
Pathologists also do postmortem examinations to determine the cause of
death when the cause is unclear. They can evaluate the extent to which treatmenthad helped a patient. Pathologists' reports help physicians in their care of other
patients with similar conditions. Sometimes pathologists serve as medical examiners
or coroner's consultants. They determine the cause of death in accidents,
poisonings, and suspected murders. Pathologists coordinate and supervise the work
of medical laboratory technologists or technicians who prepare specimens or may
perform the more routine laboratory tests themselves. Pathologists often specialize
in one field, such as hematology (the study of the blood), blood banking,
neuropathology (diseases of the nervous system ), forensic (or legal) pathology,
medical chemistry, medical microbiology, or radioisotopic pathology.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
4/31
4
Medical pathologists frequently teach students in schools and colleges that
train nurses, physicians, medical laboratory technologists, technicians, an d other
health care workers. They sometimes conduct seminars for physicians and interns in
hospitals. They help train law enforcement officers to use scientific methods of
observation when they investigate injuries or deaths. Pathologists also do scientifi c
research into drugs and disease. Laboratories developing new drugs need
pathologists to study their safety. Pathologists use microscopes, radioisotopes, and
other equipment to study the cause of disease. They also use scientific methods and
computerized data as they test theories about disease processes. Cancer,
atherosclerosis, allergies, and birth defects are among the many diseases being
studied by medical pathologists.
Animal pathologists may be veterinarians or zoologists (animal scientists).
Veterinarians specializing in pathology study diseases and disorders in animals.
They often specialize in poultry, livestock, or pets. They also help to improve the
quality of livestock and poultry used for human food. In addition, their work helps to
save human lives since animals can transmit diseases such as rabies and
tuberculosis to human beings. Similar to veterinarians and medical pathologists,
zoologists specializing in pathology may study the effects of disease, parasites, and
insects on the cells, tissues, and organs of animals. Unlike other pathologists,
zoologists are often trained to work with a wide variety of animal species. They may
study hereditary diseases or disorders in fruit flies in order to increase knowledge
about the ways diseases are passed on over a period of many generations. They
may study the development of tumors in mice to get clues about the causes and
development of cancer in human beings. Animal pathologists often use equipment
and methods that are similar to those used by medical pathologists. Zoologists and
veterinarians working in animal pathology are employed by colleges and universities,
centers for veterinary medicine, zoos, and wildlife refuges as well as government
agencies and private industry.
Plant pathologists are botanists (plant scientists) whose special field is
sometimes called phytopathology. Sometimes plant pathologists do basic research
into the nature of disease in living things. For example, they may study the effect of
air pollution on the respiration rate and o n the cells and tissues of plants. This study
may have applications for medical pathologists who are concerned with the role of
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
5/31
5
industrial pollution in causing lung cancer or emphysema in human beings. On the
other hand, many plant pathologists do research that directly relates to plant
diseases. They devise ways to control or prevent plant diseases. They help to
develop new types of plants that are disease resistant. Their work is useful in
improving our food, fiber, and lumber supplies and in preserving t he ornamental
plants and trees that make our environment more healthful and attractive. Plant
pathologists use many of the same kinds of laboratory equipment and scientific
methods that medical and animal pathologists use. Plant pathologists teach and do
research in colleges and universities. They work for government agencies and
private firms involved in agriculture, horticulture, forestry, and related fields.
(http://careers.stateuniversity.com/pages/412/Pathologist.html)
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
6/31
6
2.1DEFINITION : ANATOMICAL PATHOLOGIST
Anatomic pathology, also known as anatomical pathology, is a branch of the
medical field which involves the examination of anatomical specimens to learn more
about the processes of disease and death. Specialists in this field do everything from
examining biopsy samples taken by surgeons to determine whether or not a growthis cancerous to examining the bodies of murder victims to determine the cause of
death and collect evidence which could be used in investigation and prosecution.
The term pathology translates into the study of suffering, and this medical
discipline is focused on examining the nature, course, and resolution of disease. In
order to become an anatomic pathologist, someone must attend medical school and
complete a residency in general pathology, followed by a focus in anatomic
pathology. The other main area of focus in the field of pathology is clinical pathology,in which samples of body fluids are examined in the laboratory.
There are a number of subspecialties within the anatomic pathology field. For
example, someone could focus on neuropathology, the examination of brain tissue,
or cytopathology, the study of samples of cells. When a doctor takes a Pap smear
from a woman, the examination of the tissue is often performed by a cytopathologist.
Other specialties include molecular pathology, gynecological pathology, endocrine
pathology, dermatopathology, cardiac pathology, osteopathology, and autopsy or
forensic pathology.
The goal of a pathologist is to be able to examine an anatomical sample and
to determine whether the sample is normal or abnormal, and if it is abnormal, to
describe the abnormality. Anatomic pathology can be used in the diagnosis and
treatment of disease, to do everything from confirming that a surgeon removed all of
a tumor to diagnosing a particular form of kidney disease from a biopsy sample.
One of the more unique specialties within the field of anatomic pathology is
autopsy pathology, which involves the study of deceased individuals to learn how
they died. Autopsies are routinely requested in cases where a death is suspicious, or
when the cause of death is unclear. In forensic pathology, the pathologist studies the
body to learn not only how the person died, but when. This branch of pathology also
focuses on the collection of legal evidence.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
7/31
7
Work in the field of anatomic pathology can be varied and quite rewarding.
Candidates interested in working in this area of medicine need to have excellent
attention to detail, along with great descriptive skills which will allow them to
communicate clearly in pathology results. It can also help to have a high tolerance
for unpleasant sights and strong odors, as these frequently crop up in pathology
laboratories.
(http://www.wisegeek.com/what-is-anatomic-pathology.htm)
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
8/31
8
2.2DEFINITION : FORENSIC PATHOLOGIST
Forensic pathology is a branch of the field of pathology which applies the
principles of pathology to the legal profession. Forensic pathologists specialize in
examining bodies and evidence such as body fluids and tissue samples for the
purpose of gathering information which can be used in criminal investigation and
court trials. They are sometimes known as medical examiners, coroners, or simply
pathologists, depending on the region where they work.
Some people think that the term forensics refers to forensic pathology, which
generates considerable confusion when forensic accountants, forensic document
examiners, forensic psychiatrists, and other forensics professionals are discussed.
Forensic actually comes from the Latin forum, and it means pertaining to a trial.
The field of forensics was developed in the 1800s, when people began applying
scientific methods to criminal investigation and legal trials.
The field of pathology in general is focused on the study of disease and its
processes. A specialist in forensic pathology has training in this field, with additional
skills which can be applied to the legal field. For examp le, he or she can examine a
body to determine the cause of death, but the pathologist can also look for other
clues and information, such as defensive marks on the hands which might indicate
that the victim fought back while being attacked.
Forensic pathology can involve the study of bodies, a process known as
autopsy, or analysis of samples taken at crime scenes or from the body. In cases
where a complete body is not available for examination, the forensic pathologist can
gather information from the available materials which can be used in investigation
and eventual prosecution. They can also examine samples of tissue and body fluids
to look for toxins and signs which can provide additional clues into the nature of the
death, such as evidence that someone was suffocated and then submerged to make
the death look like a drowning.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
9/31
9
In addition to being knowledgeable about huma n anatomy and pathology, a
forensic pathologist needs some additional skills. He or she must be able to collect
evidence properly and to maintain the chain of custody, ensuring that the evidence is
not compromised. It may also be necessary for forensic pathologists to testify on the
witness stand in some cases, and in some instances, a specialist in forensic
pathology may be retained by the defense for the purpose of refuting claims made by
the specialist who works for the government or the prosecution.
(http://www.wisegeek.com/what-is-forensic-pathology.htm)
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
10/31
10
2.3SUMMARIZING
The doctor that practices both
iscalled
GENERAL PATHOLOGIST
Sub-specialities
*stated only a fewof thesubspecialitiesof anatomical pathology
Pathologyasspecialist
Clinical
Pathologist
Anatomical
Pathologist
Dermatopathology
Molecular Pathologist
Neuropathologist
FORENSIC
PATHOLOGIST
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
11/31
11
3.0CLASSIFICATION : FORENSIC PATHOLOGY VS CLINICAL PATHOLOGY
Clinical pathology is a medical specialty that is concerned with the
diagnosis of disease based on the laboratory analysis of bodily fluids such as
blood and urine, and tissues using the tools of chemistry, microbiology,
hematology and molecular pathology. Clinical pathologists work in close
collaboration with medical technologists hospital administrations and referring
physicians to ensure the accuracy and optimal utilization of laboratory testing.
We accept the view that while every forensic pathologist needs to be a
competent morbid anatomist, the reverse statement does not follow: Many morbid
anatomists will never have the inclination to undertake forensic work, i.e. work for the
police or the criminal courts. The nature of the problems most often encountered incriminal investigation is different from that most often encountered in clinical work.
So are the circumstances in which the two kinds of pathologists are called upon to
work. The Forensic Pathologist may be required in field work literally! There is also
a difference between writing an opinion for a colleague, and giving evidence
based on that opinion orbeing cross-examined on that opinion in the criminal
court. There are pathologists who feel attracted to this par ticular kind of challenge
and also have the ability to cope with it, and there are pathologists who do not feel
this urge and who may not have the right attributes. We conclude that the differencebetween a clinical pathologist and a forensic pathologist i s as much in the nature of
the man as the nature of the work.
Whilst it is certainly true that the difference between a clinical pathologist and
a forensic pathologist is in the nature of the person performing the task as well as the
nature of the work, it is not true to say that forensic pathology can be carried
out only by medical practitioners with a certain type of personality . Instead, this
personal aspect of the difference between clinical and forensic pathologists is
accounted for by training and experience . The forensic pathologist has to be
trained in, and develop an understanding and aptitude for, the legal process of
investigation in conjunction with their knowledge of the scientific process of
investigation. These two approaches to investigating matters are quite distinct and
few medical practitioners have any real understanding of or feel for the legal
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
12/31
12
investigative method . It is a knowledge of the role that legal systems play in
society, as well as an understanding of the legal process and legal method, that
distinguish forensic pathologists from their clinical counterparts. Certainly there are
areas of specialist factual knowledge that forensic pathologists are familiar with
that their clinical counterparts are not.
However, simply acquiring factual knowledge on forensic issues will not
provide a clinical pathologist with sufficient skills to undertake forensic work .
A practical result of this difference is that forensic pathology does not sit
comfortably within a professional clinical pathology environment. Indeed, the
service requirements of forensic pathology mean that the service is usually more
efficiently provided by specialist forensic pathologists working together and
providing a broad based regional forensic pathology service for a ran ge of
clients.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
13/31
13
3.1 CLASSIFICATION : FORENSIC PATHOLOGY VS CORONER
In order to examine the role of the forensic pathologist, it is essential to
understand the development of death investigation systems including the role the
coroner plays in such jurisdictions. The office of coroner has its roots in Normantimes where death investigation had associated with it important political and
financial considerations . Coroners were associated with the collection of a number
of fines and taxes that could be levied by the Crown in association with certain types
of deaths. Deodands comprised taxes paid to the Crown that were based on the
financial value of the implement or object that had caused a person's unnatural
death, so that if a person was run over by a cart, the cart or its value was forfeited to
the Crown as a tax and the coroner was responsible for ensuring that the tax was
paid. Similarly the fine of presentment of Englishry was payable by a local
community if the coroner found that a deceased person was not of English blood.
The role of the coroner in criminal matters relat ing to death was limited,
although the coroner had the ability to ensure that potential criminal matters
were brought within the criminal justice system . Their main function in relation to
crime was to keep a check on the sheriff and to ensure that revenue s such as
fines reached the King . With regard to the prevention of deaths, the coroner had
little or no direct function, although some early coroners made attempts to
highlight hazards in the community and to reduce their impact.
Over time, the coroner's role diminished and the office became an onerous
one with the coroner having to pay many of the fees associated with the work out of
his own pocket. Early coroners were not necessarily medically or legally trained, and
many of the early coroners appointments were essentially political rather than
professional.
Today the approach of coroners in Australia differs from that of coroners
in England and Wales . Much of the function of the office of coroners in Australia is
focused on prevention , with the coroner empowered to make broad
recommendations surrounding the issues of public health and safety and judicial
administration. Such an approach gives the coroner a dynamic function in
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
14/31
14
contributing to the welfare of the community. In this modern framework the rol e of the
full-time forensic pathologist has been revitalized. The forensic pathologist is not
involved only with the investigation of suspicious deaths that may have a criminal
connotation. Instead, the forensic pathologists role has been widened to includ e a
wide range of natural and unintentional deaths, investigation of which, can lead to
improvements in the health and safety of the community. In conjunction with the
coroner, the forensic pathologist is a watchdog who maintains a constant
surveillance on potential fatal hazards in our society and ensures that preventable
deaths are recognized and the issues surrounding them addressed.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
15/31
15
4.0PATHWAY TO BECOME FORENSIC PATHOLOGIST
You need advanced training to become a pathologist. As an undergraduate,
you should major in premedical studies, a biological science, chemistry, or a related
field. It generally takes fouryears to earn a bachelor's degree and another one or
two years to obtain a master's degree.
Medical pathologists usually go to medical school for four years after they
graduate from college. They receive the degree of doctor of medicine (M.D.). In
some cases they spend six years in medical school and earn a doctoral deg ree
in pathology in addition to their medical degree.
After medical school, pathologists spend about four more years in ahospital as a resident in pathology . If they choose, they may also take additional
training in one of the subspecialties in medical p athology.
Medical pathologists need to be licensed by their state to practice
medicine and must also be certified by the American Board ofPathology .
Medical pathologists are likely to spend a total of at least twelve years in
training before they are fully qualified in their profession. Pathologists must spend
time reading and studying throughout their careers in order to keep up with newdevelopments in their field.
(http://careers.stateuniversity.com/pages/412/Pathologist.html )
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
16/31
16
5.0ROLES AS FORENSIC PATHOLOGIST
5.1 MEDICAL PRACTITIONER
Most forensic pathologists do not take part in clinical medical practice
involving the diagnosis of illness and disease or the provision of surgical and
medical treatment. They are none the less medical practitioners, committed to
the maintenance of good health within the community . The forensic pathologist
retains the basic medical skills in clinical diagnosis and therapeutics. In providing an
autopsy service for the coroner and other individuals involved in the heal th and
justice systems, the forensic pathologist is involved in analysis of clinical,
diagnostic and therapeutic issues as well as broad public health issues
including occupational health and safety. The media, the lay community and indeeda number of medical and legal professionals tend to view the forensic pathologist as
being concerned only with criminal justice aspects of death investigation. In reality,
deaths involving a suspicion of criminal activity represent a small percentage
of the work of the forensic pathologist . Whilst the forensic pathologist remains a
watchdog on the lookout for criminality during death investigations , most of
their work involves deaths associated with natural disease and unintentional
traumatic injury. These deaths have important considerations for public health
policy and health service planning as well as for community health and safety.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
17/31
17
5.2 PUBLIC HEALTH
The forensic pathologist in the course of everyday work identifies natural
disease processes within all age groups and all sections of the community. In order
to completely identify all aspects of natural disease in an autopsy , the investigation
has to be thorough and complete . In many cases, the identification of a cause of
death at autopsy is straightforward. However, in order to identify and recognize all
the natural disease processes that are present and to assess their relevance both for
the death and the ante-mortem symptoms, a thorough autopsy examination is
required. In those legal systems where the forensic autopsy simply provides a
cause of death, the quality of information obtained from autopsies may be limited.
However, the coronial system in the more modern jurisdictions has a responsibility to
find not only the cause of death, but also the circumstances of the death, andany factors that contributed to it , including those associated with the operation of
the health and legal systems. The autopsies performed within these jurisdictions
provide much more information. In reality, no cause of death can be satisfactorily
ascertained at autopsy without ensuring that the autopsy investigation has
been thorough enough to exclude potentially significant but rare natural
diseases. In autopsies where the death is the result of an unnatura l process, in
particular deaths from intentional injuries such as homicides, it is essential to
accurately assess, document - and in some circumstances to exclude - the influenceof natural disease processes. In criminal cases, the forensic pathologist is often
asked to assess the degree to which a pre-existing disease might have contributed
to the traumatic death.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
18/31
18
5.3 SPEACIALIST PATHOLOGIST
Most forensic pathologists are qualified clinical pathologists , and indeed their
work calls upon the basic scientific knowledge of pathology as well as the skills and
knowledge associated with each of the major branches of clinical pathology. As we
have seen, forensic case work can involve recognition and understanding of
the principles of haematology, microbiolo gy, chemical pathology,
immunology, and anatomical pathology or histopathology . In this regard,
forensic pathology can be seen as an applied area of clinical pathology which has
its focus on the delivery of primary information to the legal system regarding the
medical issues surrounding the causation and the circumstances of a death.
5.4 DEATH SCENE EXAMINER
The forensic pathologists work extends beyond the routine performance of
autopsies and the presentation of the results to the coroner and the courts. The case
investigation for a forensic pathologist is initiated by a death; the investigation
process includes analysis of information relating to the deceased person prior to their
death, together with examination and analysis of the scene and environment in
which they died or were found dead .
In allegedly suspicious deaths, the death scene is examined by a team of
individuals that comprises police officers, forensic scientists, forensic
pathologists and other specialist examiners such as forensic anthropologists
(for investigation of skeletal remains). A variety of other individuals are also involved
in the examination of a scene of a suspicious death including photographers and
video cameramen.
In most cases after a dead body is found in suspicious circumstances, the forensic
pathologist is called to the scene not only to examine the body and provide i nitial
information to the investigators, but also to study the environment in which the
body lies. The investigation of the environment of the death helps the pathologist
in coming to conclusions regarding the subsequent macroscopic and
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
19/31
19
microscopic autopsy findings. In many cases, by virtue of training and long
experience in attending at death scenes associated with crimes, the forensic
pathologist can contribute directly to the crime scene examination and provide
initial advice in areas of forensic science, including forensic biology and
ballistics. The inclusion of specialist forensic scientists from a wide variety of
disciplines within the death scene investigation team is important, and the forensic
pathologist may well have a part to play in help ing to determine the
appropriate specialists that may be required.
5.5 DEAD BODY EXAMINER
The media and most of the lay public recognize the forensic pathologist as a dead
body examiner. As we have just seen, the pathologist performs a preliminary
examination of a body at the death scene (or the place in which the body is found).
The formal examination of a dead body occurs of course during the process of the
autopsy. But the autopsy is more than an external examination of the body
followed by dissection and an internal examination . The process of an autopsy
covers a wide range of activities, and can include radiology and fluoroscopy
as well as endoscopic techniques for examining the interior of the body without
formal dissection.
The scope of examination of a body at the scene of death depends on the
circumstances, but in most cases, some initial information can be gathered from the
position of the body, the presence or absence of any rigor mortis or post-mortem
hypostatic lividity (discoloration of the skin), and the temperature of the body. A body
that is fully clothed or otherwise wrapped and partly concealed, may be difficult to
examine adequately at the scene, and no definitive conclusions regarding the nature
of the death should be made until the body has been examined fully at autopsy and
the necessary follow up tests have been completed.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
20/31
20
5.6 FORENSIC SOCIOLOGIST
It may seem strange to consider forensic sociology in the list of roles carried out
by forensic pathologists. In practice however, forensic pathology has to do with
issues of human behaviour in settings which involve violen ce and death . There
is no doubt that forensic pathologists acquire considerable expertise in certain
areas of criminology and in respect of certain community social settings .
Knowledge of police culture, prison culture, drug culture and other particular
subcultures is a feature of the professional experience of forensic pathologists. The
very nature of their work with regard to the investigation of suspicious and non -
suspicious deaths involves them with many of these subcultures. A variety of
sociological issues cause enormous community concern. Many of these areassociated with the work of forensic pathologists: deaths in custody, violence
associated with control agency response, deaths associated with failures of health
professionals including health and social services, suicide and the influence of
mental health on crime and social
5.7 MEDICAL DETECTIVE
Forensic pathologists, more than all other specialists in medical practice, are
medical detectives . Acting as a co-investigator for a coroner or the pol ice,
forensic pathologists play a far wider role than just providing an autopsy report. They
are often involved in all phases of a death investigation and form part of the
detective team which analyses the circumstances of a death . This role of
medical detective is often glorified in the media, and in such productions the
forensic pathologist is often elevated to the key player in the investigation .
This is certainly not the case in practice. Despite the media portrayal of the fore nsic
pathologist as a high-profile medical sleuth, the reality is that the forensic pathologist
participates on an equal basis with all other specialist investigators in the team
investigating the death.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
21/31
21
6.0SKILLS NEEDED TO BE FORENSIC PATHOLOGIST
6.1 CLINICAL SKILLS
Forensic pathologists are first and foremost medical practitioners . They have
undergone a full undergraduate training course , offive to seven years which has
included both pre-clinical and clinical studies . All forensic pathologists have spent
at least one yearand, in some cases, several years working in clinical medicine
within a hospital setting. Some will have spent a considerable time working in
other clinical specialty areas within a hospital or, in some cases, in general practice
and their knowledge in these clinical areas may be considerable. However it should
not be assumed that because of such experience they are currently experts in
clinical medicine or that they have kept their clinical medical s kills up to date .
The rapidity of developments in clinical forensic medicine and therapeutics makes it
is difficult for practitioners who are not actively engaged in clinical medicine to
maintain clinical medical skills. With the rapid increase in clinical sub-specialties,
any forensic pathologists knowledge of clinical medical practice will be
necessarily limited in most cases to general principles only .
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
22/31
22
6.2 FORENSIC PATHOLOGY SKILLS
Some of the basic knowledge in certain important field, whi ch should a forensic
pathologist well-aware are:
1. Neuropathology
2. Cytopathology
3. Haematology
4. Microbiology
5. Immunology
6. Toxicology
6.3 LEGAL SKILLS
The areas of knowledge that distinguishes forensic pathologists from their clinical
colleagues, is their understanding of legal process, medical law, court
procedures and their rules of evidence . Whilst doctors who engage in civil injuries
work are also familiar with court processes, the remainder of the medical profession
has little contact with the legal system and consequently has little knowledge of the
legal principles involved in civil and criminal cases. Many forensic pathologists have
gained their knowledge of the legal system through long experience of
working with it. Most forensic pathologists agree that a sound knowledge of the
legal principles that underlie their forensic work is of value in improving the
quality of service they provide for the legal system . In general, the legal
profession also is more comfortable dealing with those medical practi tioners who are
familiar with, and regularly participate in, the legal process.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
23/31
23
6.4 SCIENTIFIC SKILLS
When assessing the skills of the forensic pathologist, it is important to remember
that, as doctors with a general background and training in medici ne, their early
training both at secondary and tertiary level has been based on the sciences .
All medical students study science either before or at the time of entering a medical
course and in many medical schools the first year of undergraduate medical t eaching
often includes further study of physics, chemistry, mathematics and biological
science although these are naturally oriented towards the needs of medical
practitioners. The remainder of undergraduate pre -clinical and clinical training relies
upon the knowledge of scientific principles, and such basic scientific
knowledge is further developed and reinforced during a medical course.
For the pathologist and forensic pathologist, many of these areas of general
scientific knowledge take on special meaning and relevance to professional forensic
pathology practice. General principles of physics apply to ballistics, and
chemistry and biology have particular relevance to toxicology and chemical
pathology. Principles of mathematics including the use of statistics apply
across the board. Forensic medical practitioners should remember that they have
specialist knowledge in many sciences but that the extent of their knowledge variesbetween different scientific areas. In the same way, it is important for lawyers to
recognize that medical practitioners have a basic general scientific background
which will, on occasions, enable them to give opinion evidence as experts in certain
scientific areas.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
24/31
24
6.5 COMMUNICATION SKILLS
As discussed earlier, skill in medico-legal communications is a particular
attribute of forensic pathologists. Such skill does not arise solely from experience
in forensic pathology or formal training in witness techniques . The reason that
doctors often make good witnesses is that communication with patients in a
medical consultation lies at the heart of the practice of medicine . Through their
undergraduate training and addi tional years of postgraduate training, doctors
develop and rely upon communication skills . The term bedside manner is used
by lay people to describe a doctors performance as a communicator. Regardless
of the nature or type of medical consultation, a variety of communication skills are
employed. Doctors are familiar with techniques to overcome barriers tocommunication. They are aware of the deliberate use of silence,
confrontational, and summarizing techniques . When one examines these skills, it
becomes clear that many of the communication skills involved in medical
consultations are similar to the skills of barristers examining or cross -examining
witnesses in court. In practical terms, individuals in a jury are very similar to the
patient in a medical consultation. Their range of medical knowledge, intellectual
ability, scientific background, attention and commitment, mirrors closely the range
found by doctors when dealing with patients. As a result, the skills that a doctor usesto communicate with a patient can be used to great effect in communicating with a
jury.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
25/31
25
7.0SUB-SPECIALITIES OF ANATOMICAL PATHOLOGY
7.1SURGICAL PATHOLOGY
Surgical pathology is the most significant and time-consuming area of practice for
most anatomical pathologists. Surgical pathology involves the gross and microscopic
examination of surgical specimens, as well as biopsies submitted by non-surgeons
such as general internists, medical subspecialists, dermatologists, and interventional
radiologists. Surgical pathology increasingly requires technologies and skills
traditionally associated with clinical pathology such as molecular diagnostics.
7.2RENAL PATHOLOGY
Renal pathology is a sub-discipline of anatomical pathology concerned with the
diagnosis of medical (non-tumor) kidney diseases, including both native kidneys and
transplants. Renal pathologists routinely employ techniques of immunofluorescence
and electron microscopy, in addition to light microscopy, for kidney biopsy and
nephrectomy specimens. The renal pathologist integrates the microscopic findings
from these three techniques along with the clinical presentation of the patient and the
patient's clinical laboratory results to arrive at a diagnosis.
7.3CYTOPATHOLOGY
Cytopathology is a sub-discipline of anatomical pathology concerned with the
microscopic examination of whole, individual cells obtained from smears or fine
needle aspirates. Cytopathologists are trained to perform fine -needle aspirates of
superficially located organs, masses, or cysts, and are often able to render an
immediate diagnosis in the presence of the patient and consulting physician. In the
case of screening tests such as the Papanicolaou smear, non-physician
cytotechnologists are often employed to perform initial reviews, with only positive or
uncertain cases examined by the pathologist. Cytopathology is a board-certifiablesubspecialty in the U.S.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
26/31
26
7.4MOLECULAR PATHOLOGY
Molecular pathology is an emerging discipline within pathology, and focuses in the
study and diagnosis of disease through the examination of molecules within organs,
tissues or bodily fluids. Molecular pathology shares some aspects of practice with
both anatomic pathology and clinical pathology, molecular biology, biochemistry,proteomics and genetics, and is sometimes considered a "crossover" discipline. It is
multi-disciplinary in nature and focuses mainly on the sub-microscopic aspects of
disease and unknown illnesses with strange causes.
It is a scientific discipline that encompasses the development of molecular and
genetic approaches to the diagnosis and classification of human tumors, the design
and validation of predictive biomarkers for treatment response and disease
progression, the susceptibility of individuals of different genetic constitution todevelop cancer, and the environmental and lifestyle factors implicated in
carcinogenesis.
7.5AUTOPSY PATHOLOGY
General anatomical pathologists are trained in performing autopsies, which are used
to determine the disease factors contributing to a person's death. Autopsies areimportant in the ongoing medical education of clinicians, and in efforts to improve
and verify the quality of medical care. Dieners are non-physicians who assist
pathologists in the gross dissection portion of the autopsy. The recently established
field of Pathologists Assistant has taken over the role of Diener and contributes a
great deal to the pre-diagnosis of disease within the pathology laboratory. Autop sies
represent less than 10% of the workload of typical pathologists in the United States. ]
However, the autopsy is central to public perceptions of the field, in part due to
portrayals of pathologists on television programs such as Quincy, M.E. and SilentWitness.
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
27/31
27
7.6DERMATOPATHOLOGY
Dermatopathology is a subspecialty of anatomic pathology that focuses on the skin
as an organ. It is unique in that there are two routes which a physician can use to
obtain this specialization. All general pathologists and general dermatologists are
trained in the pathology of the skin; however, the dermatopathologist is a specialist inthis organ. In the USA, either a general pathologist or a dermatologist can undergo a
1 to 2 year fellowship in the field of dermatopathology. The completion of this
fellowship allows one to take a subspecialty board examination, and becomes a
board certified dermatpathologist.
(http://en.wikipedia.org/wiki/Anatomical_pathology )
(http://en.wikipedia.org/wiki/Pathology)
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
28/31
28
8.0FAQS : PATHOLOGY & FORENSIC PATHOLOGY
1 Q. What is forensic pathology? A. Forensic pathology is the subspecialty of pathology that focuses on themedicolegal investigation of sudden or unexpected death.
2 Q. How many years of schooling and training does it take to become aforensic pathologist?
A. After high school you'll have to undertake:
y 4 years of college, to get a bachelors degreey 4 years of medical school, to get the doctor of medicine (MD) degreey 4 or 5 years of residency (4 for anatomic pathology only, or 5 for
combined anatomic/clinical pathology, the latter track beingrecommended) to become eligible to take the Board exams inpathology
y 1 or 2 years of forensic pathology fellowship, to be eligible to take the
subspecialty Board exam in forensic pathology
3 Q. Wow! Thirteen to fifteen years after high school before you can get ajob? To hell with that!
A. It's not as bad as it sounds. Of course you have to pay tuition and livingexpenses for the eight years of college and med school, but residents andfellows earn a decent living wage (about $26,000/yr to start). From what I'veseen, the people who get in trouble financially are those that insist on startingfamilies while still in school and borrow a lot of money to finance a middle -class, American-dream lifestyle. When they finally finish training, they arebeset with the payback of onerous loans. On the other hand, if you're single,
live in not-the-best neighborhoods, and split expenses with housemates, medschool is very affordable, even fun.
4 Q. What do forensic pathologists do at work?A. Forensic pathologists split their time among
1) performing autopsies,
2) acquiring data from investigating officers, and
3) testifying in court.
Occasionally they may visit scenes of crimes or accidents, but I think this is
uncommon for most.
5 Q. What personality characteristics are required in a good forensicpathologist?
A. Varying combinations of the following ingredients:
y A talent for and interest in science. This should include not onlybiology, but physics, chemistry, and the social sciences (anthropologyand psychology). For the bread-and-butter technical part of your work,
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
29/31
29
you should especially have a good grasp of spatial relationships.y Good communication skills.You will not only be interacting with law
officers, but you'll be trying to convince judges and juries that yourfindings are valid.
y Strong stomach.You'll be routinely dealing with dismembered and/orrotting bodies. From a pure visceral standpoint there is no job moredisgusting than forensic pathology.
y Thick skin.You willbe periodically raked over the coals by the localmedia, who apparently cannot to resist the urge to armchair-quarterback your work. You will also make many enemies among thecitizenry. For instance, when you determine that Daddy killed himself,and he wasn'tpoisoned by that blond bimbo who was only interested inhis money, you are going to have some very angry children buzzingaround you.
y The mind of a detective. You will have to constantly be on guardagainst being fooled by malefactors smarter and more focused thanyou. You will have to have some insight into the heart and min d of acriminal.
6 Q. Where should I go to high school/college? Where should I do mypathology residency/forensic pathology fellowship?
A.You can go to high school anywhere. At any school, rich or poor, public orprivate, most of the teachers are mediocre, a few are totally incompetent, anda few are wonderful. The bottom line is that you, the student, are ultimatelyresponsible for your education. Even if you are so unfortunate as to be thevictim of uniformly abysmal teaching, the information is out there, and it is upto you to get it. Also, if you develop good time management skills in highschool, college will not only be easier, but fun, too. The potential for anenjoyable social life in college is great, but you have to come armed with asense of priorities to succeed both socially and academically on campus.
The choice ofcollege is a little more important. I am going to tell you right offthat I have a strong bias against two-year colleges (from which you couldtheoretically transfer to complete your premedical education at a four -yearcollege). These are cold, dismal places populated by desperate studentswhose joie de vivre was left behind years ago. At eighteen, you don't needthis.
I have a smaller bias against large, state -sponsored, four-year universities.For one thing, you are lost in the crowd. More importantly, your huge survey -level classes are often taught by unmotivated graduate students who may or
may not be able to speak understandable English. Do you really want this?(Of course, many grads of large universities are quick to defend their almaematres, such as one individual whose e-mailed argument was so eloquentthat I just had to post it here.)
This leaves four-year liberal arts colleges, which I highly recommend. Believeme, twenty years later, you'll be happy you made this choice. I think thecollege education is the single most i mportant (but least appreciated) part ofone's education. Its value is subtle, though, and it may take decades for its
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
30/31
30
promise to flower.
Medical school is an easy choice: go to the cheapest one you can get into.The quality of education is the same in every U.S. school. You have the sametextbooks, the same human bodies with the same diseases, and the samequality of faculty. Unfortunately, faculty members in med schools are not hiredor promoted based on their teaching skills, but on their practice skill s and
research accomplishments. Don't get me wrong; there are plenty of excellentmedical educators, but you never know where they'll turn up.
The choice ofresidency is more important. I strongly suggest a programassociated with a university, not a private hospital (although you can rotate atprivate hospitals under the aegis of university -based teaching programs). Somuch of the value of a residency program depends on the rapport betweenresidents and faculty. This is a hard parameter to measure from a distance,so you should consider doing a med school pathology elective in one or moreof the departments you are looking at for residency training. It is usually easyto arrange this, even between schools in different states.
Regarding yourforensic pathology fellowship, you will have to go to a bigcity to get sufficient experience. You will want to look for a program in whichthe fellow (you) does about 250 autopsies a year. Too many less than that,and you won't get enough experience. Too many more, and you'll be so busyyou won't have time to read, study, and do thorough workups on your cases.Of course, you will also want to look for a place that has senior faculty youcan respect and have rapport with.
7 Q. What are the advantages of being a forensic pathologist?A. The hours are better than for most other physicians, but this is not a nine -to-five office job by any means. Don't even think about going to med school ifyou are a clock-watcher.
You have the satisfaction of not only helping to put criminals away, but ofcomforting grieving families, thus, "It was over very quickly. She did notsuffer."
The job is very challenging, and boredom will not be a problem.
(http://web2.airmail.net/uthman/forensic_career.html)
-
8/7/2019 Hannan Forensic Pathology Finished Alhamdulillah Finished
31/31
9.0BIBILIOGRAPHY
1. David Ranson, The Role ofForensic Pathology
2. http://en.wikipedia.org/wiki/Pathology
3. http://careers.stateuniversity.com/pages/412/Pathologist.html
4. http://www.wisegeek.com/what-is-anatomic-pathology.htm
5. http://en.wikipedia.org/wiki/Anatomical_pathology
6. http://web2.airmail.net/uthman/forensic_career.html
top related