The Impact of Context on Manner-of-Death Determinations

Earlier this year, I shared about a study conducted by Dr. Itiel Dror and others, which found that medically irrelevant contextual information had an impact on a forensic pathologist’s determination of manner of death (homicide, suicide, accidental, natural, undetermined).

The study’s authors did not suggest that forensic pathologists not be provided any contextual information; after all, nonmedical contextual information often must be considered to determine a manner of death. For example, a single gunshot wound to the side of the head, absent any context, could be the result of an accident, a homicide, or a suicide. In that case, nonmedical contextual information would be critical to a determination of the manner of death. But the race of the decedent, for example, would be irrelevant to the determination and should have no impact. Yet Dror and his co-authors found that it often did.

Building on that groundbreaking study, Dr. Dror and several colleagues conducted a new study on the impact contextual information has on determining the manner of death. This new study was concerned not with the role irrelevant contextual information played in a medicolegal death investigation but with the level of impact contextual information in general has on a manner-of-death determination, and whether the level of impact changes based on when the forensic pathologist receives the contextual information in relation to the autopsy itself.

Participants in the study, all members of the National Association of Medical Examiners, received identical autopsy photos for four cases, each involving a single gunshot wound of the right posterior head. For each case, one group of participants received information suggesting a suicidal context; the other group received information suggesting a homicidal context. Each group was then broken down into subgroups. One subgroup received the contextual information before the autopsy; the other subgroup received the contextual information after the autopsy.

The results of the study revealed:

  • the impact of contextual information was so significant participants tended to rely on it more than on autopsy information to determine the manner of death;

  • this finding was true regardless of when the contextual information was provided, but this may be because the autopsy information provided here was of minimal value to the manner-of-death determination; and

  • if the more impactful information (the contextual information) was presented first, the addition of the autopsy information (of minimal impact) was less likely to change the preliminary manner-of-death determination. But when the autopsy information was provided first, the addition of the contextual information was much more likely to change the preliminary manner-of-death determination.

The findings of this new study have important implications for criminal defense practitioners. Juries rely heavily on experts when considering cause and manner of death. Given the impact contextual information has on a forensic pathologist’s determination, defense counsel should know not only what information the forensic pathologist was provided as part of the pathologist’s medicolegal death investigation, but also when the pathologist received that information in relation to the autopsy.

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