The most frequent approach is to diagnose sudden cardiac death (SCD), myocardial infarction, and ischemic damage of the myocardium by determining the proteins in the myocardium, such as myosin, myoglobin, troponins, in blood, and/or pericardial fluid by immunoassay. An example is the method for identifying the used weapon in the case of injury/homicide by detecting the organ-specific antigen. In cases of suspicious death, a forensic pathologist is charged with determining the cause and manner of death. Forensic pathology refers to an area of study; not an individual.
The goal of each system is the same, namely the determination of the cause and manner of death for an individual dying in sudden, suspicious, or traumatic circumstances. At the international level there are even more categories of authorities that supervise death investigation including departments of law enforcement, justice, and health. This is the probable reason that some conclusions obtained from different studies on the same substance are sometimes contradictory. In other states, the pathologist is also permitted to enter “undetermined” or a variant. Strictly speaking, this is not part of forensic entomology, but it does involve insect behaviour after death. The task is to function as a medical expert for justice, not primarily to support one of the parties in the trial. Forensic pathologists may work in academic departments, state or government institutions, or independently.
In forensic pathology, the diagnosis of fatal hypothermia may be problematic due to the subtlety of morphological features, nonspecific findings at autopsy, variability and difference in the frequency of diagnostic findings, and the possibility of suspicious circumstances due to aberrant behavior prior to death (Wedin et al., 1979; Rothschild and Schneider, 1995; Figure 1). Although each U.S. state has its own standards for determining competence, the question usually reduces to whether a defendant had the mental capacity to form an intent to commit a crime. The final duty of the forensic pathologist is to render opinions in court as to the cause and manner of death. Forensic pathology is practiced by those in general with a background in histopathology or anatomical pathology.
In cases involving mechanical trauma/injuries, the forensic pathologist deals mostly with the examination of the deceased or injured person to determine the nature and cause of the injuries/death. An interesting approach to diagnose the cause of infantile sudden death was the immunostaining of the components of human and cow milk in the lung. The primary role of the forensic pathologist is to determine the cause of death based on a detailed and complete autopsy and to confirm if the cause of death is in accordance with the manner of death as proposed by the investigating agencies enquiring into sudden, suspicious, and nonnatural deaths.
Such predictions may enable the police to prevent the next crime in the series. Though this kind of analysis is an issue of diagnosis required at forensic autopsy, it also depends on forensic toxicological analysis: drug-related pathological changes, including immunohistochemical detection of drug/poison distributed in the body, and the quantitation of drug/poison in autopsy materials. Other states have a coroner system, in which the chief officer may not be a physician but employs forensic pathologists to carry out the necessary duties.
Forensic pathology In cases of suspicious death, a forensic pathologist is charged with determining the cause and manner of death.
In complicated death cases, it is easy for an untrained pathologist to make a mistake in determining the cause and manner of death, which may lead to a miscarriage of justice. Forensic pathologists are physicians and as such take the Hippocratic oath to ‘do no harm.’ This applies to all patients, the dead as well as the living.
Body fluids other than blood/urine or extract of tissue-homogenate cannot normally be considered for clinical use. The role of the forensic entomologist is mainly to help determine the postmortem interval by examining which insect populations inhabit the body. Medical examiners and coroners are called to court quite often and must be able to present their testimony without shocking the jury. In many countries, forensic medicine represents a medical specialty within the legal system, not within the health-care system. The forensic pathologist’s work is directed to assisting in predominantly judicial or legal processes by establishing manner, time, and cause of death. It is advisable to obtain and freeze a portion of liver from the right lobe routinely and other tissues as indicated.
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