medical examiner

Social Media for Coroners

Coroner media twitterThe use of social media, such as Facebook, Twitter, Google+, Tumbler and Instagram in a Coroner’s office is often looked at as taboo at best and forbidden by most. But lets look at another side of the proverbial coin and see where social media can play a valuable role in the operation and community engagement the office serves.

Coroners and Medical Examiners are often not seen; a presence behind the scenes, known agencies, but never really a subject most of the community knows much about. Unlike local police and fire who get most of the press and valor, coroners are typically forgotten.

Now I must admit, this is probably not malicious, but rather just a product of the environment and the way it’s always been. I advocate change. I say that by getting involved in the community and allowing the community into “our world”, we can change the tide of common perception. By changing perception and being noticed in a positive light, we will be in a better position to be seen as a valuable, professional agency deserving of notice.

What does being noticed matter, you might ask. Well, positive community engagement can turn the wheels that fund our agencies. It can help in re-election campaigns by allowing current office holders to be seen as real people, with real staff, who will be affected by a failed election. When people don’t know, they don’t care, and the candidate that spends the most money or with a more impressive CV, regardless of real experience, may unseat a great coroner. Great social media and community engagement is no replacement for doing a good job and operating a professional office. However, letting the public in to see how great your agency is can’t hurt.

Lets look a five rules for properly using social media

  1. Provide Useful Information

Keep the community, your fans and followers informed. Give them a reason to follow you on their already crowded feeds. Provide information like upcoming weather conditions, disease outbreaks, medication warnings, and public service announcements. Another great use is to provide links to other expert articles or have experts guest post on your feeds.

  1. Post Regularly

Nothing says unprofessional like a Twitter stream or Facebook feed with old content. Imagine going to a business page and seeing the last post weeks and months ago. Is the business even still open? The community will see this as how you run your office; behind, and unengaged. They won’t see it as “oh they must really be busy”. Use an application like Buffer or Hootsuit to schedule some regular posts that automagically post to your feeds. You can supplement and add to your application as news or events need to be shared.

  1. Be Everywhere

Be everywhere, but only where you can be. Use every social media platform available – but only the ones you can keep up with. This goes along with point number two. If Facebook and Twitter are all you can handle, fine. Don’t start accounts and every social media community, then go dark. Better not to be there than be on the roles but not present. Facebook and Twitter are number one and two respectively, with Facebook being a minimum must in my opinion.

  1. Stay Positive

No one likes to hear you complain and people won’t stick around for controversy and contention. Keep your social media positive and helpful. Yes you may have issues you wish you could tell the world, but your Facebook page is not the place for it. Use this media to post training your staff has completed or that your office is hosting. Make birth and wedding announcements concerning your staff. You and your staff are real people, share real things. Humanize your office and showcase your accomplishments.   Mix it up though, do not make all your posts about how good you are. The rule here is 70% useful, relevant content or messages and 30% self promotion.

  1. Engage Your Community

Social media is, well, social, and you need to engage and interact with your fans and followers. No one likes to always be talked to, rather they liked to be talked with. Engage on some of their posts, start conversations, ask questions. Here again, be real! Let people know that your office is part of the same community they are.

  1. (Bonus) Know what you can and can not post

State law and agency policies differ around the country and the world. Most of the day to day work you do can not be posted about. However, you can post any public information or news release. If a double shooting occurred at the 2300 block of wherever and two people are dead, fine stop there. Never reveal anything that could interfere with a police investigation. But we should all know that anyway. Never post photos of bodies or bloody scenes. I would however recommend that you post a weekly or month summary of your caseload. Number of deaths, cause and manners. This is public information and will tell the public just how large your caseload is without really telling them, and the public loves the stuff.

Ships turn slow

Using social media in our offices may be a huge step for some and Coroner opinion may vary on this topic. Does the agency I’m employed with use social media you might ask? Not like we should, but again the ship is turning and social media is becoming a part of our agency operation. The practices outlined here are the same ones we are putting in place.

Last word of caution, start today. Do not wait until election year to start your social media engagement. It might very well be seen like an election strategy. This media should be used to promote the agency and for the overall good of the community. Any election benefit you might get is secondary. But again, letting the public see real people doing a real job can’t hurt.

 

Cop Life – Compassion for Death

Cop Life PodcastCompassion v. Security. Police officers have the unique job of showing compassion to family and friends at the scene of a death while maintaining good scene security.  This can be a slippery slope if not approached correctly.  So what is your number one goal; compassion or security – and can you be successful in both?  In today’s “anti-police” environment, compassion is critical if you want to prevent or mend, bad community relations. But can this go to far?

What is Compassion ? 

Compassion is not a singular thing. Rather it is composed of five mental and emotional states.

  • Respect and Caring – these are mental and emotional attitudes associated with commitment, responsibility, and reverence towards others.
  • Empathy – is a deep understanding of the emotional state of another. It is what enables an officer to connect with others, which can lead to compassionate feelings.
  • Selfless and Unconditional – this is placing others’ before your own needs; this mental and emotional state does not expect reciprocity or equal exchange. It is giving unselflessly.
  • Committed Action – for compassion to exist, it must be characterized by a helping action, a willingness to act on the mental and emotional state.
  • Benefitting Others – this is action given without any thought of gain; an act to alleviate suffering and providing help without recognition.

The core of compassion is a heartfelt connection in situations where others are suffering and need help and the taking of action to provide help.

Why Protect the Scene – Even from family 

The most important aspect of evidence collection and preservation is protecting the crime scene. This is to keep the pertinent evidence uncontaminated until it can be recorded and collected. The successful prosecution of a case can hinge on the state of the physical evidence at the time it is collected. The protection of the scene begins with the arrival of the first police officer at the scene and ends when the scene is released from police custody.

In this episode 

This and much more is the topic of the discussion I have in this episode with Crpl. Keith Farley. Keith is also the host of the popular podcast -cop life podcast. Which can be found on iTunes or at the web site coplifepodcast.com 

Cop Life Podcast

 

 

 


tags: coroner,coroner training, become a coroner,coroner talk podcast,medicolegal death investigator,police,police training,medical examiner,fire fighter,csi,paramedic,death,death investigation,training, deputy,sheriff,deputy sheriff,mcmea,crime scene,crime scene training,darren dake, cops life podcast,keith farley

 

Forensic Anthropology – Dr Tersigni-Tarrant

Tarrant_MariaForensic anthropology is the analysis of skeletal, badly decomposed, or otherwise unidentified human remains, and  is important in both legal and humanitarian contexts. Forensic anthropologists apply standard scientific techniques developed in physical anthropology to analyze human remains, and to aid in the detection of crime. In addition to assisting in locating and recovering human skeletal remains, forensic anthropologists work to assess the age, sex, ancestry, stature, and unique features of a decedent from the skeleton. Forensic anthropologists frequently work in conjunction with forensic pathologists, odontologists, and homicide investigators to identify a decedent, document trauma to the skeleton, and/or estimate the postmortem interval.

In this episode 

In this episode I talk with Dr.MariaTeresa A. Tersigni-Tarrant about what is forensic anthropology and how it can help you  in solving your case or answering the unanswered. We dive into the how-to’s of scene work and the obstacles that come with recovering and packaging skeletal  remains.

Important Links 

Dr.MariaTeresa A. Tersigni-Tarrant email:  m.tersigni.tarrant@gmail.com 

ABFA – American Board of Forensic Anthropology:

Todays Guest

Skeletal ServicesDr.MariaTeresa A. Tersigni-Tarrant is a practicing, board-certified Forensic Anthropologist, one just over 100 individuals ever certified by the American Board of Forensic Anthropology.  Dr. Tersigni-Tarrant received her Bachelor’s of Science Degrees in Microbiology and Anthropology from Michigan State University in 2000.  She received her M.A. and Ph.D. in Physical Anthropology from the University of Tennessee in Knoxville.  Dr. Tersigni-Tarrant was awarded a post-doctoral fellowship in 2005 at the Joint POW-MIA Accounting Command’s Central Identification Laboratory (JPAC-CIL) on Hickam AFB, Hawaii.  During this fellowship, she was instrumental in establishing standard operating procedures for the histological analysis of human remains for the purpose of identifying missing armed-service members.  From 2006- 2012, Dr. Tersigni-Tarrant held several teaching positions at undergraduate, graduate and medical school institutions.  Most recently, as a course director and instructor, she developed and implemented curriculum for medical gross anatomy (including the laboratory component) and medical embryology for first year medical students.  Dr. Tersigni-Tarrant served as the Forensic Anthropologist for the State of Georgia-At-Large working with the Georgia Bureau of Investigation (GBI) from 2009-2012.  She continues to consult with GBI on various cases.  Dr. Tersigni-Tarrant returned to JPAC-CIL in 2012, where she was employed as a Forensic Anthropologist and managed the histology casework at the CIL.  She currently owns her own consulting firm offering consulting services related to forensic anthropology casework to medicolegal agencies including the Saint Louis City Medical Examiner’s Office, the GBI and the Department of Defense.  Dr. Tersigni-Tarrant s as an Associate Professor in the Department of Surgery’s Center for Anatomical Science and Education where she teaches gross anatomy and embryology to first year medical students, anatomy graduate students and PA, AT, PT and OT students. She also serves as the Director of Forensic Education and an Adjunct Associate Professor in the Department of Pathology at Saint Louis University, where she runs the Medicolegal Death Investigators training Courses and the Masters Medicolegal Death Investigation Course. Her research interests include bone biology; human and non-human histology, child abuse: patterned fractures and timing of healing, human decomposition research, bone pathology, and developmental anatomy.

Forensic Video Production

Video CameraIn most cases it’s as much, or more, about the technique than the equipment when it comes to crime  scene videography. Forensic video production is valuable for showing an overview of the crime scene and should be considered in major cases. While video cannot replace still photographs due to its lower resolution, video does provide an easily understandable viewing medium that shows the layout of the crime scene and the location of evidence. Videos of crime scenes are not often used in court, but they are valuable illustrations for explaining the scene to other investigators and are often used to refresh the memory of those who were involved in processing the crime scene.

Crime scene videotaping techniques

When videoing  crime scenes, you should start the video with a brief introduction presented by an investigator. The introduction should include the date, time, location, type of crime scene, and any other important introductory information. The introduction should also include a brief description of the rooms and evidence that will be viewed in the video. The investigator may want to display a basic diagram as an illustration during the introduction.

Following the introduction the recording is paused and the microphone is turned off. This will prevent any distracting sounds from recording on the video  during the recording of the scene. Begin videoing the crime scene with a general overview of the scene and surrounding area. Continue throughout the scene using wide angle and close up views to show the layout of the scene, location of evidence, and the relevance of evidence within the crime scene. While videoing, use slow camera movements such as panning, and zooming.

In-camera editing is an ideal way to produce crime scene videos. In this method you start and stop the recording at the angles and areas you want. This prevents  distractions and distortion  of moving  around and fast zooming. Editing software can then seamlessly put these clips together for a complete overall video production.

Equipment 

Many departments and agencies can not afford high-end commercial use cameras for forensic video production.  That’s perfectly fine, smaller cameras and even iPhone / iPads can be used to produce high quality video production of your crime scene.  In most cases it’s as much, or more, about the technique than the equipment when it comes to crime  scene videography.

Training 

It is critical  investigators get some training in proper forensic video production techniques. These classes are not offered as much as still photography courses. However, it is critical you find these courses. If courses in this area of crime scene processing are not found in your area then search out those people who produce video for other fields, such as television camera operators and wedding videographers. Techniques and camera familiarization can be learn from these professionals and you can adapt what you need for your use.

Above all – try.  Your first crime scene video may not be of the standards you wish it be be. However, with each time, and practice on non-crime scene shoots, you will improve with each shoot.

Episode Guest 

On this episode of the Coroner Talk™ podcast I talk with Scott Alan Kuntz of  Scott Alan Video LLC.  Scott is an active law enforcement officer and owns his own company helping other agencies in training and consulting work.  More about Scott and how he can help your agency can be found at:

http://www.scottalanvideo.com

 

Investigating Gun Shot Wounds

Certain routine steps  are taken in investigating fatal injury inflicted by a firearm either as a result of foul play or accident.’ A fatal gunshot case presents many challenging medicolegal problems which involve cooperation among the forensic pathologist, firearms identification expert, laboratory technician and the police. The belief that an “expert” can view the body and without further corroborating evidence testify in court as to the range at which this person was shot and the calibre of the weapon is one of the most common fallacies.’ Since the average person interested in law enforcement is generally not trained in medicine it seems best to discuss the information which can be obtained from an examination of a gunshot victim’s body. Suppose a male corpse is brought to a coroner’s office for the purpose of identification and determination of cause of death. First, it must be established whether or not the individual has been shot and, secondly, whether or not the gunshot was the cause of death. If no projectiles can be found in the body through X-ray or exploration, the question of whether the individual has been shot is by no means resolved. For example, multiple wounds inflicted by an ice pick in the back oftentimes gives the appearance of buckshot wounds. Bullet wounds, from external appearance, are of two types; entrance and exit.

Few injuries resulting from the discharge of a firearm rule out the possibility of foul play. Firearms identification is also known as “forensic ballistics.” However, since the science of ballistics relates to the study of projectiles in flight the term firearms identification seems preferable.  A review of the leading American text, Hatcher, Jerry & Weller, Firearms Identification, Investigation and Evidence, Stackpole Company, Harrisburg (1957), should quickly dispel any doubts on this matter.

For an excellent discussion of the historical role of the coroner in identifying deceased persons see Harvard, The Detection of Secret Homicide, Cambridge (1960).  Smith and Glaister, Recent Advances in Forensic Medicine, Blakeston’s, Philadelphia (1939) ch. 1, contains a variety of material on the mechanics of gunshot injury.  The use of X-ray examination to locate projectiles or fragments of pellets is particularly important where the investigator wishes to weigh the bullet in order to have some approximation of caliber.  Smith and Glaister, op. cit. supra n. 5 at 20. Published by EngagedScholarship@CSU, 1964 1 FATAL GUNSHOT WOUNDS.

On this Episode 

On this show we talk to Dr Judy Melinek about the issues in investigating gun shot wounds.  We talk about types of wounds and what obstacles investigators can encounter in a fatal shooting incident.

Article Reprinting from Section of:   Journal of Criminal Law and Criminology

Panel Discussion – Wrongful Convictions in Shaken Baby Death Cases

Screen Shot 2015-06-06 at 14.41.46Much has been said about the science and medical findings in Shaken Baby Deaths.  Now new, or not so new,  opinions say  the injuries to the brain which is used as fact evidence is not accurate. This panel discusses these issues and the investigation that goes into these deaths.  The panel members are Craig Smith of C.B. Smith Training & Consulting Ltd. in Canada,  Paul Parker of Parker Medicolegal Services in Arizona and Dr. Judy Melinek of the Alameda County Coroners Office in California.  All panelist contact information is located below.

What  started this discussion was a recent article written for CBS News that shed doubt on the medical findings of a Shaken Baby  Cases and whether or not those finding have lead to the wrongful conviction of parents and care givers in these cases.   That article is reposted below again for review.  This panel does not and did not intend to discredit the writer of this article or CBS News.  The intent was to discuss this opposing opinion and bring  light to the need for accurate and complete investigation so that medical findings alone are not disputed.  The panel does an amazing job at bringing out  every aspect of  this discussion.

Resource talked about on the show 

Mr. Craig Smith referenced at report generated by the  National District Attorney Association that outlines defense objections to head trauma injuries.  That publication can be found here and downloaded  for free.

National District Attorney Association

Panelist Contact Information

Craig SmithCraig Smith 

Paul ParkerPaul Parker 

Melinek-Slide_0Dr. Judy Melinek 

 


 

 

Questionable convictions in “shaken baby” cases?

Deborah Tuerkheimer is a Professor of Law at Northwestern University and the author of “Flawed Convictions: ‘Shaken Baby Syndrome’ and the Inertia of Injustice.” She also appears onSaturday’s “48 Hours” investigation into the case of Melissa Calusinski, a former day care provider who says she is wrongfully convicted in a toddler’s death. Here, Tuerkheimer weighs in on questionable convictions in child death cases. Her opinions do not necessarily reflect those of CBS News.

A few months ago, a 55-year-old Florida day care provider became yet another caregiver accused of shaking a toddler to death. The woman, who had worked with children for decades, denied harming the boy. But pediatricians concluded that this was a case of Shaken Baby Syndrome (SBS).

Even before an autopsy was performed, the state charged the woman with murder. She is being held in jail without bond and if convicted, she faces mandatory life in prison without the possibility of parole.

Based on the press reports, this case resembles many that I have written about in my book, Flawed Convictions: “Shaken Baby Syndrome” and the Inertia of Injustice. Without witnesses or external signs of abuse, the classic diagnosis of Shaken Baby Syndrome rests on three neurological symptoms, otherwise known as the “triad”: bleeding beneath the outermost layer of the brain, retinal bleeding, and brain swelling.

These symptoms are said to prove that a baby was violently shaken and, what’s more, to identify the abuser– whoever was present when the child was last lucid. Shaken Baby Syndrome is, in essence, a medical diagnosis of murder. In order to convict, prosecutors must rely entirely on the claims of science.

But the science has shifted. In recent years, there has been a growing consensus among experts that the neurological symptoms once viewed as conclusive evidence of abuse may well have natural causes, and that old brain injuries can re-bleed upon little or no impact.

In short, current science raises significant questions about the guilt of many caregivers convicted of shaking babies.

Reflecting real movement in the direction of doubt, this past spring, a federal judge in Chicago issued a ruling of “actual innocence” in the case of Jennifer Del Prete, a caregiver accused of shaking a baby in her care. (My book describes this trial in detail.) Del Prete was able to show that, based on what doctors now know about alternative causes of the triad, no reasonable jury could possibly find Del Prete guilty of murder. Indeed, according to the reviewing judge, a lack of evidentiary support for the theory of Shaken Baby Syndrome means that the diagnosis is arguably “more an article of faith than a proposition of science.”

Our legal system has been slow to absorb this new reality. As a consequence, innocent parents and caregivers remain incarcerated and, perhaps more inexplicably, prosecutions based solely on the “triad” symptoms continue even to this day. The cautionary tale of Shaken Baby Syndrome shows that our system is too inclined to stay the course, and awful injustices can result.

Questionable convictions in “shaken baby” cases

Shaken BabyThe term “shaken baby syndrome” (SBS) was developed to explain those instances in which severe intracranial trauma occurred in the absence of signs of external head trauma. SBS is the severe intentional application of violent force (shaking) in one or more episodes, resulting in intracranial injuries to the child. Physical abuse of children by shaking usually is not an isolated event. Many shaken infants show evidence of previous trauma.

Frequently, the shaking has been preceded by other types of abuse.

Mechanism of Injury

The mechanism of injury in SBS is thought to result from a combination of physical factors, including the proportionately large cranial size of infants, the laxity of their neck muscles, and the vulnerability of their intracranial bridging veins, which is due to the fact that the subarachnoid space (the space between the arachnoid membrane and the pia mater, which are the inner two of the three membranes that cover the brain) are somewhat larger in infants. However, the primary factor is the proportionately large size of the adult relative to the child. Shaking by admitted assailants has produced remarkably similar injury patterns:

  • The infant is held by the chest, facing the assailant, and is shaken violently back and forth.
  • The shaking causes the infant’s head to whip forward and backward from the chest to the back.
  • The infant’s chest is compressed, and the arms and legs move about with a whiplash action.
  • At the completion of the assault, the infant may be limp and either not breathing or breathing shallowly.
  • During the assault, the infant’s head may strike a solid object.
  • After the shaking, the infant may be dropped, thrown, or slammed onto a solid surface.
  • The last two events likely explain the many cases of blunt injury, including skull fractures, found in shaken infants. However, although blunt injury may be seen at autopsy in shaken infants, research data suggest that shaking in and of itself is often sufficient to cause serious intracranial injury or death.

 

 

Questionable convictions in “shaken baby” cases?

Deborah Tuerkheimer is a Professor of Law at Northwestern University and the author of “Flawed Convictions: ‘Shaken Baby Syndrome’ and the Inertia of Injustice.” She also appears onSaturday’s “48 Hours” investigation into the case of Melissa Calusinski, a former day care provider who says she is wrongfully convicted in a toddler’s death. Here, Tuerkheimer weighs in on questionable convictions in child death cases. Her opinions do not necessarily reflect those of CBS News.

A few months ago, a 55-year-old Florida day care provider became yet another caregiver accused of shaking a toddler to death. The woman, who had worked with children for decades, denied harming the boy. But pediatricians concluded that this was a case of Shaken Baby Syndrome (SBS).

Even before an autopsy was performed, the state charged the woman with murder. She is being held in jail without bond and if convicted, she faces mandatory life in prison without the possibility of parole.

Based on the press reports, this case resembles many that I have written about in my book, Flawed Convictions: “Shaken Baby Syndrome” and the Inertia of Injustice. Without witnesses or external signs of abuse, the classic diagnosis of Shaken Baby Syndrome rests on three neurological symptoms, otherwise known as the “triad”: bleeding beneath the outermost layer of the brain, retinal bleeding, and brain swelling.

These symptoms are said to prove that a baby was violently shaken and, what’s more, to identify the abuser– whoever was present when the child was last lucid. Shaken Baby Syndrome is, in essence, a medical diagnosis of murder. In order to convict, prosecutors must rely entirely on the claims of science.

But the science has shifted. In recent years, there has been a growing consensus among experts that the neurological symptoms once viewed as conclusive evidence of abuse may well have natural causes, and that old brain injuries can re-bleed upon little or no impact.

In short, current science raises significant questions about the guilt of many caregivers convicted of shaking babies.

Reflecting real movement in the direction of doubt, this past spring, a federal judge in Chicago issued a ruling of “actual innocence” in the case of Jennifer Del Prete, a caregiver accused of shaking a baby in her care. (My book describes this trial in detail.) Del Prete was able to show that, based on what doctors now know about alternative causes of the triad, no reasonable jury could possibly find Del Prete guilty of murder. Indeed, according to the reviewing judge, a lack of evidentiary support for the theory of Shaken Baby Syndrome means that the diagnosis is arguably “more an article of faith than a proposition of science.”

Our legal system has been slow to absorb this new reality. As a consequence, innocent parents and caregivers remain incarcerated and, perhaps more inexplicably, prosecutions based solely on the “triad” symptoms continue even to this day. The cautionary tale of Shaken Baby Syndrome shows that our system is too inclined to stay the course, and awful injustices can result.

Pt 2 The Suicide Plan – Investigating Planned Suicides

SuicideThe assisted suicide movement is, if anything, indefatigable. Not only is it undeterred by its failures, but it is now more energized than any other time in recent years. By the end of March of 2015, bills were introduced in twenty-five state legislatures to legalize assisted suicide.

Defining the Subject

Many people remain confused about the exact nature of assisted suicide advocacy, sometimes confusing it with other medical issues involving end-of-life care. Thus, to fully understand the subject, we must distinguish between ethical choices at the end of life that may lead to death and the poison of euthanasia/assisted suicide.

1.      Refusing unwanted medical treatment is not assisted suicide: Fear of being “hooked up to machines” when one wishes to die at home has traditionally been a driving force behind the assisted suicide movement. But we all have the right to refuse medical interventions—even if the choice is likely to lead to death. Thus, a cancer patient can reject chemotherapy and a patient dying of Lou Gehrig’s disease can say no to a respirator.  Indeed, in 1997, the U.S. Supreme Court ruled unanimously that the right to refuse medical treatment is completely different from assisted suicide.[9]

2.      Assisted suicide/euthanasia is not the same as medical treatment for pain control: Because pain control may require strong drugs, which can cause death, assisted suicide advocates often claim that palliation and euthanasia are ethically the same under the “principle of double effect.” But this is all wrong:

  • Any legitimate medical treatment can unintentionally lead to death, including pain alleviation. In assisted suicide death is the intended effect.
  • We would never say that a patient who died during open heart surgery was euthanized. Similarly, a patient who dies from the unintended side effects of pain control has not been assisted in suicide or euthanized.
  • Pain control experts state that aggressive pain control generally does not shorten life.

3.      Assisted suicide/euthanasia is antithetical to hospice: Hospice was founded by the great medical humanitarian Dame Cicely Saunders in the late 1960s as a reform movement to bring the care of the dying out of isolated hospitals and into patients’ homes or non-institutional local care facilities. Its purpose is to provide dying people with proper treatment of pain and other disturbing symptoms as well as to render spiritual, psychological, and social support toward the end that life be lived as fully as possible until natural death.

In contrast, assisted suicide is about rushing death, making it happen sooner rather than later through lethal actions. Or to put it another way: Hospice is about living. Assisted suicide/euthanasia is about dying. As the noted palliative care expert and assisted suicide opponent Dr. Ira Byock has written, “There’s a distinction between alleviating suffering and eliminating the sufferer — between enabling someone to die gently of their disease and ending that person’s life with a lethal pill or injection.”

4.      Assisted suicide/euthanasia are acts that intentionally end life: In contrast to the above, the intended purpose of assisted suicide and euthanasia is to end life, e.g., to kill. In assisted suicide, the last act causing death is taken by the person who dies, for example, ingesting a lethal prescription of barbiturates. In euthanasia, the death is a homicide, an act of killing taken by a third person, such as a doctor injecting a patient with poisonous drugs.

From an Investigators Standpoint 

With the above statements we can see that the topic of assisted suicide is at best conversional.  As a death investigator, our job is simple; to report the facts and the facts only.  However, it is well understood that our own emotions and bias on the topic can and will play a role in how we approached these scenes. The investigators must guard against allowing these personal feelings to interfere with the proper reporting and interpretation of  the scene.

Conversation with Prosecuting Attorney 

It is  a good suggestion to have a conversation with your  prosecuting attorney and a review of your agency policy to see how best to proceed in these cases. You should always report all facts in the case, but having a better understanding of how you are expected to proceed may well help in your overall review of the case.

With Family

No matter what decision  your Prosecuting Attorney goes, some members of the deceased family will invariably not agree with the decision.  This is why it best to do a proper and complete investigation, report all and only, the facts – and let those responsible for making these critical decision do their job. You, as the investigator , can rest in the knowledge that you have done your job and can properly explain to the family exactly what took place and why decision  are made based upon these facts.  Many family members may still not agree with the outcome, but it is much better for them to have the facts than them come up with their own set of “facts’ as they see it.

Anita Brook-corner talk-secondary stressAnita Brooks    anitabrooks.com

The Suicide Plan – Investigating Planned Suicides Pt1

SuicideThe Centers for Disease Control and Prevention (CDC) collects data about mortality in the U.S., including deaths by suicide. In 2013 (the most recent year for which full data are available), 41,149 suicides were reported, making suicide the 10th leading cause of death for Americans. In that year, someone in the country died by suicide every 12.8 minutes.   With those totals, we are all bound to be involved in investigating suicides.  Suicides can be acute, meaning short term or spur of the moment final decision, or a well planned and risk assessed  action.  In this episode of Coroner Talk™ we are going to look at the pros, if there be any, and the cons of planned suicide.

Featured in this weeks show is a PBS production of  Frontline that deals with the topic of a well planned suicide and the legal and moral implication that accompany such a decision.  Regardless of where you stand on the topic, this episode will start you thinking of the other side.

The Assisted Suicide Debate

Since Oregon legalized physician-assisted suicide for the terminally ill in 1997, more than 700 people have taken their lives with prescribed medication — including Brittany Maynard, a 29-year-old with an incurable brain tumor, who ended her life earlier this month.

Advocates of assisted-suicide laws believe that mentally competent people who are suffering and have no chance of long-term survival, should have the right to die if and when they choose. If people are have the right to refuse life-saving treatments, they argue, they should also have the freedom to choose to end their own lives.

Opponents say that such laws devalue human life. Medical prognoses are often inaccurate, they note — meaning people who have been told they will soon die sometimes live for many months or even years longer. They also argue that seriously ill people often suffer from undiagnosed depression or other mental illnesses that can impair their ability to make an informed decision.

At the latest event from Intelligence Squared U.S., two teams addressed these questions while debating the motion, “Legalize Assisted Suicide.”

Before the debate, the audience at the Kaufman Music Center in New York was 65 percent in favor of the motion and 10 percent against, with 25 percent undecided. After the debate, 67 percent favored the motion, with 22 percent against, making the team arguing against the motion the winner of this debate.

http://www.npr.org/2014/11/20/365509889/debate-should-physician-assisted-suicide-be-legal

The Suicide Plan – Investigating Planned Suicide

Investigators are offered a hard road when it comes to investigating a planned suicide when it is found that family or friends may have assisted in some manner, regardless of the extent of the that assistance.  Even providing a cool drink of water to wash down the pills that will end life can be enough in some states to charge a person with assistance.  But where, as investigators, do we stand on the issue.  Some investigators are only providing cause and manner of death determinations, which can be clouded by the assistance issue. While other investigators are charged with the task  of deciding the criminal aspect of the assistance rendered.

In part two of this issue we will take a deep dive into the debate that will most assuredly muddy up the waters a bit.  That is next episode on Coroner Talk™..

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Dr. Judy Melinek – Working Stiff

Melinek-Slide_0A   forensic pathologist can not work in a vacuum, they must have critical information gathered at the scene by qualified investigators. It is only with this information and the results of the autopsy that a ruling can be made.  It is often that a ruling will be delayed, or no determination made at all, without this information and investigation by the medicolegal investigators.

In this episode I talk with Dr. Judy Melinek, and forensic pathologist working with the Alameda County Coroners Office and and private consultant at  Pathology Expert .com.   We discuss what investigators need to provide to a pathologist to help in the determination of cause and manner of death.  We also discuss her role in the 9/11 attacks as she was working in New York City at the time and witnessed the first plane hit.

Dr. Melinek, along with her husband TJ – wrote the book Working Stiff that chronicle her first two years as a forensic pathologist  and her work in New York City Medical Examiners Office during the 9/11 attacks.

 

Working-stiffThe fearless memoir of a young forensic pathologist’s “rookie season” as a NYC medical examiner, and the cases—hair-raising and heartbreaking and impossibly complex—that shaped her as both a physician and a mother.

Just two months before the September 11 terrorist attacks, Dr. Judy Melinek began her training as a New York City forensic pathologist. With her husband T.J. and their toddler Daniel holding down the home front, Judy threw herself into the fascinating world of death investigation—performing autopsies, investigating death scenes, counseling grieving relatives. Working Stiff chronicles Judy’s two years of training, taking readers behind the police tape of some of the most harrowing deaths in the Big Apple, including a firsthand account of the events of September 11, the subsequent anthrax bio-terrorism attack, and the disastrous crash of American Airlines flight 587.

Lively, action-packed, and loaded with mordant wit, Working Stiff offers a firsthand account of daily life in one of America’s most arduous professions, and the unexpected challenges of shuttling between the domains of the living and the dead. The body never lies—and through the murders, accidents, and suicides that land on her table, Dr. Melinek lays bare the truth behind the glamorized depictions of autopsy work on shows like CSI and Law & Order to reveal the secret story of the real morgue.

About the Authors

tj-mitchell-dr-judy-melinekJudy Melinek, M.D. is a graduate of Harvard University. She trained at UCLA in medicine and pathology, graduating in 1996. Her training at the Office of the Chief Medical Examiner in New York is the subject of her memoir, Working Stiff, which she co-wrote with her husband. Currently, Dr. Melinek is an Associate Clinical Professor at UCSF, and works as a forensic pathologist in Oakland. She also travels nationally and internationally to lecture on anatomic and forensic pathology and she has been consulted as a forensic expert in many high-profile legal cases, as well as for the television shows E.R. and Mythbusters.

T.J. Mitchell, her husband, graduated with an English degree from Harvard and has worked as a screenwriter’s assistant and script editor since 1991. He is a writer and stay-at-home Dad raising their three children in San Francisco. Working Stiff is his first book.