Confession of ignorance of causation in coroners' necropsies--a common problem?

Davison, A. M.; Leadbeatter, Stephen

doi:10.1136/jcp.49.6.439

Cited by 5 publications

(2 citation statements)

References 14 publications

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“…Elements of the internal dissection may be returned to in greater detail [540]. Performing isolated ventricular weights of the heart and examination of the conducting system or retention of the heart for formal examination should be considered as well as submission of the fresh un-cut brain for neuropathological assessment [541]. Molecular biological investigation may be required when all else has failed [4].…”

Section: The Negative Autopsy and Genetic Investigations Of Sudden Deathmentioning

confidence: 99%

Sudden adult death

Langlois

2009

Forensic Sci Med Pathol

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In the investigation of sudden death in adults, channelopathies, such as long QT syndrome, have risen to the fore in the minds of forensic pathologists in recent years. Examples of these disorders are touched upon in this review as an absence of abnormal findings at postmortem examination is characteristic and the importance of considering the diagnosis lies in the heritable nature of these conditions. Typically, a diagnosis of a possible channelopathy is evoked as an explanation for a 'negative autopsy' in a case of apparent sudden natural death. However, the one potential adverse effect of this approach is that subtle causes of sudden death may be overlooked. The intention of this article is to review and discuss potential causes of sudden adult death (mostly natural) that should be considered before resorting to a diagnosis of possible channelopathy. Nonetheless, it becomes apparent that many of the potential causes of sudden death can have a genetic basis. Thus, it becomes an important consideration that there may be a genetic basis to sudden death that extends beyond the negative autopsy.

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Section: The Negative Autopsy and Genetic Investigations Of Sudden Deathmentioning

confidence: 99%

Sudden adult death

Langlois

2009

Forensic Sci Med Pathol

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“…In the practice of medicolegal autopsy, for example, cause-of-death determination is often performed by subjectively appointing a cause of death found at the autopsy as the cause of death, making the determination idiosyncratic to the experience and personal thought processes of the individual clinician and potentially irreproducible by other similarly experienced clinicians [9,10]. In other circumstances encountered in an FM analysis, the causal assessment may be more challenging because of either insufficiency of the quantify or reliability of physical evidence or, conversely, a surfeit of findings with manifold and even mutually exclusive interpretations [11]. In order to move in the direction of both valid and repeatable causal conclusions, a technically correct and sufficiently complete forensic examination of evidence must be combined with the application of generally accepted causal methods.…”

Section: Introductionmentioning

confidence: 99%

A review of causal inference in forensic medicine

Meilia

Freeman

Herkutanto

et al. 2020

Forensic Sci Med Pathol

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The primary aim of forensic medical analysis is to provide legal factfinders with evidence regarding the causal relationship between an alleged action and a harmful outcome. Despite existing guides and manuals, the approach to formulating opinions on medicolegal causal inference used by forensic medical practitioners, and how the strength of the opinion is quantified, is mostly lacking in an evidence-based or systematically reproducible framework. In the present review, we discuss the literature describing existing methods of causal inference in forensic medicine, especially in relation to the formulation of expert opinions in legal proceedings, and their strengths and limitations. Causal inference in forensic medicine is unique and different from the process of establishing a diagnosis in clinical medicine. Because of a lack of tangibility inherent in causal analysis, even the term "cause" can have inconsistent meaning when used by different practitioners examining the same evidence. Currently, there exists no universally applied systematic methodology for formulating and assessing causality in forensic medical expert opinions. Existing approaches to causation in forensic medicine generally fall into two categories: intuitive and probabilistic. The propriety of each approach depends on the individual facts of an investigated injury, disease, or death. We opine that in most forensic medical settings, probabilistic causation is the most suitable for use and readily applicable. Forensic medical practitioners need, however, be aware of the appropriate approach to causation for different types of cases with varying degrees of complexity.

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Complexity and forensic pathology

Jones

2015

Forensic Science International

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Confession of ignorance of causation in coroners' necropsies--a common problem?

Cited by 5 publications

References 14 publications

Sudden adult death

Sudden adult death

A review of causal inference in forensic medicine

Complexity and forensic pathology

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