Death Investigation and Forensic Medicine in South Africa: Historical Perspectives, Status Quo, and Quo Vadis?

Medico-Legal Death Investigation Systems – South Africa

“…The Cape Colony in SA was settled by the Dutch East India Company in 1652 and later in 1795 by Britain. This led to the establishment of the Roman-Dutch legal system, which became the basis of common law that is still practiced in SA 4 . During British colonial rule, all suspicious deaths were investigated within the framework of the British coroner system, although it is worth noting that the office of "coroner" was never formally established in SA.…”

“…SA is a geographically and demographically diverse country that is situated at the southernmost tip of Africa. The country spans 1,219,602 km 2 and is home to more than 59 million people 3,4 . SA is a developing nation burdened with high levels of unemployment, poverty, inequality and violent crime.…”

“…Between 2010-2018, unnatural (or non-natural) deaths constituted approximately 9-11.9% of the annual deaths regi stered in the country 7 . SA annually reports the highest murder rate in Africa, with the city of Cape Town most affected over the 2021/2022 period, with a murder rate of 63 per 100 000 people 4 . Unsurprisingly, this has led to a heavily burdened death investigative system that lacks sufficient resources, funding or qualified forensic experts needed to combat high caseloads 5,6 .…”

Guest Editorial for Academic Forensic Pathology

“…For example, one theme that can be followed through the articles is the importance of law—specifically, the development of legal frameworks that define the roles of medical experts, coroners, or others in the death investigation process. This issue is touched upon in the articles of Jeffrey Jentzen for colonial North America and the early United States, Gert Saayman for South Africa, and Zhiyuan Xia for China after 1949 (13 -15).…”

“…While forensic pathology saw increasing professionalization in mid-20th century in South Africa, during the oppressive Apartheid regime medicolegal investigations were carried out under the institutional influence and potential interference of the police and state security apparatuses. The first decade of the 21st century saw a reorganization of South Africa’s medicolegal services, which were placed under the authority of provincial health departments (14).…”