Is Race Determination in the Medicolegal Setting Important?

Abstract

Racial designations have evolved over the years to accommodate the changes in our population demographics. The Federal Office of Management and Budget (OMB) has developed Federal Standards to assist with the uniform documentation and reporting of race and ethnicity. A minimum of five defined categories currently exist for race (American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander and White). Ethnicity is separated into either Hispanic origin or Non-Hispanic origin. Current death certificates allow for the selection of one or more races; however, only one ethnicity may be chosen. Race of unknown decedents is either based subjectively on the observer's opinion or, in severely decomposed or skeletal remains, by anthropological analysis utilizing sound statistical methodology. If the data and statistical analysis suggest a good classification, the race determination will be correct more often than not. Information obtained from the National Missing and Unidentified Persons System (NamUs) indicates that absence of race determination does not hinder the identification potential. Mortality rates, life expectancy, disease risk and causes of death are often disaggregated by race and/or ethnicity. Differences in the presentation, etiology and outcomes of many diseases have been based on race and ethnicity data. Uniform collection of this data is the key to its importance. Medical examiners, coroners and others tasked with examination of decedents should utilize the defined categories set forth in the OMB Revised Standards for race and ethnicity documentation.

Training Death Investigators to Identify Decedents' Sexual Orientation and Gender Identity

“…Such practice derives its justification from empirically based findings that causes of death and etiological circumstances surrounding deaths are meaningfully disaggregated by race and/or ethnicity. 19,20 Unlike race and ethnicity, however, SOGI data are not currently identified in the US Standard Certificate of Death, at least in part because to date, scientific evidence does not support its relevance in cases where the manner of death is natural. 21 However, the clear relevance of SOGI to violent deaths supports its identification in a death investigation.…”

“…This action was cognizant of the disparity between the lack of SOGI data within mortality surveillance and the routine practice of identifying personal attributes, such as race and ethnicity at the time of death, regardless of whether these factors seem related to the manner and cause of death. Such practice derives its justification from empirically based findings that causes of death and etiological circumstances surrounding deaths are meaningfully disaggregated by race and/or ethnicity 19,20 . Unlike race and ethnicity, however, SOGI data are not currently identified in the US Standard Certificate of Death, at least in part because to date, scientific evidence does not support its relevance in cases where the manner of death is natural 21 .…”