Within and Inter-Institutional Differences Between Death Certifiers on Autopsy Conclusions

Hsieh, Ming-Li; Neuilly, Melanie-Angela

doi:10.1177/0886260516647006

Cited by 3 publications

(5 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Heterogeneity of forensic investigation systems, within and across states, may impede accurate classification of suicide and other manners of death in the US [ 31 , 49 ]. With no national oversight, administration of death investigation systems varies from state control under an appointed state medical examiner to county control under an elected coroner or a medical examiner [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history

et al. 2018

View full text Add to dashboard Cite

ObjectiveA paucity of corroborative psychological and psychiatric evidence may be inhibiting detection of drug intoxication suicides in the United States. We evaluated the relative importance of suicide notes and psychiatric history in the classification of suicide by drug intoxication versus firearm (gunshot wound) plus hanging/suffocation—the other two major, but overtly violent methods.MethodsThis observational multilevel (individual/county), multivariable study employed a generalized linear mixed model (GLMM) to analyze pooled suicides and undetermined intent deaths, as possible suicides, among the population aged 15 years and older in the 17 states participating in the National Violent Death Reporting System throughout 2011–2013. The outcome measure was relative odds of suicide versus undetermined classification, adjusted for demographics, precipitating circumstances, and investigation characteristics.ResultsA suicide note, prior suicide attempt, or affective disorder was documented in less than one-third of suicides and one-quarter of undetermined deaths. The prevalence gaps were larger among drug intoxication cases than gunshot/hanging cases. The latter were more likely than intoxication cases to be classified as suicide versus undetermined manner of death (adjusted odds ratio [OR], 41.14; 95% CI, 34.43–49.15), as were cases documenting a suicide note (OR, 33.90; 95% CI, 26.11–44.05), prior suicide attempt (OR, 2.42; 95% CI, 2.11–2.77), or depression (OR, 1.61; 95% CI, 1.38 to 1.88), or bipolar disorder (OR, 1.41; 95% CI, 1.10–1.81). Stratification by mechanism/cause intensified the association between a note and suicide classification for intoxication cases (OR, 45.43; 95% CI, 31.06–66.58). Prior suicide attempt (OR, 2.64; 95% CI, 2.19–3.18) and depression (OR, 1.48; 95% CI, 1.17–1.87) were associated with suicide classification in intoxication but not gunshot/hanging cases.ConclusionsWithout psychological/psychiatric evidence contributing to manner of death classification, suicide by drug intoxication in the US is likely profoundly under-reported. Findings harbor adverse implications for surveillance, etiologic understanding, and prevention of suicides and drug deaths.

show abstract

Section: Discussionmentioning

confidence: 99%

Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history

et al. 2018

View full text Add to dashboard Cite

show abstract

“…For example, if there were more studies addressing racial disparities in the manner of death determination [91,93,94], both at the national and regional levels, these studies could then be analyzed together to produce a more robust and specific effect size estimate of the effect of race on decisions in forensic pathology. Furthermore, research has demonstrated that there are individual-level and institutional-level differences in forensic science decision making [100][101][102], while the growing body of research into implicit cognitive bias in forensic science is certainly promising, clearly much work needs to be performed.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of the Effects of Race in the Criminal Justice System with Respect to Forensic Science Decision Making: Implications for Forensic Anthropology

Yim,

Passalacqua

2023

Humans

View full text Add to dashboard Cite

Instances of racial disparities are well documented in the United States’ criminal justice system. This study reviewed the literature and conducted quantitative analyses on the role of race in forensic decision making among practitioners and other stakeholders in the criminal justice system. We hypothesized that Black, Indigenous, and People of Color (BIPOC) individuals will be significantly more likely to be associated with adverse outcomes than White individuals. A search strategy was developed and registered before the study commenced. Quantitative data were extracted from eligible studies to estimate the pooled effect size (odds ratio) for the effects of race. A final sample of 11 data sources (published study or dataset) was identified. Decision making by all stakeholders in the criminal justice system, including forensic practitioners, case investigators, and juries were evaluated in these studies. Two datasets evaluated the decision-making process involving forensic psychology or psychiatry, three focused on forensic evidence, four on forensic pathology, one involved forensic anthropology cases, and one involved clinical forensic medicine cases. The pooled odds ratio was estimated to be 1.10 (95% confidence interval: 0.67–1.81), indicating a trivial or negligible effect of race (i.e., BIPOC individuals were no more likely to be associated with adverse outcomes given the current evidence). Importantly, the results of this study do not indicate that bias or disparity related to race does not exist in forensic decision making in the criminal justice system. More research into systemic bias in forensic decision making, especially in relation to race, is needed. Forensic anthropologists are uniquely positioned to study and address racial disparities in the criminal justice system involving forensic science because of its interdisciplinary and multidisciplinary nature. This study highlights the need for further research and advocates for forensic anthropologists to be more involved in the study of the science and the impacts of forensic science rather than focusing on methodological advancement.

show abstract

“…Results showed lack of agreement and highlighted the fact that classifying the manner of death may not be as clear‐cut as some TV shows would have us believe. Further work has solidified these findings: not only a follow‐up on the original survey by Hanzlick, Goodin, and Haden‐Pinneri [37], but also work addressing different angles of this question, including some by this author [17], and other using experimental designs [11].…”

Section: Individual Decision‐makingmentioning

confidence: 92%

“…First, a statistical analysis of autopsy reports randomly selected from all four of the author's research sites [17] showed that men were more likely than women to classify deaths as homicides (or be assigned to homicides, this remains to be clarified) and that French medicolegal professionals were more likely than American ones to classify deaths as homicides. The latter finding makes sense within the larger institutional context presented earlier.…”

Section: Individual Decision‐makingmentioning

confidence: 99%

See 1 more Smart Citation

Sources of bias in death determination: A research note articulating the need to include systemic sources of biases along with cognitive ones as impacting mortality data

Neuilly

2022

Journal of Forensic Sciences

View full text Add to dashboard Cite

There are structural and organizational factors that impact how and what mortality data are collected. There are individual decision-making processes and implicit cognitive biases that influence how and what mortality data are collected. Yet there seems to be a disconnect between how and why these two broad sources of bias may collide and how both need to be understood in order to be able to approach solutions aimed at strengthening the accuracy of mortality data. Using results from a mixed-method, long-term research project at four medicolegal offices in two countries, France and the United States, this research note proposes that truly understanding the sources of implicit cognitive bias in forensic pathologists and other medicolegal actors requires knowledge of legal, cultural, and organizational structures that shape medicolegal systems and in turn constrain individual actors' decision-making processes. The goal is to advocate for multilevel and multi-methods approaches to propose systemic solutions to the issue of implicit cognitive biases in forensic pathologists and other medicolegal actors' decision-making processes. For this purpose, the author outlines a series of specific issues to be integrated in future research.

show abstract

Within and Inter-Institutional Differences Between Death Certifiers on Autopsy Conclusions

Cited by 3 publications

References 41 publications

Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history

Discerning suicide in drug intoxication deaths: Paucity and primacy of suicide notes and psychiatric history

A Systematic Review and Meta-Analysis of the Effects of Race in the Criminal Justice System with Respect to Forensic Science Decision Making: Implications for Forensic Anthropology

Sources of bias in death determination: A research note articulating the need to include systemic sources of biases along with cognitive ones as impacting mortality data

Contact Info

Product

Resources

About