Boundaries of the field of expertise Forensic Pathology

Core activities

The primary focus of the forensic pathologist is to conduct an external and internal examination on the body of a deceased person, in principle in the context of criminal law. A forensic pathologist conducts a post-mortem examination in order to (help) answer
medico-legal questions in cases of (suspected) unnatural death:

1. homicide or suspected homicide;
2. sudden, unexplained death, including sudden infant death;
3. violation of human rights such as suspicion of torture or any other form of ill treatment;
4. suicide or suspected suicide;
5. suspected medical malpractice;
6. accidents, whether transportational, occupational or domestic;
7. occupational disease and hazards;
8. technological or environmental disasters;
9. death in custody or death associated with police or military activities;
10. unidentified or skeletalised bodies;
11. euthanasia and assisted suicide.

The task of the forensic pathologist is:

• To establish the cause and mechanism of death (including trigger and pre-existing pathology).
• To establish or to help establish the identity of the deceased.
• To establish or to help establish the nature, cause and consequences of any injuries.
• To establish or to help establish the manner of death.

In addition, a forensic pathologist is:

• Able to determine or evaluate the (methods of) determination of the approximate post-mortem interval.
• Aware of the possibilities and limitations of answering various questions, such as the survival time and the capacity of the person to act prior to death.
• Able to determine or evaluate the medico-legal findings of a crime scene.
• Aware of fundamental principles of forensic investigations (e.g. crime scene investigation, chain of custody, principles of evidence).
• Is able to determine whether ancillary or additional investigation is needed (at least post-mortem imaging/radiology, toxicology, biochemistry, tissue sampling and gunshot residue examination).

Boundaries of the field of expertise

Within the field of forensic and legal medicine, two distinct areas of practice exist:

• Forensic clinical medicine (in the Netherlands performed by forensisch geneeskundigen) which has its primary focus on the examination of the living.
• Forensic pathology which has its primary focus on the dead and to conduct a medico-legal or forensic autopsies autopsy.

The activities of these fields of expertise show an overlap to a certain extent, but for both fields of expertise specific knowledge and experience are needed that set experts within these fields apart from each other. In principle, the activities within the field of forensic clinical medicine fall outside of the field of forensic pathology as defined by the NRGD for registration. The following related fields of expertise also fall outside of the field of forensic pathology as defined by the NRGD for registration:

• Forensic odontolog.
• Forensic radiology.
• forensic anthropology.

Though the related fields of expertise fall outside of the field of forensic pathology, a registered forensic pathologist has to have knowledge of the principles of the abovementioned related fields of expertise, is able to adequately refer the commissioning party, to adequately deal with sampling in the chain of investigations and to integrate the findings in the final expert conclusion.