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The Autopsy Imperative: Medicine, Law, and the Coronial Investigation

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Abstract

The central purpose of this paper is to address the tension between legal and medical discourses within the coronial system. Medical expertise, based largely upon internal autopsy, becomes positioned as providing the more important information, rather than the legal model which focuses on evidence gathering at the scene. This paper will examine the aspects of the history, philosophy and consequences of the processes by which the medical model gained its current dominance and will conclude that, while autopsies are necessary, they are also over-used in the coronial system.

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Notes

  1. J. Bierig. “Informed Consent in the Practice of Pathology.” Archives of Pathology and Laboratory Medicine, 125, no.11 (2001): 1425–1429.

  2. T. Luce, Death certification and Investigation in England, Wales and Northern Ireland: The Report of a Fundamental Review (Crown Copyright: 2003); B. Carpenter, M. Barnes, G. Adkins, C. Naylor and N. Begum. Report of Australian Research Council funded research on the autopsy decision making of Coroners in the state of Queensland, Australia 12/03–12/04. (Brisbane: Unpublished, 2008).

  3. T. Luce, 2003, 12.

  4. J. Smith, “The Shipman Inquiry: death certification.” Science, Medicine and Law, 44, no.4 (Oct, 2004): 283.

  5. T. Luce, 2003; T. Luce, “Death Certification and the Coroner Service.” Science, Medicine and Law. 44, no.4, (Oct. 2004): 287–294; J. Smith, The Shipman Inquiry. Third report—Death certification and the Investigation of deaths by Coroners. (Command paper CM 5854, 2003); J. Smith, 2004.

  6. A. Edwards, Regulation and Repression: the study of social control. (Sydney: Allen and Unwin, 1998): 101.

  7. M. Barnes, Queensland State Coroner’s Guidelines. (2003).

  8. Constitutional Affairs Committee. Reform of the Coroners’ system and death certification. Eighth Report of Session 2005–2006. (London: House of Commons, 2006).

  9. B. Carpenter et al., 2008.

  10. R. Hunnisett, The Medieval Coroner. (WMW. Gaunt & Sons, Inc.: Florida, 1961): 1.

  11. P. Knapman, “The crowner’s quest.” Journal of the Royal Society of Medicine. 86, (1993): 716.

  12. Ibid., 719.

  13. I. Freckelton and D. Ranson. Death investigation and the Coroner’s inquest. (Victoria: Oxford University Press, 2006: 15.

  14. Plueckhahn, V. D. Ethics, legal medicine and forensic pathology. (Melbourne: Melbourne University Press, 1983): 98.

  15. I. Freckleton and D. Ranson, 2006, 21.

  16. Ibid, 49–50.

  17. I. Burney, Bodies of Evidence: medicine and the politics of the English Inquest, 1830–1926. (Baltimore: John Hopkins University, 2000).

  18. Ibid, 18.

  19. Ibid, 19.

  20. Ibid, 11.

  21. G. Burchell, G. “Liberal Government and Techniques of the Self”. Economy and Society. 22, no.3 (1993): 267–283.

  22. C. Gordon, “Governmental Rationality: An Introduction.” In The Foucault Effect: Studies in Governmentality, eds. G. Burchell, C. Gordon and P. Miller, (London: Harvester Wheatsheaf, 1991); N. Rose, “Government, Authority and Expertise in Advanced Liberalism,” Economy and Society. 22, no.3 (1993): 283–299.

  23. K. Popper, The Logic of Scientific Discovery, (London: Hutchinson, 1959); P. Feyerabend, Against Method. (London: Verso, 1975).

  24. I. Burney, 2000, 8.

  25. P. Feyerabend, Science in a Free society. (London: Verso, 1978).

  26. N. Collins, Changing Order: Replication and Induction in Scientific Practice. (London: Sage, 1985).

  27. M. Mendoza, “For Network and Cable TV, Crime Does Pay,” Dallas Morning News, July 5, 2005.

  28. E. Harrington, “Nation, Identity and the Fascination with forensic science in Sherlock Holmes and CSI,” International Journal of Cultural Studies, 10, no.2 (2007): 365–382.

  29. M. Geyer, “The Spectacle of Crime, Digitised: CSI: Crime Scene Investigation and Social Anatomy,” European Journal of Cultural Studies, 8, no.4 (2005): 445–463.

  30. S. Tait, “Autoptic vision and the necrophilic imaginary in CSI.” International Journal of Cultural Studies, 9, no.1 (2006): 58.

  31. M. Geyer, 2005, 453.

  32. J. Zaslow, ‘A Real Reality Show’, USA Weekend, 20 January, 2002: http://www.usaweekend.com/02_issues/020120/020120petersen.html.

  33. K. Roane, “The CSI Effect,” US News & World Report, 138, no.15 (2005): 50.

  34. E. Harrington, “Nation, Identity and the Fascination with forensic science in Sherlock Holmes and CSI,” International Journal of Cultural Studies, 10, no.2 (2007): 365–382.

  35. M. Mendoza, op. cit.

  36. U. Beck, Risk Society: Towards a New Modernity. (London: Sage, 1992).

  37. F. Ewald, “Insurance and Risk.” In The Foucault Effect: Studies in Governmentality, eds. G. Burchell, C. Gordon and P. Miller (London: Harvester/Wheatsheaf, 1991).

  38. J. Smith, 2003.

  39. J. Smith, 2004, 284.

  40. T. Luce, 2003, 70.

  41. J. Barnes, 2003.

  42. A. Davidson, J. McFarlane and J. Clark. “Differences in Forensic practice between Scotland and England.” Medical Scientific Law. 38, no.4 (1998): 285.

  43. B. Carpenter et al, 2008.

  44. A. Davidson, J. McFarlane and J. Clark, op cit, 283)

  45. J. Smith, 2003, 166.

  46. Ibid, 196.

  47. As noted by the British Medical Association (2006), cited in the Constitutional Affairs Committee, 2006, 47.

  48. Carpenter et al, 2006.

  49. Constitutional Affairs Committee, 2006, 34.

  50. The National Confidential Enquiry into Patient Outcome and Death, cited in Constitutional Affairs Committee 2006, 48.

  51. J. Smith, 2004, 283.

  52. B. Carpenter et al., 2008.

  53. Segal, G. “Law and Practice in relation to Coronial Postmortems—a social perspective.” Medicine and Law. 25, (2006): 101–113.

  54. Carpenter et al., 2008.

  55. Segal, 2006.

  56. M. Lynch, “Forensic Pathology: Redefining Medico-Legal Death Investigation.” Journal of Law and Medicine. 7 (August, 1999): 67–74; S. Emmett, S. Ibrahim, A. Charles and D. Ranson. “Coronial autopsies: a rising tide of objections.” Medical Journal of Australia. 181, no.3 (2004): 173.

  57. R. Mittleman, J. Davis, W. Kasztl and W. Graves. “Practical approach to Investigative Ethics and Religious Objections to the Autopsy.” Journal of Forensic Sciences. 37, no.3 (1992): 824–829; Vines, P. “The Sacred and the Profane: The Role of Property Concepts in Disputes about Post Mortem Examinations.” University of New South Wales Faculty of Law Research Series. Paper 13. (2007): http://law.bepress.com/unswwps/flrps/art13.

  58. J. Bombi, J. Ramierz, M. Sole, J. Grau, E. Chabas, J. Astudillo and J. Balasch. “Clinical and Autopsy Correlation Evaluated in a University Hospital in Spain (1991–2000).” Pathology Research and Practice. 199, (2003): 9–14.

  59. D. Jason, P. Lantz, and J. Preisser. “A National Survey of Autopsy Cost and Workload.” Journal of Forensic Science. 42, no.2 (1997): 271.

  60. J. Smith, 2003, 221.

  61. M. Lynch, 1999.

  62. L. Roberts, K. Nolte, T. Warner, T. McCarty, L. Rosenbaum and R. Zumwalt. “Perceptions of the Ethical acceptability of using medical examiner autopsies for research and education.” Archives of Pathology and Laboratory Medicine. 124, no.10 (2000): 1485–1495.

  63. McPhee, S. and K. Bottles. “Autopsy: moribund art or vital science.” American Journal of Medicine. 78 (1985): 107–113.

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Authors and Affiliations

  1. School of Justice, Faculty of Law, Queensland University of Technology (Gardens Point), Brisbane, Queensland, Australia

    Belinda Carpenter

  2. School of Cultural and Language Studies in Education, Queensland University of Technology (Kelvin Grove), Brisbane, Queensland, Australia

    Gordon Tait

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  1. Belinda Carpenter
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Correspondence to Belinda Carpenter.

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Carpenter, B., Tait, G. The Autopsy Imperative: Medicine, Law, and the Coronial Investigation. J Med Humanit 31, 205–221 (2010). https://doi.org/10.1007/s10912-010-9111-7

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