1. Under the Microscope

2.  Wrongful convictions  Evidence based Medicine  Recognition of what we can deliver and what we cannot  National Academy of Science report on Forensic Science (USA)

3.  Hospital based  Routine Autopsy Service  Anyone can do an autopsy  Certification in Pathology required a candidate to be able to perform a medico legal autopsy  Group of forensic pathologists recognized the need for specialty training  Goudge Inquiry  Royal College grants Specialty status to Forensic Pathology (specialty training 2008)

4.  Forensic Pathology under the radar until Goudge inquiry  Notable exceptions – Stephen Truscott  1959 conviction of murder, sentenced to death (appeal denied but sentence commuted to life)  Dr. Penistan (district pathologist) testified to time of death based on gastric emptying supported by Dr. Brooks (Medical officer)  Appeal to Supreme Court 1966 – Battle of the Forensic Pathologists  Milton Helpern, Keith Simpson – Crown  Francis Camps, Charles Petty – Defense  It was a well known tenant of Forensic pathology even in 1959 that time of death cannot be accurately assessed (Helpern was one of the authors)

5.  Others  Dalton 1989  Johnson 1993  (Wrongful Acquittals)?????

6.  Evolved from clinical epidemiology 1988  The use of best evidence in making decisions relating to diagnosis, investigation and management  Assessing quality of evidence * (multiple systems)  Level A – Randomized controlled  Level B – Retrospective case controlled  Level C – Case series  Level D – Expert opinion, physiology, first principal UK National Health Service

7.  Important to recognize what forensic pathology can and cannot deliver  1. Time of Death  2. Age of injuries  3. How much force  Particular issue in infant and child deaths homicide vs Accident  4. How long did it take

8.  Strengthening Forensic Science in the United States (2009)  1.Certification and Accreditation should be mandatory  2. Evidence base often sparse and varies between disciplines  Sparse to non in fingerprints, tool mark (bite mark)  3. Testimony should be grounded in science, acknowledge uncertainties  4. Strong independent leadership

9.  1. Hot tubbing for expert witness  Crown and defense experts meet prior to court  Review issues and confirm  Areas in which they agree  In areas of dispute discussion takes place, often conflicts are understood and at times what at first appears as a conflict may not be such a conflict  Must be in Non adversarial

10.  Forensic medicine  Opinion on non fatal trauma by a forensic pathologist (physcian)  Clinicians have a different confidence level to make a diagnosis (51%)  Any charge involving physical injury should have a mandatory review before proceeding to court  Diagnosis vs opinion  Medical records (aint what they used to be)