What is forensic pathology? Medicine for the law, for the living and the dead.
Forensic pathology is often described as the medicine of the dead. That is incomplete. It is a recognized subspecialty of medicine in which physicians with specialized training and board certification apply medical knowledge to legal problems, whether the person at the center of the question has died or is alive.
Medically reviewed by Evan W. Matshes, MD, FRCPC, D-ABP, Medical Director and Chief Forensic Pathologist · Updated
- Forensic pathologists are physicians, not technicians or investigators.
- In the United States, they complete medical school, residency training in pathology, a fellowship in forensic pathology, and board certification by examination.
- Their work answers legal questions: how and why a person died, how an injury happened, when it happened, and what it means.
- That work involves living patients too: alleged child abuse, survived strangulation, fracture interpretation and injuries in family-law disputes.
- Forensic pathologists work with subspecialists such as neuropathologists, forensic anthropologists, forensic odontologists and radiologists.
Is forensic pathology only about the dead?
No. The autopsy is the most visible part of the specialty, but the forensic pathologist’s real expertise is the interpretation of injury and disease in a legal context. The same knowledge that explains a fatal head injury explains a nonfatal one. Forensic pathologists are regularly asked to interpret injuries in living children whose caregivers are accused of abuse, in adults who survived strangulation, and in people whose injuries are disputed in criminal, civil, dependency and family-law proceedings.
What training does a forensic pathologist have?
In the United States, a forensic pathologist is a physician who has completed medical school, then residency training in anatomic pathology (or anatomic and clinical pathology), then a dedicated fellowship in forensic pathology. Certification in forensic pathology is awarded by the American Board of Pathology after a separate examination. Training in other countries follows a comparable path through a national certifying body. Many forensic pathologists add further subspecialty expertise, for example in pediatric forensic pathology or neuropathology.
This matters because the word expert is not regulated. A court may hear opinions about the cause of an injury or death from people with very different training. When the question is medical, the training and certification of the person answering it should be medical too.
What questions does a forensic pathologist answer?
- Cause of death: the disease or injury that started the chain of events leading to death.
- Manner of death: natural, accident, suicide, homicide or undetermined, as certified on the death certificate.
- Mechanism and timing of injury: what kind of force, how much, from what direction, and when.
- Identity: with forensic anthropologists and odontologists, who the person is.
- The significance of disease, drugs and medical care: whether a natural disease, a drug or a medical intervention caused or contributed to an outcome.
- Injury interpretation in the living: whether injuries are consistent with what is alleged, and what else could explain them.
How is a forensic pathologist different from a coroner or medical examiner?
A coroner is a public official responsible for investigating certain deaths. In most California counties the sheriff serves as coroner, and the office relies on forensic pathologists to perform examinations and provide the medical findings on which its cause and manner determinations rest. A medical examiner system places that responsibility with a physician. Either way, the medical examination is the forensic pathologist’s work. NAAG performs that work for California sheriff-coroners under Government Code § 27491, and for attorneys, agencies and families.
Who else is part of the team?
Complex cases draw on several disciplines at once. Forensic neuropathologists examine the brain, spinal cord and eyes. Forensic anthropologists examine bone, including fracture healing and metabolic bone disease. Forensic odontologists identify people from their teeth. Radiologists interpret imaging, including postmortem CT. Geneticists and laboratory specialists test for inherited disease. NAAG brings these subspecialists together in one institution, so the evidence is examined side by side rather than in sequence.
Frequently asked questions.
Is a forensic pathologist a doctor?
Yes. A forensic pathologist is a physician who has completed medical school, residency training in pathology and a fellowship in forensic pathology, and who is board certified in forensic pathology.
Do forensic pathologists examine living people?
Yes. Forensic pathologists interpret injuries in living children and adults, for example in alleged child abuse, survived strangulation and disputed injuries in criminal, civil and family-law cases.
What is the difference between a forensic pathologist and a medical examiner?
Medical examiner is an official position; forensic pathologist is a medical specialty. Many medical examiners are forensic pathologists, and coroner systems such as California’s rely on forensic pathologists to perform their examinations.
How do I know an expert is qualified?
Ask whether the person is a physician, whether they are board certified in forensic pathology (or the relevant subspecialty), and whether they personally performed or reviewed the examinations they are testifying about.
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