Comments from a veteran forensic pathologist;
The district court that first allowed that the pathologist could use the mother’s statements to the police that sealed his decision about the cause and manner of death when he testified as an expert in a criminal homicide case. The standards of “certainty” for a death certificate are not so high as the standards for a criminal conviction “beyond a reasonable doubt”. I have always used the standard for a death certificate cause of death as “more likely than not”, in other words “probable”. the State and National instructions for a physician completing a death certificate are of little issue on this matter. For example, California’s instructions for a physician completing the cause of death statement are to “enter the cause of death”. For the manner of death the instructions are to ” check the appropriate manner of death: natural, homicide, suicide, accident, undetermined. For any case that seems like it might be anything other than natural, the physician or someone is supposed to refer the case to the coroner/ME for investigation and certification of the cause and manner of death.
So the author of the above article was missing the point. The doctor was testifying to his opinion, based on the information he received about the circumstances of death and the consistency of the circumstances with the autopsy findings. Personally, I think the district court was right in allowing the ME to testify. Prosecution and defense should clarify for the jury ( if the ME hasn’t already done so) that his opinion about the cause and manner are not as high as the standard for a criminal conviction, that is, “beyond a reasonable doubt”.
One of the ironies in all this is that Calif. statutes specifically say that the death certificate shall not be entered as evidence in a court proceeding, yet routinely the DA’s submit it as an exhibit, unchallenged by the defense (in my experience of around 500 homicide trials).
This case defines some limits to what a medical expert can consider in rendering “with medical certainty” testimony. This should be a message to the odontologists who rely on law enforcement to determine how many people should be considered potential “biters” [e.g. “uncorroborated’ and unscientific”]. The case was remanded, in part, on this issue.
In the state of Iowa, there is an assistant medical examiner who testified at a hearing before trial in a newborn death case that ……….. [read further in the following section].
Later, the Iowa higher court, upon appeal by the convicted mother, ruled that……
“On retrial, should the State attempt to use Dr. Thompson as an expert witness, the district court should prohibit him from testifying that the cause of death was “drowning” and the manner of death was “homicide.” Likewise, it should redact the portions of the autopsy report stating his ultimate opinions on cause and…
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