TIME: Almanac 1990/1990 Time Magazine Compact Almanac, The (1991)(Time).iso/time/081489/08148900.002

Text File | 1990-09-17 | 6KB | 96 lines

MEDICINE, Page 61

Coroners Who Miss All the Clues

Too many medical investigators are ill prepared to spot crimes

By Anastasia Toufexis


    The headless, handless body of a woman covered with green algae
was fished out of a lake in upstate New York. The hospital
pathologist who performed the autopsy judged the slim, athletically
built victim to be in her 20s and said she had been dead three
weeks. A few days later, medical examiner Michael Baden autopsied
the body and came to a startlingly different conclusion. Bone spurs
on the woman's spine and her atrophied ovaries revealed that she
was about 55 years old, and microscopic study of the algae
indicated that the body had been in the water at least 1 1/2 years.

    Far from being an isolated outrage, such a botch-up is
shockingly common, claims Baden, co-director of the forensic
sciences unit of the New York state police. In a new book,
Unnatural Death (Random House; $17.95), he and co-author Judith
Adler Hennessee present a fascinating and disturbing picture of a
shamefully inadequate U.S. coroner system. About 7% of the 2
million Americans who die annually meet an untimely end, by murder,
suicide or accident. By law, such deaths must be investigated.
Though the public may believe that every coroner is a skilled
sleuth like television's Quincy, fewer than 400 forensic
pathologists -- medical doctors with advanced training in anatomy,
laboratory testing and legal-medical investigation -- are on public
payrolls; twelve states do not employ any medical examiners at all.

    Often the coroner is a funeral-home director and sometimes even
a tow-truck operator, whose primary ability is transporting bodies.
The coroner frequently hires hospital pathologists to do the
autopsy. Those unfamiliar with signs of violence may confuse
gunshot entrance and exit wounds or may be unable to tell whether
a fractured skull was caused by a fall or a blow. Or they may
ignore important evidence, such as the contents of a victim's
stomach or hairs and fibers left on clothing or skin.

    As a result, the guilty often go free. People get away with
murder in about a third of the 20,000 deaths identified as
homicides each year; other murders go undetected. Misinterpreted
evidence can also lead to the innocent being punished. Even worse,
people are sometimes jailed for crimes that never occurred. The
classic example: when an alcoholic dies after a fight, the police
often assume that the assault killed him, but a careful autopsy may
show a lethal level of alcohol in the blood. Bungled investigations
can also create lasting controversies. Mistakes in the autopsy of
John F. Kennedy fueled charges of a conspiracy and cover-up.

    Moreover, public health is damaged by the lack of trained
medical detectives. M.E.s are usually the first to sound the alarm
about faulty product design, new diseases or social problems like
child abuse. Says Dr. Donald Reay, Seattle's chief medical
examiner: "Look how much the public knows about cocaine and
firearms. That's because people are dying from drugs and gunshots."

    Still, much valuable knowledge is being lost, according to the
Centers for Disease Control in Atlanta, because there is no uniform
method for collecting information on unnatural deaths. Increasing
numbers of M.E.s believe their expertise can also serve the living
victims of assaults. Dr. Charles Petty, chief medical examiner of
Dallas, regularly checks bruised children brought to a county
hospital to see if they are being battered.

    Another major deficiency in the current coroner system is that
it leaves medical examiners open to political pressure. Virtually
all are appointed by elected officials. And politicians and
district attorneys often want team players. M.E.s who are too
independent may eventually be ousted from their posts, charges
Baden, citing his own experience as chief medical examiner of New
York City. Former M.E.s in Detroit, Pittsburgh and Los Angeles put
forward the same claim. "No one says lie," observes Baden, "but
they want to push you further than the science permits."

    To make the prosecution's case stronger, a medical examiner may
be pressured to say a woman was raped before she was murdered,
though the evidence is equivocal. Or the M.E. may be pushed to
attribute the death of a person in police custody to the victim's
use of cocaine rather than a choke hold applied by officers. M.E.s
may deny being subjected to such nudging, but they agree that their
independence must be guarded.

    Some forensic pathologists suggest giving medical examiners
civil service status or allying them more closely with medical
schools, where independence is a tradition. Many advocate setting
up regional forensic centers to provide expert consultants to local
communities. Almost all emphasize that higher salaries are needed
to lure bright young doctors into the field. Most M.E.s make less
than $100,000 a year, while a pathologist who runs a hospital's
laboratory services can pull in more than double that amount.

    A strong system for investigating unnatural deaths is becoming
increasingly necessary. Capital punishment has returned. Defense
attorneys are more aggressive in challenging the accuracy of
evidence. Citizens groups are more vocal in their charges of police
brutality. Warns Baden: "It's more important than ever that we
don't make mistakes." A lax system will erode public faith in the
credibility of the medical examiner, and that would be a crime.